St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Percutaneous coronary intervention w AMI

Facility

$66,176.80

Service Code	APR-DRG 1742
Min. Negotiated Rate	$23,432.00
Max. Negotiated Rate	$66,176.80
Rate for Payer: Affinity Essential Plan 1&2	$66,176.80
Rate for Payer: Affinity Essential Plan 3&4	$66,176.80
Rate for Payer: Affinity Medicaid/CHP/HARP	$29,411.91
Rate for Payer: Amida Care Medicaid	$29,411.91
Rate for Payer: EmblemHealth Essential Plan 1&2	$66,176.80
Rate for Payer: EmblemHealth Essential Plan 3&4	$29,411.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,411.91
Rate for Payer: Fidelis Qualified Health Plan	$35,294.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,411.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,411.91
Rate for Payer: Healthfirst Commercial	$40,354.00
Rate for Payer: Healthfirst Essential Plan	$66,176.80
Rate for Payer: Healthfirst QHP	$23,432.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,411.91
Rate for Payer: SOMOS Essential	$66,176.80
Rate for Payer: United Healthcare Essential Plan 1&2	$66,176.80
Rate for Payer: United Healthcare Essential Plan 3&4	$66,176.80
Rate for Payer: United Healthcare Medicaid	$29,411.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,411.91

Percutaneous coronary intervention w AMI

Facility

$99,355.54

Service Code	APR-DRG 1744
Min. Negotiated Rate	$41,468.00
Max. Negotiated Rate	$99,355.54
Rate for Payer: Affinity Essential Plan 1&2	$99,355.54
Rate for Payer: Affinity Essential Plan 3&4	$99,355.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$44,158.02
Rate for Payer: Amida Care Medicaid	$44,158.02
Rate for Payer: EmblemHealth Essential Plan 1&2	$99,355.54
Rate for Payer: EmblemHealth Essential Plan 3&4	$44,158.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$44,158.02
Rate for Payer: Fidelis Qualified Health Plan	$52,989.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$44,158.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$44,158.02
Rate for Payer: Healthfirst Commercial	$71,773.00
Rate for Payer: Healthfirst Essential Plan	$99,355.54
Rate for Payer: Healthfirst QHP	$41,468.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$44,158.02
Rate for Payer: SOMOS Essential	$99,355.54
Rate for Payer: United Healthcare Essential Plan 1&2	$99,355.54
Rate for Payer: United Healthcare Essential Plan 3&4	$99,355.54
Rate for Payer: United Healthcare Medicaid	$44,158.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$44,158.02

Percutaneous coronary intervention w AMI

Facility

$76,097.88

Service Code	APR-DRG 1743
Min. Negotiated Rate	$28,582.00
Max. Negotiated Rate	$76,097.88
Rate for Payer: Affinity Essential Plan 1&2	$76,097.88
Rate for Payer: Affinity Essential Plan 3&4	$76,097.88
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,821.28
Rate for Payer: Amida Care Medicaid	$33,821.28
Rate for Payer: EmblemHealth Essential Plan 1&2	$76,097.88
Rate for Payer: EmblemHealth Essential Plan 3&4	$33,821.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,821.28
Rate for Payer: Fidelis Qualified Health Plan	$40,585.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,821.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,821.28
Rate for Payer: Healthfirst Commercial	$51,661.00
Rate for Payer: Healthfirst Essential Plan	$76,097.88
Rate for Payer: Healthfirst QHP	$28,582.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,821.28
Rate for Payer: SOMOS Essential	$76,097.88
Rate for Payer: United Healthcare Essential Plan 1&2	$76,097.88
Rate for Payer: United Healthcare Essential Plan 3&4	$76,097.88
Rate for Payer: United Healthcare Medicaid	$33,821.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,821.28

Percutaneous coronary intervention w AMI

Facility

$63,058.54

Service Code	APR-DRG 1741
Min. Negotiated Rate	$22,001.00
Max. Negotiated Rate	$63,058.54
Rate for Payer: Affinity Essential Plan 1&2	$63,058.54
Rate for Payer: Affinity Essential Plan 3&4	$63,058.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,026.02
Rate for Payer: Amida Care Medicaid	$28,026.02
Rate for Payer: EmblemHealth Essential Plan 1&2	$63,058.54
Rate for Payer: EmblemHealth Essential Plan 3&4	$28,026.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,026.02
Rate for Payer: Fidelis Qualified Health Plan	$33,631.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,026.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,026.02
Rate for Payer: Healthfirst Commercial	$36,598.00
Rate for Payer: Healthfirst Essential Plan	$63,058.54
Rate for Payer: Healthfirst QHP	$22,001.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,026.02
Rate for Payer: SOMOS Essential	$63,058.54
Rate for Payer: United Healthcare Essential Plan 1&2	$63,058.54
Rate for Payer: United Healthcare Essential Plan 3&4	$63,058.54
Rate for Payer: United Healthcare Medicaid	$28,026.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,026.02

Percutaneous coronary intervention w/o AMI

Facility

$74,550.20

Service Code	APR-DRG 1753
Min. Negotiated Rate	$20,589.00
Max. Negotiated Rate	$74,550.20
Rate for Payer: Affinity Essential Plan 1&2	$74,550.20
Rate for Payer: Affinity Essential Plan 3&4	$74,550.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,133.42
Rate for Payer: Amida Care Medicaid	$33,133.42
Rate for Payer: EmblemHealth Essential Plan 1&2	$74,550.20
Rate for Payer: EmblemHealth Essential Plan 3&4	$33,133.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,133.42
Rate for Payer: Fidelis Qualified Health Plan	$39,760.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,133.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,133.42
Rate for Payer: Healthfirst Commercial	$41,224.00
Rate for Payer: Healthfirst Essential Plan	$74,550.20
Rate for Payer: Healthfirst QHP	$20,589.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,133.42
Rate for Payer: SOMOS Essential	$74,550.20
Rate for Payer: United Healthcare Essential Plan 1&2	$74,550.20
Rate for Payer: United Healthcare Essential Plan 3&4	$74,550.20
Rate for Payer: United Healthcare Medicaid	$33,133.42
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,133.42

Percutaneous coronary intervention w/o AMI

Facility

$61,459.83

Service Code	APR-DRG 1752
Min. Negotiated Rate	$16,066.00
Max. Negotiated Rate	$61,459.83
Rate for Payer: Affinity Essential Plan 1&2	$61,459.83
Rate for Payer: Affinity Essential Plan 3&4	$61,459.83
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,315.48
Rate for Payer: Amida Care Medicaid	$27,315.48
Rate for Payer: EmblemHealth Essential Plan 1&2	$61,459.83
Rate for Payer: EmblemHealth Essential Plan 3&4	$27,315.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,315.48
Rate for Payer: Fidelis Qualified Health Plan	$32,778.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,315.48
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,315.48
Rate for Payer: Healthfirst Commercial	$27,953.00
Rate for Payer: Healthfirst Essential Plan	$61,459.83
Rate for Payer: Healthfirst QHP	$16,066.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,315.48
Rate for Payer: SOMOS Essential	$61,459.83
Rate for Payer: United Healthcare Essential Plan 1&2	$61,459.83
Rate for Payer: United Healthcare Essential Plan 3&4	$61,459.83
Rate for Payer: United Healthcare Medicaid	$27,315.48
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,315.48

Percutaneous coronary intervention w/o AMI

Facility

$57,965.22

Service Code	APR-DRG 1751
Min. Negotiated Rate	$15,095.00
Max. Negotiated Rate	$57,965.22
Rate for Payer: Affinity Essential Plan 1&2	$57,965.22
Rate for Payer: Affinity Essential Plan 3&4	$57,965.22
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,762.32
Rate for Payer: Amida Care Medicaid	$25,762.32
Rate for Payer: EmblemHealth Essential Plan 1&2	$57,965.22
Rate for Payer: EmblemHealth Essential Plan 3&4	$25,762.32
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,762.32
Rate for Payer: Fidelis Qualified Health Plan	$30,914.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,762.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,762.32
Rate for Payer: Healthfirst Commercial	$25,181.00
Rate for Payer: Healthfirst Essential Plan	$57,965.22
Rate for Payer: Healthfirst QHP	$15,095.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,762.32
Rate for Payer: SOMOS Essential	$57,965.22
Rate for Payer: United Healthcare Essential Plan 1&2	$57,965.22
Rate for Payer: United Healthcare Essential Plan 3&4	$57,965.22
Rate for Payer: United Healthcare Medicaid	$25,762.32
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,762.32

Percutaneous coronary intervention w/o AMI

Facility

$118,383.41

Service Code	APR-DRG 1754
Min. Negotiated Rate	$36,547.00
Max. Negotiated Rate	$118,383.41
Rate for Payer: Affinity Essential Plan 1&2	$118,383.41
Rate for Payer: Affinity Essential Plan 3&4	$118,383.41
Rate for Payer: Affinity Medicaid/CHP/HARP	$52,614.85
Rate for Payer: Amida Care Medicaid	$52,614.85
Rate for Payer: EmblemHealth Essential Plan 1&2	$118,383.41
Rate for Payer: EmblemHealth Essential Plan 3&4	$52,614.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$52,614.85
Rate for Payer: Fidelis Qualified Health Plan	$63,137.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$52,614.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$52,614.85
Rate for Payer: Healthfirst Commercial	$62,724.00
Rate for Payer: Healthfirst Essential Plan	$118,383.41
Rate for Payer: Healthfirst QHP	$36,547.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52,614.85
Rate for Payer: SOMOS Essential	$118,383.41
Rate for Payer: United Healthcare Essential Plan 1&2	$118,383.41
Rate for Payer: United Healthcare Essential Plan 3&4	$118,383.41
Rate for Payer: United Healthcare Medicaid	$52,614.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$52,614.85

PERCUTANEOUS INTRA-ABDOMINAL OR INTRATHORACIC VASCULAR PROCEDURES

Facility

$1,955.58

Service Code	EAPG 00122
Min. Negotiated Rate	$1,955.58
Max. Negotiated Rate	$1,955.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,955.58

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$3,332.59

Service Code	EAPG 00265
Min. Negotiated Rate	$3,332.59
Max. Negotiated Rate	$3,332.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,332.59

PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP

Facility

$201.21

Service Code	HCPCS Q9957
Hospital Charge Code	1199401116
Hospital Revenue Code	258
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$160.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.36
Rate for Payer: Aetna Government	$46.36
Rate for Payer: Brighton Health Commercial	$150.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.82
Rate for Payer: EmblemHealth Commercial	$100.61
Rate for Payer: Group Health Inc Commercial	$100.61
Rate for Payer: Group Health Inc Medicare	$70.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.61
Rate for Payer: Hamaspik Choice Inc Medicare	$100.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.79

PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP

Facility

$208.88

Service Code	HCPCS Q9957
Hospital Charge Code	1199401104
Hospital Revenue Code	258
Min. Negotiated Rate	$104.44
Max. Negotiated Rate	$104.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.44

PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP

Facility

$201.21

Service Code	HCPCS Q9957
Hospital Charge Code	1199401116
Hospital Revenue Code	258
Min. Negotiated Rate	$100.61
Max. Negotiated Rate	$100.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.61

PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP

Facility

$208.88

Service Code	HCPCS Q9957
Hospital Charge Code	1199401104
Hospital Revenue Code	258
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$167.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.36
Rate for Payer: Aetna Government	$46.36
Rate for Payer: Brighton Health Commercial	$156.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$167.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.03
Rate for Payer: EmblemHealth Commercial	$104.44
Rate for Payer: Group Health Inc Commercial	$104.44
Rate for Payer: Group Health Inc Medicare	$73.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.44
Rate for Payer: Hamaspik Choice Inc Medicare	$104.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$135.77

PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP

Facility

$192.86

Service Code	HCPCS Q9957
Hospital Charge Code	1199401720
Hospital Revenue Code	258
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$154.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.36
Rate for Payer: Aetna Government	$46.36
Rate for Payer: Brighton Health Commercial	$144.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$154.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.14
Rate for Payer: EmblemHealth Commercial	$96.43
Rate for Payer: Group Health Inc Commercial	$96.43
Rate for Payer: Group Health Inc Medicare	$67.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.43
Rate for Payer: Hamaspik Choice Inc Medicare	$96.43
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$125.36

PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP

Facility

$192.86

Service Code	HCPCS Q9957
Hospital Charge Code	1199401720
Hospital Revenue Code	258
Min. Negotiated Rate	$96.43
Max. Negotiated Rate	$96.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.43

PERIPHERAL AND CRANIAL NERVE DIAGNOSES

Facility

$220.42

Service Code	EAPG 00527
Min. Negotiated Rate	$159.69
Max. Negotiated Rate	$220.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$159.69
Rate for Payer: Healthfirst Commercial	$220.42

PERIPHERAL AND OTHER VASCULAR DIAGNOSES

Facility

$241.09

Service Code	EAPG 00596
Min. Negotiated Rate	$175.89
Max. Negotiated Rate	$241.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$175.89
Rate for Payer: Healthfirst Commercial	$241.09

PERIPHERAL AND OTHER VASCULAR RELATED INJURIES

Facility

$180.52

Service Code	EAPG 00548
Min. Negotiated Rate	$180.52
Max. Negotiated Rate	$180.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$180.52

PERIPHERAL, CRANIAL, AND AUTONOMIC NERVE INJURIES

Facility

$168.94

Service Code	EAPG 00545
Min. Negotiated Rate	$168.94
Max. Negotiated Rate	$168.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$168.94

Peripheral, cranial & autonomic nerve disorders

Facility

$41,756.60

Service Code	APR-DRG 0481
Min. Negotiated Rate	$6,396.00
Max. Negotiated Rate	$41,756.60
Rate for Payer: Affinity Essential Plan 1&2	$41,756.60
Rate for Payer: Affinity Essential Plan 3&4	$41,756.60
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,558.49
Rate for Payer: Amida Care Medicaid	$18,558.49
Rate for Payer: EmblemHealth Essential Plan 1&2	$41,756.60
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,558.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,558.49
Rate for Payer: Fidelis Qualified Health Plan	$22,270.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,558.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,558.49
Rate for Payer: Healthfirst Commercial	$10,455.00
Rate for Payer: Healthfirst Essential Plan	$41,756.60
Rate for Payer: Healthfirst QHP	$6,396.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,558.49
Rate for Payer: SOMOS Essential	$41,756.60
Rate for Payer: United Healthcare Essential Plan 1&2	$41,756.60
Rate for Payer: United Healthcare Essential Plan 3&4	$41,756.60
Rate for Payer: United Healthcare Medicaid	$18,558.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,558.49

Peripheral, cranial & autonomic nerve disorders

Facility

$45,019.08

Service Code	APR-DRG 0482
Min. Negotiated Rate	$8,151.00
Max. Negotiated Rate	$45,019.08
Rate for Payer: Affinity Essential Plan 1&2	$45,019.08
Rate for Payer: Affinity Essential Plan 3&4	$45,019.08
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,008.48
Rate for Payer: Amida Care Medicaid	$20,008.48
Rate for Payer: EmblemHealth Essential Plan 1&2	$45,019.08
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,008.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,008.48
Rate for Payer: Fidelis Qualified Health Plan	$24,010.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,008.48
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,008.48
Rate for Payer: Healthfirst Commercial	$13,595.00
Rate for Payer: Healthfirst Essential Plan	$45,019.08
Rate for Payer: Healthfirst QHP	$8,151.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,008.48
Rate for Payer: SOMOS Essential	$45,019.08
Rate for Payer: United Healthcare Essential Plan 1&2	$45,019.08
Rate for Payer: United Healthcare Essential Plan 3&4	$45,019.08
Rate for Payer: United Healthcare Medicaid	$20,008.48
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,008.48

Peripheral, cranial & autonomic nerve disorders

Facility

$51,470.17

Service Code	APR-DRG 0483
Min. Negotiated Rate	$11,395.00
Max. Negotiated Rate	$51,470.17
Rate for Payer: Affinity Essential Plan 1&2	$51,470.17
Rate for Payer: Affinity Essential Plan 3&4	$51,470.17
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,875.63
Rate for Payer: Amida Care Medicaid	$22,875.63
Rate for Payer: EmblemHealth Essential Plan 1&2	$51,470.17
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,875.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,875.63
Rate for Payer: Fidelis Qualified Health Plan	$27,450.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,875.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,875.63
Rate for Payer: Healthfirst Commercial	$19,982.00
Rate for Payer: Healthfirst Essential Plan	$51,470.17
Rate for Payer: Healthfirst QHP	$11,395.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,875.63
Rate for Payer: SOMOS Essential	$51,470.17
Rate for Payer: United Healthcare Essential Plan 1&2	$51,470.17
Rate for Payer: United Healthcare Essential Plan 3&4	$51,470.17
Rate for Payer: United Healthcare Medicaid	$22,875.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,875.63

Peripheral, cranial & autonomic nerve disorders

Facility

$93,296.65

Service Code	APR-DRG 0484
Min. Negotiated Rate	$25,438.00
Max. Negotiated Rate	$93,296.65
Rate for Payer: Affinity Essential Plan 1&2	$93,296.65
Rate for Payer: Affinity Essential Plan 3&4	$93,296.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$41,465.18
Rate for Payer: Amida Care Medicaid	$41,465.18
Rate for Payer: EmblemHealth Essential Plan 1&2	$93,296.65
Rate for Payer: EmblemHealth Essential Plan 3&4	$41,465.18
Rate for Payer: Fidelis CHP/HARP/Medicaid	$41,465.18
Rate for Payer: Fidelis Qualified Health Plan	$49,758.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$41,465.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$41,465.18
Rate for Payer: Healthfirst Commercial	$42,775.00
Rate for Payer: Healthfirst Essential Plan	$93,296.65
Rate for Payer: Healthfirst QHP	$25,438.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$41,465.18
Rate for Payer: SOMOS Essential	$93,296.65
Rate for Payer: United Healthcare Essential Plan 1&2	$93,296.65
Rate for Payer: United Healthcare Essential Plan 3&4	$93,296.65
Rate for Payer: United Healthcare Medicaid	$41,465.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$41,465.18

Peripheral & other vascular disorders

Facility

$52,785.70

Service Code	APR-DRG 1973
Min. Negotiated Rate	$12,792.00
Max. Negotiated Rate	$52,785.70
Rate for Payer: Affinity Essential Plan 1&2	$52,785.70
Rate for Payer: Affinity Essential Plan 3&4	$52,785.70
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,460.31
Rate for Payer: Amida Care Medicaid	$23,460.31
Rate for Payer: EmblemHealth Essential Plan 1&2	$52,785.70
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,460.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,460.31
Rate for Payer: Fidelis Qualified Health Plan	$28,152.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,460.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,460.31
Rate for Payer: Healthfirst Commercial	$21,444.00
Rate for Payer: Healthfirst Essential Plan	$52,785.70
Rate for Payer: Healthfirst QHP	$12,792.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,460.31
Rate for Payer: SOMOS Essential	$52,785.70
Rate for Payer: United Healthcare Essential Plan 1&2	$52,785.70
Rate for Payer: United Healthcare Essential Plan 3&4	$52,785.70
Rate for Payer: United Healthcare Medicaid	$23,460.31
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,460.31

Know your out-of-pocket cost for care.

All Charges