CPT 72190
The standard charge for X-ray pelvis, 3 or more views is $315.00. 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
$315.00Insurance Discount
-$126.00Price Negotiated by Insurer
$189.00Deductible 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
$11.05BASIC METABOLIC PANEL
$31.20CBC WITH DIFF (AUTO)
$27.95CEFTRIAXONE SODIUM, PER 250 MG
$1.70COMPL AUTOM CBC W PLT
$21.45COMPREHENSIVE METABOLIC PANEL
$35.10CT HEAD/BRAIN W/O DYE
$1,036.00CT PELVIS W/O DYE
$1,036.00CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$955.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$105.30IV THERAPY INITIAL
$429.10NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$3,629.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$112.00OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$112.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$112.00THYROID STIM HORM (TSH)
$57.85X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$156.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$170.10Price Negotiated by Insurer
$144.90Deductible 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)
$19.78CEFTRIAXONE SODIUM, PER 250 MG
$1.42COMPL AUTOM CBC W PLT
$15.18COMPREHENSIVE METABOLIC PANEL
$24.84CT HEAD/BRAIN W/O DYE
$529.46CT PELVIS W/O DYE
$649.98CULTURE URINE ROUTINE
$24.84EMERGENCY DEPT VISIT LVL 5
$644.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$74.52IV THERAPY INITIAL
$281.98NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$65.32OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$56.58OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$40.02PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$166.52THYROID STIM HORM (TSH)
$40.94X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$119.60X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$78.75Price Negotiated by Insurer
$236.25Deductible 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)
$32.25CEFTRIAXONE SODIUM, PER 250 MG
$0.45COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT PELVIS W/O DYE
$1,059.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$950.93IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$121.50IV THERAPY INITIAL
$320.44NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$3,339.68OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$92.25OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$65.25PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$271.50THYROID STIM HORM (TSH)
$66.75X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$195.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$78.75Price Negotiated by Insurer
$236.25Deductible 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)
$32.25CEFTRIAXONE SODIUM, PER 250 MG
$0.45COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT PELVIS W/O DYE
$1,059.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,189.18IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$121.50IV THERAPY INITIAL
$400.55NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$4,175.13OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$92.25OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$65.25PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$271.50THYROID STIM HORM (TSH)
$66.75X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$195.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$198.45Price Negotiated by Insurer
$116.55Deductible 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)
$15.91CEFTRIAXONE SODIUM, PER 250 MG
$1.14COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT PELVIS W/O DYE
$522.81CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$59.94IV THERAPY INITIAL
$226.81NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$45.51OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$32.19PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94THYROID STIM HORM (TSH)
$32.93X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$96.20X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$157.50Price Negotiated by Insurer
$157.50Deductible 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
$8.50BASIC METABOLIC PANEL
$24.00CBC WITH DIFF (AUTO)
$21.50CEFTRIAXONE SODIUM, PER 250 MG
$1.54COMPL AUTOM CBC W PLT
$16.50COMPREHENSIVE METABOLIC PANEL
$27.00CT HEAD/BRAIN W/O DYE
$666.00CT PELVIS W/O DYE
$666.00CULTURE URINE ROUTINE
$27.00EMERGENCY DEPT VISIT LVL 5
$745.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$81.00IV THERAPY INITIAL
$306.50NORMAL SALINE INFUSION 1000 CC
$9.78OBSERVATION ROOM 1 HR-MED SURG
$2,255.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$108.00OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$108.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$108.00THYROID STIM HORM (TSH)
$44.50X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$130.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$78.75Price Negotiated by Insurer
$236.25Deductible 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)
$32.25CEFTRIAXONE SODIUM, PER 250 MG
$2.32COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT PELVIS W/O DYE
$1,059.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,050.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$121.50IV THERAPY INITIAL
$459.75NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$106.50OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$92.25OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$65.25PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$271.50THYROID STIM HORM (TSH)
$66.75X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$195.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$61.42Price Negotiated by Insurer
$253.58Deductible 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)
$34.62CEFTRIAXONE SODIUM, PER 250 MG
$2.49COMPL AUTOM CBC W PLT
$26.56COMPREHENSIVE METABOLIC PANEL
$43.47CT HEAD/BRAIN W/O DYE
$926.56CT PELVIS W/O DYE
$1,137.46CULTURE URINE ROUTINE
$43.47EMERGENCY DEPT VISIT LVL 5
$1,127.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$130.41IV THERAPY INITIAL
$493.46NORMAL SALINE INFUSION 1000 CC
$15.75OBSERVATION ROOM 1 HR-MED SURG
$114.31OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$99.02OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$70.04PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$291.41THYROID STIM HORM (TSH)
$71.64X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$209.30X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$198.45Price Negotiated by Insurer
$116.55Deductible 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)
$15.91CEFTRIAXONE SODIUM, PER 250 MG
$1.14COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT PELVIS W/O DYE
$522.81CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$59.94IV THERAPY INITIAL
$226.81NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$45.51OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$32.19PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94THYROID STIM HORM (TSH)
$32.93X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$96.20X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$94.50Price Negotiated by Insurer
$220.50Deductible 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
$10.20BASIC METABOLIC PANEL
$28.80CBC WITH DIFF (AUTO)
$25.80CEFTRIAXONE SODIUM, PER 250 MG
$0.45COMPL AUTOM CBC W PLT
$19.80COMPREHENSIVE METABOLIC PANEL
$32.40CT HEAD/BRAIN W/O DYE
$805.70CT PELVIS W/O DYE
$989.10CULTURE URINE ROUTINE
$32.40EMERGENCY DEPT VISIT LVL 5
$1,182.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$97.20IV THERAPY INITIAL
$490.40NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$2,700.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$98.40OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$69.60PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60THYROID STIM HORM (TSH)
$53.40X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$182.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$63.00Price Negotiated by Insurer
$252.00Deductible 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
$13.60BASIC METABOLIC PANEL
$38.40CBC WITH DIFF (AUTO)
$34.40CEFTRIAXONE SODIUM, PER 250 MG
$2.47COMPL AUTOM CBC W PLT
$26.40COMPREHENSIVE METABOLIC PANEL
$43.20CT HEAD/BRAIN W/O DYE
$920.80CT PELVIS W/O DYE
$1,130.40CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,120.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$129.60IV THERAPY INITIAL
$490.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$98.40OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$69.60PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60THYROID STIM HORM (TSH)
$71.20X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$208.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$63.00Price Negotiated by Insurer
$252.00Deductible 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
$13.60BASIC METABOLIC PANEL
$38.40CBC WITH DIFF (AUTO)
$34.40CEFTRIAXONE SODIUM, PER 250 MG
$2.47COMPL AUTOM CBC W PLT
$26.40COMPREHENSIVE METABOLIC PANEL
$43.20CT HEAD/BRAIN W/O DYE
$920.80CT PELVIS W/O DYE
$1,130.40CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,120.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$129.60IV THERAPY INITIAL
$490.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$98.40OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$69.60PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60THYROID STIM HORM (TSH)
$71.20X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$208.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$63.00Price Negotiated by Insurer
$252.00Deductible 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
$13.60BASIC METABOLIC PANEL
$38.40CBC WITH DIFF (AUTO)
$34.40CEFTRIAXONE SODIUM, PER 250 MG
$2.47COMPL AUTOM CBC W PLT
$26.40COMPREHENSIVE METABOLIC PANEL
$43.20CT HEAD/BRAIN W/O DYE
$920.80CT PELVIS W/O DYE
$1,130.40CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,120.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$129.60IV THERAPY INITIAL
$490.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$98.40OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$69.60PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$289.60THYROID STIM HORM (TSH)
$71.20X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$208.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$207.90Price Negotiated by Insurer
$107.10Deductible 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
$5.78BASIC METABOLIC PANEL
$16.32CBC WITH DIFF (AUTO)
$14.62CEFTRIAXONE SODIUM, PER 250 MG
$1.05COMPL AUTOM CBC W PLT
$11.22COMPREHENSIVE METABOLIC PANEL
$18.36CT HEAD/BRAIN W/O DYE
$391.34CT PELVIS W/O DYE
$480.42CULTURE URINE ROUTINE
$18.36EMERGENCY DEPT VISIT LVL 5
$476.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$55.08IV THERAPY INITIAL
$208.42NORMAL SALINE INFUSION 1000 CC
$6.65OBSERVATION ROOM 1 HR-MED SURG
$48.28OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$41.82OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$29.58PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$123.08THYROID STIM HORM (TSH)
$30.26X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$88.40X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$110.25Price Negotiated by Insurer
$204.75Deductible 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)
$25.80CEFTRIAXONE SODIUM, PER 250 MG
$0.45COMPL AUTOM CBC W PLT
$19.80COMPREHENSIVE METABOLIC PANEL
$32.40CT HEAD/BRAIN W/O DYE
$748.15CT PELVIS W/O DYE
$918.45CULTURE URINE ROUTINE
$32.40EMERGENCY DEPT VISIT LVL 5
$1,064.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$97.20IV THERAPY INITIAL
$441.36NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$2,430.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$88.56OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$62.64PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$260.64THYROID STIM HORM (TSH)
$53.40X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$169.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$194.95Price Negotiated by Insurer
$120.05Deductible 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)
$16.39CEFTRIAXONE SODIUM, PER 250 MG
$1.18COMPL AUTOM CBC W PLT
$12.58COMPREHENSIVE METABOLIC PANEL
$20.58CT HEAD/BRAIN W/O DYE
$438.65CT PELVIS W/O DYE
$538.49CULTURE URINE ROUTINE
$20.58EMERGENCY DEPT VISIT LVL 5
$533.54IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$61.74IV THERAPY INITIAL
$233.61NORMAL SALINE INFUSION 1000 CC
$7.46OBSERVATION ROOM 1 HR-MED SURG
$54.12OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$46.88OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$33.16PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$137.96THYROID STIM HORM (TSH)
$33.92X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$99.09X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$110.25Price Negotiated by Insurer
$204.75Deductible 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)
$27.95CEFTRIAXONE SODIUM, PER 250 MG
$2.01COMPL AUTOM CBC W PLT
$21.45COMPREHENSIVE METABOLIC PANEL
$35.10CT HEAD/BRAIN W/O DYE
$748.15CT PELVIS W/O DYE
$918.45CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$910.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$105.30IV THERAPY INITIAL
$398.45NORMAL SALINE INFUSION 1000 CC
$12.72OBSERVATION ROOM 1 HR-MED SURG
$92.30OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$79.95OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$56.55PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$235.30THYROID STIM HORM (TSH)
$57.85X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$169.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$198.45Price Negotiated by Insurer
$116.55Deductible 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)
$15.91CEFTRIAXONE SODIUM, PER 250 MG
$1.14COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT PELVIS W/O DYE
$522.81CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$59.94IV THERAPY INITIAL
$226.81NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$45.51OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$32.19PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94THYROID STIM HORM (TSH)
$32.93X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$96.20X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$198.45Price Negotiated by Insurer
$116.55Deductible 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)
$15.91CEFTRIAXONE SODIUM, PER 250 MG
$1.14COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT PELVIS W/O DYE
$522.81CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$59.94IV THERAPY INITIAL
$226.81NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$45.51OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$32.19PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94THYROID STIM HORM (TSH)
$32.93X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$96.20X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$126.00Price Negotiated by Insurer
$189.00Deductible 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
$11.05BASIC METABOLIC PANEL
$31.20CBC WITH DIFF (AUTO)
$27.95CEFTRIAXONE SODIUM, PER 250 MG
$1.70COMPL AUTOM CBC W PLT
$21.45COMPREHENSIVE METABOLIC PANEL
$35.10CT HEAD/BRAIN W/O DYE
$1,036.00CT PELVIS W/O DYE
$1,036.00CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$955.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$105.30IV THERAPY INITIAL
$429.10NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$3,629.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$112.00OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$112.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$112.00THYROID STIM HORM (TSH)
$57.85X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$156.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$170.10Price Negotiated by Insurer
$144.90Deductible 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)
$19.78CEFTRIAXONE SODIUM, PER 250 MG
$1.42COMPL AUTOM CBC W PLT
$15.18COMPREHENSIVE METABOLIC PANEL
$24.84CT HEAD/BRAIN W/O DYE
$529.46CT PELVIS W/O DYE
$649.98CULTURE URINE ROUTINE
$24.84EMERGENCY DEPT VISIT LVL 5
$644.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$74.52IV THERAPY INITIAL
$281.98NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$65.32OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$56.58OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$40.02PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$166.52THYROID STIM HORM (TSH)
$40.94X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$119.60X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$78.75Price Negotiated by Insurer
$236.25Deductible 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)
$32.25CEFTRIAXONE SODIUM, PER 250 MG
$2.32COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$863.25CT PELVIS W/O DYE
$1,059.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,174.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$121.50IV THERAPY INITIAL
$459.75NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$2,652.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$179.00OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$179.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$179.00THYROID STIM HORM (TSH)
$66.75X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$195.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$137.66Price Negotiated by Insurer
$177.34Deductible 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)
$24.21CEFTRIAXONE SODIUM, PER 250 MG
$1.74COMPL AUTOM CBC W PLT
$18.58COMPREHENSIVE METABOLIC PANEL
$30.40CT HEAD/BRAIN W/O DYE
$648.01CT PELVIS W/O DYE
$795.52CULTURE URINE ROUTINE
$30.40EMERGENCY DEPT VISIT LVL 5
$881.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$91.21IV THERAPY INITIAL
$345.12NORMAL SALINE INFUSION 1000 CC
$11.02OBSERVATION ROOM 1 HR-MED SURG
$1,989.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$134.00OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$134.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$134.00THYROID STIM HORM (TSH)
$50.11X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$146.38X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$192.62Price Negotiated by Insurer
$122.38Deductible 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)
$16.71CEFTRIAXONE SODIUM, PER 250 MG
$1.20COMPL AUTOM CBC W PLT
$12.82COMPREHENSIVE METABOLIC PANEL
$20.98CT HEAD/BRAIN W/O DYE
$447.16CT PELVIS W/O DYE
$548.95CULTURE URINE ROUTINE
$20.98EMERGENCY DEPT VISIT LVL 5
$543.90IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$62.94IV THERAPY INITIAL
$238.15NORMAL SALINE INFUSION 1000 CC
$7.60OBSERVATION ROOM 1 HR-MED SURG
$55.17OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$47.79OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$33.80PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$140.64THYROID STIM HORM (TSH)
$34.58X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$101.01X-RAY EXAM OF KNEE 3, 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
$315.00Price 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)
$32.25CEFTRIAXONE SODIUM, PER 250 MG
$0.94COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$775.00CT PELVIS W/O DYE
$775.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$980.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$121.50IV THERAPY INITIAL
$459.75NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,134.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$156.00OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$156.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$156.00THYROID STIM HORM (TSH)
$66.75X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$390.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$294.80Price Negotiated by Insurer
$20.20Deductible 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
$3.17BASIC METABOLIC PANEL
$7.32CBC WITH DIFF (AUTO)
$3.20COMPL AUTOM CBC W PLT
$3.20COMPREHENSIVE METABOLIC PANEL
$10.10CULTURE URINE ROUTINE
$8.07EMERGENCY DEPT VISIT LVL 5
$611.99IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$27.14IV THERAPY INITIAL
$35.35THYROID STIM HORM (TSH)
$9.09This 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
$315.00Price 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)
$32.25CEFTRIAXONE SODIUM, PER 250 MG
$0.94COMPL AUTOM CBC W PLT
$24.75COMPREHENSIVE METABOLIC PANEL
$40.50CT HEAD/BRAIN W/O DYE
$775.00CT PELVIS W/O DYE
$775.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$980.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$121.50IV THERAPY INITIAL
$459.75NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,134.00OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$156.00OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$156.00PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$156.00THYROID STIM HORM (TSH)
$66.75X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$390.00X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$198.45Price Negotiated by Insurer
$116.55Deductible 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)
$15.91CEFTRIAXONE SODIUM, PER 250 MG
$1.14COMPL AUTOM CBC W PLT
$12.21COMPREHENSIVE METABOLIC PANEL
$19.98CT HEAD/BRAIN W/O DYE
$425.87CT PELVIS W/O DYE
$522.81CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$59.94IV THERAPY INITIAL
$226.81NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$45.51OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$32.19PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$133.94THYROID STIM HORM (TSH)
$32.93X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$96.20X-RAY EXAM OF KNEE 3, 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
$315.00Insurance Discount
-$141.75Price Negotiated by Insurer
$173.25Deductible 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)
$23.65CEFTRIAXONE SODIUM, PER 250 MG
$1.70COMPL AUTOM CBC W PLT
$18.15COMPREHENSIVE METABOLIC PANEL
$29.70CT HEAD/BRAIN W/O DYE
$633.05CT PELVIS W/O DYE
$777.15CULTURE URINE ROUTINE
$29.70EMERGENCY DEPT VISIT LVL 5
$770.00IAAD IA SEVERE AQTRESPIRSYND CORONAVIRUS
$89.10IV THERAPY INITIAL
$337.15NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$78.10OT GAIT TRAINING THERAPY EA 15 MINS (MOD 59 W KX)
$67.65OT THERAPEUTIC EXERCISES EA 15 MINS (MOD 59 W KX)
$47.85PT EVAL HIGH COMPLEX 45 MIN (MOD 59 W KX)
$199.10THYROID STIM HORM (TSH)
$48.95X-RAY EXAM HIP UNI 1 VIEW, RIGHT
$143.00X-RAY EXAM OF KNEE 3, 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.