Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: ACUTE KIDNEY INJURY

Facility

$256.75

Service Code	EAPG 729
Min. Negotiated Rate	$117.03
Max. Negotiated Rate	$256.75
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$143.30
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$119.42
Rate for Payer: EmblemHealth Medicaid	$119.42
Rate for Payer: Galaxy Health Workers Comp	$117.03
Rate for Payer: Hamaspik Choice Medicaid	$119.42
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$125.39
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$256.75
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$256.75
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$119.42
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$125.39

EAPG 3.18: ACUTE LEUKEMIA

Facility

$392.89

Service Code	EAPG 800
Min. Negotiated Rate	$179.08
Max. Negotiated Rate	$392.89
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$219.28
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$182.74
Rate for Payer: EmblemHealth Medicaid	$182.74
Rate for Payer: Galaxy Health Workers Comp	$179.08
Rate for Payer: Hamaspik Choice Medicaid	$182.74
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$191.88
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$392.89
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$392.89
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$182.74
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$191.88

EAPG 3.18: ACUTE LOWER URINARY TRACT INFECTIONS

Facility

$298.30

Service Code	EAPG 727
Min. Negotiated Rate	$135.96
Max. Negotiated Rate	$298.30
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$166.49
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$138.74
Rate for Payer: EmblemHealth Medicaid	$138.74
Rate for Payer: Galaxy Health Workers Comp	$135.96
Rate for Payer: Hamaspik Choice Medicaid	$138.74
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$145.68
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$298.30
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$298.30
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$138.74
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$145.68

EAPG 3.18: ACUTE MAJOR EYE INFECTIONS

Facility

$250.68

Service Code	EAPG 550
Min. Negotiated Rate	$114.26
Max. Negotiated Rate	$250.68
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$139.91
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$116.59
Rate for Payer: EmblemHealth Medicaid	$116.59
Rate for Payer: Galaxy Health Workers Comp	$114.26
Rate for Payer: Hamaspik Choice Medicaid	$116.59
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$122.42
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$250.68
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$250.68
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$116.59
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$122.42

EAPG 3.18: ACUTE MYOCARDIAL INFARCTION

Facility

$566.47

Service Code	EAPG 591
Min. Negotiated Rate	$258.20
Max. Negotiated Rate	$566.47
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$316.16
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$263.47
Rate for Payer: EmblemHealth Medicaid	$263.47
Rate for Payer: Galaxy Health Workers Comp	$258.20
Rate for Payer: Hamaspik Choice Medicaid	$263.47
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$276.65
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$566.47
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$566.47
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$263.47
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$276.65

EAPG 3.18: ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES

Facility

$254.45

Service Code	EAPG 825
Min. Negotiated Rate	$115.98
Max. Negotiated Rate	$254.45
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$142.01
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$118.35
Rate for Payer: EmblemHealth Medicaid	$118.35
Rate for Payer: Galaxy Health Workers Comp	$115.98
Rate for Payer: Hamaspik Choice Medicaid	$118.35
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$124.26
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$254.45
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$254.45
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$118.35
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$124.26

EAPG 3.18: ADULT PREVENTIVE MEDICINE

Facility

$267.82

Service Code	EAPG 876
Min. Negotiated Rate	$122.07
Max. Negotiated Rate	$267.82
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$149.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$124.57
Rate for Payer: EmblemHealth Medicaid	$124.57
Rate for Payer: Galaxy Health Workers Comp	$122.07
Rate for Payer: Hamaspik Choice Medicaid	$124.57
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$130.80
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$267.82
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$267.82
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$124.57
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$130.80

EAPG 3.18: AFTERCARE, BURNS, CORROSIONS, OTHER INJURIES RELATED TO THE SKIN AND SUB TIS

Facility

$335.20

Service Code	EAPG 787
Min. Negotiated Rate	$152.78
Max. Negotiated Rate	$335.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$187.08
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$155.91
Rate for Payer: EmblemHealth Medicaid	$155.91
Rate for Payer: Galaxy Health Workers Comp	$152.78
Rate for Payer: Hamaspik Choice Medicaid	$155.91
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$163.70
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$335.20
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$335.20
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$155.91
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$163.70

EAPG 3.18: AFTERCARE FOR JOINT REPLACEMENT

Facility

$251.72

Service Code	EAPG 874
Min. Negotiated Rate	$114.73
Max. Negotiated Rate	$251.72
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$140.49
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$117.08
Rate for Payer: EmblemHealth Medicaid	$117.08
Rate for Payer: Galaxy Health Workers Comp	$114.73
Rate for Payer: Hamaspik Choice Medicaid	$117.08
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$122.93
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$251.72
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$251.72
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$117.08
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$122.93

EAPG 3.18: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE INJURIES

Facility

$284.54

Service Code	EAPG 869
Min. Negotiated Rate	$129.69
Max. Negotiated Rate	$284.54
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$158.81
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$132.34
Rate for Payer: EmblemHealth Medicaid	$132.34
Rate for Payer: Galaxy Health Workers Comp	$129.69
Rate for Payer: Hamaspik Choice Medicaid	$132.34
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$138.96
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$284.54
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$284.54
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$132.34
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$138.96

EAPG 3.18: AFTERCARE, OPEN WOUNDS AND OTHER TRAUMATIC INJURIES

Facility

$328.74

Service Code	EAPG 585
Min. Negotiated Rate	$149.84
Max. Negotiated Rate	$328.74
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$183.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$152.90
Rate for Payer: EmblemHealth Medicaid	$152.90
Rate for Payer: Galaxy Health Workers Comp	$149.84
Rate for Payer: Hamaspik Choice Medicaid	$152.90
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$160.55
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$328.74
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$328.74
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$152.90
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$160.55

EAPG 3.18: AFTEREFFECTS OF CEREBROVASCULAR ACCIDENT

Facility

$263.48

Service Code	EAPG 533
Min. Negotiated Rate	$120.09
Max. Negotiated Rate	$263.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$147.05
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$122.55
Rate for Payer: EmblemHealth Medicaid	$122.55
Rate for Payer: Galaxy Health Workers Comp	$120.09
Rate for Payer: Hamaspik Choice Medicaid	$122.55
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$128.68
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$263.48
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$263.48
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$122.55
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$128.68

EAPG 3.18: AICD AND RELATED CARDIAC DEVICE INSERTION OR REPLACEMENT

Facility

$28,620.11

Service Code	EAPG 97
Min. Negotiated Rate	$13,045.45
Max. Negotiated Rate	$28,620.11
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$15,974.02
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$13,311.68
Rate for Payer: EmblemHealth Medicaid	$13,311.68
Rate for Payer: Galaxy Health Workers Comp	$13,045.45
Rate for Payer: Hamaspik Choice Medicaid	$13,311.68
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$13,977.26
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$28,620.11
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$28,620.11
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$13,311.68
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$13,977.26

EAPG 3.18: AIDS

Facility

$351.27

Service Code	EAPG 881
Min. Negotiated Rate	$160.11
Max. Negotiated Rate	$351.27
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$196.05
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$163.38
Rate for Payer: EmblemHealth Medicaid	$163.38
Rate for Payer: Galaxy Health Workers Comp	$160.11
Rate for Payer: Hamaspik Choice Medicaid	$163.38
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$171.55
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$351.27
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$351.27
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$163.38
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$171.55

EAPG 3.18: ALCOHOL ABUSE AND DEPENDENCE

Facility

$308.99

Service Code	EAPG 842
Min. Negotiated Rate	$140.84
Max. Negotiated Rate	$308.99
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$172.45
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$143.71
Rate for Payer: EmblemHealth Medicaid	$143.71
Rate for Payer: Galaxy Health Workers Comp	$140.84
Rate for Payer: Hamaspik Choice Medicaid	$143.71
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$150.90
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$308.99
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$308.99
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$143.71
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$150.90

EAPG 3.18: ALCOHOLIC LIVER DISEASE

Facility

$268.94

Service Code	EAPG 633
Min. Negotiated Rate	$122.58
Max. Negotiated Rate	$268.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$150.10
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$125.09
Rate for Payer: EmblemHealth Medicaid	$125.09
Rate for Payer: Galaxy Health Workers Comp	$122.58
Rate for Payer: Hamaspik Choice Medicaid	$125.09
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$131.34
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$268.94
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$268.94
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$125.09
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$131.34

EAPG 3.18: ALIMENTARY TESTS AND TUBE INSERTION OR PLACEMENT

Facility

$1,053.11

Service Code	EAPG 130
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$1,053.11
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$587.76
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$489.81
Rate for Payer: EmblemHealth Medicaid	$489.81
Rate for Payer: Galaxy Health Workers Comp	$480.00
Rate for Payer: Hamaspik Choice Medicaid	$489.81
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$514.31
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$1,053.11
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$1,053.11
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$489.81
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$514.31

EAPG 3.18: ALLERGIC REACTIONS

Facility

$335.01

Service Code	EAPG 850
Min. Negotiated Rate	$152.70
Max. Negotiated Rate	$335.01
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$186.98
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$155.82
Rate for Payer: EmblemHealth Medicaid	$155.82
Rate for Payer: Galaxy Health Workers Comp	$152.70
Rate for Payer: Hamaspik Choice Medicaid	$155.82
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$163.61
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$335.01
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$335.01
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$155.82
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$163.61

EAPG 3.18: ALLERGY TESTS

Facility

$530.38

Service Code	EAPG 116
Min. Negotiated Rate	$241.74
Max. Negotiated Rate	$530.38
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$296.02
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$246.68
Rate for Payer: EmblemHealth Medicaid	$246.68
Rate for Payer: Galaxy Health Workers Comp	$241.74
Rate for Payer: Hamaspik Choice Medicaid	$246.68
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$259.02
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$530.38
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$530.38
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$246.68
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$259.02

EAPG 3.18: ALLERGY THERAPY

Facility

$68.92

Service Code	EAPG 458
Min. Negotiated Rate	$31.41
Max. Negotiated Rate	$68.92
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$38.46
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$32.05
Rate for Payer: EmblemHealth Medicaid	$32.05
Rate for Payer: Galaxy Health Workers Comp	$31.41
Rate for Payer: Hamaspik Choice Medicaid	$32.05
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$33.66
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$68.92
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$68.92
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$32.05
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$33.66

EAPG 3.18: ALTERATION IN CONSCIOUSNESS

Facility

$318.02

Service Code	EAPG 883
Min. Negotiated Rate	$144.95
Max. Negotiated Rate	$318.02
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$177.49
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$147.91
Rate for Payer: EmblemHealth Medicaid	$147.91
Rate for Payer: Galaxy Health Workers Comp	$144.95
Rate for Payer: Hamaspik Choice Medicaid	$147.91
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$155.31
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$318.02
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$318.02
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$147.91
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$155.31

EAPG 3.18: AMBULATORY PATIENT MONITORING AND RELATED ASSESSMENTS

Facility

$389.32

Service Code	EAPG 418
Min. Negotiated Rate	$177.45
Max. Negotiated Rate	$389.32
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$217.29
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$181.08
Rate for Payer: EmblemHealth Medicaid	$181.08
Rate for Payer: Galaxy Health Workers Comp	$177.45
Rate for Payer: Hamaspik Choice Medicaid	$181.08
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$190.13
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$389.32
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$389.32
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$181.08
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$190.13

EAPG 3.18: ANCILLARY DRUG ADMINISTRATION

Facility

$79.33

Service Code	EAPG 109
Min. Negotiated Rate	$36.16
Max. Negotiated Rate	$79.33
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$44.28
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$36.90
Rate for Payer: EmblemHealth Medicaid	$36.90
Rate for Payer: Galaxy Health Workers Comp	$36.16
Rate for Payer: Hamaspik Choice Medicaid	$36.90
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$38.74
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$79.33
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$79.33
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$36.90
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$38.74

EAPG 3.18: ANEMIA, BLOOD AND BLOOD-FORMING ORGAN DISORDERS

Facility

$252.64

Service Code	EAPG 785
Min. Negotiated Rate	$115.15
Max. Negotiated Rate	$252.64
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$141.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$117.51
Rate for Payer: EmblemHealth Medicaid	$117.51
Rate for Payer: Galaxy Health Workers Comp	$115.15
Rate for Payer: Hamaspik Choice Medicaid	$117.51
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$123.38
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$252.64
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$252.64
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$117.51
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$123.38

EAPG 3.18: ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS

Facility

$265.75

Service Code	EAPG 598
Min. Negotiated Rate	$121.13
Max. Negotiated Rate	$265.75
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$148.32
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$123.60
Rate for Payer: EmblemHealth Medicaid	$123.60
Rate for Payer: Galaxy Health Workers Comp	$121.13
Rate for Payer: Hamaspik Choice Medicaid	$123.60
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid	$129.78
Rate for Payer: MVP Health Care of NY Essential Plan 1&2	$265.75
Rate for Payer: MVP Health Care of NY Essential Plan 3&4	$265.75
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$123.60
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid	$129.78

Know your out-of-pocket cost for care.

All Charges