Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

NANO SCISSOR (AR-10915D-1)

Facility

$841.51

Hospital Charge Code	4473026
Hospital Revenue Code	272
Min. Negotiated Rate	$546.98
Max. Negotiated Rate	$546.98
Rate for Payer: Cash Price	$631.13
Rate for Payer: Galaxy Health Commercial	$546.98

NANO SCISSOR (AR-10915D-1)

Facility

$841.51

Hospital Charge Code	4473026
Hospital Revenue Code	272
Min. Negotiated Rate	$126.23
Max. Negotiated Rate	$673.21
Rate for Payer: Aetna of NY Commercial	$589.06
Rate for Payer: Aetna of NY Medicare	$387.09
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$336.60
Rate for Payer: Cash Price	$631.13
Rate for Payer: CDPHP Medicare	$311.36
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$673.21
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$673.21
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$673.21
Rate for Payer: EmblemHealth Medicaid	$673.21
Rate for Payer: EmblemHealth Medicare	$286.11
Rate for Payer: EmblemHealth Select Care	$605.89
Rate for Payer: Fidelis Medicare	$336.60
Rate for Payer: Galaxy Health Commercial	$546.98
Rate for Payer: Hamaspik Choice Medicare	$336.60
Rate for Payer: Humana Medicare	$336.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$589.06
Rate for Payer: Local 1199SEIU Medicare	$387.09
Rate for Payer: MVP Health Care of NY Commercial	$631.13
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$473.77
Rate for Payer: MVP Health Care of NY Medicare	$353.43
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$126.23
Rate for Payer: United Healthcare Medicare	$336.60
Rate for Payer: WellCare Medicare	$462.83

NANOSCOPE HANDPIECE (AR-3210-0040)

Facility

$206.00

Hospital Charge Code	4473027
Hospital Revenue Code	272
Min. Negotiated Rate	$133.90
Max. Negotiated Rate	$133.90
Rate for Payer: Cash Price	$154.50
Rate for Payer: Galaxy Health Commercial	$133.90

NANOSCOPE HANDPIECE (AR-3210-0040)

Facility

$206.00

Hospital Charge Code	4473027
Hospital Revenue Code	272
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$164.80
Rate for Payer: Aetna of NY Commercial	$144.20
Rate for Payer: Aetna of NY Medicare	$94.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$82.40
Rate for Payer: Cash Price	$154.50
Rate for Payer: CDPHP Medicare	$76.22
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$164.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$164.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$164.80
Rate for Payer: EmblemHealth Medicaid	$164.80
Rate for Payer: EmblemHealth Medicare	$70.04
Rate for Payer: EmblemHealth Select Care	$148.32
Rate for Payer: Fidelis Medicare	$82.40
Rate for Payer: Galaxy Health Commercial	$133.90
Rate for Payer: Hamaspik Choice Medicare	$82.40
Rate for Payer: Humana Medicare	$82.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$144.20
Rate for Payer: Local 1199SEIU Medicare	$94.76
Rate for Payer: MVP Health Care of NY Commercial	$154.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$115.98
Rate for Payer: MVP Health Care of NY Medicare	$86.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$30.90
Rate for Payer: United Healthcare Medicare	$82.40
Rate for Payer: WellCare Medicare	$113.30

NAPROXEN 500MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 63739040310
Hospital Charge Code	4400542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$4.94
Rate for Payer: Aetna of NY Commercial	$4.33
Rate for Payer: Aetna of NY Medicare	$2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2.47
Rate for Payer: Cash Price	$4.64
Rate for Payer: CDPHP Medicare	$2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4.94
Rate for Payer: EmblemHealth Medicaid	$4.94
Rate for Payer: EmblemHealth Medicare	$2.10
Rate for Payer: EmblemHealth Select Care	$4.45
Rate for Payer: Fidelis Medicare	$2.47
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: Hamaspik Choice Medicare	$2.47
Rate for Payer: Humana Medicare	$2.47
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.33
Rate for Payer: Local 1199SEIU Medicare	$2.84
Rate for Payer: MVP Health Care of NY Commercial	$4.63
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3.48
Rate for Payer: MVP Health Care of NY Medicare	$2.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.93
Rate for Payer: United Healthcare Medicare	$2.47
Rate for Payer: WellCare Medicare	$3.40

NAPROXEN 500MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 63739040310
Hospital Charge Code	4400542
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$4.02
Rate for Payer: Cash Price	$4.64
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: WellCare Medicare	$3.40

NASOPHARYNGE AIRWAY 6.0

Facility

$10.30

Hospital Charge Code	4471216
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$8.24
Rate for Payer: Aetna of NY Commercial	$7.21
Rate for Payer: Aetna of NY Medicare	$4.74
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4.12
Rate for Payer: Cash Price	$7.72
Rate for Payer: CDPHP Medicare	$3.81
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$8.24
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$8.24
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$8.24
Rate for Payer: EmblemHealth Medicaid	$8.24
Rate for Payer: EmblemHealth Medicare	$3.50
Rate for Payer: EmblemHealth Select Care	$7.42
Rate for Payer: Fidelis Medicare	$4.12
Rate for Payer: Galaxy Health Commercial	$6.70
Rate for Payer: Hamaspik Choice Medicare	$4.12
Rate for Payer: Humana Medicare	$4.12
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$7.21
Rate for Payer: Local 1199SEIU Medicare	$4.74
Rate for Payer: MVP Health Care of NY Commercial	$7.72
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$5.80
Rate for Payer: MVP Health Care of NY Medicare	$4.33
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.54
Rate for Payer: United Healthcare Medicare	$4.12
Rate for Payer: WellCare Medicare	$5.67

NASOPHARYNGE AIRWAY 6.0

Facility

$10.30

Hospital Charge Code	4471216
Hospital Revenue Code	270
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$6.70
Rate for Payer: Cash Price	$7.72
Rate for Payer: Galaxy Health Commercial	$6.70

NASOPHARYNGE AIRWAY 7.0

Facility

$11.33

Hospital Charge Code	4471217
Hospital Revenue Code	270
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$7.36
Rate for Payer: Cash Price	$8.50
Rate for Payer: Galaxy Health Commercial	$7.36

NASOPHARYNGE AIRWAY 7.0

Facility

$11.33

Hospital Charge Code	4471217
Hospital Revenue Code	270
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$9.06
Rate for Payer: Aetna of NY Commercial	$7.93
Rate for Payer: Aetna of NY Medicare	$5.21
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4.53
Rate for Payer: Cash Price	$8.50
Rate for Payer: CDPHP Medicare	$4.19
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$9.06
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$9.06
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$9.06
Rate for Payer: EmblemHealth Medicaid	$9.06
Rate for Payer: EmblemHealth Medicare	$3.85
Rate for Payer: EmblemHealth Select Care	$8.16
Rate for Payer: Fidelis Medicare	$4.53
Rate for Payer: Galaxy Health Commercial	$7.36
Rate for Payer: Hamaspik Choice Medicare	$4.53
Rate for Payer: Humana Medicare	$4.53
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$7.93
Rate for Payer: Local 1199SEIU Medicare	$5.21
Rate for Payer: MVP Health Care of NY Commercial	$8.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$6.38
Rate for Payer: MVP Health Care of NY Medicare	$4.76
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.70
Rate for Payer: United Healthcare Medicare	$4.53
Rate for Payer: WellCare Medicare	$6.23

NASOPHARYNGE AIRWAY 8.0

Facility

$10.30

Hospital Charge Code	4471219
Hospital Revenue Code	270
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$6.70
Rate for Payer: Cash Price	$7.72
Rate for Payer: Galaxy Health Commercial	$6.70

NASOPHARYNGE AIRWAY 8.0

Facility

$10.30

Hospital Charge Code	4471219
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$8.24
Rate for Payer: Aetna of NY Commercial	$7.21
Rate for Payer: Aetna of NY Medicare	$4.74
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4.12
Rate for Payer: Cash Price	$7.72
Rate for Payer: CDPHP Medicare	$3.81
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$8.24
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$8.24
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$8.24
Rate for Payer: EmblemHealth Medicaid	$8.24
Rate for Payer: EmblemHealth Medicare	$3.50
Rate for Payer: EmblemHealth Select Care	$7.42
Rate for Payer: Fidelis Medicare	$4.12
Rate for Payer: Galaxy Health Commercial	$6.70
Rate for Payer: Hamaspik Choice Medicare	$4.12
Rate for Payer: Humana Medicare	$4.12
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$7.21
Rate for Payer: Local 1199SEIU Medicare	$4.74
Rate for Payer: MVP Health Care of NY Commercial	$7.72
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$5.80
Rate for Payer: MVP Health Care of NY Medicare	$4.33
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.54
Rate for Payer: United Healthcare Medicare	$4.12
Rate for Payer: WellCare Medicare	$5.67

NATRIURETIC PEPTIDE

Facility

$443.00

Service Code	HCPCS 83880
Hospital Charge Code	4301126
Hospital Revenue Code	300
Min. Negotiated Rate	$66.45
Max. Negotiated Rate	$354.40
Rate for Payer: Aetna of NY Commercial	$287.95
Rate for Payer: Aetna of NY Medicare	$203.78
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$177.20
Rate for Payer: Cash Price	$332.25
Rate for Payer: CDPHP Medicare	$163.91
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$265.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$354.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$354.40
Rate for Payer: EmblemHealth Medicaid	$354.40
Rate for Payer: EmblemHealth Medicare	$150.62
Rate for Payer: EmblemHealth Select Care	$265.80
Rate for Payer: Fidelis Medicare	$177.20
Rate for Payer: Galaxy Health Commercial	$287.95
Rate for Payer: Hamaspik Choice Medicare	$177.20
Rate for Payer: Humana Medicare	$177.20
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$287.95
Rate for Payer: Local 1199SEIU Medicare	$203.78
Rate for Payer: MVP Health Care of NY Commercial	$332.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$249.41
Rate for Payer: MVP Health Care of NY Medicare	$186.06
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$332.25
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$66.45
Rate for Payer: United Healthcare Commercial	$332.25
Rate for Payer: United Healthcare Medicare	$177.20
Rate for Payer: WellCare Medicare	$243.65

NATRIURETIC PEPTIDE

Facility

$443.00

Service Code	HCPCS 83880
Hospital Charge Code	4301126
Hospital Revenue Code	300
Min. Negotiated Rate	$287.95
Max. Negotiated Rate	$287.95
Rate for Payer: Cash Price	$332.25
Rate for Payer: Galaxy Health Commercial	$287.95

N-AUTOM URINALYS WO MICRO

Facility

$10.00

Service Code	HCPCS 81002
Hospital Charge Code	4300810
Hospital Revenue Code	300
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$6.50
Rate for Payer: Cash Price	$7.50
Rate for Payer: Galaxy Health Commercial	$6.50

N-AUTOM URINALYS WO MICRO

Facility

$10.00

Service Code	HCPCS 81002
Hospital Charge Code	4300810
Hospital Revenue Code	300
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna of NY Commercial	$6.50
Rate for Payer: Aetna of NY Medicare	$4.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4.00
Rate for Payer: Cash Price	$7.50
Rate for Payer: CDPHP Medicare	$3.70
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$6.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$8.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$8.00
Rate for Payer: EmblemHealth Medicaid	$8.00
Rate for Payer: EmblemHealth Medicare	$3.40
Rate for Payer: EmblemHealth Select Care	$6.00
Rate for Payer: Fidelis Medicare	$4.00
Rate for Payer: Galaxy Health Commercial	$6.50
Rate for Payer: Hamaspik Choice Medicare	$4.00
Rate for Payer: Humana Medicare	$4.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$6.50
Rate for Payer: Local 1199SEIU Medicare	$4.60
Rate for Payer: MVP Health Care of NY Commercial	$7.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$5.63
Rate for Payer: MVP Health Care of NY Medicare	$4.20
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$7.50
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.50
Rate for Payer: United Healthcare Commercial	$7.50
Rate for Payer: United Healthcare Medicare	$4.00
Rate for Payer: WellCare Medicare	$5.50

N BLOCK INJ PLANTAR DIGIT

Facility

$941.00

Service Code	HCPCS 64455
Hospital Charge Code	4850663
Hospital Revenue Code	761
Min. Negotiated Rate	$611.65
Max. Negotiated Rate	$611.65
Rate for Payer: Cash Price	$705.75
Rate for Payer: Galaxy Health Commercial	$611.65

N BLOCK INJ PLANTAR DIGIT

Facility

$941.00

Service Code	HCPCS 64455
Hospital Charge Code	4850663
Hospital Revenue Code	761
Min. Negotiated Rate	$141.15
Max. Negotiated Rate	$752.80
Rate for Payer: Aetna of NY Commercial	$658.70
Rate for Payer: Aetna of NY Medicare	$432.86
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$376.40
Rate for Payer: Cash Price	$705.75
Rate for Payer: CDPHP Medicare	$348.17
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$752.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$752.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$752.80
Rate for Payer: EmblemHealth Medicaid	$752.80
Rate for Payer: EmblemHealth Medicare	$319.94
Rate for Payer: EmblemHealth Select Care	$677.52
Rate for Payer: Fidelis Medicare	$376.40
Rate for Payer: Galaxy Health Commercial	$611.65
Rate for Payer: Hamaspik Choice Medicare	$376.40
Rate for Payer: Humana Medicare	$376.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$658.70
Rate for Payer: Local 1199SEIU Medicare	$432.86
Rate for Payer: MVP Health Care of NY Commercial	$705.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$529.78
Rate for Payer: MVP Health Care of NY Medicare	$395.22
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$141.15
Rate for Payer: United Healthcare Medicare	$376.40
Rate for Payer: WellCare Medicare	$517.55

NEBULIZER TERATMENT 1

Facility

$671.00

Service Code	HCPCS 94640
Hospital Charge Code	4530038
Hospital Revenue Code	410
Min. Negotiated Rate	$436.15
Max. Negotiated Rate	$436.15
Rate for Payer: Cash Price	$503.25
Rate for Payer: Galaxy Health Commercial	$436.15

NEBULIZER TERATMENT 1

Facility

$671.00

Service Code	HCPCS 94640
Hospital Charge Code	4530038
Hospital Revenue Code	410
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$536.80
Rate for Payer: Aetna of NY Commercial	$469.70
Rate for Payer: Aetna of NY Medicare	$308.66
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$268.40
Rate for Payer: Cash Price	$503.25
Rate for Payer: CDPHP Medicare	$248.27
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$536.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$536.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$536.80
Rate for Payer: EmblemHealth Medicaid	$536.80
Rate for Payer: EmblemHealth Medicare	$228.14
Rate for Payer: EmblemHealth Select Care	$483.12
Rate for Payer: Fidelis Medicare	$268.40
Rate for Payer: Galaxy Health Commercial	$436.15
Rate for Payer: Hamaspik Choice Medicare	$268.40
Rate for Payer: Humana Medicare	$268.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$469.70
Rate for Payer: Local 1199SEIU Medicare	$308.66
Rate for Payer: MVP Health Care of NY Commercial	$503.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$377.77
Rate for Payer: MVP Health Care of NY Medicare	$281.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$100.65
Rate for Payer: United Healthcare Medicare	$268.40
Rate for Payer: WellCare Medicare	$369.05

NEBULIZER TREATMENT 2

Facility

$671.00

Service Code	HCPCS 94640
Hospital Charge Code	4530039
Hospital Revenue Code	410
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$536.80
Rate for Payer: Aetna of NY Commercial	$469.70
Rate for Payer: Aetna of NY Medicare	$308.66
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$268.40
Rate for Payer: Cash Price	$503.25
Rate for Payer: CDPHP Medicare	$248.27
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$536.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$536.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$536.80
Rate for Payer: EmblemHealth Medicaid	$536.80
Rate for Payer: EmblemHealth Medicare	$228.14
Rate for Payer: EmblemHealth Select Care	$483.12
Rate for Payer: Fidelis Medicare	$268.40
Rate for Payer: Galaxy Health Commercial	$436.15
Rate for Payer: Hamaspik Choice Medicare	$268.40
Rate for Payer: Humana Medicare	$268.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$469.70
Rate for Payer: Local 1199SEIU Medicare	$308.66
Rate for Payer: MVP Health Care of NY Commercial	$503.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$377.77
Rate for Payer: MVP Health Care of NY Medicare	$281.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$100.65
Rate for Payer: United Healthcare Medicare	$268.40
Rate for Payer: WellCare Medicare	$369.05

NEBULIZER TREATMENT 2

Facility

$671.00

Service Code	HCPCS 94640
Hospital Charge Code	4530039
Hospital Revenue Code	410
Min. Negotiated Rate	$436.15
Max. Negotiated Rate	$436.15
Rate for Payer: Cash Price	$503.25
Rate for Payer: Galaxy Health Commercial	$436.15

NEBULIZER TREATMENT 3

Facility

$671.00

Service Code	HCPCS 94640
Hospital Charge Code	4530040
Hospital Revenue Code	410
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$536.80
Rate for Payer: Aetna of NY Commercial	$469.70
Rate for Payer: Aetna of NY Medicare	$308.66
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$268.40
Rate for Payer: Cash Price	$503.25
Rate for Payer: CDPHP Medicare	$248.27
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$536.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$536.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$536.80
Rate for Payer: EmblemHealth Medicaid	$536.80
Rate for Payer: EmblemHealth Medicare	$228.14
Rate for Payer: EmblemHealth Select Care	$483.12
Rate for Payer: Fidelis Medicare	$268.40
Rate for Payer: Galaxy Health Commercial	$436.15
Rate for Payer: Hamaspik Choice Medicare	$268.40
Rate for Payer: Humana Medicare	$268.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$469.70
Rate for Payer: Local 1199SEIU Medicare	$308.66
Rate for Payer: MVP Health Care of NY Commercial	$503.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$377.77
Rate for Payer: MVP Health Care of NY Medicare	$281.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$100.65
Rate for Payer: United Healthcare Medicare	$268.40
Rate for Payer: WellCare Medicare	$369.05

NEBULIZER TREATMENT 3

Facility

$671.00

Service Code	HCPCS 94640
Hospital Charge Code	4530040
Hospital Revenue Code	410
Min. Negotiated Rate	$436.15
Max. Negotiated Rate	$436.15
Rate for Payer: Cash Price	$503.25
Rate for Payer: Galaxy Health Commercial	$436.15

NEBULIZER TREATMENT 4

Facility

$671.00

Service Code	HCPCS 94640
Hospital Charge Code	4530041
Hospital Revenue Code	410
Min. Negotiated Rate	$436.15
Max. Negotiated Rate	$436.15
Rate for Payer: Cash Price	$503.25
Rate for Payer: Galaxy Health Commercial	$436.15

Know your out-of-pocket cost for care.

All Charges