Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

RECOVERY ROOM LEVEL 1( 0-3 HRS)

Facility

$912.00

Hospital Charge Code	4000213
Hospital Revenue Code	710
Min. Negotiated Rate	$592.80
Max. Negotiated Rate	$592.80
Rate for Payer: Cash Price	$684.00
Rate for Payer: Galaxy Health Commercial	$592.80

RECOVERY ROOM LEVEL 1( 0-3 HRS)

Facility

$912.00

Hospital Charge Code	4000213
Hospital Revenue Code	710
Min. Negotiated Rate	$136.80
Max. Negotiated Rate	$729.60
Rate for Payer: Aetna of NY Commercial	$638.40
Rate for Payer: Aetna of NY Medicare	$419.52
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$364.80
Rate for Payer: Cash Price	$684.00
Rate for Payer: CDPHP Medicare	$337.44
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$729.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$729.60
Rate for Payer: EmblemHealth Medicaid	$729.60
Rate for Payer: EmblemHealth Medicare	$310.08
Rate for Payer: Fidelis Medicare	$364.80
Rate for Payer: Galaxy Health Commercial	$592.80
Rate for Payer: Hamaspik Choice Medicare	$364.80
Rate for Payer: Humana Medicare	$364.80
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$638.40
Rate for Payer: Local 1199SEIU Medicare	$419.52
Rate for Payer: MVP Health Care of NY Commercial	$684.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$513.46
Rate for Payer: MVP Health Care of NY Medicare	$383.04
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$136.80
Rate for Payer: United Healthcare Medicare	$364.80
Rate for Payer: WellCare Medicare	$501.60

RECOVERY ROOM - OVER 180 MINS (3+ HRS)

Facility

$1,478.00

Hospital Charge Code	4007616
Hospital Revenue Code	710
Min. Negotiated Rate	$221.70
Max. Negotiated Rate	$1,182.40
Rate for Payer: Aetna of NY Commercial	$1,034.60
Rate for Payer: Aetna of NY Medicare	$679.88
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$591.20
Rate for Payer: Cash Price	$1,108.50
Rate for Payer: CDPHP Medicare	$546.86
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,182.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,182.40
Rate for Payer: EmblemHealth Medicaid	$1,182.40
Rate for Payer: EmblemHealth Medicare	$502.52
Rate for Payer: Fidelis Medicare	$591.20
Rate for Payer: Galaxy Health Commercial	$960.70
Rate for Payer: Hamaspik Choice Medicare	$591.20
Rate for Payer: Humana Medicare	$591.20
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,034.60
Rate for Payer: Local 1199SEIU Medicare	$679.88
Rate for Payer: MVP Health Care of NY Commercial	$1,108.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$832.11
Rate for Payer: MVP Health Care of NY Medicare	$620.76
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$221.70
Rate for Payer: United Healthcare Medicare	$591.20
Rate for Payer: WellCare Medicare	$812.90

RECOVERY ROOM - OVER 180 MINS (3+ HRS)

Facility

$1,478.00

Hospital Charge Code	4007616
Hospital Revenue Code	710
Min. Negotiated Rate	$960.70
Max. Negotiated Rate	$960.70
Rate for Payer: Cash Price	$1,108.50
Rate for Payer: Galaxy Health Commercial	$960.70

RECOVRY ROOM LEVEL2 4-9 HOURS

Facility

$1,825.00

Hospital Charge Code	4000214
Hospital Revenue Code	710
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$1,460.00
Rate for Payer: Aetna of NY Commercial	$1,277.50
Rate for Payer: Aetna of NY Medicare	$839.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$730.00
Rate for Payer: Cash Price	$1,368.75
Rate for Payer: CDPHP Medicare	$675.25
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,460.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,460.00
Rate for Payer: EmblemHealth Medicaid	$1,460.00
Rate for Payer: EmblemHealth Medicare	$620.50
Rate for Payer: Fidelis Medicare	$730.00
Rate for Payer: Galaxy Health Commercial	$1,186.25
Rate for Payer: Hamaspik Choice Medicare	$730.00
Rate for Payer: Humana Medicare	$730.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,277.50
Rate for Payer: Local 1199SEIU Medicare	$839.50
Rate for Payer: MVP Health Care of NY Commercial	$1,368.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$1,027.47
Rate for Payer: MVP Health Care of NY Medicare	$766.50
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$273.75
Rate for Payer: United Healthcare Medicare	$730.00
Rate for Payer: WellCare Medicare	$1,003.75

RECOVRY ROOM LEVEL2 4-9 HOURS

Facility

$1,825.00

Hospital Charge Code	4000214
Hospital Revenue Code	710
Min. Negotiated Rate	$1,186.25
Max. Negotiated Rate	$1,186.25
Rate for Payer: Cash Price	$1,368.75
Rate for Payer: Galaxy Health Commercial	$1,186.25

REGADENOSON INJ 0.1 MG

Facility

$218.66

Service Code	HCPCS J2785
Hospital Charge Code	4400436
Hospital Revenue Code	636
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$174.93
Rate for Payer: Aetna of NY Medicare	$100.58
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$87.46
Rate for Payer: Cash Price	$164.00
Rate for Payer: Cash Price	$164.00
Rate for Payer: CDPHP Medicare	$80.90
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$2.90
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$174.93
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$174.93
Rate for Payer: EmblemHealth Medicaid	$174.93
Rate for Payer: EmblemHealth Medicare	$74.34
Rate for Payer: EmblemHealth Select Care	$2.90
Rate for Payer: Fidelis Medicare	$87.46
Rate for Payer: Galaxy Health Commercial	$142.13
Rate for Payer: Hamaspik Choice Medicare	$87.46
Rate for Payer: Humana Medicare	$87.46
Rate for Payer: Local 1199SEIU Medicare	$100.58
Rate for Payer: MVP Health Care of NY Commercial	$164.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$123.11
Rate for Payer: MVP Health Care of NY Medicare	$91.84
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$102.76
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$32.80
Rate for Payer: United Healthcare Commercial	$102.76
Rate for Payer: United Healthcare Medicare	$87.46
Rate for Payer: WellCare Medicare	$120.26

REGADENOSON INJ 0.1 MG

Facility

$218.66

Service Code	HCPCS J2785
Hospital Charge Code	4400436
Hospital Revenue Code	636
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$142.13
Rate for Payer: Aetna of NY Commercial	$120.26
Rate for Payer: Cash Price	$164.00
Rate for Payer: Cash Price	$164.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$2.90
Rate for Payer: EmblemHealth Select Care	$2.90
Rate for Payer: Galaxy Health Commercial	$142.13
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$120.26
Rate for Payer: WellCare Medicare	$120.26

REGENERATIVE TISSUE SKIN GRAFT

Facility

$5,365.27

Hospital Charge Code	4471641
Hospital Revenue Code	270
Min. Negotiated Rate	$3,487.43
Max. Negotiated Rate	$3,487.43
Rate for Payer: Cash Price	$4,023.95
Rate for Payer: Galaxy Health Commercial	$3,487.43

REGENERATIVE TISSUE SKIN GRAFT

Facility

$5,365.27

Hospital Charge Code	4471641
Hospital Revenue Code	270
Min. Negotiated Rate	$804.79
Max. Negotiated Rate	$4,292.22
Rate for Payer: Aetna of NY Commercial	$3,755.69
Rate for Payer: Aetna of NY Medicare	$2,468.02
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2,146.11
Rate for Payer: Cash Price	$4,023.95
Rate for Payer: CDPHP Medicare	$1,985.15
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4,292.22
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4,292.22
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4,292.22
Rate for Payer: EmblemHealth Medicaid	$4,292.22
Rate for Payer: EmblemHealth Medicare	$1,824.19
Rate for Payer: EmblemHealth Select Care	$3,862.99
Rate for Payer: Fidelis Medicare	$2,146.11
Rate for Payer: Galaxy Health Commercial	$3,487.43
Rate for Payer: Hamaspik Choice Medicare	$2,146.11
Rate for Payer: Humana Medicare	$2,146.11
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$3,755.69
Rate for Payer: Local 1199SEIU Medicare	$2,468.02
Rate for Payer: MVP Health Care of NY Commercial	$4,023.95
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3,020.65
Rate for Payer: MVP Health Care of NY Medicare	$2,253.41
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$804.79
Rate for Payer: United Healthcare Medicare	$2,146.11
Rate for Payer: WellCare Medicare	$2,950.90

REM DEEP FB OF FOOT

Facility

$5,062.00

Service Code	HCPCS 28192
Hospital Charge Code	4856714
Hospital Revenue Code	761
Min. Negotiated Rate	$759.30
Max. Negotiated Rate	$4,049.60
Rate for Payer: Aetna of NY Commercial	$3,543.40
Rate for Payer: Aetna of NY Medicare	$2,328.52
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2,024.80
Rate for Payer: Cash Price	$3,796.50
Rate for Payer: CDPHP Medicare	$1,872.94
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4,049.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4,049.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4,049.60
Rate for Payer: EmblemHealth Medicaid	$4,049.60
Rate for Payer: EmblemHealth Medicare	$1,721.08
Rate for Payer: EmblemHealth Select Care	$3,644.64
Rate for Payer: Fidelis Medicare	$2,024.80
Rate for Payer: Galaxy Health Commercial	$3,290.30
Rate for Payer: Hamaspik Choice Medicare	$2,024.80
Rate for Payer: Humana Medicare	$2,024.80
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$3,543.40
Rate for Payer: Local 1199SEIU Medicare	$2,328.52
Rate for Payer: MVP Health Care of NY Commercial	$3,796.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$2,849.91
Rate for Payer: MVP Health Care of NY Medicare	$2,126.04
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$759.30
Rate for Payer: United Healthcare Medicare	$2,024.80
Rate for Payer: WellCare Medicare	$2,784.10

REM DEEP FB OF FOOT

Facility

$5,062.00

Service Code	HCPCS 28192
Hospital Charge Code	4856714
Hospital Revenue Code	761
Min. Negotiated Rate	$3,290.30
Max. Negotiated Rate	$3,290.30
Rate for Payer: Cash Price	$3,796.50
Rate for Payer: Galaxy Health Commercial	$3,290.30

REM FB FOOT; SQ

Facility

$2,170.00

Service Code	HCPCS 28190
Hospital Charge Code	4856713
Hospital Revenue Code	761
Min. Negotiated Rate	$325.50
Max. Negotiated Rate	$1,736.00
Rate for Payer: Aetna of NY Commercial	$1,519.00
Rate for Payer: Aetna of NY Medicare	$998.20
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$868.00
Rate for Payer: Cash Price	$1,627.50
Rate for Payer: CDPHP Medicare	$802.90
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$1,736.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,736.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,736.00
Rate for Payer: EmblemHealth Medicaid	$1,736.00
Rate for Payer: EmblemHealth Medicare	$737.80
Rate for Payer: EmblemHealth Select Care	$1,562.40
Rate for Payer: Fidelis Medicare	$868.00
Rate for Payer: Galaxy Health Commercial	$1,410.50
Rate for Payer: Hamaspik Choice Medicare	$868.00
Rate for Payer: Humana Medicare	$868.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,519.00
Rate for Payer: Local 1199SEIU Medicare	$998.20
Rate for Payer: MVP Health Care of NY Commercial	$1,627.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$1,221.71
Rate for Payer: MVP Health Care of NY Medicare	$911.40
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$325.50
Rate for Payer: United Healthcare Medicare	$868.00
Rate for Payer: WellCare Medicare	$1,193.50

REM FB FOOT; SQ

Facility

$2,170.00

Service Code	HCPCS 28190
Hospital Charge Code	4856713
Hospital Revenue Code	761
Min. Negotiated Rate	$1,410.50
Max. Negotiated Rate	$1,410.50
Rate for Payer: Cash Price	$1,627.50
Rate for Payer: Galaxy Health Commercial	$1,410.50

REM IMP EAR WAX

Facility

$181.00

Service Code	HCPCS 69210
Hospital Charge Code	4602124
Hospital Revenue Code	450
Min. Negotiated Rate	$117.65
Max. Negotiated Rate	$117.65
Rate for Payer: Cash Price	$135.75
Rate for Payer: Galaxy Health Commercial	$117.65

REM IMP EAR WAX

Facility

$181.00

Service Code	HCPCS 69210
Hospital Charge Code	4602124
Hospital Revenue Code	450
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$1,234.00
Rate for Payer: Aetna of NY Commercial	$1,000.00
Rate for Payer: Aetna of NY Medicare	$83.26
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$72.40
Rate for Payer: Cash Price	$135.75
Rate for Payer: Cash Price	$135.75
Rate for Payer: Cash Price	$135.75
Rate for Payer: CDPHP Medicare	$66.97
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$1,206.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$144.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$144.80
Rate for Payer: EmblemHealth Medicaid	$144.80
Rate for Payer: EmblemHealth Medicare	$61.54
Rate for Payer: EmblemHealth Select Care	$1,085.00
Rate for Payer: Fidelis Medicare	$72.40
Rate for Payer: Galaxy Health Commercial	$117.65
Rate for Payer: Hamaspik Choice Medicare	$72.40
Rate for Payer: Humana Medicare	$72.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,000.00
Rate for Payer: Local 1199SEIU Medicare	$83.26
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	$76.02
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$1,009.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$27.15
Rate for Payer: United Healthcare Commercial	$1,009.00
Rate for Payer: United Healthcare Medicare	$72.40
Rate for Payer: WellCare Medicare	$99.55

REMOTE 30 DAY ECG REV/REPORT

Facility

$114.00

Service Code	HCPCS 93270
Hospital Charge Code	4480038
Hospital Revenue Code	731
Min. Negotiated Rate	$74.10
Max. Negotiated Rate	$74.10
Rate for Payer: Cash Price	$85.50
Rate for Payer: Galaxy Health Commercial	$74.10

REMOTE 30 DAY ECG REV/REPORT

Facility

$114.00

Service Code	HCPCS 93270
Hospital Charge Code	4480038
Hospital Revenue Code	731
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$91.20
Rate for Payer: Aetna of NY Commercial	$74.10
Rate for Payer: Aetna of NY Medicare	$52.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$45.60
Rate for Payer: Cash Price	$85.50
Rate for Payer: CDPHP Medicare	$42.18
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$79.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$91.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$91.20
Rate for Payer: EmblemHealth Medicaid	$91.20
Rate for Payer: EmblemHealth Medicare	$38.76
Rate for Payer: EmblemHealth Select Care	$74.10
Rate for Payer: Fidelis Medicare	$45.60
Rate for Payer: Galaxy Health Commercial	$74.10
Rate for Payer: Hamaspik Choice Medicare	$45.60
Rate for Payer: Humana Medicare	$45.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$74.10
Rate for Payer: Local 1199SEIU Medicare	$52.44
Rate for Payer: MVP Health Care of NY Commercial	$85.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$64.18
Rate for Payer: MVP Health Care of NY Medicare	$47.88
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$17.10
Rate for Payer: United Healthcare Medicare	$45.60
Rate for Payer: WellCare Medicare	$62.70

REMOVAL INTRAUTERINE DEVICE IUD

Facility

$934.00

Service Code	HCPCS 58301
Hospital Charge Code	4602238
Hospital Revenue Code	450
Min. Negotiated Rate	$607.10
Max. Negotiated Rate	$607.10
Rate for Payer: Cash Price	$700.50
Rate for Payer: Galaxy Health Commercial	$607.10

REMOVAL INTRAUTERINE DEVICE IUD

Facility

$934.00

Service Code	HCPCS 58301
Hospital Charge Code	4602238
Hospital Revenue Code	450
Min. Negotiated Rate	$140.10
Max. Negotiated Rate	$1,234.00
Rate for Payer: Aetna of NY Commercial	$1,000.00
Rate for Payer: Aetna of NY Medicare	$429.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$373.60
Rate for Payer: Cash Price	$700.50
Rate for Payer: Cash Price	$700.50
Rate for Payer: Cash Price	$700.50
Rate for Payer: CDPHP Medicare	$345.58
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$1,206.00
Rate for Payer: EmblemHealth Medicare	$317.56
Rate for Payer: EmblemHealth Select Care	$1,085.00
Rate for Payer: Fidelis Medicare	$373.60
Rate for Payer: Galaxy Health Commercial	$607.10
Rate for Payer: Hamaspik Choice Medicare	$373.60
Rate for Payer: Humana Medicare	$373.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,000.00
Rate for Payer: Local 1199SEIU Medicare	$429.64
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	$392.28
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$1,009.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$140.10
Rate for Payer: United Healthcare Commercial	$1,009.00
Rate for Payer: United Healthcare Medicare	$373.60
Rate for Payer: WellCare Medicare	$513.70

REMOVAL OF FOREIGN BODY IN MUSCLE/TENDON

Facility

$5,062.00

Service Code	HCPCS 20520
Hospital Charge Code	4850166
Hospital Revenue Code	761
Min. Negotiated Rate	$3,290.30
Max. Negotiated Rate	$3,290.30
Rate for Payer: Cash Price	$3,796.50
Rate for Payer: Galaxy Health Commercial	$3,290.30

REMOVAL OF FOREIGN BODY IN MUSCLE/TENDON

Facility

$5,062.00

Service Code	HCPCS 20520
Hospital Charge Code	4850166
Hospital Revenue Code	761
Min. Negotiated Rate	$759.30
Max. Negotiated Rate	$4,049.60
Rate for Payer: Aetna of NY Commercial	$3,543.40
Rate for Payer: Aetna of NY Medicare	$2,328.52
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2,024.80
Rate for Payer: Cash Price	$3,796.50
Rate for Payer: CDPHP Medicare	$1,872.94
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4,049.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4,049.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4,049.60
Rate for Payer: EmblemHealth Medicaid	$4,049.60
Rate for Payer: EmblemHealth Medicare	$1,721.08
Rate for Payer: EmblemHealth Select Care	$3,644.64
Rate for Payer: Fidelis Medicare	$2,024.80
Rate for Payer: Galaxy Health Commercial	$3,290.30
Rate for Payer: Hamaspik Choice Medicare	$2,024.80
Rate for Payer: Humana Medicare	$2,024.80
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$3,543.40
Rate for Payer: Local 1199SEIU Medicare	$2,328.52
Rate for Payer: MVP Health Care of NY Commercial	$3,796.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$2,849.91
Rate for Payer: MVP Health Care of NY Medicare	$2,126.04
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$759.30
Rate for Payer: United Healthcare Medicare	$2,024.80
Rate for Payer: WellCare Medicare	$2,784.10

REMOVAL OF NAIL BED

Facility

$1,246.00

Service Code	HCPCS 11750
Hospital Charge Code	4602190
Hospital Revenue Code	450
Min. Negotiated Rate	$186.90
Max. Negotiated Rate	$1,234.00
Rate for Payer: Aetna of NY Commercial	$1,000.00
Rate for Payer: Aetna of NY Medicare	$573.16
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$498.40
Rate for Payer: Cash Price	$934.50
Rate for Payer: Cash Price	$934.50
Rate for Payer: Cash Price	$934.50
Rate for Payer: CDPHP Medicare	$461.02
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$1,206.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$996.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$996.80
Rate for Payer: EmblemHealth Medicaid	$996.80
Rate for Payer: EmblemHealth Medicare	$423.64
Rate for Payer: EmblemHealth Select Care	$1,085.00
Rate for Payer: Fidelis Medicare	$498.40
Rate for Payer: Galaxy Health Commercial	$809.90
Rate for Payer: Hamaspik Choice Medicare	$498.40
Rate for Payer: Humana Medicare	$498.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,000.00
Rate for Payer: Local 1199SEIU Medicare	$573.16
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	$523.32
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$1,009.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$186.90
Rate for Payer: United Healthcare Commercial	$1,009.00
Rate for Payer: United Healthcare Medicare	$498.40
Rate for Payer: WellCare Medicare	$685.30

REMOVAL OF NAIL BED

Facility

$1,246.00

Service Code	HCPCS 11750
Hospital Charge Code	4602190
Hospital Revenue Code	450
Min. Negotiated Rate	$809.90
Max. Negotiated Rate	$809.90
Rate for Payer: Cash Price	$934.50
Rate for Payer: Galaxy Health Commercial	$809.90

REMOVAL OF NAIL BED LEFT

Facility

$1,246.00

Service Code	HCPCS 11750 LT
Hospital Charge Code	4856658
Hospital Revenue Code	761
Min. Negotiated Rate	$186.90
Max. Negotiated Rate	$996.80
Rate for Payer: Aetna of NY Commercial	$872.20
Rate for Payer: Aetna of NY Medicare	$573.16
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$498.40
Rate for Payer: Cash Price	$934.50
Rate for Payer: CDPHP Medicare	$461.02
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$996.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$996.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$996.80
Rate for Payer: EmblemHealth Medicaid	$996.80
Rate for Payer: EmblemHealth Medicare	$423.64
Rate for Payer: EmblemHealth Select Care	$897.12
Rate for Payer: Fidelis Medicare	$498.40
Rate for Payer: Galaxy Health Commercial	$809.90
Rate for Payer: Hamaspik Choice Medicare	$498.40
Rate for Payer: Humana Medicare	$498.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$872.20
Rate for Payer: Local 1199SEIU Medicare	$573.16
Rate for Payer: MVP Health Care of NY Commercial	$934.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$701.50
Rate for Payer: MVP Health Care of NY Medicare	$523.32
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$186.90
Rate for Payer: United Healthcare Medicare	$498.40
Rate for Payer: WellCare Medicare	$685.30

Know your out-of-pocket cost for care.

All Charges