Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: ANTEPARTUM ENCOUNTERS FOR NON-ROUTINE AND ABNORMAL FINDINGS

Facility

$294.77

Service Code	EAPG 768
Min. Negotiated Rate	$134.35
Max. Negotiated Rate	$294.77
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$164.52
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$137.10
Rate for Payer: EmblemHealth Medicaid	$137.10
Rate for Payer: Galaxy Health Workers Comp	$134.35
Rate for Payer: Hamaspik Choice Medicaid	$137.10
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$143.95
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$294.77
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$294.77
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$137.10
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$143.95

EAPG 3.18: ANTEPARTUM PROCEDURES

Facility

$1,591.10

Service Code	EAPG 178
Min. Negotiated Rate	$725.22
Max. Negotiated Rate	$1,591.10
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$888.03
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$740.04
Rate for Payer: EmblemHealth Medicaid	$740.04
Rate for Payer: Galaxy Health Workers Comp	$725.22
Rate for Payer: Hamaspik Choice Medicaid	$740.04
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$777.04
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,591.10
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,591.10
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$740.04
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$777.04

EAPG 3.18: ARTERIOVENOUS FISTULA CREATION OR REVISION FOR HEMODIALYSIS

Facility

$5,324.27

Service Code	EAPG 59
Min. Negotiated Rate	$2,426.78
Max. Negotiated Rate	$5,324.27
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,971.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,476.38
Rate for Payer: EmblemHealth Medicaid	$2,476.38
Rate for Payer: Galaxy Health Workers Comp	$2,426.78
Rate for Payer: Hamaspik Choice Medicaid	$2,476.38
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,600.22
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$5,324.27
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$5,324.27
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,476.38
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,600.22

EAPG 3.18: ASTHMA

Facility

$344.46

Service Code	EAPG 575
Min. Negotiated Rate	$157.01
Max. Negotiated Rate	$344.46
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$192.25
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$160.21
Rate for Payer: EmblemHealth Medicaid	$160.21
Rate for Payer: Galaxy Health Workers Comp	$157.01
Rate for Payer: Hamaspik Choice Medicaid	$160.21
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$168.23
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$344.46
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$344.46
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$160.21
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$168.23

EAPG 3.18: ATRIAL AND VENTRICULAR RECORDING AND PACING

Facility

$1,124.48

Service Code	EAPG 96
Min. Negotiated Rate	$512.54
Max. Negotiated Rate	$1,124.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$627.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$523.01
Rate for Payer: EmblemHealth Medicaid	$523.01
Rate for Payer: Galaxy Health Workers Comp	$512.54
Rate for Payer: Hamaspik Choice Medicaid	$523.01
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$549.16
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,124.48
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,124.48
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$523.01
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$549.16

EAPG 3.18: ATRIAL FIBRILLATION

Facility

$268.09

Service Code	EAPG 602
Min. Negotiated Rate	$122.20
Max. Negotiated Rate	$268.09
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$149.63
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$124.69
Rate for Payer: EmblemHealth Medicaid	$124.69
Rate for Payer: Galaxy Health Workers Comp	$122.20
Rate for Payer: Hamaspik Choice Medicaid	$124.69
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$130.93
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$268.09
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$268.09
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$124.69
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$130.93

EAPG 3.18: AUDIOMETRY

Facility

$161.85

Service Code	EAPG 257
Min. Negotiated Rate	$73.77
Max. Negotiated Rate	$161.85
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$90.33
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$75.28
Rate for Payer: EmblemHealth Medicaid	$75.28
Rate for Payer: Galaxy Health Workers Comp	$73.77
Rate for Payer: Hamaspik Choice Medicaid	$75.28
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$79.04
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$161.85
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$161.85
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$75.28
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$79.04

EAPG 3.18: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM

Facility

$299.61

Service Code	EAPG 518
Min. Negotiated Rate	$136.56
Max. Negotiated Rate	$299.61
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$167.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$139.35
Rate for Payer: EmblemHealth Medicaid	$139.35
Rate for Payer: Galaxy Health Workers Comp	$136.56
Rate for Payer: Hamaspik Choice Medicaid	$139.35
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$146.32
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$299.61
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$299.61
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$139.35
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$146.32

EAPG 3.18: BASIC CHEMISTRY TESTS

Facility

$14.51

Service Code	EAPG 402
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$14.51
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$8.10
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$6.75
Rate for Payer: EmblemHealth Medicaid	$6.75
Rate for Payer: Galaxy Health Workers Comp	$6.62
Rate for Payer: Hamaspik Choice Medicaid	$6.75
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$7.09
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$14.51
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$14.51
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$6.75
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$7.09

EAPG 3.18: BEHAVIORAL HEALTH RESIDENTIAL TREATMENT

Facility

$253.02

Service Code	EAPG 333
Min. Negotiated Rate	$115.33
Max. Negotiated Rate	$253.02
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$141.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$117.68
Rate for Payer: EmblemHealth Medicaid	$117.68
Rate for Payer: Galaxy Health Workers Comp	$115.33
Rate for Payer: Hamaspik Choice Medicaid	$117.68
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$123.57
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$253.02
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$253.02
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$117.68
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$123.57

EAPG 3.18: BEHAVIORAL HEATLH ASSESSMENT

Facility

$397.58

Service Code	EAPG 323
Min. Negotiated Rate	$181.22
Max. Negotiated Rate	$397.58
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$221.90
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$184.92
Rate for Payer: EmblemHealth Medicaid	$184.92
Rate for Payer: Galaxy Health Workers Comp	$181.22
Rate for Payer: Hamaspik Choice Medicaid	$184.92
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$194.17
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$397.58
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$397.58
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$184.92
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$194.17

EAPG 3.18: BIPOLAR DISORDERS

Facility

$254.45

Service Code	EAPG 823
Min. Negotiated Rate	$115.98
Max. Negotiated Rate	$254.45
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$142.01
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$118.35
Rate for Payer: EmblemHealth Medicaid	$118.35
Rate for Payer: Galaxy Health Workers Comp	$115.98
Rate for Payer: Hamaspik Choice Medicaid	$118.35
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$124.26
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$254.45
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$254.45
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$118.35
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$124.26

EAPG 3.18: BLOOD PROCESSING, STORAGE AND RELATED SERVICES

Facility

$97.36

Service Code	EAPG 499
Min. Negotiated Rate	$44.38
Max. Negotiated Rate	$97.36
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$54.34
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$45.28
Rate for Payer: EmblemHealth Medicaid	$45.28
Rate for Payer: Galaxy Health Workers Comp	$44.38
Rate for Payer: Hamaspik Choice Medicaid	$45.28
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$47.55
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$97.36
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$97.36
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$45.28
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$47.55

EAPG 3.18: BONE CONDUCTION HEARING DEVICE IMPLANTATION

Facility

$7,170.77

Service Code	EAPG 3011
Min. Negotiated Rate	$3,268.41
Max. Negotiated Rate	$7,170.77
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4,002.17
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$3,335.20
Rate for Payer: EmblemHealth Medicaid	$3,335.20
Rate for Payer: Galaxy Health Workers Comp	$3,268.41
Rate for Payer: Hamaspik Choice Medicaid	$3,335.20
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$3,501.99
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$7,170.77
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$7,170.77
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3,335.20
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$3,501.99

EAPG 3.18: BONE DENSITY AND RELATED PROCEDURES

Facility

$312.20

Service Code	EAPG 291
Min. Negotiated Rate	$142.31
Max. Negotiated Rate	$312.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$174.25
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$145.21
Rate for Payer: EmblemHealth Medicaid	$145.21
Rate for Payer: Galaxy Health Workers Comp	$142.31
Rate for Payer: Hamaspik Choice Medicaid	$145.21
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$152.47
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$312.20
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$312.20
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$145.21
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$152.47

EAPG 3.18: BONE MARROW BIOPSIES

Facility

$1,062.22

Service Code	EAPG 124
Min. Negotiated Rate	$484.16
Max. Negotiated Rate	$1,062.22
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$592.85
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$494.05
Rate for Payer: EmblemHealth Medicaid	$494.05
Rate for Payer: Galaxy Health Workers Comp	$484.16
Rate for Payer: Hamaspik Choice Medicaid	$494.05
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$518.76
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,062.22
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,062.22
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$494.05
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$518.76

EAPG 3.18: BONE OR JOINT MANIPULATION UNDER ANESTHESIA

Facility

$1,943.17

Service Code	EAPG 44
Min. Negotiated Rate	$885.69
Max. Negotiated Rate	$1,943.17
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,084.53
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$903.79
Rate for Payer: EmblemHealth Medicaid	$903.79
Rate for Payer: Galaxy Health Workers Comp	$885.69
Rate for Payer: Hamaspik Choice Medicaid	$903.79
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$948.99
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,943.17
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,943.17
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$903.79
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$948.99

EAPG 3.18: BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$238.26

Service Code	EAPG 572
Min. Negotiated Rate	$108.60
Max. Negotiated Rate	$238.26
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$132.98
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$110.82
Rate for Payer: EmblemHealth Medicaid	$110.82
Rate for Payer: Galaxy Health Workers Comp	$108.60
Rate for Payer: Hamaspik Choice Medicaid	$110.82
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$116.36
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$238.26
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$238.26
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$110.82
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$116.36

EAPG 3.18: BUNION PROCEDURES

Facility

$4,717.37

Service Code	EAPG 45
Min. Negotiated Rate	$2,150.16
Max. Negotiated Rate	$4,717.37
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,632.87
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,194.10
Rate for Payer: EmblemHealth Medicaid	$2,194.10
Rate for Payer: Galaxy Health Workers Comp	$2,150.16
Rate for Payer: Hamaspik Choice Medicaid	$2,194.10
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,303.82
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,717.37
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,717.37
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,194.10
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,303.82

EAPG 3.18: CARDIAC ARREST OR OTHER CAUSES OF MORTALITY

Facility

$626.47

Service Code	EAPG 595
Min. Negotiated Rate	$285.54
Max. Negotiated Rate	$626.47
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$349.65
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$291.38
Rate for Payer: EmblemHealth Medicaid	$291.38
Rate for Payer: Galaxy Health Workers Comp	$285.54
Rate for Payer: Hamaspik Choice Medicaid	$291.38
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$305.95
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$626.47
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$626.47
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$291.38
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$305.95

EAPG 3.18: CARDIAC ARRHYTHMIA AND CONDUCTION DIAGNOSES

Facility

$298.22

Service Code	EAPG 601
Min. Negotiated Rate	$135.93
Max. Negotiated Rate	$298.22
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$166.45
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$138.71
Rate for Payer: EmblemHealth Medicaid	$138.71
Rate for Payer: Galaxy Health Workers Comp	$135.93
Rate for Payer: Hamaspik Choice Medicaid	$138.71
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$145.64
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$298.22
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$298.22
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$138.71
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$145.64

EAPG 3.18: CARDIAC ELECTROPHYSIOLOGIC TESTS AND MONITORING

Facility

$1,933.18

Service Code	EAPG 82
Min. Negotiated Rate	$881.14
Max. Negotiated Rate	$1,933.18
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,078.95
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$899.14
Rate for Payer: EmblemHealth Medicaid	$899.14
Rate for Payer: Galaxy Health Workers Comp	$881.14
Rate for Payer: Hamaspik Choice Medicaid	$899.14
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$944.11
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,933.18
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,933.18
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$899.14
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$944.11

EAPG 3.18: CARDIAC REHABILITATION

Facility

$79.75

Service Code	EAPG 94
Min. Negotiated Rate	$36.35
Max. Negotiated Rate	$79.75
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$44.51
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$37.09
Rate for Payer: EmblemHealth Medicaid	$37.09
Rate for Payer: Galaxy Health Workers Comp	$36.35
Rate for Payer: Hamaspik Choice Medicaid	$37.09
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$38.95
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$79.75
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$79.75
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$37.09
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$38.95

EAPG 3.18: CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES

Facility

$332.20

Service Code	EAPG 600
Min. Negotiated Rate	$151.42
Max. Negotiated Rate	$332.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$185.41
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$154.51
Rate for Payer: EmblemHealth Medicaid	$154.51
Rate for Payer: Galaxy Health Workers Comp	$151.42
Rate for Payer: Hamaspik Choice Medicaid	$154.51
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$162.24
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$332.20
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$332.20
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$154.51
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$162.24

EAPG 3.18: CARDIOGRAM

Facility

$87.98

Service Code	EAPG 413
Min. Negotiated Rate	$40.10
Max. Negotiated Rate	$87.98
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$49.10
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$40.92
Rate for Payer: EmblemHealth Medicaid	$40.92
Rate for Payer: Galaxy Health Workers Comp	$40.10
Rate for Payer: Hamaspik Choice Medicaid	$40.92
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$42.97
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$87.98
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$87.98
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$40.92
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$42.97

Know your out-of-pocket cost for care.

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