Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: NERVE AND MUSCLE TESTS

Facility

$287.39

Service Code	EAPG 213
Min. Negotiated Rate	$130.99
Max. Negotiated Rate	$287.39
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$160.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$133.67
Rate for Payer: EmblemHealth Medicaid	$133.67
Rate for Payer: Galaxy Health Workers Comp	$130.99
Rate for Payer: Hamaspik Choice Medicaid	$133.67
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$140.35
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$287.39
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$287.39
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$133.67
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$140.35

EAPG 3.18: NERVOUS SYSTEM MALIGNANCY

Facility

$277.82

Service Code	EAPG 521
Min. Negotiated Rate	$126.63
Max. Negotiated Rate	$277.82
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$155.06
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$129.21
Rate for Payer: EmblemHealth Medicaid	$129.21
Rate for Payer: Galaxy Health Workers Comp	$126.63
Rate for Payer: Hamaspik Choice Medicaid	$129.21
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$135.68
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$277.82
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$277.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$129.21
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$135.68

EAPG 3.18: NON-BACTERIAL GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$288.19

Service Code	EAPG 627
Min. Negotiated Rate	$131.36
Max. Negotiated Rate	$288.19
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$160.85
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.04
Rate for Payer: EmblemHealth Medicaid	$134.04
Rate for Payer: Galaxy Health Workers Comp	$131.36
Rate for Payer: Hamaspik Choice Medicaid	$134.04
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$140.74
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$288.19
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$288.19
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.04
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$140.74

EAPG 3.18: NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM

Facility

$298.26

Service Code	EAPG 519
Min. Negotiated Rate	$135.95
Max. Negotiated Rate	$298.26
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$166.47
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$138.73
Rate for Payer: EmblemHealth Medicaid	$138.73
Rate for Payer: Galaxy Health Workers Comp	$135.95
Rate for Payer: Hamaspik Choice Medicaid	$138.73
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$145.66
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$298.26
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$298.26
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$138.73
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$145.66

EAPG 3.18: NONINVASIVE VENTILATION SUPPORT

Facility

$394.62

Service Code	EAPG 2020
Min. Negotiated Rate	$179.87
Max. Negotiated Rate	$394.62
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$220.25
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$183.54
Rate for Payer: EmblemHealth Medicaid	$183.54
Rate for Payer: Galaxy Health Workers Comp	$179.87
Rate for Payer: Hamaspik Choice Medicaid	$183.54
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$192.72
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$394.62
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$394.62
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$183.54
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$192.72

EAPG 3.18: NON-PRESSURE CHRONIC SKIN ULCERS

Facility

$330.28

Service Code	EAPG 670
Min. Negotiated Rate	$150.54
Max. Negotiated Rate	$330.28
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$184.34
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$153.62
Rate for Payer: EmblemHealth Medicaid	$153.62
Rate for Payer: Galaxy Health Workers Comp	$150.54
Rate for Payer: Hamaspik Choice Medicaid	$153.62
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$161.30
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$330.28
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$330.28
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$153.62
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$161.30

EAPG 3.18: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION W/O INFARC

Facility

$262.40

Service Code	EAPG 534
Min. Negotiated Rate	$119.60
Max. Negotiated Rate	$262.40
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$146.45
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$122.05
Rate for Payer: EmblemHealth Medicaid	$122.05
Rate for Payer: Galaxy Health Workers Comp	$119.60
Rate for Payer: Hamaspik Choice Medicaid	$122.05
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$128.15
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$262.40
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$262.40
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$122.05
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$128.15

EAPG 3.18: NONTRAUMATIC STUPOR & COMA

Facility

$321.94

Service Code	EAPG 528
Min. Negotiated Rate	$146.74
Max. Negotiated Rate	$321.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$179.68
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$149.74
Rate for Payer: EmblemHealth Medicaid	$149.74
Rate for Payer: Galaxy Health Workers Comp	$146.74
Rate for Payer: Hamaspik Choice Medicaid	$149.74
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$157.23
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$321.94
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$321.94
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$149.74
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$157.23

EAPG 3.18: NORMAL NEONATE

Facility

$238.07

Service Code	EAPG 770
Min. Negotiated Rate	$108.51
Max. Negotiated Rate	$238.07
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$132.87
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$110.73
Rate for Payer: EmblemHealth Medicaid	$110.73
Rate for Payer: Galaxy Health Workers Comp	$108.51
Rate for Payer: Hamaspik Choice Medicaid	$110.73
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$116.27
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$238.07
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$238.07
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$110.73
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$116.27

EAPG 3.18: OBESITY

Facility

$258.10

Service Code	EAPG 695
Min. Negotiated Rate	$117.64
Max. Negotiated Rate	$258.10
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$144.05
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$120.04
Rate for Payer: EmblemHealth Medicaid	$120.04
Rate for Payer: Galaxy Health Workers Comp	$117.64
Rate for Payer: Hamaspik Choice Medicaid	$120.04
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$126.05
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$258.10
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$258.10
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$120.04
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$126.05

EAPG 3.18: OBSERVATION

Facility

$60.08

Service Code	EAPG 450
Min. Negotiated Rate	$27.38
Max. Negotiated Rate	$60.08
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$33.53
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$27.94
Rate for Payer: EmblemHealth Medicaid	$27.94
Rate for Payer: Galaxy Health Workers Comp	$27.38
Rate for Payer: Hamaspik Choice Medicaid	$27.94
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$29.34
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$60.08
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$60.08
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$27.94
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$29.34

EAPG 3.18: OBSTETRICAL PROCEDURES

Facility

$2,161.79

Service Code	EAPG 205
Min. Negotiated Rate	$985.34
Max. Negotiated Rate	$2,161.79
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,206.55
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,005.47
Rate for Payer: EmblemHealth Medicaid	$1,005.47
Rate for Payer: Galaxy Health Workers Comp	$985.34
Rate for Payer: Hamaspik Choice Medicaid	$1,005.47
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,055.76
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$2,161.79
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$2,161.79
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,005.47
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,055.76

EAPG 3.18: OBSTETRICAL ULTRASOUND

Facility

$267.36

Service Code	EAPG 470
Min. Negotiated Rate	$121.86
Max. Negotiated Rate	$267.36
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$149.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$124.35
Rate for Payer: EmblemHealth Medicaid	$124.35
Rate for Payer: Galaxy Health Workers Comp	$121.86
Rate for Payer: Hamaspik Choice Medicaid	$124.35
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$130.57
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$267.36
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$267.36
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$124.35
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$130.57

EAPG 3.18: OCCUPATIONAL THERAPY

Facility

$278.32

Service Code	EAPG 270
Min. Negotiated Rate	$126.86
Max. Negotiated Rate	$278.32
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$155.33
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$129.45
Rate for Payer: EmblemHealth Medicaid	$129.45
Rate for Payer: Galaxy Health Workers Comp	$126.86
Rate for Payer: Hamaspik Choice Medicaid	$129.45
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$135.92
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$278.32
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$278.32
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$129.45
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$135.92

EAPG 3.18: OCULAR AND PERIOCULAR MALIGNANCY

Facility

$289.50

Service Code	EAPG 556
Min. Negotiated Rate	$131.95
Max. Negotiated Rate	$289.50
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$161.58
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.65
Rate for Payer: EmblemHealth Medicaid	$134.65
Rate for Payer: Galaxy Health Workers Comp	$131.95
Rate for Payer: Hamaspik Choice Medicaid	$134.65
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$141.38
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$289.50
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$289.50
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.65
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.38

EAPG 3.18: OCULAR IMAGING AND RELATED SERVICES

Facility

$219.47

Service Code	EAPG 156
Min. Negotiated Rate	$100.03
Max. Negotiated Rate	$219.47
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$122.49
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$102.08
Rate for Payer: EmblemHealth Medicaid	$102.08
Rate for Payer: Galaxy Health Workers Comp	$100.03
Rate for Payer: Hamaspik Choice Medicaid	$102.08
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$107.18
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$219.47
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$219.47
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$102.08
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$107.18

EAPG 3.18: OPEN INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$5,274.00

Service Code	EAPG 266
Min. Negotiated Rate	$2,403.87
Max. Negotiated Rate	$5,274.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,943.54
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,452.99
Rate for Payer: EmblemHealth Medicaid	$2,452.99
Rate for Payer: Galaxy Health Workers Comp	$2,403.87
Rate for Payer: Hamaspik Choice Medicaid	$2,452.99
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,575.66
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$5,274.00
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$5,274.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,452.99
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,575.66

EAPG 3.18: OPEN OR PERCUTANEOUS TREATMENT OF FRACTURES

Facility

$6,218.14

Service Code	EAPG 43
Min. Negotiated Rate	$2,834.21
Max. Negotiated Rate	$6,218.14
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$3,470.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,892.12
Rate for Payer: EmblemHealth Medicaid	$2,892.12
Rate for Payer: Galaxy Health Workers Comp	$2,834.21
Rate for Payer: Hamaspik Choice Medicaid	$2,892.12
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$3,036.75
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$6,218.14
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$6,218.14
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,892.12
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$3,036.75

EAPG 3.18: OPEN WOUNDS, PUNCTURES AND OTHER OPEN TRAUMATIC INJURIES

Facility

$371.29

Service Code	EAPG 674
Min. Negotiated Rate	$169.23
Max. Negotiated Rate	$371.29
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$207.23
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$172.69
Rate for Payer: EmblemHealth Medicaid	$172.69
Rate for Payer: Galaxy Health Workers Comp	$169.23
Rate for Payer: Hamaspik Choice Medicaid	$172.69
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$181.33
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$371.29
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$371.29
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$172.69
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$181.33

EAPG 3.18: OPHTHALMOLOGICAL TESTS AND PROCEDURES

Facility

$411.50

Service Code	EAPG 230
Min. Negotiated Rate	$187.56
Max. Negotiated Rate	$411.50
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$229.67
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$191.39
Rate for Payer: EmblemHealth Medicaid	$191.39
Rate for Payer: Galaxy Health Workers Comp	$187.56
Rate for Payer: Hamaspik Choice Medicaid	$191.39
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$200.96
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$411.50
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$411.50
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$191.39
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$200.96

EAPG 3.18: OPIOID ABUSE AND DEPENDENCE

Facility

$308.99

Service Code	EAPG 840
Min. Negotiated Rate	$140.84
Max. Negotiated Rate	$308.99
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$172.45
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$143.71
Rate for Payer: EmblemHealth Medicaid	$143.71
Rate for Payer: Galaxy Health Workers Comp	$140.84
Rate for Payer: Hamaspik Choice Medicaid	$143.71
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$150.90
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$308.99
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$308.99
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$143.71
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$150.90

EAPG 3.18: ORGANIC BEHAVIORAL HEALTH DISTURBANCES

Facility

$310.49

Service Code	EAPG 827
Min. Negotiated Rate	$141.52
Max. Negotiated Rate	$310.49
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$173.29
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$144.41
Rate for Payer: EmblemHealth Medicaid	$144.41
Rate for Payer: Galaxy Health Workers Comp	$141.52
Rate for Payer: Hamaspik Choice Medicaid	$144.41
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$151.63
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$310.49
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$310.49
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$144.41
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$151.63

EAPG 3.18: ORGAN OR DISEASE ORIENTED PANELS

Facility

$56.07

Service Code	EAPG 403
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$56.07
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$31.30
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$26.08
Rate for Payer: EmblemHealth Medicaid	$26.08
Rate for Payer: Galaxy Health Workers Comp	$25.56
Rate for Payer: Hamaspik Choice Medicaid	$26.08
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$27.38
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$56.07
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$56.07
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$26.08
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$27.38

EAPG 3.18: OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS

Facility

$316.90

Service Code	EAPG 654
Min. Negotiated Rate	$144.44
Max. Negotiated Rate	$316.90
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$176.87
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$147.40
Rate for Payer: EmblemHealth Medicaid	$147.40
Rate for Payer: Galaxy Health Workers Comp	$144.44
Rate for Payer: Hamaspik Choice Medicaid	$147.40
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$154.77
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$316.90
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$316.90
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$147.40
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$154.77

EAPG 3.18: OSTEOPOROSIS

Facility

$220.74

Service Code	EAPG 662
Min. Negotiated Rate	$100.61
Max. Negotiated Rate	$220.74
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$123.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$102.67
Rate for Payer: EmblemHealth Medicaid	$102.67
Rate for Payer: Galaxy Health Workers Comp	$100.61
Rate for Payer: Hamaspik Choice Medicaid	$102.67
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$107.80
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$220.74
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$220.74
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$102.67
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$107.80

Know your out-of-pocket cost for care.

All Charges