Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 2: SUPERFICIAL NEEDLE BIOPSY AND ASPIRATION

Facility

$1,010.56

Service Code	EAPG 0002
Min. Negotiated Rate	$449.14
Max. Negotiated Rate	$1,010.56
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$1,010.56
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$449.14
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$449.14
Rate for Payer: CDPHP Essential Plan	$1,010.56
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$538.97
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$449.14
Rate for Payer: EmblemHealth Medicaid	$449.14
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$1,010.56
Rate for Payer: Hamaspik Choice Medicaid	$449.14
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$449.14
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$965.65
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$965.65
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$449.14
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$471.60

EAPG 300: LEVEL II COMPUTED TOMOGRAPHY

Facility

$707.18

Service Code	EAPG 0300
Min. Negotiated Rate	$314.30
Max. Negotiated Rate	$707.18
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$707.18
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$314.30
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$314.30
Rate for Payer: CDPHP Essential Plan	$707.18
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$377.16
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$314.30
Rate for Payer: EmblemHealth Medicaid	$314.30
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$707.18
Rate for Payer: Hamaspik Choice Medicaid	$314.30
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$314.30
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$675.74
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$675.74
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$314.30
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$330.02

EAPG 3011: BONE CONDUCTION HEARING DEVICE IMPLANTATION

Facility

$6,822.09

Service Code	EAPG 3011
Min. Negotiated Rate	$3,032.04
Max. Negotiated Rate	$6,822.09
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$6,822.09
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$3,032.04
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$3,032.04
Rate for Payer: CDPHP Essential Plan	$6,822.09
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$3,638.45
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$3,032.04
Rate for Payer: EmblemHealth Medicaid	$3,032.04
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$6,822.09
Rate for Payer: Galaxy Health Workers Comp	$4,457.10
Rate for Payer: Hamaspik Choice Medicaid	$3,032.04
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$3,032.04
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$6,518.89
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$6,518.89
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3,032.04
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$3,183.64

EAPG 301: COMPUTED TOMOGRAPHY- OTHER

Facility

$531.68

Service Code	EAPG 0301
Min. Negotiated Rate	$236.30
Max. Negotiated Rate	$531.68
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$531.68
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$236.30
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$236.30
Rate for Payer: CDPHP Essential Plan	$531.68
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$283.56
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$236.30
Rate for Payer: EmblemHealth Medicaid	$236.30
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$531.68
Rate for Payer: Hamaspik Choice Medicaid	$236.30
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$236.30
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$508.04
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$508.04
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$236.30
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$248.12

EAPG 302: COMPUTED TOMOGRAPHIC ANGIOGRAPHY

Facility

$750.33

Service Code	EAPG 0302
Min. Negotiated Rate	$333.48
Max. Negotiated Rate	$750.33
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$750.33
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$333.48
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$333.48
Rate for Payer: CDPHP Essential Plan	$750.33
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$400.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$333.48
Rate for Payer: EmblemHealth Medicaid	$333.48
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$750.33
Rate for Payer: Hamaspik Choice Medicaid	$333.48
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$333.48
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$716.98
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$716.98
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$333.48
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$350.15

EAPG 3030: SPINAL IMPLANTATION OF DRUG INFUSION DEVICE

Facility

$28,309.82

Service Code	EAPG 3030
Min. Negotiated Rate	$12,582.14
Max. Negotiated Rate	$28,309.82
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$28,309.82
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$12,582.14
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$12,582.14
Rate for Payer: CDPHP Essential Plan	$28,309.82
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$15,098.57
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$12,582.14
Rate for Payer: EmblemHealth Medicaid	$12,582.14
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$28,309.82
Rate for Payer: Galaxy Health Workers Comp	$18,495.75
Rate for Payer: Hamaspik Choice Medicaid	$12,582.14
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$12,582.14
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$27,051.60
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$27,051.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$12,582.14
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$13,211.25

EAPG 3033: INGUINAL, FEMORAL AND UMBILICAL HERNIA REPAIR

Facility

$4,157.89

Service Code	EAPG 3033
Min. Negotiated Rate	$1,847.95
Max. Negotiated Rate	$4,157.89
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$4,157.89
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$1,847.95
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$1,847.95
Rate for Payer: CDPHP Essential Plan	$4,157.89
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,217.54
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,847.95
Rate for Payer: EmblemHealth Medicaid	$1,847.95
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$4,157.89
Rate for Payer: Galaxy Health Workers Comp	$2,716.49
Rate for Payer: Hamaspik Choice Medicaid	$1,847.95
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,847.95
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$3,973.09
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$3,973.09
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,847.95
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$1,940.35

EAPG 3035: ABDOMINAL HERNIA REPAIR

Facility

$4,342.23

Service Code	EAPG 3035
Min. Negotiated Rate	$1,929.88
Max. Negotiated Rate	$4,342.23
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$4,342.23
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$1,929.88
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$1,929.88
Rate for Payer: CDPHP Essential Plan	$4,342.23
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$2,315.86
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$1,929.88
Rate for Payer: EmblemHealth Medicaid	$1,929.88
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$4,342.23
Rate for Payer: Galaxy Health Workers Comp	$2,836.92
Rate for Payer: Hamaspik Choice Medicaid	$1,929.88
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$1,929.88
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$4,149.24
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$4,149.24
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1,929.88
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$2,026.37

EAPG 304: MINOR SPECIMEN COLLECTION SERVICES

Facility

$79.42

Service Code	EAPG 0304
Min. Negotiated Rate	$35.30
Max. Negotiated Rate	$79.42
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$79.42
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$35.30
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$35.30
Rate for Payer: CDPHP Essential Plan	$79.42
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$42.36
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$35.30
Rate for Payer: EmblemHealth Medicaid	$35.30
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$79.42
Rate for Payer: Hamaspik Choice Medicaid	$35.30
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$35.30
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$75.90
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$75.90
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$35.30
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$37.06

EAPG 305: LEVEL I SURGICAL PATHOLOGY TESTS

Facility

$113.13

Service Code	EAPG 0305
Min. Negotiated Rate	$50.28
Max. Negotiated Rate	$113.13
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$113.13
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$50.28
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$50.28
Rate for Payer: CDPHP Essential Plan	$113.13
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$60.34
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$50.28
Rate for Payer: EmblemHealth Medicaid	$50.28
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$113.13
Rate for Payer: Hamaspik Choice Medicaid	$50.28
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$50.28
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$108.10
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$108.10
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$50.28
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$52.79

EAPG 306: LEVEL II SURGICAL PATHOLOGY TESTS

Facility

$159.44

Service Code	EAPG 0306
Min. Negotiated Rate	$70.86
Max. Negotiated Rate	$159.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$159.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$70.86
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$70.86
Rate for Payer: CDPHP Essential Plan	$159.44
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$85.03
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$70.86
Rate for Payer: EmblemHealth Medicaid	$70.86
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$159.44
Rate for Payer: Hamaspik Choice Medicaid	$70.86
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$70.86
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$152.35
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$152.35
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$70.86
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$74.40

EAPG 307: INSERTION OR REMOVAL OF DRUG DELIVERY DEVICE

Facility

$642.31

Service Code	EAPG 0307
Min. Negotiated Rate	$285.47
Max. Negotiated Rate	$642.31
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$642.31
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$285.47
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$285.47
Rate for Payer: CDPHP Essential Plan	$642.31
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$342.56
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$285.47
Rate for Payer: EmblemHealth Medicaid	$285.47
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$642.31
Rate for Payer: Hamaspik Choice Medicaid	$285.47
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$285.47
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$613.76
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$613.76
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$285.47
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$299.74

EAPG 308: LEVEL III PATHOLOGY TESTS

Facility

$170.19

Service Code	EAPG 0308
Min. Negotiated Rate	$75.64
Max. Negotiated Rate	$170.19
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$170.19
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$75.64
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$75.64
Rate for Payer: CDPHP Essential Plan	$170.19
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$90.77
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$75.64
Rate for Payer: EmblemHealth Medicaid	$75.64
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$170.19
Rate for Payer: Hamaspik Choice Medicaid	$75.64
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$75.64
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$162.63
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$162.63
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$75.64
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$79.42

EAPG 310: DEVELOPMENTAL & NEUROPSYCHOLOGICAL TESTING

Facility

$302.60

Service Code	EAPG 0310
Min. Negotiated Rate	$134.49
Max. Negotiated Rate	$302.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$302.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$134.49
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$134.49
Rate for Payer: CDPHP Essential Plan	$302.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$161.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.49
Rate for Payer: EmblemHealth Medicaid	$134.49
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$302.60
Rate for Payer: Hamaspik Choice Medicaid	$134.49
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$134.49
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$289.15
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$289.15
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.49
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.21

EAPG 315: COUNSELLING OR INDIVIDUAL BRIEF PSYCHOTHERAPY

Facility

$226.96

Service Code	EAPG 0315
Min. Negotiated Rate	$100.87
Max. Negotiated Rate	$226.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$226.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$100.87
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$100.87
Rate for Payer: CDPHP Essential Plan	$226.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$121.04
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$100.87
Rate for Payer: EmblemHealth Medicaid	$100.87
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$226.96
Rate for Payer: Hamaspik Choice Medicaid	$100.87
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$100.87
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$216.87
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$216.87
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$100.87
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$105.91

EAPG 316: INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY

Facility

$302.60

Service Code	EAPG 0316
Min. Negotiated Rate	$134.49
Max. Negotiated Rate	$302.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$302.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$134.49
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$134.49
Rate for Payer: CDPHP Essential Plan	$302.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$161.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.49
Rate for Payer: EmblemHealth Medicaid	$134.49
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$302.60
Rate for Payer: Hamaspik Choice Medicaid	$134.49
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$134.49
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$289.15
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$289.15
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.49
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.21

EAPG 317: FAMILY PSYCHOTHERAPY

Facility

$226.96

Service Code	EAPG 0317
Min. Negotiated Rate	$100.87
Max. Negotiated Rate	$226.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$226.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$100.87
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$100.87
Rate for Payer: CDPHP Essential Plan	$226.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$121.04
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$100.87
Rate for Payer: EmblemHealth Medicaid	$100.87
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$226.96
Rate for Payer: Hamaspik Choice Medicaid	$100.87
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$100.87
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$216.87
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$216.87
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$100.87
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$105.91

EAPG 318: GROUP PSYCHOTHERAPY

Facility

$117.25

Service Code	EAPG 0318
Min. Negotiated Rate	$52.11
Max. Negotiated Rate	$117.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$117.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$52.11
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$52.11
Rate for Payer: CDPHP Essential Plan	$117.25
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$62.53
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$52.11
Rate for Payer: EmblemHealth Medicaid	$52.11
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$117.25
Rate for Payer: Hamaspik Choice Medicaid	$52.11
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$52.11
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$112.04
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$112.04
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$52.11
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$54.72

EAPG 321: CRISIS INTERVENTION

Facility

$302.60

Service Code	EAPG 0321
Min. Negotiated Rate	$134.49
Max. Negotiated Rate	$302.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$302.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$134.49
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$134.49
Rate for Payer: CDPHP Essential Plan	$302.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$161.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$134.49
Rate for Payer: EmblemHealth Medicaid	$134.49
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$302.60
Rate for Payer: Hamaspik Choice Medicaid	$134.49
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$134.49
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$289.15
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$289.15
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$134.49
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$141.21

EAPG 322: MEDICATION ADMINISTRATION & OBSERVATION

Facility

$43.11

Service Code	EAPG 0322
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$43.11
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$43.11
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$19.16
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$19.16
Rate for Payer: CDPHP Essential Plan	$43.11
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$22.99
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$19.16
Rate for Payer: EmblemHealth Medicaid	$19.16
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$43.11
Rate for Payer: Hamaspik Choice Medicaid	$19.16
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$19.16
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$41.19
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$41.19
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$19.16
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$20.12

EAPG 323: BEHAVIORAL HEATLH ASSESSMENT

Facility

$378.25

Service Code	EAPG 0323
Min. Negotiated Rate	$168.11
Max. Negotiated Rate	$378.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$378.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$168.11
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$168.11
Rate for Payer: CDPHP Essential Plan	$378.25
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$201.73
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$168.11
Rate for Payer: EmblemHealth Medicaid	$168.11
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$378.25
Rate for Payer: Hamaspik Choice Medicaid	$168.11
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$168.11
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$361.44
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$361.44
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$168.11
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$176.52

EAPG 324: SCREENING FOR BEHAVIORAL CHANGE OR RISK ASSESSMENT

Facility

$102.51

Service Code	EAPG 0324
Min. Negotiated Rate	$45.56
Max. Negotiated Rate	$102.51
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$102.51
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$45.56
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$45.56
Rate for Payer: CDPHP Essential Plan	$102.51
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$54.67
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$45.56
Rate for Payer: EmblemHealth Medicaid	$45.56
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$102.51
Rate for Payer: Hamaspik Choice Medicaid	$45.56
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$45.56
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$97.95
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$97.95
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$45.56
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$47.84

EAPG 327: INTENSIVE OUTPATIENT PSYCHIATRIC TREATMENT

Facility

$222.80

Service Code	EAPG 0327
Min. Negotiated Rate	$99.02
Max. Negotiated Rate	$222.80
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$222.80
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$99.02
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$99.02
Rate for Payer: CDPHP Essential Plan	$222.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$118.82
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$99.02
Rate for Payer: EmblemHealth Medicaid	$99.02
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$222.80
Rate for Payer: Hamaspik Choice Medicaid	$99.02
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$99.02
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$212.89
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$212.89
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$99.02
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$103.97

EAPG 328: DAY REHABILITATION, HALF DAY

Facility

$180.54

Service Code	EAPG 0328
Min. Negotiated Rate	$80.24
Max. Negotiated Rate	$180.54
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$180.54
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$80.24
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$80.24
Rate for Payer: CDPHP Essential Plan	$180.54
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$96.29
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$80.24
Rate for Payer: EmblemHealth Medicaid	$80.24
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$180.54
Rate for Payer: Hamaspik Choice Medicaid	$80.24
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$80.24
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$172.52
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$172.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$80.24
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$84.25

EAPG 329: DAY REHABILITATION, FULL DAY

Facility

$240.73

Service Code	EAPG 0329
Min. Negotiated Rate	$106.99
Max. Negotiated Rate	$240.73
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan	$240.73
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid	$106.99
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan	$106.99
Rate for Payer: CDPHP Essential Plan	$240.73
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$128.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$106.99
Rate for Payer: EmblemHealth Medicaid	$106.99
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid	$240.73
Rate for Payer: Hamaspik Choice Medicaid	$106.99
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$106.99
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$230.03
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$230.03
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$106.99
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$112.34

Know your out-of-pocket cost for care.

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