Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: OTHER PATHOLOGICAL FRACTURES W/O MUSCULOSKELETAL MALIGNANCY

Facility

$330.93

Service Code	EAPG 649
Min. Negotiated Rate	$150.84
Max. Negotiated Rate	$330.93
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$184.70
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$153.92
Rate for Payer: EmblemHealth Medicaid	$153.92
Rate for Payer: Galaxy Health Workers Comp	$150.84
Rate for Payer: Hamaspik Choice Medicaid	$153.92
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$161.62
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$330.93
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$330.93
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$153.92
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$161.62

EAPG 3.18: OTHER RESPIRATORY SYSTEM DIAGNOSES

Facility

$296.99

Service Code	EAPG 576
Min. Negotiated Rate	$135.37
Max. Negotiated Rate	$296.99
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$165.76
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$138.14
Rate for Payer: EmblemHealth Medicaid	$138.14
Rate for Payer: Galaxy Health Workers Comp	$135.37
Rate for Payer: Hamaspik Choice Medicaid	$138.14
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$145.04
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$296.99
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$296.99
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$138.14
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$145.04

EAPG 3.18: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES

Facility

$251.60

Service Code	EAPG 675
Min. Negotiated Rate	$114.68
Max. Negotiated Rate	$251.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$140.42
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$117.02
Rate for Payer: EmblemHealth Medicaid	$117.02
Rate for Payer: Galaxy Health Workers Comp	$114.68
Rate for Payer: Hamaspik Choice Medicaid	$117.02
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$122.87
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$251.60
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$251.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$117.02
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$122.87

EAPG 3.18: OTORHINOLARYNGOLOGIC FUNCTION TESTS

Facility

$283.66

Service Code	EAPG 251
Min. Negotiated Rate	$129.29
Max. Negotiated Rate	$283.66
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$158.32
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$131.93
Rate for Payer: EmblemHealth Medicaid	$131.93
Rate for Payer: Galaxy Health Workers Comp	$129.29
Rate for Payer: Hamaspik Choice Medicaid	$131.93
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$138.53
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$283.66
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$283.66
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$131.93
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$138.53

EAPG 3.18: PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT

Facility

$13,327.41

Service Code	EAPG 86
Min. Negotiated Rate	$6,074.59
Max. Negotiated Rate	$13,327.41
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$7,438.33
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$6,198.72
Rate for Payer: EmblemHealth Medicaid	$6,198.72
Rate for Payer: Galaxy Health Workers Comp	$6,074.59
Rate for Payer: Hamaspik Choice Medicaid	$6,198.72
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$6,508.71
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$13,327.41
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$13,327.41
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$6,198.72
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$6,508.71

EAPG 3.18: PAIN

Facility

$291.84

Service Code	EAPG 663
Min. Negotiated Rate	$133.02
Max. Negotiated Rate	$291.84
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$162.89
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$135.74
Rate for Payer: EmblemHealth Medicaid	$135.74
Rate for Payer: Galaxy Health Workers Comp	$133.02
Rate for Payer: Hamaspik Choice Medicaid	$135.74
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$142.53
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$291.84
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$291.84
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$135.74
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$142.53

EAPG 3.18: PANCREAS DIAGNOSES EXCEPT MALIGNANCY

Facility

$262.83

Service Code	EAPG 635
Min. Negotiated Rate	$119.79
Max. Negotiated Rate	$262.83
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$146.69
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$122.24
Rate for Payer: EmblemHealth Medicaid	$122.24
Rate for Payer: Galaxy Health Workers Comp	$119.79
Rate for Payer: Hamaspik Choice Medicaid	$122.24
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$128.36
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$262.83
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$262.83
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$122.24
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$128.36

EAPG 3.18: PAP SMEARS

Facility

$62.80

Service Code	EAPG 392
Min. Negotiated Rate	$28.63
Max. Negotiated Rate	$62.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$35.05
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$29.21
Rate for Payer: EmblemHealth Medicaid	$29.21
Rate for Payer: Galaxy Health Workers Comp	$28.63
Rate for Payer: Hamaspik Choice Medicaid	$29.21
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$30.67
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$62.80
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$62.80
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$29.21
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$30.67

EAPG 3.18: PARTIAL THICKNESS BURNS W OR W/O SKIN GRAFT

Facility

$331.78

Service Code	EAPG 861
Min. Negotiated Rate	$151.22
Max. Negotiated Rate	$331.78
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$185.17
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$154.31
Rate for Payer: EmblemHealth Medicaid	$154.31
Rate for Payer: Galaxy Health Workers Comp	$151.22
Rate for Payer: Hamaspik Choice Medicaid	$154.31
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$162.03
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$331.78
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$331.78
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$154.31
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$162.03

EAPG 3.18: PATHOLOGY CONSULTATION AND INTERPRETATION

Facility

$141.41

Service Code	EAPG 158
Min. Negotiated Rate	$64.45
Max. Negotiated Rate	$141.41
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$78.92
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$65.77
Rate for Payer: EmblemHealth Medicaid	$65.77
Rate for Payer: Galaxy Health Workers Comp	$64.45
Rate for Payer: Hamaspik Choice Medicaid	$65.77
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$69.06
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$141.41
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$141.41
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$65.77
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$69.06

EAPG 3.18: PELVIS, FEMUR AND UPPER LEG PROCEDURES

Facility

$4,597.37

Service Code	EAPG 27
Min. Negotiated Rate	$2,095.47
Max. Negotiated Rate	$4,597.37
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,565.90
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,138.29
Rate for Payer: EmblemHealth Medicaid	$2,138.29
Rate for Payer: Galaxy Health Workers Comp	$2,095.47
Rate for Payer: Hamaspik Choice Medicaid	$2,138.29
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,245.22
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,597.37
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,597.37
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,138.29
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,245.22

EAPG 3.18: PEPTIC ULCER AND GASTRITIS

Facility

$327.13

Service Code	EAPG 621
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$327.13
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$182.58
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$152.15
Rate for Payer: EmblemHealth Medicaid	$152.15
Rate for Payer: Galaxy Health Workers Comp	$149.10
Rate for Payer: Hamaspik Choice Medicaid	$152.15
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$159.76
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$327.13
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$327.13
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$152.15
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$159.76

EAPG 3.18: PERCUTANEOUS INTRA-ABDOMINAL OR INTRATHORACIC VASCULAR PROCEDURES

Facility

$3,249.73

Service Code	EAPG 122
Min. Negotiated Rate	$1,481.21
Max. Negotiated Rate	$3,249.73
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,813.75
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,511.48
Rate for Payer: EmblemHealth Medicaid	$1,511.48
Rate for Payer: Galaxy Health Workers Comp	$1,481.21
Rate for Payer: Hamaspik Choice Medicaid	$1,511.48
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,587.07
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$3,249.73
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$3,249.73
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,511.48
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,587.07

EAPG 3.18: PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$5,535.17

Service Code	EAPG 265
Min. Negotiated Rate	$2,522.91
Max. Negotiated Rate	$5,535.17
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$3,089.30
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,574.47
Rate for Payer: EmblemHealth Medicaid	$2,574.47
Rate for Payer: Galaxy Health Workers Comp	$2,522.91
Rate for Payer: Hamaspik Choice Medicaid	$2,574.47
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,703.21
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$5,535.17
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$5,535.17
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,574.47
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,703.21

EAPG 3.18: PERIPHERAL AND CRANIAL NERVE DIAGNOSES

Facility

$265.75

Service Code	EAPG 527
Min. Negotiated Rate	$121.13
Max. Negotiated Rate	$265.75
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$148.32
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$123.60
Rate for Payer: EmblemHealth Medicaid	$123.60
Rate for Payer: Galaxy Health Workers Comp	$121.13
Rate for Payer: Hamaspik Choice Medicaid	$123.60
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$129.78
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$265.75
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$265.75
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$123.60
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$129.78

EAPG 3.18: PERIPHERAL AND OTHER VASCULAR DIAGNOSES

Facility

$290.65

Service Code	EAPG 596
Min. Negotiated Rate	$132.48
Max. Negotiated Rate	$290.65
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$162.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$135.19
Rate for Payer: EmblemHealth Medicaid	$135.19
Rate for Payer: Galaxy Health Workers Comp	$132.48
Rate for Payer: Hamaspik Choice Medicaid	$135.19
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$141.95
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$290.65
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$290.65
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$135.19
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.95

EAPG 3.18: PERIPHERAL AND OTHER VASCULAR RELATED INJURIES

Facility

$298.76

Service Code	EAPG 548
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$298.76
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$166.75
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$138.96
Rate for Payer: EmblemHealth Medicaid	$138.96
Rate for Payer: Galaxy Health Workers Comp	$136.18
Rate for Payer: Hamaspik Choice Medicaid	$138.96
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$145.91
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$298.76
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$298.76
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$138.96
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$145.91

EAPG 3.18: PERIPHERAL, CRANIAL, AND AUTONOMIC NERVE INJURIES

Facility

$280.74

Service Code	EAPG 545
Min. Negotiated Rate	$127.96
Max. Negotiated Rate	$280.74
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$156.69
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$130.57
Rate for Payer: EmblemHealth Medicaid	$130.57
Rate for Payer: Galaxy Health Workers Comp	$127.96
Rate for Payer: Hamaspik Choice Medicaid	$130.57
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$137.10
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$280.74
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$280.74
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$130.57
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$137.10

EAPG 3.18: PERIPHERAL VASCULAR BYPASS PROCEDURES

Facility

$4,926.27

Service Code	EAPG 123
Min. Negotiated Rate	$2,245.38
Max. Negotiated Rate	$4,926.27
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,749.46
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,291.26
Rate for Payer: EmblemHealth Medicaid	$2,291.26
Rate for Payer: Galaxy Health Workers Comp	$2,245.38
Rate for Payer: Hamaspik Choice Medicaid	$2,291.26
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,405.84
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,926.27
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,926.27
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,291.26
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,405.84

EAPG 3.18: PERSONALITY AND IMPULSE CONTROL DIAGNOSES

Facility

$254.45

Service Code	EAPG 822
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: PET SCANS

Facility

$2,882.76

Service Code	EAPG 290
Min. Negotiated Rate	$1,314.00
Max. Negotiated Rate	$2,882.76
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,608.98
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,340.82
Rate for Payer: EmblemHealth Medicaid	$1,340.82
Rate for Payer: Galaxy Health Workers Comp	$1,314.00
Rate for Payer: Hamaspik Choice Medicaid	$1,340.82
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,407.86
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$2,882.76
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$2,882.76
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,340.82
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,407.86

EAPG 3.18: PHARMACOTHERAPY BY EXTENDED INFUSION

Facility

$1,500.85

Service Code	EAPG 110
Min. Negotiated Rate	$684.08
Max. Negotiated Rate	$1,500.85
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$837.66
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$698.06
Rate for Payer: EmblemHealth Medicaid	$698.06
Rate for Payer: Galaxy Health Workers Comp	$684.08
Rate for Payer: Hamaspik Choice Medicaid	$698.06
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$732.97
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,500.85
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,500.85
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$698.06
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$732.97

EAPG 3.18: PHARMACOTHERAPY EXCEPT BY EXTENDED INFUSION

Facility

$562.09

Service Code	EAPG 111
Min. Negotiated Rate	$256.20
Max. Negotiated Rate	$562.09
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$313.71
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$261.43
Rate for Payer: EmblemHealth Medicaid	$261.43
Rate for Payer: Galaxy Health Workers Comp	$256.20
Rate for Payer: Hamaspik Choice Medicaid	$261.43
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$274.51
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$562.09
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$562.09
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$261.43
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$274.51

EAPG 3.18: PHLEBITIS

Facility

$252.29

Service Code	EAPG 597
Min. Negotiated Rate	$114.99
Max. Negotiated Rate	$252.29
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$140.81
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$117.34
Rate for Payer: EmblemHealth Medicaid	$117.34
Rate for Payer: Galaxy Health Workers Comp	$114.99
Rate for Payer: Hamaspik Choice Medicaid	$117.34
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$123.21
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$252.29
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$252.29
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$117.34
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$123.21

EAPG 3.18: PHYSICAL THERAPY

Facility

$262.40

Service Code	EAPG 271
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

Know your out-of-pocket cost for care.

All Charges