Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

1.2 MICRON FILTER EXTENTION SE

Facility

$38.11

Hospital Charge Code	4471902
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

12" PANEL BINDER 30-45"

Facility

$33.99

Hospital Charge Code	4479168
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

12" PANEL BINDER 30-45"

Facility

$33.99

Hospital Charge Code	4479168
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

12" PANEL BINDER 45-62"

Facility

$33.99

Hospital Charge Code	4479169
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

12" PANEL BINDER 45-62"

Facility

$33.99

Hospital Charge Code	4479169
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

12" PERSONAL BINDER

Facility

$33.99

Hospital Charge Code	4479170
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

12" PERSONAL BINDER

Facility

$33.99

Hospital Charge Code	4479170
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

1/3TH TUBULAR PLATE W/ COLLAR

Facility

$263.68

Hospital Charge Code	4472226
Hospital Revenue Code	278
Min. Negotiated Rate	$39.55
Max. Negotiated Rate	$210.94
Rate for Payer: Aetna of NY Commercial	$184.58
Rate for Payer: Aetna of NY Medicare	$121.29
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$105.47
Rate for Payer: Cash Price	$197.76
Rate for Payer: CDPHP Medicare	$97.56
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$131.84
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$210.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$210.94
Rate for Payer: EmblemHealth Medicaid	$210.94
Rate for Payer: EmblemHealth Medicare	$89.65
Rate for Payer: EmblemHealth Select Care	$131.84
Rate for Payer: Fidelis Medicare	$105.47
Rate for Payer: Galaxy Health Commercial	$171.39
Rate for Payer: Hamaspik Choice Medicare	$105.47
Rate for Payer: Humana Medicare	$105.47
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$184.58
Rate for Payer: Local 1199SEIU Medicare	$121.29
Rate for Payer: MVP Health Care of NY Commercial	$171.39
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$171.39
Rate for Payer: MVP Health Care of NY Medicare	$110.75
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$39.55
Rate for Payer: United Healthcare Medicare	$105.47
Rate for Payer: WellCare Medicare	$145.02

1/3TH TUBULAR PLATE W/ COLLAR

Facility

$263.68

Hospital Charge Code	4472226
Hospital Revenue Code	278
Min. Negotiated Rate	$118.66
Max. Negotiated Rate	$184.58
Rate for Payer: Aetna of NY Commercial	$184.58
Rate for Payer: Cash Price	$197.76
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$131.84
Rate for Payer: EmblemHealth Select Care	$131.84
Rate for Payer: Galaxy Health Commercial	$171.39
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$184.58
Rate for Payer: Multiplan Commercial	$118.66
Rate for Payer: MVP Health Care of NY Commercial	$171.39
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$171.39
Rate for Payer: WellCare Medicare	$145.02

14FR 23CM LOOP SUPRAPUBIC CATH

Facility

$195.70

Hospital Charge Code	4478208
Hospital Revenue Code	270
Min. Negotiated Rate	$29.36
Max. Negotiated Rate	$156.56
Rate for Payer: Aetna of NY Commercial	$136.99
Rate for Payer: Aetna of NY Medicare	$90.02
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$78.28
Rate for Payer: Cash Price	$146.77
Rate for Payer: CDPHP Medicare	$72.41
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$156.56
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$156.56
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$156.56
Rate for Payer: EmblemHealth Medicaid	$156.56
Rate for Payer: EmblemHealth Medicare	$66.54
Rate for Payer: EmblemHealth Select Care	$140.90
Rate for Payer: Fidelis Medicare	$78.28
Rate for Payer: Galaxy Health Commercial	$127.20
Rate for Payer: Hamaspik Choice Medicare	$78.28
Rate for Payer: Humana Medicare	$78.28
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$136.99
Rate for Payer: Local 1199SEIU Medicare	$90.02
Rate for Payer: MVP Health Care of NY Commercial	$146.78
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$110.18
Rate for Payer: MVP Health Care of NY Medicare	$82.19
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$29.36
Rate for Payer: United Healthcare Medicare	$78.28
Rate for Payer: WellCare Medicare	$107.64

14FR 23CM LOOP SUPRAPUBIC CATH

Facility

$195.70

Hospital Charge Code	4478208
Hospital Revenue Code	270
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$127.20
Rate for Payer: Cash Price	$146.77
Rate for Payer: Galaxy Health Commercial	$127.20

14FR COUDE CATH

Facility

$62.83

Hospital Charge Code	4471427
Hospital Revenue Code	270
Min. Negotiated Rate	$40.84
Max. Negotiated Rate	$40.84
Rate for Payer: Cash Price	$47.12
Rate for Payer: Galaxy Health Commercial	$40.84

14FR COUDE CATH

Facility

$62.83

Hospital Charge Code	4471427
Hospital Revenue Code	270
Min. Negotiated Rate	$9.42
Max. Negotiated Rate	$50.26
Rate for Payer: Aetna of NY Commercial	$43.98
Rate for Payer: Aetna of NY Medicare	$28.90
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$25.13
Rate for Payer: Cash Price	$47.12
Rate for Payer: CDPHP Medicare	$23.25
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$50.26
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$50.26
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$50.26
Rate for Payer: EmblemHealth Medicaid	$50.26
Rate for Payer: EmblemHealth Medicare	$21.36
Rate for Payer: EmblemHealth Select Care	$45.24
Rate for Payer: Fidelis Medicare	$25.13
Rate for Payer: Galaxy Health Commercial	$40.84
Rate for Payer: Hamaspik Choice Medicare	$25.13
Rate for Payer: Humana Medicare	$25.13
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$43.98
Rate for Payer: Local 1199SEIU Medicare	$28.90
Rate for Payer: MVP Health Care of NY Commercial	$47.12
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$35.37
Rate for Payer: MVP Health Care of NY Medicare	$26.39
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$9.42
Rate for Payer: United Healthcare Medicare	$25.13
Rate for Payer: WellCare Medicare	$34.56

14FR FOLEY CATHETER 8760514

Facility

$16.48

Hospital Charge Code	4479177
Hospital Revenue Code	270
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$13.18
Rate for Payer: Aetna of NY Commercial	$11.54
Rate for Payer: Aetna of NY Medicare	$7.58
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$6.59
Rate for Payer: Cash Price	$12.36
Rate for Payer: CDPHP Medicare	$6.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$13.18
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$13.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$13.18
Rate for Payer: EmblemHealth Medicaid	$13.18
Rate for Payer: EmblemHealth Medicare	$5.60
Rate for Payer: EmblemHealth Select Care	$11.87
Rate for Payer: Fidelis Medicare	$6.59
Rate for Payer: Galaxy Health Commercial	$10.71
Rate for Payer: Hamaspik Choice Medicare	$6.59
Rate for Payer: Humana Medicare	$6.59
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$11.54
Rate for Payer: Local 1199SEIU Medicare	$7.58
Rate for Payer: MVP Health Care of NY Commercial	$12.36
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$9.28
Rate for Payer: MVP Health Care of NY Medicare	$6.92
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.47
Rate for Payer: United Healthcare Medicare	$6.59
Rate for Payer: WellCare Medicare	$9.06

14FR FOLEY CATHETER 8760514

Facility

$16.48

Hospital Charge Code	4479177
Hospital Revenue Code	270
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$10.71
Rate for Payer: Cash Price	$12.36
Rate for Payer: Galaxy Health Commercial	$10.71

1.4 K-WIRE

Facility

$109.18

Hospital Charge Code	4471232
Hospital Revenue Code	270
Min. Negotiated Rate	$70.97
Max. Negotiated Rate	$70.97
Rate for Payer: Cash Price	$81.89
Rate for Payer: Galaxy Health Commercial	$70.97

1.4 K-WIRE

Facility

$109.18

Hospital Charge Code	4471232
Hospital Revenue Code	270
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$87.34
Rate for Payer: Aetna of NY Commercial	$76.43
Rate for Payer: Aetna of NY Medicare	$50.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$43.67
Rate for Payer: Cash Price	$81.89
Rate for Payer: CDPHP Medicare	$40.40
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$87.34
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$87.34
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$87.34
Rate for Payer: EmblemHealth Medicaid	$87.34
Rate for Payer: EmblemHealth Medicare	$37.12
Rate for Payer: EmblemHealth Select Care	$78.61
Rate for Payer: Fidelis Medicare	$43.67
Rate for Payer: Galaxy Health Commercial	$70.97
Rate for Payer: Hamaspik Choice Medicare	$43.67
Rate for Payer: Humana Medicare	$43.67
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$76.43
Rate for Payer: Local 1199SEIU Medicare	$50.22
Rate for Payer: MVP Health Care of NY Commercial	$81.89
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$61.47
Rate for Payer: MVP Health Care of NY Medicare	$45.86
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$16.38
Rate for Payer: United Healthcare Medicare	$43.67
Rate for Payer: WellCare Medicare	$60.05

15G HYDROMARK COIL 3 TITANIUM - COIL SHAPE

Facility

$344.02

Service Code	HCPCS A4648
Hospital Charge Code	4470951
Hospital Revenue Code	278
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$275.22
Rate for Payer: Aetna of NY Commercial	$240.81
Rate for Payer: Aetna of NY Medicare	$158.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$137.61
Rate for Payer: Cash Price	$258.02
Rate for Payer: CDPHP Medicare	$127.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$172.01
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$275.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$275.22
Rate for Payer: EmblemHealth Medicaid	$275.22
Rate for Payer: EmblemHealth Medicare	$116.97
Rate for Payer: EmblemHealth Select Care	$172.01
Rate for Payer: Fidelis Medicare	$137.61
Rate for Payer: Galaxy Health Commercial	$223.61
Rate for Payer: Hamaspik Choice Medicare	$137.61
Rate for Payer: Humana Medicare	$137.61
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$240.81
Rate for Payer: Local 1199SEIU Medicare	$158.25
Rate for Payer: MVP Health Care of NY Commercial	$223.61
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$223.61
Rate for Payer: MVP Health Care of NY Medicare	$144.49
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$51.60
Rate for Payer: United Healthcare Medicare	$137.61
Rate for Payer: WellCare Medicare	$189.21

15G HYDROMARK COIL 3 TITANIUM - COIL SHAPE

Facility

$344.02

Service Code	HCPCS A4648
Hospital Charge Code	4470951
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$240.81
Rate for Payer: Aetna of NY Commercial	$240.81
Rate for Payer: Cash Price	$258.02
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$172.01
Rate for Payer: EmblemHealth Select Care	$172.01
Rate for Payer: Galaxy Health Commercial	$223.61
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$240.81
Rate for Payer: Multiplan Commercial	$154.81
Rate for Payer: MVP Health Care of NY Commercial	$223.61
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$223.61
Rate for Payer: WellCare Medicare	$189.21

15G HYDROMARK COIL 4 TITANIUM

Facility

$344.02

Service Code	HCPCS A4648
Hospital Charge Code	4470952
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$240.81
Rate for Payer: Aetna of NY Commercial	$240.81
Rate for Payer: Cash Price	$258.02
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$172.01
Rate for Payer: EmblemHealth Select Care	$172.01
Rate for Payer: Galaxy Health Commercial	$223.61
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$240.81
Rate for Payer: Multiplan Commercial	$154.81
Rate for Payer: MVP Health Care of NY Commercial	$223.61
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$223.61
Rate for Payer: WellCare Medicare	$189.21

15G HYDROMARK COIL 4 TITANIUM

Facility

$344.02

Service Code	HCPCS A4648
Hospital Charge Code	4470952
Hospital Revenue Code	278
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$275.22
Rate for Payer: Aetna of NY Commercial	$240.81
Rate for Payer: Aetna of NY Medicare	$158.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$137.61
Rate for Payer: Cash Price	$258.02
Rate for Payer: CDPHP Medicare	$127.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$172.01
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$275.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$275.22
Rate for Payer: EmblemHealth Medicaid	$275.22
Rate for Payer: EmblemHealth Medicare	$116.97
Rate for Payer: EmblemHealth Select Care	$172.01
Rate for Payer: Fidelis Medicare	$137.61
Rate for Payer: Galaxy Health Commercial	$223.61
Rate for Payer: Hamaspik Choice Medicare	$137.61
Rate for Payer: Humana Medicare	$137.61
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$240.81
Rate for Payer: Local 1199SEIU Medicare	$158.25
Rate for Payer: MVP Health Care of NY Commercial	$223.61
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$223.61
Rate for Payer: MVP Health Care of NY Medicare	$144.49
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$51.60
Rate for Payer: United Healthcare Medicare	$137.61
Rate for Payer: WellCare Medicare	$189.21

15X7MM OSCILLATING BLADES

Facility

$35.02

Hospital Charge Code	4471197
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

15X7MM OSCILLATING BLADES

Facility

$35.02

Hospital Charge Code	4471197
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

16FR FOLEY CATHETER 8760516

Facility

$16.48

Hospital Charge Code	4479178
Hospital Revenue Code	270
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$10.71
Rate for Payer: Cash Price	$12.36
Rate for Payer: Galaxy Health Commercial	$10.71

16FR FOLEY CATHETER 8760516

Facility

$16.48

Hospital Charge Code	4479178
Hospital Revenue Code	270
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$13.18
Rate for Payer: Aetna of NY Commercial	$11.54
Rate for Payer: Aetna of NY Medicare	$7.58
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$6.59
Rate for Payer: Cash Price	$12.36
Rate for Payer: CDPHP Medicare	$6.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$13.18
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$13.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$13.18
Rate for Payer: EmblemHealth Medicaid	$13.18
Rate for Payer: EmblemHealth Medicare	$5.60
Rate for Payer: EmblemHealth Select Care	$11.87
Rate for Payer: Fidelis Medicare	$6.59
Rate for Payer: Galaxy Health Commercial	$10.71
Rate for Payer: Hamaspik Choice Medicare	$6.59
Rate for Payer: Humana Medicare	$6.59
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$11.54
Rate for Payer: Local 1199SEIU Medicare	$7.58
Rate for Payer: MVP Health Care of NY Commercial	$12.36
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$9.28
Rate for Payer: MVP Health Care of NY Medicare	$6.92
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.47
Rate for Payer: United Healthcare Medicare	$6.59
Rate for Payer: WellCare Medicare	$9.06

Know your out-of-pocket cost for care.

All Charges