Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

16 FR SILICONE FOLEY CATH

Facility

$55.62

Hospital Charge Code	4471965
Hospital Revenue Code	272
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$36.15
Rate for Payer: Cash Price	$41.72
Rate for Payer: Galaxy Health Commercial	$36.15

16 FR SILICONE FOLEY CATH

Facility

$55.62

Hospital Charge Code	4471965
Hospital Revenue Code	272
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna of NY Commercial	$38.93
Rate for Payer: Aetna of NY Medicare	$25.59
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$22.25
Rate for Payer: Cash Price	$41.72
Rate for Payer: CDPHP Medicare	$20.58
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$44.50
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$44.50
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$44.50
Rate for Payer: EmblemHealth Medicaid	$44.50
Rate for Payer: EmblemHealth Medicare	$18.91
Rate for Payer: EmblemHealth Select Care	$40.05
Rate for Payer: Fidelis Medicare	$22.25
Rate for Payer: Galaxy Health Commercial	$36.15
Rate for Payer: Hamaspik Choice Medicare	$22.25
Rate for Payer: Humana Medicare	$22.25
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$38.93
Rate for Payer: Local 1199SEIU Medicare	$25.59
Rate for Payer: MVP Health Care of NY Commercial	$41.72
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$31.31
Rate for Payer: MVP Health Care of NY Medicare	$23.36
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$8.34
Rate for Payer: United Healthcare Medicare	$22.25
Rate for Payer: WellCare Medicare	$30.59

16G X 100 RADIOFREQUENCY CANNULA

Facility

$63.86

Hospital Charge Code	4473032
Hospital Revenue Code	272
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$51.09
Rate for Payer: Aetna of NY Commercial	$44.70
Rate for Payer: Aetna of NY Medicare	$29.38
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$25.54
Rate for Payer: Cash Price	$47.90
Rate for Payer: CDPHP Medicare	$23.63
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$51.09
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$51.09
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$51.09
Rate for Payer: EmblemHealth Medicaid	$51.09
Rate for Payer: EmblemHealth Medicare	$21.71
Rate for Payer: EmblemHealth Select Care	$45.98
Rate for Payer: Fidelis Medicare	$25.54
Rate for Payer: Galaxy Health Commercial	$41.51
Rate for Payer: Hamaspik Choice Medicare	$25.54
Rate for Payer: Humana Medicare	$25.54
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$44.70
Rate for Payer: Local 1199SEIU Medicare	$29.38
Rate for Payer: MVP Health Care of NY Commercial	$47.90
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$35.95
Rate for Payer: MVP Health Care of NY Medicare	$26.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$9.58
Rate for Payer: United Healthcare Medicare	$25.54
Rate for Payer: WellCare Medicare	$35.12

16G X 100 RADIOFREQUENCY CANNULA

Facility

$63.86

Hospital Charge Code	4473032
Hospital Revenue Code	272
Min. Negotiated Rate	$41.51
Max. Negotiated Rate	$41.51
Rate for Payer: Cash Price	$47.90
Rate for Payer: Galaxy Health Commercial	$41.51

16" QUICK-FIT BASIC KNEE SPLIN

Facility

$44.29

Hospital Charge Code	4471598
Hospital Revenue Code	270
Min. Negotiated Rate	$28.79
Max. Negotiated Rate	$28.79
Rate for Payer: Cash Price	$33.22
Rate for Payer: Galaxy Health Commercial	$28.79

16" QUICK-FIT BASIC KNEE SPLIN

Facility

$44.29

Hospital Charge Code	4471598
Hospital Revenue Code	270
Min. Negotiated Rate	$6.64
Max. Negotiated Rate	$35.43
Rate for Payer: Aetna of NY Commercial	$31.00
Rate for Payer: Aetna of NY Medicare	$20.37
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$17.72
Rate for Payer: Cash Price	$33.22
Rate for Payer: CDPHP Medicare	$16.39
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$35.43
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$35.43
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$35.43
Rate for Payer: EmblemHealth Medicaid	$35.43
Rate for Payer: EmblemHealth Medicare	$15.06
Rate for Payer: EmblemHealth Select Care	$31.89
Rate for Payer: Fidelis Medicare	$17.72
Rate for Payer: Galaxy Health Commercial	$28.79
Rate for Payer: Hamaspik Choice Medicare	$17.72
Rate for Payer: Humana Medicare	$17.72
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$31.00
Rate for Payer: Local 1199SEIU Medicare	$20.37
Rate for Payer: MVP Health Care of NY Commercial	$33.22
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$24.94
Rate for Payer: MVP Health Care of NY Medicare	$18.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$6.64
Rate for Payer: United Healthcare Medicare	$17.72
Rate for Payer: WellCare Medicare	$24.36

17G TUOHY NDL WINGED#491117

Facility

$10.30

Hospital Charge Code	4479282
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

17G TUOHY NDL WINGED#491117

Facility

$10.30

Hospital Charge Code	4479282
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

17G TUOHY NEEDLE#4908

Facility

$24.72

Hospital Charge Code	4479283
Hospital Revenue Code	270
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$19.78
Rate for Payer: Aetna of NY Commercial	$17.30
Rate for Payer: Aetna of NY Medicare	$11.37
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$9.89
Rate for Payer: Cash Price	$18.54
Rate for Payer: CDPHP Medicare	$9.15
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$19.78
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$19.78
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$19.78
Rate for Payer: EmblemHealth Medicaid	$19.78
Rate for Payer: EmblemHealth Medicare	$8.40
Rate for Payer: EmblemHealth Select Care	$17.80
Rate for Payer: Fidelis Medicare	$9.89
Rate for Payer: Galaxy Health Commercial	$16.07
Rate for Payer: Hamaspik Choice Medicare	$9.89
Rate for Payer: Humana Medicare	$9.89
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$17.30
Rate for Payer: Local 1199SEIU Medicare	$11.37
Rate for Payer: MVP Health Care of NY Commercial	$18.54
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$13.92
Rate for Payer: MVP Health Care of NY Medicare	$10.38
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3.71
Rate for Payer: United Healthcare Medicare	$9.89
Rate for Payer: WellCare Medicare	$13.60

17G TUOHY NEEDLE#4908

Facility

$24.72

Hospital Charge Code	4479283
Hospital Revenue Code	270
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$16.07
Rate for Payer: Cash Price	$18.54
Rate for Payer: Galaxy Health Commercial	$16.07

17G X 3.5" WAVE POINT INTRODUC

Facility

$38.11

Hospital Charge Code	4472135
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

17G X 3.5" WAVE POINT INTRODUC

Facility

$38.11

Hospital Charge Code	4472135
Hospital Revenue Code	270
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$30.49
Rate for Payer: Aetna of NY Commercial	$26.68
Rate for Payer: Aetna of NY Medicare	$17.53
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$15.24
Rate for Payer: Cash Price	$28.58
Rate for Payer: CDPHP Medicare	$14.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$30.49
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$30.49
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$30.49
Rate for Payer: EmblemHealth Medicaid	$30.49
Rate for Payer: EmblemHealth Medicare	$12.96
Rate for Payer: EmblemHealth Select Care	$27.44
Rate for Payer: Fidelis Medicare	$15.24
Rate for Payer: Galaxy Health Commercial	$24.77
Rate for Payer: Hamaspik Choice Medicare	$15.24
Rate for Payer: Humana Medicare	$15.24
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$26.68
Rate for Payer: Local 1199SEIU Medicare	$17.53
Rate for Payer: MVP Health Care of NY Commercial	$28.58
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$21.46
Rate for Payer: MVP Health Care of NY Medicare	$16.01
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$5.72
Rate for Payer: United Healthcare Medicare	$15.24
Rate for Payer: WellCare Medicare	$20.96

18FR COUDE CATH

Facility

$145.23

Hospital Charge Code	4471429
Hospital Revenue Code	270
Min. Negotiated Rate	$94.40
Max. Negotiated Rate	$94.40
Rate for Payer: Cash Price	$108.92
Rate for Payer: Galaxy Health Commercial	$94.40

18FR COUDE CATH

Facility

$145.23

Hospital Charge Code	4471429
Hospital Revenue Code	270
Min. Negotiated Rate	$21.78
Max. Negotiated Rate	$116.18
Rate for Payer: Aetna of NY Commercial	$101.66
Rate for Payer: Aetna of NY Medicare	$66.81
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$58.09
Rate for Payer: Cash Price	$108.92
Rate for Payer: CDPHP Medicare	$53.74
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$116.18
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$116.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$116.18
Rate for Payer: EmblemHealth Medicaid	$116.18
Rate for Payer: EmblemHealth Medicare	$49.38
Rate for Payer: EmblemHealth Select Care	$104.57
Rate for Payer: Fidelis Medicare	$58.09
Rate for Payer: Galaxy Health Commercial	$94.40
Rate for Payer: Hamaspik Choice Medicare	$58.09
Rate for Payer: Humana Medicare	$58.09
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$101.66
Rate for Payer: Local 1199SEIU Medicare	$66.81
Rate for Payer: MVP Health Care of NY Commercial	$108.92
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$81.76
Rate for Payer: MVP Health Care of NY Medicare	$61.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$21.78
Rate for Payer: United Healthcare Medicare	$58.09
Rate for Payer: WellCare Medicare	$79.88

18FR FOLEY CATHETER 8760518

Facility

$16.48

Hospital Charge Code	4479179
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

18FR FOLEY CATHETER 8760518

Facility

$16.48

Hospital Charge Code	4479179
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

18FR PEG FEEDING TUBE W/ BALLO

Facility

$95.79

Hospital Charge Code	4471976
Hospital Revenue Code	270
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$76.63
Rate for Payer: Aetna of NY Commercial	$67.05
Rate for Payer: Aetna of NY Medicare	$44.06
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$38.32
Rate for Payer: Cash Price	$71.84
Rate for Payer: CDPHP Medicare	$35.44
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$76.63
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$76.63
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$76.63
Rate for Payer: EmblemHealth Medicaid	$76.63
Rate for Payer: EmblemHealth Medicare	$32.57
Rate for Payer: EmblemHealth Select Care	$68.97
Rate for Payer: Fidelis Medicare	$38.32
Rate for Payer: Galaxy Health Commercial	$62.26
Rate for Payer: Hamaspik Choice Medicare	$38.32
Rate for Payer: Humana Medicare	$38.32
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$67.05
Rate for Payer: Local 1199SEIU Medicare	$44.06
Rate for Payer: MVP Health Care of NY Commercial	$71.84
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$53.93
Rate for Payer: MVP Health Care of NY Medicare	$40.23
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$14.37
Rate for Payer: United Healthcare Medicare	$38.32
Rate for Payer: WellCare Medicare	$52.68

18FR PEG FEEDING TUBE W/ BALLO

Facility

$95.79

Hospital Charge Code	4471976
Hospital Revenue Code	270
Min. Negotiated Rate	$62.26
Max. Negotiated Rate	$62.26
Rate for Payer: Cash Price	$71.84
Rate for Payer: Galaxy Health Commercial	$62.26

18G 3-1/2 IN SPINAL NEEDLE

Facility

$35.02

Hospital Charge Code	4471378
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

18G 3-1/2 IN SPINAL NEEDLE

Facility

$35.02

Hospital Charge Code	4471378
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

18GA 1 1/2" NEEDLE PORTEX

Facility

$1.03

Hospital Charge Code	4472019
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.82
Rate for Payer: Aetna of NY Commercial	$0.72
Rate for Payer: Aetna of NY Medicare	$0.47
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$0.41
Rate for Payer: Cash Price	$0.77
Rate for Payer: CDPHP Medicare	$0.38
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$0.82
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$0.82
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$0.82
Rate for Payer: EmblemHealth Medicaid	$0.82
Rate for Payer: EmblemHealth Medicare	$0.35
Rate for Payer: EmblemHealth Select Care	$0.74
Rate for Payer: Fidelis Medicare	$0.41
Rate for Payer: Galaxy Health Commercial	$0.67
Rate for Payer: Hamaspik Choice Medicare	$0.41
Rate for Payer: Humana Medicare	$0.41
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$0.72
Rate for Payer: Local 1199SEIU Medicare	$0.47
Rate for Payer: MVP Health Care of NY Commercial	$0.77
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$0.58
Rate for Payer: MVP Health Care of NY Medicare	$0.43
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.15
Rate for Payer: United Healthcare Medicare	$0.41
Rate for Payer: WellCare Medicare	$0.57

18GA 1 1/2" NEEDLE PORTEX

Facility

$1.03

Hospital Charge Code	4472019
Hospital Revenue Code	270
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Cash Price	$0.77
Rate for Payer: Galaxy Health Commercial	$0.67

18GAUGE ORTHO WIRE

Facility

$48.41

Hospital Charge Code	4479312
Hospital Revenue Code	278
Min. Negotiated Rate	$7.26
Max. Negotiated Rate	$38.73
Rate for Payer: Aetna of NY Commercial	$33.89
Rate for Payer: Aetna of NY Medicare	$22.27
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$19.36
Rate for Payer: Cash Price	$36.31
Rate for Payer: CDPHP Medicare	$17.91
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$24.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$38.73
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$38.73
Rate for Payer: EmblemHealth Medicaid	$38.73
Rate for Payer: EmblemHealth Medicare	$16.46
Rate for Payer: EmblemHealth Select Care	$24.20
Rate for Payer: Fidelis Medicare	$19.36
Rate for Payer: Galaxy Health Commercial	$31.47
Rate for Payer: Hamaspik Choice Medicare	$19.36
Rate for Payer: Humana Medicare	$19.36
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$33.89
Rate for Payer: Local 1199SEIU Medicare	$22.27
Rate for Payer: MVP Health Care of NY Commercial	$31.47
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$31.47
Rate for Payer: MVP Health Care of NY Medicare	$20.33
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$7.26
Rate for Payer: United Healthcare Medicare	$19.36
Rate for Payer: WellCare Medicare	$26.63

18GAUGE ORTHO WIRE

Facility

$48.41

Hospital Charge Code	4479312
Hospital Revenue Code	278
Min. Negotiated Rate	$21.78
Max. Negotiated Rate	$33.89
Rate for Payer: Aetna of NY Commercial	$33.89
Rate for Payer: Cash Price	$36.31
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$24.20
Rate for Payer: EmblemHealth Select Care	$24.20
Rate for Payer: Galaxy Health Commercial	$31.47
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$33.89
Rate for Payer: Multiplan Commercial	$21.78
Rate for Payer: MVP Health Care of NY Commercial	$31.47
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$31.47
Rate for Payer: WellCare Medicare	$26.63

18G X 100 RADIOFREQUENCY CANNULA

Facility

$25.75

Hospital Charge Code	4473033
Hospital Revenue Code	272
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

Know your out-of-pocket cost for care.

All Charges