Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

6-0 VICRYL UNDYED 18" PC-3 CON

Facility

$35.02

Hospital Charge Code	4471911
Hospital Revenue Code	270
Min. Negotiated Rate	$22.76
Max. Negotiated Rate	$22.76
Rate for Payer: Cash Price	$26.26
Rate for Payer: Galaxy Health Commercial	$22.76

6-0 VICRYL UNDYED 18" PC-3 CON

Facility

$35.02

Hospital Charge Code	4471912
Hospital Revenue Code	270
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$28.02
Rate for Payer: Aetna of NY Commercial	$24.51
Rate for Payer: Aetna of NY Medicare	$16.11
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$14.01
Rate for Payer: Cash Price	$26.26
Rate for Payer: CDPHP Medicare	$12.96
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$28.02
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$28.02
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$28.02
Rate for Payer: EmblemHealth Medicaid	$28.02
Rate for Payer: EmblemHealth Medicare	$11.91
Rate for Payer: EmblemHealth Select Care	$25.21
Rate for Payer: Fidelis Medicare	$14.01
Rate for Payer: Galaxy Health Commercial	$22.76
Rate for Payer: Hamaspik Choice Medicare	$14.01
Rate for Payer: Humana Medicare	$14.01
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$24.51
Rate for Payer: Local 1199SEIU Medicare	$16.11
Rate for Payer: MVP Health Care of NY Commercial	$26.27
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$19.72
Rate for Payer: MVP Health Care of NY Medicare	$14.71
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$5.25
Rate for Payer: United Healthcare Medicare	$14.01
Rate for Payer: WellCare Medicare	$19.26

6-0 VICRYL UNDYED 18" PC-3 CON

Facility

$35.02

Hospital Charge Code	4471911
Hospital Revenue Code	270
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$28.02
Rate for Payer: Aetna of NY Commercial	$24.51
Rate for Payer: Aetna of NY Medicare	$16.11
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$14.01
Rate for Payer: Cash Price	$26.26
Rate for Payer: CDPHP Medicare	$12.96
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$28.02
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$28.02
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$28.02
Rate for Payer: EmblemHealth Medicaid	$28.02
Rate for Payer: EmblemHealth Medicare	$11.91
Rate for Payer: EmblemHealth Select Care	$25.21
Rate for Payer: Fidelis Medicare	$14.01
Rate for Payer: Galaxy Health Commercial	$22.76
Rate for Payer: Hamaspik Choice Medicare	$14.01
Rate for Payer: Humana Medicare	$14.01
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$24.51
Rate for Payer: Local 1199SEIU Medicare	$16.11
Rate for Payer: MVP Health Care of NY Commercial	$26.27
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$19.72
Rate for Payer: MVP Health Care of NY Medicare	$14.71
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$5.25
Rate for Payer: United Healthcare Medicare	$14.01
Rate for Payer: WellCare Medicare	$19.26

6-0 VICRYL UNDYED 18" PC-3 CON

Facility

$35.02

Hospital Charge Code	4471912
Hospital Revenue Code	270
Min. Negotiated Rate	$22.76
Max. Negotiated Rate	$22.76
Rate for Payer: Cash Price	$26.26
Rate for Payer: Galaxy Health Commercial	$22.76

6" 15G PERCUTANEOUS DISCECTOMY

Facility

$6,723.84

Hospital Charge Code	4471348
Hospital Revenue Code	270
Min. Negotiated Rate	$1,008.58
Max. Negotiated Rate	$5,379.07
Rate for Payer: Aetna of NY Commercial	$4,706.69
Rate for Payer: Aetna of NY Medicare	$3,092.97
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2,689.54
Rate for Payer: Cash Price	$5,042.88
Rate for Payer: CDPHP Medicare	$2,487.82
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$5,379.07
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$5,379.07
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$5,379.07
Rate for Payer: EmblemHealth Medicaid	$5,379.07
Rate for Payer: EmblemHealth Medicare	$2,286.11
Rate for Payer: EmblemHealth Select Care	$4,841.16
Rate for Payer: Fidelis Medicare	$2,689.54
Rate for Payer: Galaxy Health Commercial	$4,370.50
Rate for Payer: Hamaspik Choice Medicare	$2,689.54
Rate for Payer: Humana Medicare	$2,689.54
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4,706.69
Rate for Payer: Local 1199SEIU Medicare	$3,092.97
Rate for Payer: MVP Health Care of NY Commercial	$5,042.88
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3,785.52
Rate for Payer: MVP Health Care of NY Medicare	$2,824.01
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,008.58
Rate for Payer: United Healthcare Medicare	$2,689.54
Rate for Payer: WellCare Medicare	$3,698.11

6" 15G PERCUTANEOUS DISCECTOMY

Facility

$6,723.84

Hospital Charge Code	4471348
Hospital Revenue Code	270
Min. Negotiated Rate	$4,370.50
Max. Negotiated Rate	$4,370.50
Rate for Payer: Cash Price	$5,042.88
Rate for Payer: Galaxy Health Commercial	$4,370.50

6" 17G PERCUTANEOUS DISCECTOMY

Facility

$6,723.84

Hospital Charge Code	4471347
Hospital Revenue Code	270
Min. Negotiated Rate	$4,370.50
Max. Negotiated Rate	$4,370.50
Rate for Payer: Cash Price	$5,042.88
Rate for Payer: Galaxy Health Commercial	$4,370.50

6" 17G PERCUTANEOUS DISCECTOMY

Facility

$6,723.84

Hospital Charge Code	4471347
Hospital Revenue Code	270
Min. Negotiated Rate	$1,008.58
Max. Negotiated Rate	$5,379.07
Rate for Payer: Aetna of NY Commercial	$4,706.69
Rate for Payer: Aetna of NY Medicare	$3,092.97
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2,689.54
Rate for Payer: Cash Price	$5,042.88
Rate for Payer: CDPHP Medicare	$2,487.82
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$5,379.07
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$5,379.07
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$5,379.07
Rate for Payer: EmblemHealth Medicaid	$5,379.07
Rate for Payer: EmblemHealth Medicare	$2,286.11
Rate for Payer: EmblemHealth Select Care	$4,841.16
Rate for Payer: Fidelis Medicare	$2,689.54
Rate for Payer: Galaxy Health Commercial	$4,370.50
Rate for Payer: Hamaspik Choice Medicare	$2,689.54
Rate for Payer: Humana Medicare	$2,689.54
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4,706.69
Rate for Payer: Local 1199SEIU Medicare	$3,092.97
Rate for Payer: MVP Health Care of NY Commercial	$5,042.88
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3,785.52
Rate for Payer: MVP Health Care of NY Medicare	$2,824.01
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,008.58
Rate for Payer: United Healthcare Medicare	$2,689.54
Rate for Payer: WellCare Medicare	$3,698.11

6.5 ET TUBE CUFFED

Facility

$23.69

Hospital Charge Code	4479148
Hospital Revenue Code	270
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna of NY Commercial	$16.58
Rate for Payer: Aetna of NY Medicare	$10.90
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$9.48
Rate for Payer: Cash Price	$17.77
Rate for Payer: CDPHP Medicare	$8.77
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$18.95
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$18.95
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$18.95
Rate for Payer: EmblemHealth Medicaid	$18.95
Rate for Payer: EmblemHealth Medicare	$8.05
Rate for Payer: EmblemHealth Select Care	$17.06
Rate for Payer: Fidelis Medicare	$9.48
Rate for Payer: Galaxy Health Commercial	$15.40
Rate for Payer: Hamaspik Choice Medicare	$9.48
Rate for Payer: Humana Medicare	$9.48
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$16.58
Rate for Payer: Local 1199SEIU Medicare	$10.90
Rate for Payer: MVP Health Care of NY Commercial	$17.77
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$13.34
Rate for Payer: MVP Health Care of NY Medicare	$9.95
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3.55
Rate for Payer: United Healthcare Medicare	$9.48
Rate for Payer: WellCare Medicare	$13.03

6.5 ET TUBE CUFFED

Facility

$23.69

Hospital Charge Code	4479148
Hospital Revenue Code	270
Min. Negotiated Rate	$15.40
Max. Negotiated Rate	$15.40
Rate for Payer: Cash Price	$17.77
Rate for Payer: Galaxy Health Commercial	$15.40

6" ESMARK

Facility

$17.51

Hospital Charge Code	4471829
Hospital Revenue Code	270
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$14.01
Rate for Payer: Aetna of NY Commercial	$12.26
Rate for Payer: Aetna of NY Medicare	$8.05
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$7.00
Rate for Payer: Cash Price	$13.13
Rate for Payer: CDPHP Medicare	$6.48
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$14.01
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$14.01
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$14.01
Rate for Payer: EmblemHealth Medicaid	$14.01
Rate for Payer: EmblemHealth Medicare	$5.95
Rate for Payer: EmblemHealth Select Care	$12.61
Rate for Payer: Fidelis Medicare	$7.00
Rate for Payer: Galaxy Health Commercial	$11.38
Rate for Payer: Hamaspik Choice Medicare	$7.00
Rate for Payer: Humana Medicare	$7.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$12.26
Rate for Payer: Local 1199SEIU Medicare	$8.05
Rate for Payer: MVP Health Care of NY Commercial	$13.13
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$9.86
Rate for Payer: MVP Health Care of NY Medicare	$7.35
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.63
Rate for Payer: United Healthcare Medicare	$7.00
Rate for Payer: WellCare Medicare	$9.63

6" ESMARK

Facility

$17.51

Hospital Charge Code	4471829
Hospital Revenue Code	270
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$11.38
Rate for Payer: Cash Price	$13.13
Rate for Payer: Galaxy Health Commercial	$11.38

6" SMOOTH CAST PADDING

Facility

$13.39

Hospital Charge Code	4471794
Hospital Revenue Code	270
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$10.71
Rate for Payer: Aetna of NY Commercial	$9.37
Rate for Payer: Aetna of NY Medicare	$6.16
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$5.36
Rate for Payer: Cash Price	$10.04
Rate for Payer: CDPHP Medicare	$4.95
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$10.71
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$10.71
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$10.71
Rate for Payer: EmblemHealth Medicaid	$10.71
Rate for Payer: EmblemHealth Medicare	$4.55
Rate for Payer: EmblemHealth Select Care	$9.64
Rate for Payer: Fidelis Medicare	$5.36
Rate for Payer: Galaxy Health Commercial	$8.70
Rate for Payer: Hamaspik Choice Medicare	$5.36
Rate for Payer: Humana Medicare	$5.36
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$9.37
Rate for Payer: Local 1199SEIU Medicare	$6.16
Rate for Payer: MVP Health Care of NY Commercial	$10.04
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$7.54
Rate for Payer: MVP Health Care of NY Medicare	$5.62
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.01
Rate for Payer: United Healthcare Medicare	$5.36
Rate for Payer: WellCare Medicare	$7.36

6" SMOOTH CAST PADDING

Facility

$13.39

Hospital Charge Code	4471794
Hospital Revenue Code	270
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Cash Price	$10.04
Rate for Payer: Galaxy Health Commercial	$8.70

6" STOCKINETTE DBLE PLY STRL

Facility

$14.42

Hospital Charge Code	4471035
Hospital Revenue Code	270
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$9.37
Rate for Payer: Cash Price	$10.82
Rate for Payer: Galaxy Health Commercial	$9.37

6" STOCKINETTE DBLE PLY STRL

Facility

$14.42

Hospital Charge Code	4471035
Hospital Revenue Code	270
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$11.54
Rate for Payer: Aetna of NY Commercial	$10.09
Rate for Payer: Aetna of NY Medicare	$6.63
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$5.77
Rate for Payer: Cash Price	$10.82
Rate for Payer: CDPHP Medicare	$5.34
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$11.54
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$11.54
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$11.54
Rate for Payer: EmblemHealth Medicaid	$11.54
Rate for Payer: EmblemHealth Medicare	$4.90
Rate for Payer: EmblemHealth Select Care	$10.38
Rate for Payer: Fidelis Medicare	$5.77
Rate for Payer: Galaxy Health Commercial	$9.37
Rate for Payer: Hamaspik Choice Medicare	$5.77
Rate for Payer: Humana Medicare	$5.77
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$10.09
Rate for Payer: Local 1199SEIU Medicare	$6.63
Rate for Payer: MVP Health Care of NY Commercial	$10.81
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$8.12
Rate for Payer: MVP Health Care of NY Medicare	$6.06
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.16
Rate for Payer: United Healthcare Medicare	$5.77
Rate for Payer: WellCare Medicare	$7.93

6"X0.045" K-WIRES

Facility

$22.66

Hospital Charge Code	4471408
Hospital Revenue Code	270
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$18.13
Rate for Payer: Aetna of NY Commercial	$15.86
Rate for Payer: Aetna of NY Medicare	$10.42
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$9.06
Rate for Payer: Cash Price	$17.00
Rate for Payer: CDPHP Medicare	$8.38
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$18.13
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$18.13
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$18.13
Rate for Payer: EmblemHealth Medicaid	$18.13
Rate for Payer: EmblemHealth Medicare	$7.70
Rate for Payer: EmblemHealth Select Care	$16.32
Rate for Payer: Fidelis Medicare	$9.06
Rate for Payer: Galaxy Health Commercial	$14.73
Rate for Payer: Hamaspik Choice Medicare	$9.06
Rate for Payer: Humana Medicare	$9.06
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$15.86
Rate for Payer: Local 1199SEIU Medicare	$10.42
Rate for Payer: MVP Health Care of NY Commercial	$17.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$12.76
Rate for Payer: MVP Health Care of NY Medicare	$9.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3.40
Rate for Payer: United Healthcare Medicare	$9.06
Rate for Payer: WellCare Medicare	$12.46

6"X0.045" K-WIRES

Facility

$22.66

Hospital Charge Code	4471408
Hospital Revenue Code	270
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$14.73
Rate for Payer: Cash Price	$17.00
Rate for Payer: Galaxy Health Commercial	$14.73

6"X.035 TROCAR 1 END K-WIRE

Facility

$31.93

Hospital Charge Code	4479307
Hospital Revenue Code	278
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna of NY Commercial	$22.35
Rate for Payer: Cash Price	$23.95
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$15.96
Rate for Payer: EmblemHealth Select Care	$15.96
Rate for Payer: Galaxy Health Commercial	$20.75
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$22.35
Rate for Payer: Multiplan Commercial	$14.37
Rate for Payer: MVP Health Care of NY Commercial	$20.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$20.75
Rate for Payer: WellCare Medicare	$17.56

6"X.035 TROCAR 1 END K-WIRE

Facility

$31.93

Hospital Charge Code	4479307
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$25.54
Rate for Payer: Aetna of NY Commercial	$22.35
Rate for Payer: Aetna of NY Medicare	$14.69
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$12.77
Rate for Payer: Cash Price	$23.95
Rate for Payer: CDPHP Medicare	$11.81
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$15.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$25.54
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$25.54
Rate for Payer: EmblemHealth Medicaid	$25.54
Rate for Payer: EmblemHealth Medicare	$10.86
Rate for Payer: EmblemHealth Select Care	$15.96
Rate for Payer: Fidelis Medicare	$12.77
Rate for Payer: Galaxy Health Commercial	$20.75
Rate for Payer: Hamaspik Choice Medicare	$12.77
Rate for Payer: Humana Medicare	$12.77
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$22.35
Rate for Payer: Local 1199SEIU Medicare	$14.69
Rate for Payer: MVP Health Care of NY Commercial	$20.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$20.75
Rate for Payer: MVP Health Care of NY Medicare	$13.41
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$4.79
Rate for Payer: United Healthcare Medicare	$12.77
Rate for Payer: WellCare Medicare	$17.56

6"X.035 TROCAR 2 END K-WIRE

Facility

$31.93

Hospital Charge Code	4479306
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$25.54
Rate for Payer: Aetna of NY Commercial	$22.35
Rate for Payer: Aetna of NY Medicare	$14.69
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$12.77
Rate for Payer: Cash Price	$23.95
Rate for Payer: CDPHP Medicare	$11.81
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$15.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$25.54
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$25.54
Rate for Payer: EmblemHealth Medicaid	$25.54
Rate for Payer: EmblemHealth Medicare	$10.86
Rate for Payer: EmblemHealth Select Care	$15.96
Rate for Payer: Fidelis Medicare	$12.77
Rate for Payer: Galaxy Health Commercial	$20.75
Rate for Payer: Hamaspik Choice Medicare	$12.77
Rate for Payer: Humana Medicare	$12.77
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$22.35
Rate for Payer: Local 1199SEIU Medicare	$14.69
Rate for Payer: MVP Health Care of NY Commercial	$20.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$20.75
Rate for Payer: MVP Health Care of NY Medicare	$13.41
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$4.79
Rate for Payer: United Healthcare Medicare	$12.77
Rate for Payer: WellCare Medicare	$17.56

6"X.035 TROCAR 2 END K-WIRE

Facility

$31.93

Hospital Charge Code	4479306
Hospital Revenue Code	278
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna of NY Commercial	$22.35
Rate for Payer: Cash Price	$23.95
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$15.96
Rate for Payer: EmblemHealth Select Care	$15.96
Rate for Payer: Galaxy Health Commercial	$20.75
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$22.35
Rate for Payer: Multiplan Commercial	$14.37
Rate for Payer: MVP Health Care of NY Commercial	$20.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$20.75
Rate for Payer: WellCare Medicare	$17.56

6"X.045 TROCAR 1 END K-WIRE

Facility

$31.93

Hospital Charge Code	4479309
Hospital Revenue Code	278
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna of NY Commercial	$22.35
Rate for Payer: Cash Price	$23.95
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$15.96
Rate for Payer: EmblemHealth Select Care	$15.96
Rate for Payer: Galaxy Health Commercial	$20.75
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$22.35
Rate for Payer: Multiplan Commercial	$14.37
Rate for Payer: MVP Health Care of NY Commercial	$20.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$20.75
Rate for Payer: WellCare Medicare	$17.56

6"X.045 TROCAR 1 END K-WIRE

Facility

$31.93

Hospital Charge Code	4479309
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$25.54
Rate for Payer: Aetna of NY Commercial	$22.35
Rate for Payer: Aetna of NY Medicare	$14.69
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$12.77
Rate for Payer: Cash Price	$23.95
Rate for Payer: CDPHP Medicare	$11.81
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$15.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$25.54
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$25.54
Rate for Payer: EmblemHealth Medicaid	$25.54
Rate for Payer: EmblemHealth Medicare	$10.86
Rate for Payer: EmblemHealth Select Care	$15.96
Rate for Payer: Fidelis Medicare	$12.77
Rate for Payer: Galaxy Health Commercial	$20.75
Rate for Payer: Hamaspik Choice Medicare	$12.77
Rate for Payer: Humana Medicare	$12.77
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$22.35
Rate for Payer: Local 1199SEIU Medicare	$14.69
Rate for Payer: MVP Health Care of NY Commercial	$20.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$20.75
Rate for Payer: MVP Health Care of NY Medicare	$13.41
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$4.79
Rate for Payer: United Healthcare Medicare	$12.77
Rate for Payer: WellCare Medicare	$17.56

6"X.045 TROCAR 2 END K-WIRE

Facility

$31.93

Hospital Charge Code	4479308
Hospital Revenue Code	278
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna of NY Commercial	$22.35
Rate for Payer: Cash Price	$23.95
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$15.96
Rate for Payer: EmblemHealth Select Care	$15.96
Rate for Payer: Galaxy Health Commercial	$20.75
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$22.35
Rate for Payer: Multiplan Commercial	$14.37
Rate for Payer: MVP Health Care of NY Commercial	$20.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$20.75
Rate for Payer: WellCare Medicare	$17.56

Know your out-of-pocket cost for care.

All Charges