Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

26" QUICK-FIT BASIC KNEE SPLIN

Facility

$71.07

Hospital Charge Code	4471601
Hospital Revenue Code	270
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$46.20
Rate for Payer: Cash Price	$53.30
Rate for Payer: Galaxy Health Commercial	$46.20

2.7 LOCKING SCREW

Facility

$1,192.74

Service Code	HCPCS C1713
Hospital Charge Code	4473001
Hospital Revenue Code	278
Min. Negotiated Rate	$536.73
Max. Negotiated Rate	$834.92
Rate for Payer: Aetna of NY Commercial	$834.92
Rate for Payer: Cash Price	$894.56
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$596.37
Rate for Payer: EmblemHealth Select Care	$596.37
Rate for Payer: Galaxy Health Commercial	$775.28
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$834.92
Rate for Payer: Multiplan Commercial	$536.73
Rate for Payer: MVP Health Care of NY Commercial	$775.28
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$775.28
Rate for Payer: WellCare Medicare	$656.01

2.7 LOCKING SCREW

Facility

$1,192.74

Service Code	HCPCS C1713
Hospital Charge Code	4473001
Hospital Revenue Code	278
Min. Negotiated Rate	$178.91
Max. Negotiated Rate	$954.19
Rate for Payer: Aetna of NY Commercial	$834.92
Rate for Payer: Aetna of NY Medicare	$548.66
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$477.10
Rate for Payer: Cash Price	$894.56
Rate for Payer: CDPHP Medicare	$441.31
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$596.37
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$954.19
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$954.19
Rate for Payer: EmblemHealth Medicaid	$954.19
Rate for Payer: EmblemHealth Medicare	$405.53
Rate for Payer: EmblemHealth Select Care	$596.37
Rate for Payer: Fidelis Medicare	$477.10
Rate for Payer: Galaxy Health Commercial	$775.28
Rate for Payer: Hamaspik Choice Medicare	$477.10
Rate for Payer: Humana Medicare	$477.10
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$834.92
Rate for Payer: Local 1199SEIU Medicare	$548.66
Rate for Payer: MVP Health Care of NY Commercial	$775.28
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$775.28
Rate for Payer: MVP Health Care of NY Medicare	$500.95
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$178.91
Rate for Payer: United Healthcare Medicare	$477.10
Rate for Payer: WellCare Medicare	$656.01

2.7 NON-LOCKING SCREW

Facility

$604.61

Service Code	HCPCS C1713
Hospital Charge Code	4473002
Hospital Revenue Code	278
Min. Negotiated Rate	$272.07
Max. Negotiated Rate	$423.23
Rate for Payer: Aetna of NY Commercial	$423.23
Rate for Payer: Cash Price	$453.46
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$302.31
Rate for Payer: EmblemHealth Select Care	$302.31
Rate for Payer: Galaxy Health Commercial	$393.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$423.23
Rate for Payer: Multiplan Commercial	$272.07
Rate for Payer: MVP Health Care of NY Commercial	$393.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$393.00
Rate for Payer: WellCare Medicare	$332.54

2.7 NON-LOCKING SCREW

Facility

$604.61

Service Code	HCPCS C1713
Hospital Charge Code	4473002
Hospital Revenue Code	278
Min. Negotiated Rate	$90.69
Max. Negotiated Rate	$483.69
Rate for Payer: Aetna of NY Commercial	$423.23
Rate for Payer: Aetna of NY Medicare	$278.12
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$241.84
Rate for Payer: Cash Price	$453.46
Rate for Payer: CDPHP Medicare	$223.71
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$302.31
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$483.69
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$483.69
Rate for Payer: EmblemHealth Medicaid	$483.69
Rate for Payer: EmblemHealth Medicare	$205.57
Rate for Payer: EmblemHealth Select Care	$302.31
Rate for Payer: Fidelis Medicare	$241.84
Rate for Payer: Galaxy Health Commercial	$393.00
Rate for Payer: Hamaspik Choice Medicare	$241.84
Rate for Payer: Humana Medicare	$241.84
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$423.23
Rate for Payer: Local 1199SEIU Medicare	$278.12
Rate for Payer: MVP Health Care of NY Commercial	$393.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$393.00
Rate for Payer: MVP Health Care of NY Medicare	$253.94
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$90.69
Rate for Payer: United Healthcare Medicare	$241.84
Rate for Payer: WellCare Medicare	$332.54

2.7X14MM LOCK SCREW

Facility

$729.24

Hospital Charge Code	4471835
Hospital Revenue Code	270
Min. Negotiated Rate	$109.39
Max. Negotiated Rate	$583.39
Rate for Payer: Aetna of NY Commercial	$510.47
Rate for Payer: Aetna of NY Medicare	$335.45
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$291.70
Rate for Payer: Cash Price	$546.93
Rate for Payer: CDPHP Medicare	$269.82
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$583.39
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$583.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$583.39
Rate for Payer: EmblemHealth Medicaid	$583.39
Rate for Payer: EmblemHealth Medicare	$247.94
Rate for Payer: EmblemHealth Select Care	$525.05
Rate for Payer: Fidelis Medicare	$291.70
Rate for Payer: Galaxy Health Commercial	$474.01
Rate for Payer: Hamaspik Choice Medicare	$291.70
Rate for Payer: Humana Medicare	$291.70
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$510.47
Rate for Payer: Local 1199SEIU Medicare	$335.45
Rate for Payer: MVP Health Care of NY Commercial	$546.93
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$410.56
Rate for Payer: MVP Health Care of NY Medicare	$306.28
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$109.39
Rate for Payer: United Healthcare Medicare	$291.70
Rate for Payer: WellCare Medicare	$401.08

2.7X14MM LOCK SCREW

Facility

$729.24

Hospital Charge Code	4471835
Hospital Revenue Code	270
Min. Negotiated Rate	$474.01
Max. Negotiated Rate	$474.01
Rate for Payer: Cash Price	$546.93
Rate for Payer: Galaxy Health Commercial	$474.01

2.7X16MM LOCK SCREW

Facility

$729.24

Hospital Charge Code	4471836
Hospital Revenue Code	270
Min. Negotiated Rate	$109.39
Max. Negotiated Rate	$583.39
Rate for Payer: Aetna of NY Commercial	$510.47
Rate for Payer: Aetna of NY Medicare	$335.45
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$291.70
Rate for Payer: Cash Price	$546.93
Rate for Payer: CDPHP Medicare	$269.82
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$583.39
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$583.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$583.39
Rate for Payer: EmblemHealth Medicaid	$583.39
Rate for Payer: EmblemHealth Medicare	$247.94
Rate for Payer: EmblemHealth Select Care	$525.05
Rate for Payer: Fidelis Medicare	$291.70
Rate for Payer: Galaxy Health Commercial	$474.01
Rate for Payer: Hamaspik Choice Medicare	$291.70
Rate for Payer: Humana Medicare	$291.70
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$510.47
Rate for Payer: Local 1199SEIU Medicare	$335.45
Rate for Payer: MVP Health Care of NY Commercial	$546.93
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$410.56
Rate for Payer: MVP Health Care of NY Medicare	$306.28
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$109.39
Rate for Payer: United Healthcare Medicare	$291.70
Rate for Payer: WellCare Medicare	$401.08

2.7X16MM LOCK SCREW

Facility

$729.24

Hospital Charge Code	4471836
Hospital Revenue Code	270
Min. Negotiated Rate	$474.01
Max. Negotiated Rate	$474.01
Rate for Payer: Cash Price	$546.93
Rate for Payer: Galaxy Health Commercial	$474.01

2.7X22MM LOCK SCREW

Facility

$729.24

Hospital Charge Code	4471837
Hospital Revenue Code	270
Min. Negotiated Rate	$109.39
Max. Negotiated Rate	$583.39
Rate for Payer: Aetna of NY Commercial	$510.47
Rate for Payer: Aetna of NY Medicare	$335.45
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$291.70
Rate for Payer: Cash Price	$546.93
Rate for Payer: CDPHP Medicare	$269.82
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$583.39
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$583.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$583.39
Rate for Payer: EmblemHealth Medicaid	$583.39
Rate for Payer: EmblemHealth Medicare	$247.94
Rate for Payer: EmblemHealth Select Care	$525.05
Rate for Payer: Fidelis Medicare	$291.70
Rate for Payer: Galaxy Health Commercial	$474.01
Rate for Payer: Hamaspik Choice Medicare	$291.70
Rate for Payer: Humana Medicare	$291.70
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$510.47
Rate for Payer: Local 1199SEIU Medicare	$335.45
Rate for Payer: MVP Health Care of NY Commercial	$546.93
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$410.56
Rate for Payer: MVP Health Care of NY Medicare	$306.28
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$109.39
Rate for Payer: United Healthcare Medicare	$291.70
Rate for Payer: WellCare Medicare	$401.08

2.7X22MM LOCK SCREW

Facility

$729.24

Hospital Charge Code	4471837
Hospital Revenue Code	270
Min. Negotiated Rate	$474.01
Max. Negotiated Rate	$474.01
Rate for Payer: Cash Price	$546.93
Rate for Payer: Galaxy Health Commercial	$474.01

2" COBAN STERILE LF

Facility

$13.39

Hospital Charge Code	4471423
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

2" COBAN STERILE LF

Facility

$13.39

Hospital Charge Code	4471423
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

2D TTE W OR W/O FOL W/CON CO

Facility

$2,403.00

Service Code	HCPCS C8923
Hospital Charge Code	4480105
Hospital Revenue Code	480
Min. Negotiated Rate	$360.45
Max. Negotiated Rate	$1,922.40
Rate for Payer: Aetna of NY Commercial	$1,682.10
Rate for Payer: Aetna of NY Medicare	$1,105.38
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$961.20
Rate for Payer: Cash Price	$1,802.25
Rate for Payer: CDPHP Medicare	$889.11
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$1,682.10
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1,922.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,922.40
Rate for Payer: EmblemHealth Medicaid	$1,922.40
Rate for Payer: EmblemHealth Medicare	$817.02
Rate for Payer: EmblemHealth Select Care	$1,561.95
Rate for Payer: Fidelis Medicare	$961.20
Rate for Payer: Galaxy Health Commercial	$1,561.95
Rate for Payer: Hamaspik Choice Medicare	$961.20
Rate for Payer: Humana Medicare	$961.20
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1,682.10
Rate for Payer: Local 1199SEIU Medicare	$1,105.38
Rate for Payer: MVP Health Care of NY Commercial	$1,802.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$1,352.89
Rate for Payer: MVP Health Care of NY Medicare	$1,009.26
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$1,802.25
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$360.45
Rate for Payer: United Healthcare Commercial	$1,802.25
Rate for Payer: United Healthcare Medicare	$961.20
Rate for Payer: WellCare Medicare	$1,321.65

2D TTE W OR W/O FOL W/CON CO

Facility

$2,403.00

Service Code	HCPCS C8923
Hospital Charge Code	4480105
Hospital Revenue Code	480
Min. Negotiated Rate	$1,561.95
Max. Negotiated Rate	$1,561.95
Rate for Payer: Cash Price	$1,802.25
Rate for Payer: Galaxy Health Commercial	$1,561.95

2D TTE W OR W/O FOL W/CON FU

Facility

$1,100.00

Service Code	HCPCS C8924
Hospital Charge Code	4480104
Hospital Revenue Code	480
Min. Negotiated Rate	$715.00
Max. Negotiated Rate	$715.00
Rate for Payer: Cash Price	$825.00
Rate for Payer: Galaxy Health Commercial	$715.00

2D TTE W OR W/O FOL W/CON FU

Facility

$1,100.00

Service Code	HCPCS C8924
Hospital Charge Code	4480104
Hospital Revenue Code	480
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$880.00
Rate for Payer: Aetna of NY Commercial	$770.00
Rate for Payer: Aetna of NY Medicare	$506.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$440.00
Rate for Payer: Cash Price	$825.00
Rate for Payer: CDPHP Medicare	$407.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$770.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$880.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$880.00
Rate for Payer: EmblemHealth Medicaid	$880.00
Rate for Payer: EmblemHealth Medicare	$374.00
Rate for Payer: EmblemHealth Select Care	$715.00
Rate for Payer: Fidelis Medicare	$440.00
Rate for Payer: Galaxy Health Commercial	$715.00
Rate for Payer: Hamaspik Choice Medicare	$440.00
Rate for Payer: Humana Medicare	$440.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$770.00
Rate for Payer: Local 1199SEIU Medicare	$506.00
Rate for Payer: MVP Health Care of NY Commercial	$825.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$619.30
Rate for Payer: MVP Health Care of NY Medicare	$462.00
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$825.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$165.00
Rate for Payer: United Healthcare Commercial	$825.00
Rate for Payer: United Healthcare Medicare	$440.00
Rate for Payer: WellCare Medicare	$605.00

2 FIBERWIRE SUTURE

Facility

$70.04

Hospital Charge Code	4471715
Hospital Revenue Code	278
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$56.03
Rate for Payer: Aetna of NY Commercial	$49.03
Rate for Payer: Aetna of NY Medicare	$32.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$28.02
Rate for Payer: Cash Price	$52.53
Rate for Payer: CDPHP Medicare	$25.91
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$35.02
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$56.03
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$56.03
Rate for Payer: EmblemHealth Medicaid	$56.03
Rate for Payer: EmblemHealth Medicare	$23.81
Rate for Payer: EmblemHealth Select Care	$35.02
Rate for Payer: Fidelis Medicare	$28.02
Rate for Payer: Galaxy Health Commercial	$45.53
Rate for Payer: Hamaspik Choice Medicare	$28.02
Rate for Payer: Humana Medicare	$28.02
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$49.03
Rate for Payer: Local 1199SEIU Medicare	$32.22
Rate for Payer: MVP Health Care of NY Commercial	$45.53
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$45.53
Rate for Payer: MVP Health Care of NY Medicare	$29.42
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$10.51
Rate for Payer: United Healthcare Medicare	$28.02
Rate for Payer: WellCare Medicare	$38.52

2 FIBERWIRE SUTURE

Facility

$70.04

Hospital Charge Code	4471715
Hospital Revenue Code	278
Min. Negotiated Rate	$31.52
Max. Negotiated Rate	$49.03
Rate for Payer: Aetna of NY Commercial	$49.03
Rate for Payer: Cash Price	$52.53
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$35.02
Rate for Payer: EmblemHealth Select Care	$35.02
Rate for Payer: Galaxy Health Commercial	$45.53
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$49.03
Rate for Payer: Multiplan Commercial	$31.52
Rate for Payer: MVP Health Care of NY Commercial	$45.53
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$45.53
Rate for Payer: WellCare Medicare	$38.52

2" SMOOTH CAST PADDING STERILE

Facility

$28.84

Hospital Charge Code	4471792
Hospital Revenue Code	270
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Cash Price	$21.63
Rate for Payer: Galaxy Health Commercial	$18.75

2" SMOOTH CAST PADDING STERILE

Facility

$28.84

Hospital Charge Code	4471792
Hospital Revenue Code	270
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$23.07
Rate for Payer: Aetna of NY Commercial	$20.19
Rate for Payer: Aetna of NY Medicare	$13.27
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$11.54
Rate for Payer: Cash Price	$21.63
Rate for Payer: CDPHP Medicare	$10.67
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$23.07
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$23.07
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$23.07
Rate for Payer: EmblemHealth Medicaid	$23.07
Rate for Payer: EmblemHealth Medicare	$9.81
Rate for Payer: EmblemHealth Select Care	$20.76
Rate for Payer: Fidelis Medicare	$11.54
Rate for Payer: Galaxy Health Commercial	$18.75
Rate for Payer: Hamaspik Choice Medicare	$11.54
Rate for Payer: Humana Medicare	$11.54
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$20.19
Rate for Payer: Local 1199SEIU Medicare	$13.27
Rate for Payer: MVP Health Care of NY Commercial	$21.63
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$16.24
Rate for Payer: MVP Health Care of NY Medicare	$12.11
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$4.33
Rate for Payer: United Healthcare Medicare	$11.54
Rate for Payer: WellCare Medicare	$15.86

2" STRETCH BANDAGE

Facility

$2.06

Hospital Charge Code	4471767
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$1.65
Rate for Payer: Aetna of NY Commercial	$1.44
Rate for Payer: Aetna of NY Medicare	$0.95
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$0.82
Rate for Payer: Cash Price	$1.54
Rate for Payer: CDPHP Medicare	$0.76
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$1.65
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$1.65
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1.65
Rate for Payer: EmblemHealth Medicaid	$1.65
Rate for Payer: EmblemHealth Medicare	$0.70
Rate for Payer: EmblemHealth Select Care	$1.48
Rate for Payer: Fidelis Medicare	$0.82
Rate for Payer: Galaxy Health Commercial	$1.34
Rate for Payer: Hamaspik Choice Medicare	$0.82
Rate for Payer: Humana Medicare	$0.82
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$1.44
Rate for Payer: Local 1199SEIU Medicare	$0.95
Rate for Payer: MVP Health Care of NY Commercial	$1.54
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$1.16
Rate for Payer: MVP Health Care of NY Medicare	$0.87
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.31
Rate for Payer: United Healthcare Medicare	$0.82
Rate for Payer: WellCare Medicare	$1.13

2" STRETCH BANDAGE

Facility

$2.06

Hospital Charge Code	4471767
Hospital Revenue Code	270
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Cash Price	$1.54
Rate for Payer: Galaxy Health Commercial	$1.34

2"X10YDS HYPAFIX

Facility

$20.60

Hospital Charge Code	4471264
Hospital Revenue Code	270
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$13.39
Rate for Payer: Cash Price	$15.45
Rate for Payer: Galaxy Health Commercial	$13.39

2"X10YDS HYPAFIX

Facility

$20.60

Hospital Charge Code	4471264
Hospital Revenue Code	270
Min. Negotiated Rate	$3.09
Max. Negotiated Rate	$16.48
Rate for Payer: Aetna of NY Commercial	$14.42
Rate for Payer: Aetna of NY Medicare	$9.48
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$8.24
Rate for Payer: Cash Price	$15.45
Rate for Payer: CDPHP Medicare	$7.62
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$16.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$16.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$16.48
Rate for Payer: EmblemHealth Medicaid	$16.48
Rate for Payer: EmblemHealth Medicare	$7.00
Rate for Payer: EmblemHealth Select Care	$14.83
Rate for Payer: Fidelis Medicare	$8.24
Rate for Payer: Galaxy Health Commercial	$13.39
Rate for Payer: Hamaspik Choice Medicare	$8.24
Rate for Payer: Humana Medicare	$8.24
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$14.42
Rate for Payer: Local 1199SEIU Medicare	$9.48
Rate for Payer: MVP Health Care of NY Commercial	$15.45
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$11.60
Rate for Payer: MVP Health Care of NY Medicare	$8.65
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3.09
Rate for Payer: United Healthcare Medicare	$8.24
Rate for Payer: WellCare Medicare	$11.33

Know your out-of-pocket cost for care.

All Charges