CPT 72072
The standard charge for X-ray thoracic spine, 3 views is $502.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
10 Healthy Way, Ellenville, NY, 12428CONTACT
(845) 647-6400 Visit WebsiteEllenville Regional Hospital is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.
In compliance with federal law, Ellenville Regional Hospital provides a list of standard charges. These are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient’s unique needs.
I understand that the list of standard charges includes only hospital services and does not contain professional fees for non-Ellenville Regional Hospital physicians or advanced practice providers. It does not contain professional fees for anesthesia, physicians or advanced practice providers.
I understand that a single line item charge may not represent a complete medical service. In general, multiple charge line items are necessary to represent all components of a service (e.g. procedures, supplies, and drugs).
I understand that the list of standard charges is not intended for media use.
I understand prices are the list price of all hospital charges and not necessarily what my insurance company will pay or what I will owe to the hospital. My actual bill may include one or more of list price charges.
The hospital typically accepts a rate that is less than the list charges. Your insurer will determine what you will owe after they have paid their agreed upon amount.
We know that the billing and payment processes may seem overwhelming at times. Please contact our team at 845-647-6400.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$502.00Insurance Discount
-$200.80Price Negotiated by Insurer
$301.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$11.05BASIC METABOLIC PANEL
$31.20CBC WITH DIFF (AUTO)
$27.95COMPL AUTOM CBC W PLT
$21.45COMPREHENSIVE METABOLIC PANEL
$35.10CT HEAD/BRAIN W/O DYE
$1,036.00CT NECK SPINE W/O DYE
$1,036.00CULTURE URINE ROUTINE
$35.10EKG 12 LEAD; TRACING ONLY
$126.75EMERGENCY DEPT VISIT LVL 3
$955.00EMERGENCY DEPT VISIT LVL 4
$955.00EMERGENCY DEPT VISIT LVL 5
$955.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$350.00MAGNESIUM
$24.70NATRIURETIC PEPTIDE
$287.95NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$3,629.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$112.00VITAMIN B-12 INJECTION TO 1000 MCG
$3.40X-RAY EXAM CHEST 2 VIEWS
$156.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$156.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$271.08Price Negotiated by Insurer
$230.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$7.82BASIC METABOLIC PANEL
$22.08CBC WITH DIFF (AUTO)
$19.78COMPL AUTOM CBC W PLT
$15.18COMPREHENSIVE METABOLIC PANEL
$24.84CT HEAD/BRAIN W/O DYE
$529.46CT NECK SPINE W/O DYE
$692.76CULTURE URINE ROUTINE
$24.84EKG 12 LEAD; TRACING ONLY
$89.70EMERGENCY DEPT VISIT LVL 3
$345.00EMERGENCY DEPT VISIT LVL 4
$506.00EMERGENCY DEPT VISIT LVL 5
$644.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$203.32IVP SINGLE DRUG OR SUBSTANCE
$230.00MAGNESIUM
$17.48NATRIURETIC PEPTIDE
$203.78NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$65.32PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$166.52VITAMIN B-12 INJECTION TO 1000 MCG
$2.84X-RAY EXAM CHEST 2 VIEWS
$119.60X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$119.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$125.50Price Negotiated by Insurer
$376.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$12.75BASIC METABOLIC PANEL
$36.00CBC WITH DIFF (AUTO)
$32.25COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT NECK SPINE W/O DYE
$1,129.50CULTURE URINE ROUTINE
$40.50EKG 12 LEAD; TRACING ONLY
$146.25EMERGENCY DEPT VISIT LVL 3
$950.93EMERGENCY DEPT VISIT LVL 4
$950.93EMERGENCY DEPT VISIT LVL 5
$950.93IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$320.44MAGNESIUM
$28.50NATRIURETIC PEPTIDE
$332.25NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$3,339.68PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$271.50VITAMIN B-12 INJECTION TO 1000 MCG
$1.42X-RAY EXAM CHEST 2 VIEWS
$195.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$195.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$125.50Price Negotiated by Insurer
$376.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$12.75BASIC METABOLIC PANEL
$36.00CBC WITH DIFF (AUTO)
$32.25COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT NECK SPINE W/O DYE
$1,129.50CULTURE URINE ROUTINE
$40.50EKG 12 LEAD; TRACING ONLY
$146.25EMERGENCY DEPT VISIT LVL 3
$1,189.18EMERGENCY DEPT VISIT LVL 4
$1,189.18EMERGENCY DEPT VISIT LVL 5
$1,189.18IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$400.55MAGNESIUM
$28.50NATRIURETIC PEPTIDE
$332.25NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$4,175.13PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$271.50VITAMIN B-12 INJECTION TO 1000 MCG
$1.42X-RAY EXAM CHEST 2 VIEWS
$195.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$195.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$316.26Price Negotiated by Insurer
$185.74Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$6.29BASIC METABOLIC PANEL
$17.76CBC WITH DIFF (AUTO)
$15.91COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT NECK SPINE W/O DYE
$557.22CULTURE URINE ROUTINE
$19.98EKG 12 LEAD; TRACING ONLY
$72.15EMERGENCY DEPT VISIT LVL 3
$277.50EMERGENCY DEPT VISIT LVL 4
$407.00EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00MAGNESIUM
$14.06NATRIURETIC PEPTIDE
$163.91NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94VITAMIN B-12 INJECTION TO 1000 MCG
$2.29X-RAY EXAM CHEST 2 VIEWS
$96.20X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$96.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$251.00Price Negotiated by Insurer
$251.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$8.50BASIC METABOLIC PANEL
$24.00CBC WITH DIFF (AUTO)
$21.50COMPL AUTOM CBC W PLT
$16.50COMPREHENSIVE METABOLIC PANEL
$27.00CT HEAD/BRAIN W/O DYE
$666.00CT NECK SPINE W/O DYE
$666.00CULTURE URINE ROUTINE
$27.00EKG 12 LEAD; TRACING ONLY
$97.50EMERGENCY DEPT VISIT LVL 3
$657.00EMERGENCY DEPT VISIT LVL 4
$745.00EMERGENCY DEPT VISIT LVL 5
$745.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$221.00IVP SINGLE DRUG OR SUBSTANCE
$250.00MAGNESIUM
$19.00NATRIURETIC PEPTIDE
$221.50NORMAL SALINE INFUSION 1000 CC
$9.78OBSERVATION ROOM 1 HR-MED SURG
$2,255.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$108.00VITAMIN B-12 INJECTION TO 1000 MCG
$3.09X-RAY EXAM CHEST 2 VIEWS
$130.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$130.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$125.50Price Negotiated by Insurer
$376.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$12.75BASIC METABOLIC PANEL
$36.00CBC WITH DIFF (AUTO)
$32.25COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT NECK SPINE W/O DYE
$1,129.50CULTURE URINE ROUTINE
$40.50EKG 12 LEAD; TRACING ONLY
$146.25EMERGENCY DEPT VISIT LVL 3
$562.50EMERGENCY DEPT VISIT LVL 4
$825.00EMERGENCY DEPT VISIT LVL 5
$1,050.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00MAGNESIUM
$28.50NATRIURETIC PEPTIDE
$332.25NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$106.50PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$271.50VITAMIN B-12 INJECTION TO 1000 MCG
$4.64X-RAY EXAM CHEST 2 VIEWS
$195.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$195.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$97.89Price Negotiated by Insurer
$404.11Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$13.68BASIC METABOLIC PANEL
$38.64CBC WITH DIFF (AUTO)
$34.62COMPL AUTOM CBC W PLT
$26.56COMPREHENSIVE METABOLIC PANEL
$43.47CT HEAD/BRAIN W/O DYE
$926.56CT NECK SPINE W/O DYE
$1,212.33CULTURE URINE ROUTINE
$43.47EKG 12 LEAD; TRACING ONLY
$156.98EMERGENCY DEPT VISIT LVL 3
$603.75EMERGENCY DEPT VISIT LVL 4
$885.50EMERGENCY DEPT VISIT LVL 5
$1,127.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$355.81IVP SINGLE DRUG OR SUBSTANCE
$402.50MAGNESIUM
$30.59NATRIURETIC PEPTIDE
$356.62NORMAL SALINE INFUSION 1000 CC
$15.75OBSERVATION ROOM 1 HR-MED SURG
$114.31PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$291.41VITAMIN B-12 INJECTION TO 1000 MCG
$4.97X-RAY EXAM CHEST 2 VIEWS
$209.30X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$209.30This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$316.26Price Negotiated by Insurer
$185.74Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$6.29BASIC METABOLIC PANEL
$17.76CBC WITH DIFF (AUTO)
$15.91COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT NECK SPINE W/O DYE
$557.22CULTURE URINE ROUTINE
$19.98EKG 12 LEAD; TRACING ONLY
$72.15EMERGENCY DEPT VISIT LVL 3
$277.50EMERGENCY DEPT VISIT LVL 4
$407.00EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00MAGNESIUM
$14.06NATRIURETIC PEPTIDE
$163.91NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94VITAMIN B-12 INJECTION TO 1000 MCG
$2.29X-RAY EXAM CHEST 2 VIEWS
$96.20X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$96.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$150.60Price Negotiated by Insurer
$351.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$10.20BASIC METABOLIC PANEL
$28.80CBC WITH DIFF (AUTO)
$25.80COMPL AUTOM CBC W PLT
$19.80COMPREHENSIVE METABOLIC PANEL
$32.40CT HEAD/BRAIN W/O DYE
$805.70CT NECK SPINE W/O DYE
$1,054.20CULTURE URINE ROUTINE
$32.40EKG 12 LEAD; TRACING ONLY
$136.50EMERGENCY DEPT VISIT LVL 3
$1,182.00EMERGENCY DEPT VISIT LVL 4
$1,182.00EMERGENCY DEPT VISIT LVL 5
$1,182.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$265.20IVP SINGLE DRUG OR SUBSTANCE
$400.00MAGNESIUM
$22.80NATRIURETIC PEPTIDE
$265.80NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$2,700.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60VITAMIN B-12 INJECTION TO 1000 MCG
$1.42X-RAY EXAM CHEST 2 VIEWS
$182.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$182.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$100.40Price Negotiated by Insurer
$401.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$13.60BASIC METABOLIC PANEL
$38.40CBC WITH DIFF (AUTO)
$34.40COMPL AUTOM CBC W PLT
$26.40COMPREHENSIVE METABOLIC PANEL
$43.20CT HEAD/BRAIN W/O DYE
$920.80CT NECK SPINE W/O DYE
$1,204.80CULTURE URINE ROUTINE
$43.20EKG 12 LEAD; TRACING ONLY
$156.00EMERGENCY DEPT VISIT LVL 3
$600.00EMERGENCY DEPT VISIT LVL 4
$880.00EMERGENCY DEPT VISIT LVL 5
$1,120.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$400.00MAGNESIUM
$30.40NATRIURETIC PEPTIDE
$354.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60VITAMIN B-12 INJECTION TO 1000 MCG
$4.94X-RAY EXAM CHEST 2 VIEWS
$208.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$208.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$100.40Price Negotiated by Insurer
$401.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$13.60BASIC METABOLIC PANEL
$38.40CBC WITH DIFF (AUTO)
$34.40COMPL AUTOM CBC W PLT
$26.40COMPREHENSIVE METABOLIC PANEL
$43.20CT HEAD/BRAIN W/O DYE
$920.80CT NECK SPINE W/O DYE
$1,204.80CULTURE URINE ROUTINE
$43.20EKG 12 LEAD; TRACING ONLY
$156.00EMERGENCY DEPT VISIT LVL 3
$600.00EMERGENCY DEPT VISIT LVL 4
$880.00EMERGENCY DEPT VISIT LVL 5
$1,120.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$400.00MAGNESIUM
$30.40NATRIURETIC PEPTIDE
$354.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60VITAMIN B-12 INJECTION TO 1000 MCG
$4.94X-RAY EXAM CHEST 2 VIEWS
$208.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$208.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$100.40Price Negotiated by Insurer
$401.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$13.60BASIC METABOLIC PANEL
$38.40CBC WITH DIFF (AUTO)
$34.40COMPL AUTOM CBC W PLT
$26.40COMPREHENSIVE METABOLIC PANEL
$43.20CT HEAD/BRAIN W/O DYE
$920.80CT NECK SPINE W/O DYE
$1,204.80CULTURE URINE ROUTINE
$43.20EKG 12 LEAD; TRACING ONLY
$156.00EMERGENCY DEPT VISIT LVL 3
$600.00EMERGENCY DEPT VISIT LVL 4
$880.00EMERGENCY DEPT VISIT LVL 5
$1,120.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$400.00MAGNESIUM
$30.40NATRIURETIC PEPTIDE
$354.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60VITAMIN B-12 INJECTION TO 1000 MCG
$4.94X-RAY EXAM CHEST 2 VIEWS
$208.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$208.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$331.32Price Negotiated by Insurer
$170.68Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$5.78BASIC METABOLIC PANEL
$16.32CBC WITH DIFF (AUTO)
$14.62COMPL AUTOM CBC W PLT
$11.22COMPREHENSIVE METABOLIC PANEL
$18.36CT HEAD/BRAIN W/O DYE
$391.34CT NECK SPINE W/O DYE
$512.04CULTURE URINE ROUTINE
$18.36EKG 12 LEAD; TRACING ONLY
$66.30EMERGENCY DEPT VISIT LVL 3
$255.00EMERGENCY DEPT VISIT LVL 4
$374.00EMERGENCY DEPT VISIT LVL 5
$476.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$150.28IVP SINGLE DRUG OR SUBSTANCE
$170.00MAGNESIUM
$12.92NATRIURETIC PEPTIDE
$150.62NORMAL SALINE INFUSION 1000 CC
$6.65OBSERVATION ROOM 1 HR-MED SURG
$48.28PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$123.08VITAMIN B-12 INJECTION TO 1000 MCG
$2.10X-RAY EXAM CHEST 2 VIEWS
$88.40X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$88.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$175.70Price Negotiated by Insurer
$326.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$10.20BASIC METABOLIC PANEL
$28.80CBC WITH DIFF (AUTO)
$25.80COMPL AUTOM CBC W PLT
$19.80COMPREHENSIVE METABOLIC PANEL
$32.40CT HEAD/BRAIN W/O DYE
$748.15CT NECK SPINE W/O DYE
$978.90CULTURE URINE ROUTINE
$32.40EKG 12 LEAD; TRACING ONLY
$126.75EMERGENCY DEPT VISIT LVL 3
$1,064.00EMERGENCY DEPT VISIT LVL 4
$1,064.00EMERGENCY DEPT VISIT LVL 5
$1,064.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$265.20IVP SINGLE DRUG OR SUBSTANCE
$360.00MAGNESIUM
$22.80NATRIURETIC PEPTIDE
$265.80NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$2,430.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$260.64VITAMIN B-12 INJECTION TO 1000 MCG
$1.42X-RAY EXAM CHEST 2 VIEWS
$169.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$169.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$310.69Price Negotiated by Insurer
$191.31Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$6.48BASIC METABOLIC PANEL
$18.29CBC WITH DIFF (AUTO)
$16.39COMPL AUTOM CBC W PLT
$12.58COMPREHENSIVE METABOLIC PANEL
$20.58CT HEAD/BRAIN W/O DYE
$438.65CT NECK SPINE W/O DYE
$573.94CULTURE URINE ROUTINE
$20.58EKG 12 LEAD; TRACING ONLY
$74.31EMERGENCY DEPT VISIT LVL 3
$285.82EMERGENCY DEPT VISIT LVL 4
$419.21EMERGENCY DEPT VISIT LVL 5
$533.54IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$168.45IVP SINGLE DRUG OR SUBSTANCE
$190.55MAGNESIUM
$14.48NATRIURETIC PEPTIDE
$168.83NORMAL SALINE INFUSION 1000 CC
$7.46OBSERVATION ROOM 1 HR-MED SURG
$54.12PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$137.96VITAMIN B-12 INJECTION TO 1000 MCG
$2.36X-RAY EXAM CHEST 2 VIEWS
$99.09X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$99.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$175.70Price Negotiated by Insurer
$326.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$11.05BASIC METABOLIC PANEL
$31.20CBC WITH DIFF (AUTO)
$27.95COMPL AUTOM CBC W PLT
$21.45COMPREHENSIVE METABOLIC PANEL
$35.10CT HEAD/BRAIN W/O DYE
$748.15CT NECK SPINE W/O DYE
$978.90CULTURE URINE ROUTINE
$35.10EKG 12 LEAD; TRACING ONLY
$126.75EMERGENCY DEPT VISIT LVL 3
$487.50EMERGENCY DEPT VISIT LVL 4
$715.00EMERGENCY DEPT VISIT LVL 5
$910.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$325.00MAGNESIUM
$24.70NATRIURETIC PEPTIDE
$287.95NORMAL SALINE INFUSION 1000 CC
$12.72OBSERVATION ROOM 1 HR-MED SURG
$92.30PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$235.30VITAMIN B-12 INJECTION TO 1000 MCG
$4.02X-RAY EXAM CHEST 2 VIEWS
$169.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$169.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$316.26Price Negotiated by Insurer
$185.74Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$6.29BASIC METABOLIC PANEL
$17.76CBC WITH DIFF (AUTO)
$15.91COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT NECK SPINE W/O DYE
$557.22CULTURE URINE ROUTINE
$19.98EKG 12 LEAD; TRACING ONLY
$72.15EMERGENCY DEPT VISIT LVL 3
$277.50EMERGENCY DEPT VISIT LVL 4
$407.00EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00MAGNESIUM
$14.06NATRIURETIC PEPTIDE
$163.91NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94VITAMIN B-12 INJECTION TO 1000 MCG
$2.29X-RAY EXAM CHEST 2 VIEWS
$96.20X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$96.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$316.26Price Negotiated by Insurer
$185.74Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$6.29BASIC METABOLIC PANEL
$17.76CBC WITH DIFF (AUTO)
$15.91COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT NECK SPINE W/O DYE
$557.22CULTURE URINE ROUTINE
$19.98EKG 12 LEAD; TRACING ONLY
$72.15EMERGENCY DEPT VISIT LVL 3
$277.50EMERGENCY DEPT VISIT LVL 4
$407.00EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00MAGNESIUM
$14.06NATRIURETIC PEPTIDE
$163.91NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94VITAMIN B-12 INJECTION TO 1000 MCG
$2.29X-RAY EXAM CHEST 2 VIEWS
$96.20X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$96.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$200.80Price Negotiated by Insurer
$301.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$11.05BASIC METABOLIC PANEL
$31.20CBC WITH DIFF (AUTO)
$27.95COMPL AUTOM CBC W PLT
$21.45COMPREHENSIVE METABOLIC PANEL
$35.10CT HEAD/BRAIN W/O DYE
$1,036.00CT NECK SPINE W/O DYE
$1,036.00CULTURE URINE ROUTINE
$35.10EKG 12 LEAD; TRACING ONLY
$126.75EMERGENCY DEPT VISIT LVL 3
$955.00EMERGENCY DEPT VISIT LVL 4
$955.00EMERGENCY DEPT VISIT LVL 5
$955.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$350.00MAGNESIUM
$24.70NATRIURETIC PEPTIDE
$287.95NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$3,629.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$112.00VITAMIN B-12 INJECTION TO 1000 MCG
$3.40X-RAY EXAM CHEST 2 VIEWS
$156.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$156.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$271.08Price Negotiated by Insurer
$230.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$7.82BASIC METABOLIC PANEL
$22.08CBC WITH DIFF (AUTO)
$19.78COMPL AUTOM CBC W PLT
$15.18COMPREHENSIVE METABOLIC PANEL
$24.84CT HEAD/BRAIN W/O DYE
$529.46CT NECK SPINE W/O DYE
$692.76CULTURE URINE ROUTINE
$24.84EKG 12 LEAD; TRACING ONLY
$89.70EMERGENCY DEPT VISIT LVL 3
$345.00EMERGENCY DEPT VISIT LVL 4
$506.00EMERGENCY DEPT VISIT LVL 5
$644.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$203.32IVP SINGLE DRUG OR SUBSTANCE
$230.00MAGNESIUM
$17.48NATRIURETIC PEPTIDE
$203.78NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$65.32PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$166.52VITAMIN B-12 INJECTION TO 1000 MCG
$2.84X-RAY EXAM CHEST 2 VIEWS
$119.60X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$119.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$125.50Price Negotiated by Insurer
$376.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$12.75BASIC METABOLIC PANEL
$36.00CBC WITH DIFF (AUTO)
$32.25COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT NECK SPINE W/O DYE
$1,129.50CULTURE URINE ROUTINE
$40.50EKG 12 LEAD; TRACING ONLY
$146.25EMERGENCY DEPT VISIT LVL 3
$1,174.00EMERGENCY DEPT VISIT LVL 4
$1,174.00EMERGENCY DEPT VISIT LVL 5
$1,174.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00MAGNESIUM
$28.50NATRIURETIC PEPTIDE
$332.25NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$2,652.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$179.00VITAMIN B-12 INJECTION TO 1000 MCG
$4.64X-RAY EXAM CHEST 2 VIEWS
$195.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$195.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$219.37Price Negotiated by Insurer
$282.63Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$9.57BASIC METABOLIC PANEL
$27.02CBC WITH DIFF (AUTO)
$24.21COMPL AUTOM CBC W PLT
$18.58COMPREHENSIVE METABOLIC PANEL
$30.40CT HEAD/BRAIN W/O DYE
$648.01CT NECK SPINE W/O DYE
$847.88CULTURE URINE ROUTINE
$30.40EKG 12 LEAD; TRACING ONLY
$109.78EMERGENCY DEPT VISIT LVL 3
$881.00EMERGENCY DEPT VISIT LVL 4
$881.00EMERGENCY DEPT VISIT LVL 5
$881.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$248.85IVP SINGLE DRUG OR SUBSTANCE
$281.50MAGNESIUM
$21.39NATRIURETIC PEPTIDE
$249.41NORMAL SALINE INFUSION 1000 CC
$11.02OBSERVATION ROOM 1 HR-MED SURG
$1,989.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$134.00VITAMIN B-12 INJECTION TO 1000 MCG
$3.48X-RAY EXAM CHEST 2 VIEWS
$146.38X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$146.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$306.97Price Negotiated by Insurer
$195.03Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$6.60BASIC METABOLIC PANEL
$18.65CBC WITH DIFF (AUTO)
$16.71COMPL AUTOM CBC W PLT
$12.82COMPREHENSIVE METABOLIC PANEL
$20.98CT HEAD/BRAIN W/O DYE
$447.16CT NECK SPINE W/O DYE
$585.08CULTURE URINE ROUTINE
$20.98EKG 12 LEAD; TRACING ONLY
$75.76EMERGENCY DEPT VISIT LVL 3
$291.38EMERGENCY DEPT VISIT LVL 4
$427.35EMERGENCY DEPT VISIT LVL 5
$543.90IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$171.72IVP SINGLE DRUG OR SUBSTANCE
$194.25MAGNESIUM
$14.76NATRIURETIC PEPTIDE
$172.11NORMAL SALINE INFUSION 1000 CC
$7.60OBSERVATION ROOM 1 HR-MED SURG
$55.17PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$140.64VITAMIN B-12 INJECTION TO 1000 MCG
$2.40X-RAY EXAM CHEST 2 VIEWS
$101.01X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$101.01This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$112.00Price Negotiated by Insurer
$390.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$12.75BASIC METABOLIC PANEL
$36.00CBC WITH DIFF (AUTO)
$32.25COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$775.00CT NECK SPINE W/O DYE
$775.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 3
$980.00EMERGENCY DEPT VISIT LVL 4
$980.00EMERGENCY DEPT VISIT LVL 5
$980.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00MAGNESIUM
$28.50NATRIURETIC PEPTIDE
$332.25NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,134.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$156.00VITAMIN B-12 INJECTION TO 1000 MCG
$2.16X-RAY EXAM CHEST 2 VIEWS
$390.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$390.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$471.70Price Negotiated by Insurer
$30.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$3.17BASIC METABOLIC PANEL
$7.32CBC WITH DIFF (AUTO)
$3.20COMPL AUTOM CBC W PLT
$3.20COMPREHENSIVE METABOLIC PANEL
$10.10CULTURE URINE ROUTINE
$8.07EKG 12 LEAD; TRACING ONLY
$7.58EMERGENCY DEPT VISIT LVL 3
$271.85EMERGENCY DEPT VISIT LVL 4
$422.00EMERGENCY DEPT VISIT LVL 5
$611.99IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$85.59IVP SINGLE DRUG OR SUBSTANCE
$204.22MAGNESIUM
$5.08NATRIURETIC PEPTIDE
$34.41VITAMIN B-12 INJECTION TO 1000 MCG
$1.42X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$12.63This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$112.00Price Negotiated by Insurer
$390.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$12.75BASIC METABOLIC PANEL
$36.00CBC WITH DIFF (AUTO)
$32.25COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$775.00CT NECK SPINE W/O DYE
$775.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 3
$980.00EMERGENCY DEPT VISIT LVL 4
$980.00EMERGENCY DEPT VISIT LVL 5
$980.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00MAGNESIUM
$28.50NATRIURETIC PEPTIDE
$332.25NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,134.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$156.00VITAMIN B-12 INJECTION TO 1000 MCG
$2.16X-RAY EXAM CHEST 2 VIEWS
$390.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$390.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$316.26Price Negotiated by Insurer
$185.74Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$6.29BASIC METABOLIC PANEL
$17.76CBC WITH DIFF (AUTO)
$15.91COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT NECK SPINE W/O DYE
$557.22CULTURE URINE ROUTINE
$19.98EKG 12 LEAD; TRACING ONLY
$72.15EMERGENCY DEPT VISIT LVL 3
$277.50EMERGENCY DEPT VISIT LVL 4
$407.00EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00MAGNESIUM
$14.06NATRIURETIC PEPTIDE
$163.91NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94VITAMIN B-12 INJECTION TO 1000 MCG
$2.29X-RAY EXAM CHEST 2 VIEWS
$96.20X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$96.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.
Total estimated charges
$502.00Insurance Discount
-$225.90Price Negotiated by Insurer
$276.10Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AUTOM URINE DIP W MICRO
$9.35BASIC METABOLIC PANEL
$26.40CBC WITH DIFF (AUTO)
$23.65COMPL AUTOM CBC W PLT
$18.15COMPREHENSIVE METABOLIC PANEL
$29.70CT HEAD/BRAIN W/O DYE
$633.05CT NECK SPINE W/O DYE
$828.30CULTURE URINE ROUTINE
$29.70EKG 12 LEAD; TRACING ONLY
$107.25EMERGENCY DEPT VISIT LVL 3
$412.50EMERGENCY DEPT VISIT LVL 4
$605.00EMERGENCY DEPT VISIT LVL 5
$770.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$243.10IVP SINGLE DRUG OR SUBSTANCE
$275.00MAGNESIUM
$20.90NATRIURETIC PEPTIDE
$243.65NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$78.10PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$199.10VITAMIN B-12 INJECTION TO 1000 MCG
$3.40X-RAY EXAM CHEST 2 VIEWS
$143.00X-RAY EXAM OF HAND 3+ VIEWS, LEFT
$143.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ellenville Regional Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ellenville Regional Hospital directly.