St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 0803: Acute major eye infections

Facility IP

$50,945.06

Service Code	APR-DRG 0803
Min. Negotiated Rate	$10,912.00
Max. Negotiated Rate	$50,945.06
Rate for Payer: Amida Care Medicaid	$22,642.25
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,642.25
Rate for Payer: Fidelis Qualified Health Plan	$27,170.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,642.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,642.25
Rate for Payer: Healthfirst Commercial	$18,667.00
Rate for Payer: Healthfirst Essential Plan	$50,945.06
Rate for Payer: Healthfirst QHP	$10,912.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,642.25
Rate for Payer: SOMOS Essential	$50,945.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,642.25

APR-DRG 0804: Acute major eye infections

Facility IP

$53,421.37

Service Code	APR-DRG 0804
Min. Negotiated Rate	$11,716.00
Max. Negotiated Rate	$53,421.37
Rate for Payer: Amida Care Medicaid	$23,742.83
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,742.83
Rate for Payer: Fidelis Qualified Health Plan	$28,491.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,742.83
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,742.83
Rate for Payer: Healthfirst Commercial	$21,496.00
Rate for Payer: Healthfirst Essential Plan	$53,421.37
Rate for Payer: Healthfirst QHP	$11,716.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,742.83
Rate for Payer: SOMOS Essential	$53,421.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,742.83

APR-DRG 0821: Eye disorders except major infections

Facility IP

$38,252.18

Service Code	APR-DRG 0821
Min. Negotiated Rate	$5,849.00
Max. Negotiated Rate	$38,252.18
Rate for Payer: Amida Care Medicaid	$17,000.97
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,000.97
Rate for Payer: Fidelis Qualified Health Plan	$20,401.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,000.97
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,000.97
Rate for Payer: Healthfirst Commercial	$10,072.00
Rate for Payer: Healthfirst Essential Plan	$38,252.18
Rate for Payer: Healthfirst QHP	$5,849.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,000.97
Rate for Payer: SOMOS Essential	$38,252.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,000.97

APR-DRG 0822: Eye disorders except major infections

Facility IP

$40,081.28

Service Code	APR-DRG 0822
Min. Negotiated Rate	$6,730.00
Max. Negotiated Rate	$40,081.28
Rate for Payer: Amida Care Medicaid	$17,813.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,813.90
Rate for Payer: Fidelis Qualified Health Plan	$21,376.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,813.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,813.90
Rate for Payer: Healthfirst Commercial	$11,189.00
Rate for Payer: Healthfirst Essential Plan	$40,081.28
Rate for Payer: Healthfirst QHP	$6,730.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,813.90
Rate for Payer: SOMOS Essential	$40,081.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,813.90

APR-DRG 0823: Eye disorders except major infections

Facility IP

$47,689.60

Service Code	APR-DRG 0823
Min. Negotiated Rate	$10,435.00
Max. Negotiated Rate	$47,689.60
Rate for Payer: Amida Care Medicaid	$21,195.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,195.38
Rate for Payer: Fidelis Qualified Health Plan	$25,434.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,195.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,195.38
Rate for Payer: Healthfirst Commercial	$17,568.00
Rate for Payer: Healthfirst Essential Plan	$47,689.60
Rate for Payer: Healthfirst QHP	$10,435.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,195.38
Rate for Payer: SOMOS Essential	$47,689.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,195.38

APR-DRG 0824: Eye disorders except major infections

Facility IP

$48,196.12

Service Code	APR-DRG 0824
Min. Negotiated Rate	$10,858.00
Max. Negotiated Rate	$48,196.12
Rate for Payer: Amida Care Medicaid	$21,420.50
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,420.50
Rate for Payer: Fidelis Qualified Health Plan	$25,704.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,420.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,420.50
Rate for Payer: Healthfirst Commercial	$19,450.00
Rate for Payer: Healthfirst Essential Plan	$48,196.12
Rate for Payer: Healthfirst QHP	$10,858.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,420.50
Rate for Payer: SOMOS Essential	$48,196.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,420.50

APR-DRG 0891: Major cranial/facial bone procedures

Facility IP

$53,621.86

Service Code	APR-DRG 0891
Min. Negotiated Rate	$16,434.00
Max. Negotiated Rate	$53,621.86
Rate for Payer: Amida Care Medicaid	$23,831.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,831.94
Rate for Payer: Fidelis Qualified Health Plan	$28,598.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,831.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,831.94
Rate for Payer: Healthfirst Commercial	$25,475.00
Rate for Payer: Healthfirst Essential Plan	$53,621.86
Rate for Payer: Healthfirst QHP	$16,434.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,831.94
Rate for Payer: SOMOS Essential	$53,621.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,831.94

APR-DRG 0892: Major cranial/facial bone procedures

Facility IP

$67,670.73

Service Code	APR-DRG 0892
Min. Negotiated Rate	$24,288.00
Max. Negotiated Rate	$67,670.73
Rate for Payer: Amida Care Medicaid	$30,075.88
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,075.88
Rate for Payer: Fidelis Qualified Health Plan	$36,091.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,075.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,075.88
Rate for Payer: Healthfirst Commercial	$37,510.00
Rate for Payer: Healthfirst Essential Plan	$67,670.73
Rate for Payer: Healthfirst QHP	$24,288.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,075.88
Rate for Payer: SOMOS Essential	$67,670.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,075.88

APR-DRG 0893: Major cranial/facial bone procedures

Facility IP

$96,651.36

Service Code	APR-DRG 0893
Min. Negotiated Rate	$40,398.00
Max. Negotiated Rate	$96,651.36
Rate for Payer: Amida Care Medicaid	$42,956.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$42,956.16
Rate for Payer: Fidelis Qualified Health Plan	$51,547.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$42,956.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$42,956.16
Rate for Payer: Healthfirst Commercial	$58,506.00
Rate for Payer: Healthfirst Essential Plan	$96,651.36
Rate for Payer: Healthfirst QHP	$40,398.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$42,956.16
Rate for Payer: SOMOS Essential	$96,651.36
Rate for Payer: Wellcare CHP/FHP/Medicaid	$42,956.16

APR-DRG 0894: Major cranial/facial bone procedures

Facility IP

$149,564.99

Service Code	APR-DRG 0894
Min. Negotiated Rate	$66,473.33
Max. Negotiated Rate	$149,564.99
Rate for Payer: Amida Care Medicaid	$66,473.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$66,473.33
Rate for Payer: Fidelis Qualified Health Plan	$79,768.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$66,473.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$66,473.33
Rate for Payer: Healthfirst Commercial	$107,217.00
Rate for Payer: Healthfirst Essential Plan	$149,564.99
Rate for Payer: Healthfirst QHP	$109,141.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$66,473.33
Rate for Payer: SOMOS Essential	$149,564.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$66,473.33

APR-DRG 0901: Major larynx & trachea procedures

Facility IP

$42,984.97

Service Code	APR-DRG 0901
Min. Negotiated Rate	$9,600.00
Max. Negotiated Rate	$42,984.97
Rate for Payer: Amida Care Medicaid	$19,104.43
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,104.43
Rate for Payer: Fidelis Qualified Health Plan	$22,925.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,104.43
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,104.43
Rate for Payer: Healthfirst Commercial	$13,650.00
Rate for Payer: Healthfirst Essential Plan	$42,984.97
Rate for Payer: Healthfirst QHP	$9,600.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,104.43
Rate for Payer: SOMOS Essential	$42,984.97
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,104.43

APR-DRG 0902: Major larynx & trachea procedures

Facility IP

$69,603.59

Service Code	APR-DRG 0902
Min. Negotiated Rate	$24,484.00
Max. Negotiated Rate	$69,603.59
Rate for Payer: Amida Care Medicaid	$30,934.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,934.93
Rate for Payer: Fidelis Qualified Health Plan	$37,121.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,934.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,934.93
Rate for Payer: Healthfirst Commercial	$41,544.00
Rate for Payer: Healthfirst Essential Plan	$69,603.59
Rate for Payer: Healthfirst QHP	$24,484.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,934.93
Rate for Payer: SOMOS Essential	$69,603.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,934.93

APR-DRG 0903: Major larynx & trachea procedures

Facility IP

$101,516.04

Service Code	APR-DRG 0903
Min. Negotiated Rate	$45,118.24
Max. Negotiated Rate	$101,516.04
Rate for Payer: Amida Care Medicaid	$45,118.24
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45,118.24
Rate for Payer: Fidelis Qualified Health Plan	$54,141.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$45,118.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$45,118.24
Rate for Payer: Healthfirst Commercial	$76,034.00
Rate for Payer: Healthfirst Essential Plan	$101,516.04
Rate for Payer: Healthfirst QHP	$48,324.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45,118.24
Rate for Payer: SOMOS Essential	$101,516.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45,118.24

APR-DRG 0904: Major larynx & trachea procedures

Facility IP

$227,157.37

Service Code	APR-DRG 0904
Min. Negotiated Rate	$56,520.00
Max. Negotiated Rate	$227,157.37
Rate for Payer: Amida Care Medicaid	$100,958.83
Rate for Payer: Fidelis CHP/HARP/Medicaid	$100,958.83
Rate for Payer: Fidelis Qualified Health Plan	$121,150.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$100,958.83
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$100,958.83
Rate for Payer: Healthfirst Commercial	$93,589.00
Rate for Payer: Healthfirst Essential Plan	$227,157.37
Rate for Payer: Healthfirst QHP	$56,520.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$100,958.83
Rate for Payer: SOMOS Essential	$227,157.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$100,958.83

APR-DRG 0911: Other major head & neck procedures

Facility IP

$53,115.34

Service Code	APR-DRG 0911
Min. Negotiated Rate	$15,619.00
Max. Negotiated Rate	$53,115.34
Rate for Payer: Amida Care Medicaid	$23,606.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,606.82
Rate for Payer: Fidelis Qualified Health Plan	$28,328.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,606.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,606.82
Rate for Payer: Healthfirst Commercial	$26,055.00
Rate for Payer: Healthfirst Essential Plan	$53,115.34
Rate for Payer: Healthfirst QHP	$15,619.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,606.82
Rate for Payer: SOMOS Essential	$53,115.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,606.82

APR-DRG 0912: Other major head & neck procedures

Facility IP

$79,749.81

Service Code	APR-DRG 0912
Min. Negotiated Rate	$35,444.36
Max. Negotiated Rate	$79,749.81
Rate for Payer: Amida Care Medicaid	$35,444.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,444.36
Rate for Payer: Fidelis Qualified Health Plan	$42,533.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,444.36
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,444.36
Rate for Payer: Healthfirst Commercial	$56,212.00
Rate for Payer: Healthfirst Essential Plan	$79,749.81
Rate for Payer: Healthfirst QHP	$48,034.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,444.36
Rate for Payer: SOMOS Essential	$79,749.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,444.36

APR-DRG 0913: Other major head & neck procedures

Facility IP

$94,445.89

Service Code	APR-DRG 0913
Min. Negotiated Rate	$41,975.95
Max. Negotiated Rate	$94,445.89
Rate for Payer: Amida Care Medicaid	$41,975.95
Rate for Payer: Fidelis CHP/HARP/Medicaid	$41,975.95
Rate for Payer: Fidelis Qualified Health Plan	$50,371.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$41,975.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$41,975.95
Rate for Payer: Healthfirst Commercial	$77,896.00
Rate for Payer: Healthfirst Essential Plan	$94,445.89
Rate for Payer: Healthfirst QHP	$48,038.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$41,975.95
Rate for Payer: SOMOS Essential	$94,445.89
Rate for Payer: Wellcare CHP/FHP/Medicaid	$41,975.95

APR-DRG 0914: Other major head & neck procedures

Facility IP

$102,502.71

Service Code	APR-DRG 0914
Min. Negotiated Rate	$45,556.76
Max. Negotiated Rate	$102,502.71
Rate for Payer: Amida Care Medicaid	$45,556.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45,556.76
Rate for Payer: Fidelis Qualified Health Plan	$54,668.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$45,556.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$45,556.76
Rate for Payer: Healthfirst Commercial	$85,295.00
Rate for Payer: Healthfirst Essential Plan	$102,502.71
Rate for Payer: Healthfirst QHP	$48,038.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45,556.76
Rate for Payer: SOMOS Essential	$102,502.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45,556.76

APR-DRG 0921: Facial bone procedures except major cranial/facial bone procedures

Facility IP

$48,138.10

Service Code	APR-DRG 0921
Min. Negotiated Rate	$11,069.00
Max. Negotiated Rate	$48,138.10
Rate for Payer: Amida Care Medicaid	$21,394.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,394.71
Rate for Payer: Fidelis Qualified Health Plan	$25,673.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,394.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,394.71
Rate for Payer: Healthfirst Commercial	$19,185.00
Rate for Payer: Healthfirst Essential Plan	$48,138.10
Rate for Payer: Healthfirst QHP	$11,069.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,394.71
Rate for Payer: SOMOS Essential	$48,138.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,394.71

APR-DRG 0922: Facial bone procedures except major cranial/facial bone procedures

Facility IP

$53,641.22

Service Code	APR-DRG 0922
Min. Negotiated Rate	$13,455.00
Max. Negotiated Rate	$53,641.22
Rate for Payer: Amida Care Medicaid	$23,840.54
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,840.54
Rate for Payer: Fidelis Qualified Health Plan	$28,608.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,840.54
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,840.54
Rate for Payer: Healthfirst Commercial	$22,414.00
Rate for Payer: Healthfirst Essential Plan	$53,641.22
Rate for Payer: Healthfirst QHP	$13,455.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,840.54
Rate for Payer: SOMOS Essential	$53,641.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,840.54

APR-DRG 0923: Facial bone procedures except major cranial/facial bone procedures

Facility IP

$67,969.71

Service Code	APR-DRG 0923
Min. Negotiated Rate	$23,205.00
Max. Negotiated Rate	$67,969.71
Rate for Payer: Amida Care Medicaid	$30,208.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,208.76
Rate for Payer: Fidelis Qualified Health Plan	$36,250.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,208.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,208.76
Rate for Payer: Healthfirst Commercial	$33,618.00
Rate for Payer: Healthfirst Essential Plan	$67,969.71
Rate for Payer: Healthfirst QHP	$23,205.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,208.76
Rate for Payer: SOMOS Essential	$67,969.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,208.76

APR-DRG 0924: Facial bone procedures except major cranial/facial bone procedures

Facility IP

$158,970.76

Service Code	APR-DRG 0924
Min. Negotiated Rate	$24,234.00
Max. Negotiated Rate	$158,970.76
Rate for Payer: Amida Care Medicaid	$70,653.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$70,653.67
Rate for Payer: Fidelis Qualified Health Plan	$84,784.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$70,653.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$70,653.67
Rate for Payer: Healthfirst Commercial	$36,803.00
Rate for Payer: Healthfirst Essential Plan	$158,970.76
Rate for Payer: Healthfirst QHP	$24,234.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$70,653.67
Rate for Payer: SOMOS Essential	$158,970.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$70,653.67

APR-DRG 0931: Sinus & mastoid procedures

Facility IP

$45,419.08

Service Code	APR-DRG 0931
Min. Negotiated Rate	$8,780.00
Max. Negotiated Rate	$45,419.08
Rate for Payer: Amida Care Medicaid	$20,186.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,186.26
Rate for Payer: Fidelis Qualified Health Plan	$24,223.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,186.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,186.26
Rate for Payer: Healthfirst Commercial	$14,831.00
Rate for Payer: Healthfirst Essential Plan	$45,419.08
Rate for Payer: Healthfirst QHP	$8,780.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,186.26
Rate for Payer: SOMOS Essential	$45,419.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,186.26

APR-DRG 0932: Sinus & mastoid procedures

Facility IP

$51,342.52

Service Code	APR-DRG 0932
Min. Negotiated Rate	$11,493.00
Max. Negotiated Rate	$51,342.52
Rate for Payer: Amida Care Medicaid	$22,818.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,818.90
Rate for Payer: Fidelis Qualified Health Plan	$27,382.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,818.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,818.90
Rate for Payer: Healthfirst Commercial	$20,353.00
Rate for Payer: Healthfirst Essential Plan	$51,342.52
Rate for Payer: Healthfirst QHP	$11,493.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,818.90
Rate for Payer: SOMOS Essential	$51,342.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,818.90

APR-DRG 0933: Sinus & mastoid procedures

Facility IP

$71,291.99

Service Code	APR-DRG 0933
Min. Negotiated Rate	$21,120.00
Max. Negotiated Rate	$71,291.99
Rate for Payer: Amida Care Medicaid	$31,685.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,685.33
Rate for Payer: Fidelis Qualified Health Plan	$38,022.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,685.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,685.33
Rate for Payer: Healthfirst Commercial	$37,309.00
Rate for Payer: Healthfirst Essential Plan	$71,291.99
Rate for Payer: Healthfirst QHP	$21,120.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,685.33
Rate for Payer: SOMOS Essential	$71,291.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,685.33

Price Transparency.

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