Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: FRACTURES, DISLOCATIONS, SPRAINS, OTHER INJURIES OF THE SHOULDER AND UPPER ARM

Facility

$355.92

Service Code	EAPG 647
Min. Negotiated Rate	$162.23
Max. Negotiated Rate	$355.92
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$198.65
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$165.54
Rate for Payer: EmblemHealth Medicaid	$165.54
Rate for Payer: Galaxy Health Workers Comp	$162.23
Rate for Payer: Hamaspik Choice Medicaid	$165.54
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$173.82
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$355.92
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$355.92
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$165.54
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$173.82

EAPG 3.18: GALLBLADDER AND BILIARY TRACT DIAGNOSES

Facility

$246.14

Service Code	EAPG 637
Min. Negotiated Rate	$112.19
Max. Negotiated Rate	$246.14
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$137.38
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$114.48
Rate for Payer: EmblemHealth Medicaid	$114.48
Rate for Payer: Galaxy Health Workers Comp	$112.19
Rate for Payer: Hamaspik Choice Medicaid	$114.48
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$120.21
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$246.14
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$246.14
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$114.48
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$120.21

EAPG 3.18: GASTROINTESTINAL AND PERITONEAL INFECTION DIAGNOSES

Facility

$285.35

Service Code	EAPG 619
Min. Negotiated Rate	$130.06
Max. Negotiated Rate	$285.35
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$159.26
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$132.72
Rate for Payer: EmblemHealth Medicaid	$132.72
Rate for Payer: Galaxy Health Workers Comp	$130.06
Rate for Payer: Hamaspik Choice Medicaid	$132.72
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$139.36
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$285.35
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$285.35
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$132.72
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$139.36

EAPG 3.18: GASTROINTESTINAL HEMORRHAGE DIAGNOSES

Facility

$287.08

Service Code	EAPG 617
Min. Negotiated Rate	$130.85
Max. Negotiated Rate	$287.08
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$160.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$133.52
Rate for Payer: EmblemHealth Medicaid	$133.52
Rate for Payer: Galaxy Health Workers Comp	$130.85
Rate for Payer: Hamaspik Choice Medicaid	$133.52
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$140.20
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$287.08
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$287.08
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$133.52
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$140.20

EAPG 3.18: GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$307.26

Service Code	EAPG 642
Min. Negotiated Rate	$140.05
Max. Negotiated Rate	$307.26
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$171.49
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$142.91
Rate for Payer: EmblemHealth Medicaid	$142.91
Rate for Payer: Galaxy Health Workers Comp	$140.05
Rate for Payer: Hamaspik Choice Medicaid	$142.91
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$150.06
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$307.26
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$307.26
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$142.91
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$150.06

EAPG 3.18: GENETIC COUNSELING

Facility

$267.82

Service Code	EAPG 882
Min. Negotiated Rate	$122.07
Max. Negotiated Rate	$267.82
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$149.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$124.57
Rate for Payer: EmblemHealth Medicaid	$124.57
Rate for Payer: Galaxy Health Workers Comp	$122.07
Rate for Payer: Hamaspik Choice Medicaid	$124.57
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$130.80
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$267.82
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$267.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$124.57
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$130.80

EAPG 3.18: GLAUCOMA

Facility

$259.87

Service Code	EAPG 552
Min. Negotiated Rate	$118.45
Max. Negotiated Rate	$259.87
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$145.04
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$120.87
Rate for Payer: EmblemHealth Medicaid	$120.87
Rate for Payer: Galaxy Health Workers Comp	$118.45
Rate for Payer: Hamaspik Choice Medicaid	$120.87
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$126.91
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$259.87
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$259.87
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$120.87
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$126.91

EAPG 3.18: GROUP PSYCHOTHERAPY

Facility

$123.26

Service Code	EAPG 318
Min. Negotiated Rate	$56.18
Max. Negotiated Rate	$123.26
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$68.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$57.33
Rate for Payer: EmblemHealth Medicaid	$57.33
Rate for Payer: Galaxy Health Workers Comp	$56.18
Rate for Payer: Hamaspik Choice Medicaid	$57.33
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$60.20
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$123.26
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$123.26
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$57.33
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$60.20

EAPG 3.18: GYNECOLOGIC PREVENTIVE MEDICINE

Facility

$267.82

Service Code	EAPG 878
Min. Negotiated Rate	$122.07
Max. Negotiated Rate	$267.82
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$149.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$124.57
Rate for Payer: EmblemHealth Medicaid	$124.57
Rate for Payer: Galaxy Health Workers Comp	$122.07
Rate for Payer: Hamaspik Choice Medicaid	$124.57
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$130.80
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$267.82
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$267.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$124.57
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$130.80

EAPG 3.18: HAND AND FOOT TENOTOMY

Facility

$1,445.89

Service Code	EAPG 48
Min. Negotiated Rate	$659.03
Max. Negotiated Rate	$1,445.89
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$806.98
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$672.50
Rate for Payer: EmblemHealth Medicaid	$672.50
Rate for Payer: Galaxy Health Workers Comp	$659.03
Rate for Payer: Hamaspik Choice Medicaid	$672.50
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$706.13
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,445.89
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,445.89
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$672.50
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$706.13

EAPG 3.18: HEADACHES OTHER THAN MIGRAINE

Facility

$298.42

Service Code	EAPG 530
Min. Negotiated Rate	$136.02
Max. Negotiated Rate	$298.42
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$166.55
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$138.80
Rate for Payer: EmblemHealth Medicaid	$138.80
Rate for Payer: Galaxy Health Workers Comp	$136.02
Rate for Payer: Hamaspik Choice Medicaid	$138.80
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$145.74
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$298.42
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$298.42
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$138.80
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$145.74

EAPG 3.18: HEAD TRAUMA

Facility

$285.39

Service Code	EAPG 532
Min. Negotiated Rate	$130.08
Max. Negotiated Rate	$285.39
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$159.28
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$132.74
Rate for Payer: EmblemHealth Medicaid	$132.74
Rate for Payer: Galaxy Health Workers Comp	$130.08
Rate for Payer: Hamaspik Choice Medicaid	$132.74
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$139.37
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$285.39
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$285.39
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$132.74
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$139.37

EAPG 3.18: HEAD TRAUMA WITH LOC/COMA MORE THEN 1 HR

Facility

$285.39

Service Code	EAPG 538
Min. Negotiated Rate	$130.08
Max. Negotiated Rate	$285.39
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$159.28
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$132.74
Rate for Payer: EmblemHealth Medicaid	$132.74
Rate for Payer: Galaxy Health Workers Comp	$130.08
Rate for Payer: Hamaspik Choice Medicaid	$132.74
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$139.37
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$285.39
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$285.39
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$132.74
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$139.37

EAPG 3.18: HEART FAILURE

Facility

$289.92

Service Code	EAPG 594
Min. Negotiated Rate	$132.15
Max. Negotiated Rate	$289.92
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$161.81
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.85
Rate for Payer: EmblemHealth Medicaid	$134.85
Rate for Payer: Galaxy Health Workers Comp	$132.15
Rate for Payer: Hamaspik Choice Medicaid	$134.85
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$141.59
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$289.92
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$289.92
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.85
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.59

EAPG 3.18: HEPATITIS WITHOUT COMA

Facility

$303.61

Service Code	EAPG 636
Min. Negotiated Rate	$138.38
Max. Negotiated Rate	$303.61
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$169.45
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$141.21
Rate for Payer: EmblemHealth Medicaid	$141.21
Rate for Payer: Galaxy Health Workers Comp	$138.38
Rate for Payer: Hamaspik Choice Medicaid	$141.21
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$148.27
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$303.61
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$303.61
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$141.21
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$148.27

EAPG 3.18: HERNIA

Facility

$254.52

Service Code	EAPG 631
Min. Negotiated Rate	$116.01
Max. Negotiated Rate	$254.52
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$142.06
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$118.38
Rate for Payer: EmblemHealth Medicaid	$118.38
Rate for Payer: Galaxy Health Workers Comp	$116.01
Rate for Payer: Hamaspik Choice Medicaid	$118.38
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$124.30
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$254.52
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$254.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$118.38
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$124.30

EAPG 3.18: HERNIA REPAIRS

Facility

$4,283.50

Service Code	EAPG 139
Min. Negotiated Rate	$1,952.40
Max. Negotiated Rate	$4,283.50
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,390.72
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,992.30
Rate for Payer: EmblemHealth Medicaid	$1,992.30
Rate for Payer: Galaxy Health Workers Comp	$1,952.40
Rate for Payer: Hamaspik Choice Medicaid	$1,992.30
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,091.93
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,283.50
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,283.50
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,992.30
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,091.93

EAPG 3.18: HIV INFECTION

Facility

$308.37

Service Code	EAPG 880
Min. Negotiated Rate	$140.55
Max. Negotiated Rate	$308.37
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$172.11
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$143.43
Rate for Payer: EmblemHealth Medicaid	$143.43
Rate for Payer: Galaxy Health Workers Comp	$140.55
Rate for Payer: Hamaspik Choice Medicaid	$143.43
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$150.60
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$308.37
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$308.37
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$143.43
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$150.60

EAPG 3.18: H. PYLORI INFECTION

Facility

$207.67

Service Code	EAPG 810
Min. Negotiated Rate	$94.66
Max. Negotiated Rate	$207.67
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$115.91
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$96.59
Rate for Payer: EmblemHealth Medicaid	$96.59
Rate for Payer: Galaxy Health Workers Comp	$94.66
Rate for Payer: Hamaspik Choice Medicaid	$96.59
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$101.42
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$207.67
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$207.67
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$96.59
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$101.42

EAPG 3.18: HYPERTENSION

Facility

$249.37

Service Code	EAPG 599
Min. Negotiated Rate	$113.66
Max. Negotiated Rate	$249.37
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$139.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$115.99
Rate for Payer: EmblemHealth Medicaid	$115.99
Rate for Payer: Galaxy Health Workers Comp	$113.66
Rate for Payer: Hamaspik Choice Medicaid	$115.99
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$121.79
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$249.37
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$249.37
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$115.99
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$121.79

EAPG 3.18: IMPLANTED TISSUE OF ANY TYPE

Facility

$2,243.48

Service Code	EAPG 455
Min. Negotiated Rate	$1,022.61
Max. Negotiated Rate	$2,243.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,252.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,043.48
Rate for Payer: EmblemHealth Medicaid	$1,043.48
Rate for Payer: Galaxy Health Workers Comp	$1,022.61
Rate for Payer: Hamaspik Choice Medicaid	$1,043.48
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,095.65
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$2,243.48
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$2,243.48
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,043.48
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,095.65

EAPG 3.18: INBORN ERRORS OF METABOLISM

Facility

$234.57

Service Code	EAPG 691
Min. Negotiated Rate	$106.92
Max. Negotiated Rate	$234.57
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$130.92
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$109.10
Rate for Payer: EmblemHealth Medicaid	$109.10
Rate for Payer: Galaxy Health Workers Comp	$106.92
Rate for Payer: Hamaspik Choice Medicaid	$109.10
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$114.56
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$234.57
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$234.57
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$109.10
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$114.56

EAPG 3.18: INCIDENTAL INTRAOPERATIVE PROCEDURES

Facility

$3,560.67

Service Code	EAPG 2008
Min. Negotiated Rate	$1,622.94
Max. Negotiated Rate	$3,560.67
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,987.29
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,656.11
Rate for Payer: EmblemHealth Medicaid	$1,656.11
Rate for Payer: Galaxy Health Workers Comp	$1,622.94
Rate for Payer: Hamaspik Choice Medicaid	$1,656.11
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,738.93
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$3,560.67
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$3,560.67
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,656.11
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,738.93

EAPG 3.18: INCIDENTAL SKIN SUBSTITUTES

Facility

$2,481.89

Service Code	EAPG 2010
Min. Negotiated Rate	$1,131.24
Max. Negotiated Rate	$2,481.89
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,385.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,154.35
Rate for Payer: EmblemHealth Medicaid	$1,154.35
Rate for Payer: Galaxy Health Workers Comp	$1,131.24
Rate for Payer: Hamaspik Choice Medicaid	$1,154.35
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,212.08
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$2,481.89
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$2,481.89
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,154.35
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,212.08

EAPG 3.18: INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY

Facility

$318.06

Service Code	EAPG 316
Min. Negotiated Rate	$144.97
Max. Negotiated Rate	$318.06
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$177.52
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$147.93
Rate for Payer: EmblemHealth Medicaid	$147.93
Rate for Payer: Galaxy Health Workers Comp	$144.97
Rate for Payer: Hamaspik Choice Medicaid	$147.93
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$155.33
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$318.06
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$318.06
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$147.93
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$155.33

Know your out-of-pocket cost for care.

All Charges