Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: OTHER AFTERCARE AND CONVALESCENCE

Facility

$262.33

Service Code	EAPG 872
Min. Negotiated Rate	$119.57
Max. Negotiated Rate	$262.33
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$146.41
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$122.01
Rate for Payer: EmblemHealth Medicaid	$122.01
Rate for Payer: Galaxy Health Workers Comp	$119.57
Rate for Payer: Hamaspik Choice Medicaid	$122.01
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$128.11
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$262.33
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$262.33
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$122.01
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$128.11

EAPG 3.18: OTHER ANTEPARTUM DIAGNOSES

Facility

$294.77

Service Code	EAPG 765
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: OTHER BEHAVIORAL HEALTH DIAGNOSES

Facility

$254.45

Service Code	EAPG 831
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: OTHER CARDIOVASCULAR SYSTEM DIAGNOSES

Facility

$273.32

Service Code	EAPG 592
Min. Negotiated Rate	$124.58
Max. Negotiated Rate	$273.32
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$152.55
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$127.12
Rate for Payer: EmblemHealth Medicaid	$127.12
Rate for Payer: Galaxy Health Workers Comp	$124.58
Rate for Payer: Hamaspik Choice Medicaid	$127.12
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$133.48
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$273.32
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$273.32
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$127.12
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$133.48

EAPG 3.18: OTHER CENTRAL NERVOUS SYSTEM DIAGNOSES

Facility

$261.52

Service Code	EAPG 524
Min. Negotiated Rate	$119.20
Max. Negotiated Rate	$261.52
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$145.96
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$121.64
Rate for Payer: EmblemHealth Medicaid	$121.64
Rate for Payer: Galaxy Health Workers Comp	$119.20
Rate for Payer: Hamaspik Choice Medicaid	$121.64
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$127.72
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$261.52
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$261.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$121.64
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$127.72

EAPG 3.18: OTHER COMPLICATIONS OF TREATMENT

Facility

$331.16

Service Code	EAPG 852
Min. Negotiated Rate	$150.94
Max. Negotiated Rate	$331.16
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$184.83
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$154.03
Rate for Payer: EmblemHealth Medicaid	$154.03
Rate for Payer: Galaxy Health Workers Comp	$150.94
Rate for Payer: Hamaspik Choice Medicaid	$154.03
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$161.73
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$331.16
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$331.16
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$154.03
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$161.73

EAPG 3.18: OTHER CRANIOTOMY PROCEDURES INCLUDING CRANIOPLASTY

Facility

$5,667.16

Service Code	EAPG 267
Min. Negotiated Rate	$2,583.07
Max. Negotiated Rate	$5,667.16
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$3,162.97
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,635.86
Rate for Payer: EmblemHealth Medicaid	$2,635.86
Rate for Payer: Galaxy Health Workers Comp	$2,583.07
Rate for Payer: Hamaspik Choice Medicaid	$2,635.86
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,767.67
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$5,667.16
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$5,667.16
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,635.86
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,767.67

EAPG 3.18: OTHER DRUG ABUSE AND DEPENDENCE

Facility

$308.99

Service Code	EAPG 843
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: OTHER EAR, NOSE, MOUTH, THROAT AND CRANIOFACIAL DIAGNOSES

Facility

$269.74

Service Code	EAPG 564
Min. Negotiated Rate	$122.95
Max. Negotiated Rate	$269.74
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$150.55
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$125.46
Rate for Payer: EmblemHealth Medicaid	$125.46
Rate for Payer: Galaxy Health Workers Comp	$122.95
Rate for Payer: Hamaspik Choice Medicaid	$125.46
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$131.73
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$269.74
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$269.74
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$125.46
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$131.73

EAPG 3.18: OTHER ENDOCRINE SYSTEM DIAGNOSES

Facility

$264.55

Service Code	EAPG 692
Min. Negotiated Rate	$120.58
Max. Negotiated Rate	$264.55
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$147.65
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$123.05
Rate for Payer: EmblemHealth Medicaid	$123.05
Rate for Payer: Galaxy Health Workers Comp	$120.58
Rate for Payer: Hamaspik Choice Medicaid	$123.05
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$129.20
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$264.55
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$264.55
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$123.05
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$129.20

EAPG 3.18: OTHER EYE INFECTION DIAGNOSES

Facility

$289.12

Service Code	EAPG 557
Min. Negotiated Rate	$131.78
Max. Negotiated Rate	$289.12
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$161.36
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.47
Rate for Payer: EmblemHealth Medicaid	$134.47
Rate for Payer: Galaxy Health Workers Comp	$131.78
Rate for Payer: Hamaspik Choice Medicaid	$134.47
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$141.20
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$289.12
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$289.12
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.47
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.20

EAPG 3.18: OTHER FEMALE REPRODUCTIVE SYSTEM AND MENSTRUAL DIAGNOSES

Facility

$249.03

Service Code	EAPG 752
Min. Negotiated Rate	$113.51
Max. Negotiated Rate	$249.03
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$138.99
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$115.83
Rate for Payer: EmblemHealth Medicaid	$115.83
Rate for Payer: Galaxy Health Workers Comp	$113.51
Rate for Payer: Hamaspik Choice Medicaid	$115.83
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$121.62
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$249.03
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$249.03
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$115.83
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$121.62

EAPG 3.18: OTHER GASTROINTESTINAL SYSTEM DIAGNOSES

Facility

$282.27

Service Code	EAPG 624
Min. Negotiated Rate	$128.66
Max. Negotiated Rate	$282.27
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$157.54
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$131.29
Rate for Payer: EmblemHealth Medicaid	$131.29
Rate for Payer: Galaxy Health Workers Comp	$128.66
Rate for Payer: Hamaspik Choice Medicaid	$131.29
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$137.85
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$282.27
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$282.27
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$131.29
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$137.85

EAPG 3.18: OTHER GYNECOLOGICAL PROCEDURES

Facility

$1,182.56

Service Code	EAPG 209
Min. Negotiated Rate	$539.01
Max. Negotiated Rate	$1,182.56
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$660.01
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$550.02
Rate for Payer: EmblemHealth Medicaid	$550.02
Rate for Payer: Galaxy Health Workers Comp	$539.01
Rate for Payer: Hamaspik Choice Medicaid	$550.02
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$577.53
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,182.56
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,182.56
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$550.02
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$577.53

EAPG 3.18: OTHER HEMATOLOGICAL DIAGNOSES

Facility

$305.18

Service Code	EAPG 780
Min. Negotiated Rate	$139.10
Max. Negotiated Rate	$305.18
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$170.33
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$141.94
Rate for Payer: EmblemHealth Medicaid	$141.94
Rate for Payer: Galaxy Health Workers Comp	$139.10
Rate for Payer: Hamaspik Choice Medicaid	$141.94
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$149.04
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$305.18
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$305.18
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$141.94
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$149.04

EAPG 3.18: OTHER HEPATOBILIARY SYSTEM DIAGNOSES

Facility

$277.28

Service Code	EAPG 639
Min. Negotiated Rate	$126.38
Max. Negotiated Rate	$277.28
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$154.75
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$128.96
Rate for Payer: EmblemHealth Medicaid	$128.96
Rate for Payer: Galaxy Health Workers Comp	$126.38
Rate for Payer: Hamaspik Choice Medicaid	$128.96
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$135.41
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$277.28
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$277.28
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$128.96
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$135.41

EAPG 3.18: OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$258.06

Service Code	EAPG 809
Min. Negotiated Rate	$117.62
Max. Negotiated Rate	$258.06
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$144.03
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$120.03
Rate for Payer: EmblemHealth Medicaid	$120.03
Rate for Payer: Galaxy Health Workers Comp	$117.62
Rate for Payer: Hamaspik Choice Medicaid	$120.03
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$126.03
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$258.06
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$258.06
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$120.03
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$126.03

EAPG 3.18: OTHER INJURIES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE

Facility

$402.42

Service Code	EAPG 652
Min. Negotiated Rate	$183.42
Max. Negotiated Rate	$402.42
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$224.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$187.17
Rate for Payer: EmblemHealth Medicaid	$187.17
Rate for Payer: Galaxy Health Workers Comp	$183.42
Rate for Payer: Hamaspik Choice Medicaid	$187.17
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$196.53
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$402.42
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$402.42
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$187.17
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$196.53

EAPG 3.18: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$346.12

Service Code	EAPG 853
Min. Negotiated Rate	$157.76
Max. Negotiated Rate	$346.12
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$193.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$160.98
Rate for Payer: EmblemHealth Medicaid	$160.98
Rate for Payer: Galaxy Health Workers Comp	$157.76
Rate for Payer: Hamaspik Choice Medicaid	$160.98
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$169.03
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$346.12
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$346.12
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$160.98
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$169.03

EAPG 3.18: OTHER INTRA-ABDOMINAL AND INTRAPERITONEAL SURGICAL PROCEDURES

Facility

$4,361.87

Service Code	EAPG 108
Min. Negotiated Rate	$1,988.13
Max. Negotiated Rate	$4,361.87
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,434.46
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,028.75
Rate for Payer: EmblemHealth Medicaid	$2,028.75
Rate for Payer: Galaxy Health Workers Comp	$1,988.13
Rate for Payer: Hamaspik Choice Medicaid	$2,028.75
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,130.21
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,361.87
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,361.87
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,028.75
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,130.21

EAPG 3.18: OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$280.93

Service Code	EAPG 726
Min. Negotiated Rate	$128.05
Max. Negotiated Rate	$280.93
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$156.79
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$130.66
Rate for Payer: EmblemHealth Medicaid	$130.66
Rate for Payer: Galaxy Health Workers Comp	$128.05
Rate for Payer: Hamaspik Choice Medicaid	$130.66
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$137.20
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$280.93
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$280.93
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$130.66
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$137.20

EAPG 3.18: OTHER MAJOR LIVER DIAGNOSES

Facility

$267.48

Service Code	EAPG 641
Min. Negotiated Rate	$121.91
Max. Negotiated Rate	$267.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$149.28
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$124.41
Rate for Payer: EmblemHealth Medicaid	$124.41
Rate for Payer: Galaxy Health Workers Comp	$121.91
Rate for Payer: Hamaspik Choice Medicaid	$124.41
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$130.63
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$267.48
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$267.48
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$124.41
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$130.63

EAPG 3.18: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES

Facility

$275.28

Service Code	EAPG 741
Min. Negotiated Rate	$125.47
Max. Negotiated Rate	$275.28
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$153.64
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$128.04
Rate for Payer: EmblemHealth Medicaid	$128.04
Rate for Payer: Galaxy Health Workers Comp	$125.47
Rate for Payer: Hamaspik Choice Medicaid	$128.04
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$134.44
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$275.28
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$275.28
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$128.04
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$134.44

EAPG 3.18: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$292.81

Service Code	EAPG 660
Min. Negotiated Rate	$133.46
Max. Negotiated Rate	$292.81
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$163.42
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$136.19
Rate for Payer: EmblemHealth Medicaid	$136.19
Rate for Payer: Galaxy Health Workers Comp	$133.46
Rate for Payer: Hamaspik Choice Medicaid	$136.19
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$143.00
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$292.81
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$292.81
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$136.19
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$143.00

EAPG 3.18: OTHER OPHTHALMIC SYSTEM DIAGNOSES

Facility

$289.12

Service Code	EAPG 553
Min. Negotiated Rate	$131.78
Max. Negotiated Rate	$289.12
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$161.36
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.47
Rate for Payer: EmblemHealth Medicaid	$134.47
Rate for Payer: Galaxy Health Workers Comp	$131.78
Rate for Payer: Hamaspik Choice Medicaid	$134.47
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$141.20
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$289.12
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$289.12
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.47
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.20

Know your out-of-pocket cost for care.

All Charges