Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EPHEDRINE SULFATE

Facility

$127.46

Service Code	NDC 17478051500
Hospital Charge Code	4408983
Hospital Revenue Code	250
Min. Negotiated Rate	$19.12
Max. Negotiated Rate	$101.97
Rate for Payer: Aetna of NY Commercial	$89.22
Rate for Payer: Aetna of NY Medicare	$58.63
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$50.98
Rate for Payer: Cash Price	$95.60
Rate for Payer: CDPHP Medicare	$47.16
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$101.97
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$101.97
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$101.97
Rate for Payer: EmblemHealth Medicaid	$101.97
Rate for Payer: EmblemHealth Medicare	$43.34
Rate for Payer: EmblemHealth Select Care	$91.77
Rate for Payer: Fidelis Medicare	$50.98
Rate for Payer: Galaxy Health Commercial	$82.85
Rate for Payer: Hamaspik Choice Medicare	$50.98
Rate for Payer: Humana Medicare	$50.98
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$89.22
Rate for Payer: Local 1199SEIU Medicare	$58.63
Rate for Payer: MVP Health Care of NY Commercial	$95.59
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$71.76
Rate for Payer: MVP Health Care of NY Medicare	$53.53
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$19.12
Rate for Payer: United Healthcare Medicare	$50.98
Rate for Payer: WellCare Medicare	$70.10

EPIDIDYMECTOMY UNILATERAL

Facility

$10,804.00

Service Code	HCPCS 54860
Hospital Charge Code	4002057
Hospital Revenue Code	490
Min. Negotiated Rate	$1,620.60
Max. Negotiated Rate	$8,643.20
Rate for Payer: Aetna of NY Commercial	$1,900.00
Rate for Payer: Aetna of NY Medicare	$4,969.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4,321.60
Rate for Payer: Cash Price	$8,103.00
Rate for Payer: Cash Price	$8,103.00
Rate for Payer: CDPHP Medicare	$3,997.48
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$8,643.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$8,643.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$8,643.20
Rate for Payer: EmblemHealth Medicaid	$8,643.20
Rate for Payer: EmblemHealth Medicare	$3,673.36
Rate for Payer: EmblemHealth Select Care	$7,778.88
Rate for Payer: Fidelis Medicare	$4,321.60
Rate for Payer: Galaxy Health Commercial	$7,022.60
Rate for Payer: Hamaspik Choice Medicare	$4,321.60
Rate for Payer: Humana Medicare	$4,321.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,900.00
Rate for Payer: Local 1199SEIU Medicare	$4,969.84
Rate for Payer: Multiplan Commercial	$8,643.20
Rate for Payer: MVP Health Care of NY Commercial	$8,103.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$6,082.65
Rate for Payer: MVP Health Care of NY Medicare	$4,537.68
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$2,097.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,620.60
Rate for Payer: United Healthcare Commercial	$2,097.00
Rate for Payer: United Healthcare Medicare	$4,321.60
Rate for Payer: WellCare Medicare	$5,942.20

EPIDIDYMECTOMY UNILATERAL

Facility

$10,804.00

Service Code	HCPCS 54860
Hospital Charge Code	4002057
Hospital Revenue Code	490
Min. Negotiated Rate	$7,022.60
Max. Negotiated Rate	$7,022.60
Rate for Payer: Cash Price	$8,103.00
Rate for Payer: Galaxy Health Commercial	$7,022.60

EPIDURAL CATHETER HMS# 2000

Facility

$370.80

Hospital Charge Code	4479082
Hospital Revenue Code	270
Min. Negotiated Rate	$55.62
Max. Negotiated Rate	$296.64
Rate for Payer: Aetna of NY Commercial	$259.56
Rate for Payer: Aetna of NY Medicare	$170.57
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$148.32
Rate for Payer: Cash Price	$278.10
Rate for Payer: CDPHP Medicare	$137.20
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$296.64
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$296.64
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$296.64
Rate for Payer: EmblemHealth Medicaid	$296.64
Rate for Payer: EmblemHealth Medicare	$126.07
Rate for Payer: EmblemHealth Select Care	$266.98
Rate for Payer: Fidelis Medicare	$148.32
Rate for Payer: Galaxy Health Commercial	$241.02
Rate for Payer: Hamaspik Choice Medicare	$148.32
Rate for Payer: Humana Medicare	$148.32
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$259.56
Rate for Payer: Local 1199SEIU Medicare	$170.57
Rate for Payer: MVP Health Care of NY Commercial	$278.10
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$208.76
Rate for Payer: MVP Health Care of NY Medicare	$155.74
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$55.62
Rate for Payer: United Healthcare Medicare	$148.32
Rate for Payer: WellCare Medicare	$203.94

EPIDURAL CATHETER HMS# 2000

Facility

$370.80

Hospital Charge Code	4479082
Hospital Revenue Code	270
Min. Negotiated Rate	$241.02
Max. Negotiated Rate	$241.02
Rate for Payer: Cash Price	$278.10
Rate for Payer: Galaxy Health Commercial	$241.02

EPIDURAL CATHETER SET

Facility

$235.87

Hospital Charge Code	4479153
Hospital Revenue Code	270
Min. Negotiated Rate	$153.32
Max. Negotiated Rate	$153.32
Rate for Payer: Cash Price	$176.90
Rate for Payer: Galaxy Health Commercial	$153.32

EPIDURAL CATHETER SET

Facility

$235.87

Hospital Charge Code	4479153
Hospital Revenue Code	270
Min. Negotiated Rate	$35.38
Max. Negotiated Rate	$188.70
Rate for Payer: Aetna of NY Commercial	$165.11
Rate for Payer: Aetna of NY Medicare	$108.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$94.35
Rate for Payer: Cash Price	$176.90
Rate for Payer: CDPHP Medicare	$87.27
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$188.70
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$188.70
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$188.70
Rate for Payer: EmblemHealth Medicaid	$188.70
Rate for Payer: EmblemHealth Medicare	$80.20
Rate for Payer: EmblemHealth Select Care	$169.83
Rate for Payer: Fidelis Medicare	$94.35
Rate for Payer: Galaxy Health Commercial	$153.32
Rate for Payer: Hamaspik Choice Medicare	$94.35
Rate for Payer: Humana Medicare	$94.35
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$165.11
Rate for Payer: Local 1199SEIU Medicare	$108.50
Rate for Payer: MVP Health Care of NY Commercial	$176.90
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$132.79
Rate for Payer: MVP Health Care of NY Medicare	$99.07
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$35.38
Rate for Payer: United Healthcare Medicare	$94.35
Rate for Payer: WellCare Medicare	$129.73

EPISTAT NASAL CATH II

Facility

$170.98

Hospital Charge Code	4471334
Hospital Revenue Code	270
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$136.78
Rate for Payer: Aetna of NY Commercial	$119.69
Rate for Payer: Aetna of NY Medicare	$78.65
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$68.39
Rate for Payer: Cash Price	$128.23
Rate for Payer: CDPHP Medicare	$63.26
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$136.78
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$136.78
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$136.78
Rate for Payer: EmblemHealth Medicaid	$136.78
Rate for Payer: EmblemHealth Medicare	$58.13
Rate for Payer: EmblemHealth Select Care	$123.11
Rate for Payer: Fidelis Medicare	$68.39
Rate for Payer: Galaxy Health Commercial	$111.14
Rate for Payer: Hamaspik Choice Medicare	$68.39
Rate for Payer: Humana Medicare	$68.39
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$119.69
Rate for Payer: Local 1199SEIU Medicare	$78.65
Rate for Payer: MVP Health Care of NY Commercial	$128.24
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$96.26
Rate for Payer: MVP Health Care of NY Medicare	$71.81
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$25.65
Rate for Payer: United Healthcare Medicare	$68.39
Rate for Payer: WellCare Medicare	$94.04

EPISTAT NASAL CATH II

Facility

$170.98

Hospital Charge Code	4471334
Hospital Revenue Code	270
Min. Negotiated Rate	$111.14
Max. Negotiated Rate	$111.14
Rate for Payer: Cash Price	$128.23
Rate for Payer: Galaxy Health Commercial	$111.14

ER ABSORBABLE HEMOSTATE 4 X 8 INCHES

Facility

$110.21

Hospital Charge Code	4472203
Hospital Revenue Code	270
Min. Negotiated Rate	$71.64
Max. Negotiated Rate	$71.64
Rate for Payer: Cash Price	$82.66
Rate for Payer: Galaxy Health Commercial	$71.64

ER ABSORBABLE HEMOSTATE 4 X 8 INCHES

Facility

$110.21

Hospital Charge Code	4472203
Hospital Revenue Code	270
Min. Negotiated Rate	$16.53
Max. Negotiated Rate	$88.17
Rate for Payer: Aetna of NY Commercial	$77.15
Rate for Payer: Aetna of NY Medicare	$50.70
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$44.08
Rate for Payer: Cash Price	$82.66
Rate for Payer: CDPHP Medicare	$40.78
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$88.17
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$88.17
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$88.17
Rate for Payer: EmblemHealth Medicaid	$88.17
Rate for Payer: EmblemHealth Medicare	$37.47
Rate for Payer: EmblemHealth Select Care	$79.35
Rate for Payer: Fidelis Medicare	$44.08
Rate for Payer: Galaxy Health Commercial	$71.64
Rate for Payer: Hamaspik Choice Medicare	$44.08
Rate for Payer: Humana Medicare	$44.08
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$77.15
Rate for Payer: Local 1199SEIU Medicare	$50.70
Rate for Payer: MVP Health Care of NY Commercial	$82.66
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$62.05
Rate for Payer: MVP Health Care of NY Medicare	$46.29
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$16.53
Rate for Payer: United Healthcare Medicare	$44.08
Rate for Payer: WellCare Medicare	$60.62

ER ARM SLING ADULT

Facility

$15.45

Hospital Charge Code	4472162
Hospital Revenue Code	270
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$12.36
Rate for Payer: Aetna of NY Commercial	$10.81
Rate for Payer: Aetna of NY Medicare	$7.11
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$6.18
Rate for Payer: Cash Price	$11.59
Rate for Payer: CDPHP Medicare	$5.72
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$12.36
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$12.36
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$12.36
Rate for Payer: EmblemHealth Medicaid	$12.36
Rate for Payer: EmblemHealth Medicare	$5.25
Rate for Payer: EmblemHealth Select Care	$11.12
Rate for Payer: Fidelis Medicare	$6.18
Rate for Payer: Galaxy Health Commercial	$10.04
Rate for Payer: Hamaspik Choice Medicare	$6.18
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$10.81
Rate for Payer: Local 1199SEIU Medicare	$7.11
Rate for Payer: MVP Health Care of NY Commercial	$11.59
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$8.70
Rate for Payer: MVP Health Care of NY Medicare	$6.49
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.32
Rate for Payer: United Healthcare Medicare	$6.18
Rate for Payer: WellCare Medicare	$8.50

ER ARM SLING ADULT

Facility

$15.45

Hospital Charge Code	4472162
Hospital Revenue Code	270
Min. Negotiated Rate	$10.04
Max. Negotiated Rate	$10.04
Rate for Payer: Cash Price	$11.59
Rate for Payer: Galaxy Health Commercial	$10.04

ER ARM SLING CHILD

Facility

$15.45

Hospital Charge Code	4472161
Hospital Revenue Code	270
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$12.36
Rate for Payer: Aetna of NY Commercial	$10.81
Rate for Payer: Aetna of NY Medicare	$7.11
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$6.18
Rate for Payer: Cash Price	$11.59
Rate for Payer: CDPHP Medicare	$5.72
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$12.36
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$12.36
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$12.36
Rate for Payer: EmblemHealth Medicaid	$12.36
Rate for Payer: EmblemHealth Medicare	$5.25
Rate for Payer: EmblemHealth Select Care	$11.12
Rate for Payer: Fidelis Medicare	$6.18
Rate for Payer: Galaxy Health Commercial	$10.04
Rate for Payer: Hamaspik Choice Medicare	$6.18
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$10.81
Rate for Payer: Local 1199SEIU Medicare	$7.11
Rate for Payer: MVP Health Care of NY Commercial	$11.59
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$8.70
Rate for Payer: MVP Health Care of NY Medicare	$6.49
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.32
Rate for Payer: United Healthcare Medicare	$6.18
Rate for Payer: WellCare Medicare	$8.50

ER ARM SLING CHILD

Facility

$15.45

Hospital Charge Code	4472161
Hospital Revenue Code	270
Min. Negotiated Rate	$10.04
Max. Negotiated Rate	$10.04
Rate for Payer: Cash Price	$11.59
Rate for Payer: Galaxy Health Commercial	$10.04

ER CARDIOVERSION ELECTIVE EXT

Facility

$2,026.00

Service Code	HCPCS 92960
Hospital Charge Code	4600049
Hospital Revenue Code	450
Min. Negotiated Rate	$303.90
Max. Negotiated Rate	$1,620.80
Rate for Payer: Aetna of NY Commercial	$1,000.00
Rate for Payer: Aetna of NY Medicare	$931.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$810.40
Rate for Payer: Cash Price	$1,519.50
Rate for Payer: Cash Price	$1,519.50
Rate for Payer: Cash Price	$1,519.50
Rate for Payer: CDPHP Medicare	$749.62
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$1,206.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,620.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,620.80
Rate for Payer: EmblemHealth Medicaid	$1,620.80
Rate for Payer: EmblemHealth Medicare	$688.84
Rate for Payer: EmblemHealth Select Care	$1,085.00
Rate for Payer: Fidelis Medicare	$810.40
Rate for Payer: Galaxy Health Commercial	$1,316.90
Rate for Payer: Hamaspik Choice Medicare	$810.40
Rate for Payer: Humana Medicare	$810.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,000.00
Rate for Payer: Local 1199SEIU Medicare	$931.96
Rate for Payer: MVP Health Care of NY Commercial	$1,234.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$925.00
Rate for Payer: MVP Health Care of NY Medicare	$850.92
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$1,009.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$303.90
Rate for Payer: United Healthcare Commercial	$1,009.00
Rate for Payer: United Healthcare Medicare	$810.40
Rate for Payer: WellCare Medicare	$1,114.30

ER CARDIOVERSION ELECTIVE EXT

Facility

$2,026.00

Service Code	HCPCS 92960
Hospital Charge Code	4600049
Hospital Revenue Code	450
Min. Negotiated Rate	$1,316.90
Max. Negotiated Rate	$1,316.90
Rate for Payer: Cash Price	$1,519.50
Rate for Payer: Galaxy Health Commercial	$1,316.90

ER CATH FOLEY(BARD) ANY SIZE

Facility

$33.99

Hospital Charge Code	4472175
Hospital Revenue Code	270
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$27.19
Rate for Payer: Aetna of NY Commercial	$23.79
Rate for Payer: Aetna of NY Medicare	$15.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$13.60
Rate for Payer: Cash Price	$25.49
Rate for Payer: CDPHP Medicare	$12.58
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$27.19
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$27.19
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$27.19
Rate for Payer: EmblemHealth Medicaid	$27.19
Rate for Payer: EmblemHealth Medicare	$11.56
Rate for Payer: EmblemHealth Select Care	$24.47
Rate for Payer: Fidelis Medicare	$13.60
Rate for Payer: Galaxy Health Commercial	$22.09
Rate for Payer: Hamaspik Choice Medicare	$13.60
Rate for Payer: Humana Medicare	$13.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$23.79
Rate for Payer: Local 1199SEIU Medicare	$15.64
Rate for Payer: MVP Health Care of NY Commercial	$25.49
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$19.14
Rate for Payer: MVP Health Care of NY Medicare	$14.28
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$5.10
Rate for Payer: United Healthcare Medicare	$13.60
Rate for Payer: WellCare Medicare	$18.69

ER CATH FOLEY(BARD) ANY SIZE

Facility

$33.99

Hospital Charge Code	4472175
Hospital Revenue Code	270
Min. Negotiated Rate	$22.09
Max. Negotiated Rate	$22.09
Rate for Payer: Cash Price	$25.49
Rate for Payer: Galaxy Health Commercial	$22.09

ER CATH FOLEY(DOVER) ANY SIZE

Facility

$60.77

Hospital Charge Code	4472174
Hospital Revenue Code	270
Min. Negotiated Rate	$9.12
Max. Negotiated Rate	$48.62
Rate for Payer: Aetna of NY Commercial	$42.54
Rate for Payer: Aetna of NY Medicare	$27.95
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$24.31
Rate for Payer: Cash Price	$45.58
Rate for Payer: CDPHP Medicare	$22.48
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$48.62
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$48.62
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$48.62
Rate for Payer: EmblemHealth Medicaid	$48.62
Rate for Payer: EmblemHealth Medicare	$20.66
Rate for Payer: EmblemHealth Select Care	$43.75
Rate for Payer: Fidelis Medicare	$24.31
Rate for Payer: Galaxy Health Commercial	$39.50
Rate for Payer: Hamaspik Choice Medicare	$24.31
Rate for Payer: Humana Medicare	$24.31
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$42.54
Rate for Payer: Local 1199SEIU Medicare	$27.95
Rate for Payer: MVP Health Care of NY Commercial	$45.58
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$34.21
Rate for Payer: MVP Health Care of NY Medicare	$25.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$9.12
Rate for Payer: United Healthcare Medicare	$24.31
Rate for Payer: WellCare Medicare	$33.42

ER CATH FOLEY(DOVER) ANY SIZE

Facility

$60.77

Hospital Charge Code	4472174
Hospital Revenue Code	270
Min. Negotiated Rate	$39.50
Max. Negotiated Rate	$39.50
Rate for Payer: Cash Price	$45.58
Rate for Payer: Galaxy Health Commercial	$39.50

ER CATH TROCAR ANY SIZE

Facility

$51.50

Hospital Charge Code	4472173
Hospital Revenue Code	270
Min. Negotiated Rate	$33.48
Max. Negotiated Rate	$33.48
Rate for Payer: Cash Price	$38.62
Rate for Payer: Galaxy Health Commercial	$33.48

ER CATH TROCAR ANY SIZE

Facility

$51.50

Hospital Charge Code	4472173
Hospital Revenue Code	270
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$41.20
Rate for Payer: Aetna of NY Commercial	$36.05
Rate for Payer: Aetna of NY Medicare	$23.69
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$20.60
Rate for Payer: Cash Price	$38.62
Rate for Payer: CDPHP Medicare	$19.05
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$41.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$41.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$41.20
Rate for Payer: EmblemHealth Medicaid	$41.20
Rate for Payer: EmblemHealth Medicare	$17.51
Rate for Payer: EmblemHealth Select Care	$37.08
Rate for Payer: Fidelis Medicare	$20.60
Rate for Payer: Galaxy Health Commercial	$33.48
Rate for Payer: Hamaspik Choice Medicare	$20.60
Rate for Payer: Humana Medicare	$20.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$36.05
Rate for Payer: Local 1199SEIU Medicare	$23.69
Rate for Payer: MVP Health Care of NY Commercial	$38.62
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$28.99
Rate for Payer: MVP Health Care of NY Medicare	$21.63
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$7.72
Rate for Payer: United Healthcare Medicare	$20.60
Rate for Payer: WellCare Medicare	$28.32

ER CERVICAL COLLAR

Facility

$25.75

Hospital Charge Code	4472170
Hospital Revenue Code	270
Min. Negotiated Rate	$16.74
Max. Negotiated Rate	$16.74
Rate for Payer: Cash Price	$19.31
Rate for Payer: Galaxy Health Commercial	$16.74

ER CERVICAL COLLAR

Facility

$25.75

Hospital Charge Code	4472170
Hospital Revenue Code	270
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$20.60
Rate for Payer: Aetna of NY Commercial	$18.02
Rate for Payer: Aetna of NY Medicare	$11.85
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$10.30
Rate for Payer: Cash Price	$19.31
Rate for Payer: CDPHP Medicare	$9.53
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$20.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$20.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$20.60
Rate for Payer: EmblemHealth Medicaid	$20.60
Rate for Payer: EmblemHealth Medicare	$8.76
Rate for Payer: EmblemHealth Select Care	$18.54
Rate for Payer: Fidelis Medicare	$10.30
Rate for Payer: Galaxy Health Commercial	$16.74
Rate for Payer: Hamaspik Choice Medicare	$10.30
Rate for Payer: Humana Medicare	$10.30
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$18.02
Rate for Payer: Local 1199SEIU Medicare	$11.85
Rate for Payer: MVP Health Care of NY Commercial	$19.31
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$14.50
Rate for Payer: MVP Health Care of NY Medicare	$10.81
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3.86
Rate for Payer: United Healthcare Medicare	$10.30
Rate for Payer: WellCare Medicare	$14.16

Know your out-of-pocket cost for care.

All Charges