Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: THERAPEUTIC NUCLEAR MEDICINE

Facility

$815.96

Service Code	EAPG 340
Min. Negotiated Rate	$371.91
Max. Negotiated Rate	$815.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$455.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$379.51
Rate for Payer: EmblemHealth Medicaid	$379.51
Rate for Payer: Galaxy Health Workers Comp	$371.91
Rate for Payer: Hamaspik Choice Medicaid	$379.51
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$398.49
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$815.96
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$815.96
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$379.51
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$398.49

EAPG 3.18: THORACENTESIS, RELATED BIOPSY AND PLEURAL DRAINAGE PROCEDURES

Facility

$1,264.51

Service Code	EAPG 68
Min. Negotiated Rate	$576.36
Max. Negotiated Rate	$1,264.51
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$705.75
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$588.14
Rate for Payer: EmblemHealth Medicaid	$588.14
Rate for Payer: Galaxy Health Workers Comp	$576.36
Rate for Payer: Hamaspik Choice Medicaid	$588.14
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$617.55
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,264.51
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,264.51
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$588.14
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$617.55

EAPG 3.18: THROMBOLYSIS

Facility

$440.09

Service Code	EAPG 95
Min. Negotiated Rate	$200.59
Max. Negotiated Rate	$440.09
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$245.63
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$204.69
Rate for Payer: EmblemHealth Medicaid	$204.69
Rate for Payer: Galaxy Health Workers Comp	$200.59
Rate for Payer: Hamaspik Choice Medicaid	$204.69
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$214.93
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$440.09
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$440.09
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$204.69
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$214.93

EAPG 3.18: THYROID AND PARATHYROID DIAGNOSES

Facility

$263.06

Service Code	EAPG 696
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$263.06
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$146.82
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$122.35
Rate for Payer: EmblemHealth Medicaid	$122.35
Rate for Payer: Galaxy Health Workers Comp	$119.90
Rate for Payer: Hamaspik Choice Medicaid	$122.35
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$128.47
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$263.06
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$263.06
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$122.35
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$128.47

EAPG 3.18: THYROID AND PARATHYROID PROCEDURES

Facility

$6,127.39

Service Code	EAPG 263
Min. Negotiated Rate	$2,792.84
Max. Negotiated Rate	$6,127.39
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$3,419.83
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$2,849.92
Rate for Payer: EmblemHealth Medicaid	$2,849.92
Rate for Payer: Galaxy Health Workers Comp	$2,792.84
Rate for Payer: Hamaspik Choice Medicaid	$2,849.92
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,992.44
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$6,127.39
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$6,127.39
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,849.92
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,992.44

EAPG 3.18: TONSIL AND ADENOID PROCEDURES

Facility

$3,025.49

Service Code	EAPG 256
Min. Negotiated Rate	$1,379.01
Max. Negotiated Rate	$3,025.49
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,688.59
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,407.19
Rate for Payer: EmblemHealth Medicaid	$1,407.19
Rate for Payer: Galaxy Health Workers Comp	$1,379.01
Rate for Payer: Hamaspik Choice Medicaid	$1,407.19
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,477.56
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$3,025.49
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$3,025.49
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,407.19
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,477.56

EAPG 3.18: TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$300.84

Service Code	EAPG 854
Min. Negotiated Rate	$137.12
Max. Negotiated Rate	$300.84
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$167.90
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$139.92
Rate for Payer: EmblemHealth Medicaid	$139.92
Rate for Payer: Galaxy Health Workers Comp	$137.12
Rate for Payer: Hamaspik Choice Medicaid	$139.92
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$146.92
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$300.84
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$300.84
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$139.92
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$146.92

EAPG 3.18: TOXICOLOGY TESTS

Facility

$41.06

Service Code	EAPG 404
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$41.06
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$22.92
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$19.10
Rate for Payer: EmblemHealth Medicaid	$19.10
Rate for Payer: Galaxy Health Workers Comp	$18.72
Rate for Payer: Hamaspik Choice Medicaid	$19.10
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$20.05
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$41.06
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$41.06
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$19.10
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$20.05

EAPG 3.18: TRACHEOSTOMY AND RELATED TRACHEAL PROCEDURES

Facility

$4,185.26

Service Code	EAPG 72
Min. Negotiated Rate	$1,907.63
Max. Negotiated Rate	$4,185.26
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,335.89
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,946.61
Rate for Payer: EmblemHealth Medicaid	$1,946.61
Rate for Payer: Galaxy Health Workers Comp	$1,907.63
Rate for Payer: Hamaspik Choice Medicaid	$1,946.61
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,043.96
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,185.26
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,185.26
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,946.61
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,043.96

EAPG 3.18: TRANSIENT ISCHEMIA

Facility

$255.83

Service Code	EAPG 526
Min. Negotiated Rate	$116.61
Max. Negotiated Rate	$255.83
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$142.78
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$118.99
Rate for Payer: EmblemHealth Medicaid	$118.99
Rate for Payer: Galaxy Health Workers Comp	$116.61
Rate for Payer: Hamaspik Choice Medicaid	$118.99
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$124.94
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$255.83
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$255.83
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$118.99
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$124.94

EAPG 3.18: TRAUMATIC INJURIES

Facility

$314.60

Service Code	EAPG 568
Min. Negotiated Rate	$143.39
Max. Negotiated Rate	$314.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$175.58
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$146.32
Rate for Payer: EmblemHealth Medicaid	$146.32
Rate for Payer: Galaxy Health Workers Comp	$143.39
Rate for Payer: Hamaspik Choice Medicaid	$146.32
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$153.64
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$314.60
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$314.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$146.32
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$153.64

EAPG 3.18: TUBE REPLACEMENT, REVISION OR REMOVAL

Facility

$752.58

Service Code	EAPG 421
Min. Negotiated Rate	$343.02
Max. Negotiated Rate	$752.58
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$420.03
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$350.03
Rate for Payer: EmblemHealth Medicaid	$350.03
Rate for Payer: Galaxy Health Workers Comp	$343.02
Rate for Payer: Hamaspik Choice Medicaid	$350.03
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$367.54
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$752.58
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$752.58
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$350.03
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$367.54

EAPG 3.18: ULTRASOUND GUIDANCE

Facility

$444.13

Service Code	EAPG 472
Min. Negotiated Rate	$202.43
Max. Negotiated Rate	$444.13
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$247.88
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$206.57
Rate for Payer: EmblemHealth Medicaid	$206.57
Rate for Payer: Galaxy Health Workers Comp	$202.43
Rate for Payer: Hamaspik Choice Medicaid	$206.57
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$216.90
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$444.13
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$444.13
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$206.57
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$216.90

EAPG 3.18: URINALYSIS

Facility

$22.88

Service Code	EAPG 410
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$22.88
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$12.77
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$10.64
Rate for Payer: EmblemHealth Medicaid	$10.64
Rate for Payer: Galaxy Health Workers Comp	$10.43
Rate for Payer: Hamaspik Choice Medicaid	$10.64
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$11.17
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$22.88
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$22.88
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$10.64
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$11.17

EAPG 3.18: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$293.65

Service Code	EAPG 724
Min. Negotiated Rate	$133.85
Max. Negotiated Rate	$293.65
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$163.89
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$136.58
Rate for Payer: EmblemHealth Medicaid	$136.58
Rate for Payer: Galaxy Health Workers Comp	$133.85
Rate for Payer: Hamaspik Choice Medicaid	$136.58
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$143.41
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$293.65
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$293.65
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$136.58
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$143.41

EAPG 3.18: URINARY STUDIES AND PROCEDURES

Facility

$891.68

Service Code	EAPG 161
Min. Negotiated Rate	$406.42
Max. Negotiated Rate	$891.68
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$497.66
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$414.73
Rate for Payer: EmblemHealth Medicaid	$414.73
Rate for Payer: Galaxy Health Workers Comp	$406.42
Rate for Payer: Hamaspik Choice Medicaid	$414.73
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$435.47
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$891.68
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$891.68
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$414.73
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$435.47

EAPG 3.18: VACCINE ADMINISTRATION

Facility

$31.79

Service Code	EAPG 459
Min. Negotiated Rate	$14.49
Max. Negotiated Rate	$31.79
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$17.74
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$14.78
Rate for Payer: EmblemHealth Medicaid	$14.78
Rate for Payer: Galaxy Health Workers Comp	$14.49
Rate for Payer: Hamaspik Choice Medicaid	$14.78
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$15.52
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$31.79
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$31.79
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$14.78
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$15.52

EAPG 3.18: VAGINAL DELIVERY PROCEDURES

Facility

$4,193.02

Service Code	EAPG 195
Min. Negotiated Rate	$1,911.17
Max. Negotiated Rate	$4,193.02
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,340.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,950.22
Rate for Payer: EmblemHealth Medicaid	$1,950.22
Rate for Payer: Galaxy Health Workers Comp	$1,911.17
Rate for Payer: Hamaspik Choice Medicaid	$1,950.22
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$2,047.75
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,193.02
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,193.02
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,950.22
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,047.75

EAPG 3.18: VASCULAR ACCESS BY NEEDLE OR CATHETER

Facility

$399.08

Service Code	EAPG 423
Min. Negotiated Rate	$181.90
Max. Negotiated Rate	$399.08
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$222.74
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$185.62
Rate for Payer: EmblemHealth Medicaid	$185.62
Rate for Payer: Galaxy Health Workers Comp	$181.90
Rate for Payer: Hamaspik Choice Medicaid	$185.62
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$194.90
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$399.08
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$399.08
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$185.62
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$194.90

EAPG 3.18: VENTILATION ASSISTANCE AND MANAGEMENT

Facility

$394.62

Service Code	EAPG 67
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: VERTIGINOUS DIAGNOSES EXCEPT FOR BENIGN VERTIGO

Facility

$290.38

Service Code	EAPG 561
Min. Negotiated Rate	$132.36
Max. Negotiated Rate	$290.38
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$162.07
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$135.06
Rate for Payer: EmblemHealth Medicaid	$135.06
Rate for Payer: Galaxy Health Workers Comp	$132.36
Rate for Payer: Hamaspik Choice Medicaid	$135.06
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$141.81
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$290.38
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$290.38
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$135.06
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.81

EAPG 3.18: VIRAL ILLNESS

Facility

$272.36

Service Code	EAPG 808
Min. Negotiated Rate	$124.14
Max. Negotiated Rate	$272.36
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$152.01
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$126.68
Rate for Payer: EmblemHealth Medicaid	$126.68
Rate for Payer: Galaxy Health Workers Comp	$124.14
Rate for Payer: Hamaspik Choice Medicaid	$126.68
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$133.01
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$272.36
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$272.36
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$126.68
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$133.01

EAPG 3.18: VIRAL MENINGITIS

Facility

$307.87

Service Code	EAPG 812
Min. Negotiated Rate	$140.33
Max. Negotiated Rate	$307.87
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$171.83
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$143.19
Rate for Payer: EmblemHealth Medicaid	$143.19
Rate for Payer: Galaxy Health Workers Comp	$140.33
Rate for Payer: Hamaspik Choice Medicaid	$143.19
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$150.36
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$307.87
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$307.87
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$143.19
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$150.36

EASY CAP CO2 DETECTOR

Facility

$38.11

Hospital Charge Code	4479167
Hospital Revenue Code	270
Min. Negotiated Rate	$24.77
Max. Negotiated Rate	$24.77
Rate for Payer: Cash Price	$28.58
Rate for Payer: Galaxy Health Commercial	$24.77

EASY CAP CO2 DETECTOR

Facility

$38.11

Hospital Charge Code	4479167
Hospital Revenue Code	270
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$30.49
Rate for Payer: Aetna of NY Commercial	$26.68
Rate for Payer: Aetna of NY Medicare	$17.53
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$15.24
Rate for Payer: Cash Price	$28.58
Rate for Payer: CDPHP Medicare	$14.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$30.49
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$30.49
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$30.49
Rate for Payer: EmblemHealth Medicaid	$30.49
Rate for Payer: EmblemHealth Medicare	$12.96
Rate for Payer: EmblemHealth Select Care	$27.44
Rate for Payer: Fidelis Medicare	$15.24
Rate for Payer: Galaxy Health Commercial	$24.77
Rate for Payer: Hamaspik Choice Medicare	$15.24
Rate for Payer: Humana Medicare	$15.24
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$26.68
Rate for Payer: Local 1199SEIU Medicare	$17.53
Rate for Payer: MVP Health Care of NY Commercial	$28.58
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$21.46
Rate for Payer: MVP Health Care of NY Medicare	$16.01
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$5.72
Rate for Payer: United Healthcare Medicare	$15.24
Rate for Payer: WellCare Medicare	$20.96

Know your out-of-pocket cost for care.

All Charges