
CPT 72114
The standard charge for X-ray complete lumbar spine (with bending), 6 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.
AEROBIC/ANAEROBIC CULTURE
$50.05AUTOM URINE DIP W MICRO
$11.05CBC WITH DIFF (AUTO)
$27.95COMPREHENSIVE METABOLIC PANEL
$35.10CPK TOTAL
$24.70CT ABD & PELV W/ DYE
$1,036.00CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$955.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$350.00LACTIC ACID
$53.30LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$7.15MAGNESIUM
$24.70MRI LUMBAR SPINE W/O DYE
$1,738.00MRI THORACIC SPINE W/O DYE
$1,738.00NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$3,629.00X-RAY EXAM CHEST 1 VIEW
$156.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$189.00X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$189.00This 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.
AEROBIC/ANAEROBIC CULTURE
$35.42AUTOM URINE DIP W MICRO
$7.82CBC WITH DIFF (AUTO)
$19.78COMPREHENSIVE METABOLIC PANEL
$24.84CPK TOTAL
$17.48CT ABD & PELV W/ DYE
$692.30CULTURE URINE ROUTINE
$24.84EMERGENCY DEPT VISIT LVL 5
$644.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$203.32IVP SINGLE DRUG OR SUBSTANCE
$230.00LACTIC ACID
$37.72LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.98MAGNESIUM
$17.48MRI LUMBAR SPINE W/O DYE
$1,095.26MRI THORACIC SPINE W/O DYE
$1,047.88NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$65.32X-RAY EXAM CHEST 1 VIEW
$119.60X-RAY EXAM OF PELVIS 1-2 VIEWS
$144.90X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$144.90This 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.
AEROBIC/ANAEROBIC CULTURE
$57.75AUTOM URINE DIP W MICRO
$12.75CBC WITH DIFF (AUTO)
$32.25COMPREHENSIVE METABOLIC PANEL
$40.50CPK TOTAL
$28.50CT ABD & PELV W/ DYE
$1,128.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$950.93IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$320.44LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$0.96MAGNESIUM
$28.50MRI LUMBAR SPINE W/O DYE
$1,785.75MRI THORACIC SPINE W/O DYE
$1,708.50NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$3,339.68X-RAY EXAM CHEST 1 VIEW
$195.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$236.25X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$236.25This 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.
AEROBIC/ANAEROBIC CULTURE
$57.75AUTOM URINE DIP W MICRO
$12.75CBC WITH DIFF (AUTO)
$32.25COMPREHENSIVE METABOLIC PANEL
$40.50CPK TOTAL
$28.50CT ABD & PELV W/ DYE
$1,128.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,189.18IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$400.55LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$0.96MAGNESIUM
$28.50MRI LUMBAR SPINE W/O DYE
$1,785.75MRI THORACIC SPINE W/O DYE
$1,708.50NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$4,175.13X-RAY EXAM CHEST 1 VIEW
$195.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$236.25X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$236.25This 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.
AEROBIC/ANAEROBIC CULTURE
$28.49AUTOM URINE DIP W MICRO
$6.29CBC WITH DIFF (AUTO)
$15.91COMPREHENSIVE METABOLIC PANEL
$19.98CPK TOTAL
$14.06CT ABD & PELV W/ DYE
$556.85CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00LACTIC ACID
$30.34LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.81MAGNESIUM
$14.06MRI LUMBAR SPINE W/O DYE
$880.97MRI THORACIC SPINE W/O DYE
$842.86NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54X-RAY EXAM CHEST 1 VIEW
$96.20X-RAY EXAM OF PELVIS 1-2 VIEWS
$116.55X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$116.55This 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.
AEROBIC/ANAEROBIC CULTURE
$38.50AUTOM URINE DIP W MICRO
$8.50CBC WITH DIFF (AUTO)
$21.50COMPREHENSIVE METABOLIC PANEL
$27.00CPK TOTAL
$19.00CT ABD & PELV W/ DYE
$666.00CULTURE URINE ROUTINE
$27.00EMERGENCY DEPT VISIT LVL 5
$745.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$221.00IVP SINGLE DRUG OR SUBSTANCE
$250.00LACTIC ACID
$41.00LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$6.50MAGNESIUM
$19.00MRI LUMBAR SPINE W/O DYE
$794.00MRI THORACIC SPINE W/O DYE
$794.00NORMAL SALINE INFUSION 1000 CC
$9.78OBSERVATION ROOM 1 HR-MED SURG
$2,255.00X-RAY EXAM CHEST 1 VIEW
$130.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$157.50X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$157.50This 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.
AEROBIC/ANAEROBIC CULTURE
$57.75AUTOM URINE DIP W MICRO
$12.75CBC WITH DIFF (AUTO)
$32.25COMPREHENSIVE METABOLIC PANEL
$40.50CPK TOTAL
$28.50CT ABD & PELV W/ DYE
$1,128.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,050.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$9.75MAGNESIUM
$28.50MRI LUMBAR SPINE W/O DYE
$1,785.75MRI THORACIC SPINE W/O DYE
$1,708.50NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$106.50X-RAY EXAM CHEST 1 VIEW
$195.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$236.25X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$236.25This 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.
AEROBIC/ANAEROBIC CULTURE
$61.98AUTOM URINE DIP W MICRO
$13.68CBC WITH DIFF (AUTO)
$34.62COMPREHENSIVE METABOLIC PANEL
$43.47CPK TOTAL
$30.59CT ABD & PELV W/ DYE
$1,211.52CULTURE URINE ROUTINE
$43.47EMERGENCY DEPT VISIT LVL 5
$1,127.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$355.81IVP SINGLE DRUG OR SUBSTANCE
$402.50LACTIC ACID
$66.01LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$10.46MAGNESIUM
$30.59MRI LUMBAR SPINE W/O DYE
$1,916.70MRI THORACIC SPINE W/O DYE
$1,833.79NORMAL SALINE INFUSION 1000 CC
$15.75OBSERVATION ROOM 1 HR-MED SURG
$114.31X-RAY EXAM CHEST 1 VIEW
$209.30X-RAY EXAM OF PELVIS 1-2 VIEWS
$253.58X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$253.58This 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.
AEROBIC/ANAEROBIC CULTURE
$28.49AUTOM URINE DIP W MICRO
$6.29CBC WITH DIFF (AUTO)
$15.91COMPREHENSIVE METABOLIC PANEL
$19.98CPK TOTAL
$14.06CT ABD & PELV W/ DYE
$556.85CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00LACTIC ACID
$30.34LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.81MAGNESIUM
$14.06MRI LUMBAR SPINE W/O DYE
$880.97MRI THORACIC SPINE W/O DYE
$842.86NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54X-RAY EXAM CHEST 1 VIEW
$96.20X-RAY EXAM OF PELVIS 1-2 VIEWS
$116.55X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$116.55This 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.
AEROBIC/ANAEROBIC CULTURE
$46.20AUTOM URINE DIP W MICRO
$10.20CBC WITH DIFF (AUTO)
$25.80COMPREHENSIVE METABOLIC PANEL
$32.40CPK TOTAL
$22.80CT ABD & PELV W/ DYE
$1,053.50CULTURE URINE ROUTINE
$32.40EMERGENCY DEPT VISIT LVL 5
$1,182.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$265.20IVP SINGLE DRUG OR SUBSTANCE
$400.00LACTIC ACID
$49.20LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$0.96MAGNESIUM
$22.80MRI LUMBAR SPINE W/O DYE
$1,666.70MRI THORACIC SPINE W/O DYE
$1,594.60NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$2,700.00X-RAY EXAM CHEST 1 VIEW
$182.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$220.50X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$220.50This 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.
AEROBIC/ANAEROBIC CULTURE
$61.60AUTOM URINE DIP W MICRO
$13.60CBC WITH DIFF (AUTO)
$34.40COMPREHENSIVE METABOLIC PANEL
$43.20CPK TOTAL
$30.40CT ABD & PELV W/ DYE
$1,204.00CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,120.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$400.00LACTIC ACID
$65.60LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$10.40MAGNESIUM
$30.40MRI LUMBAR SPINE W/O DYE
$1,904.80MRI THORACIC SPINE W/O DYE
$1,822.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60X-RAY EXAM CHEST 1 VIEW
$208.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$252.00X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$252.00This 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.
AEROBIC/ANAEROBIC CULTURE
$61.60AUTOM URINE DIP W MICRO
$13.60CBC WITH DIFF (AUTO)
$34.40COMPREHENSIVE METABOLIC PANEL
$43.20CPK TOTAL
$30.40CT ABD & PELV W/ DYE
$1,204.00CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,120.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$400.00LACTIC ACID
$65.60LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$10.40MAGNESIUM
$30.40MRI LUMBAR SPINE W/O DYE
$1,904.80MRI THORACIC SPINE W/O DYE
$1,822.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60X-RAY EXAM CHEST 1 VIEW
$208.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$252.00X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$252.00This 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.
AEROBIC/ANAEROBIC CULTURE
$61.60AUTOM URINE DIP W MICRO
$13.60CBC WITH DIFF (AUTO)
$34.40COMPREHENSIVE METABOLIC PANEL
$43.20CPK TOTAL
$30.40CT ABD & PELV W/ DYE
$1,204.00CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,120.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$400.00LACTIC ACID
$65.60LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$10.40MAGNESIUM
$30.40MRI LUMBAR SPINE W/O DYE
$1,904.80MRI THORACIC SPINE W/O DYE
$1,822.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$113.60X-RAY EXAM CHEST 1 VIEW
$208.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$252.00X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$252.00This 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.
AEROBIC/ANAEROBIC CULTURE
$26.18AUTOM URINE DIP W MICRO
$5.78CBC WITH DIFF (AUTO)
$14.62COMPREHENSIVE METABOLIC PANEL
$18.36CPK TOTAL
$12.92CT ABD & PELV W/ DYE
$511.70CULTURE URINE ROUTINE
$18.36EMERGENCY DEPT VISIT LVL 5
$476.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$150.28IVP SINGLE DRUG OR SUBSTANCE
$170.00LACTIC ACID
$27.88LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.42MAGNESIUM
$12.92MRI LUMBAR SPINE W/O DYE
$809.54MRI THORACIC SPINE W/O DYE
$774.52NORMAL SALINE INFUSION 1000 CC
$6.65OBSERVATION ROOM 1 HR-MED SURG
$48.28X-RAY EXAM CHEST 1 VIEW
$88.40X-RAY EXAM OF PELVIS 1-2 VIEWS
$107.10X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$107.10This 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.
AEROBIC/ANAEROBIC CULTURE
$46.20AUTOM URINE DIP W MICRO
$10.20CBC WITH DIFF (AUTO)
$25.80COMPREHENSIVE METABOLIC PANEL
$32.40CPK TOTAL
$22.80CT ABD & PELV W/ DYE
$978.25CULTURE URINE ROUTINE
$32.40EMERGENCY DEPT VISIT LVL 5
$1,064.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$265.20IVP SINGLE DRUG OR SUBSTANCE
$360.00LACTIC ACID
$49.20LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$0.96MAGNESIUM
$22.80MRI LUMBAR SPINE W/O DYE
$1,547.65MRI THORACIC SPINE W/O DYE
$1,480.70NORMAL SALINE INFUSION 1000 CC
$2.61OBSERVATION ROOM 1 HR-MED SURG
$2,430.00X-RAY EXAM CHEST 1 VIEW
$169.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$204.75X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$204.75This 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.
AEROBIC/ANAEROBIC CULTURE
$29.34AUTOM URINE DIP W MICRO
$6.48CBC WITH DIFF (AUTO)
$16.39COMPREHENSIVE METABOLIC PANEL
$20.58CPK TOTAL
$14.48CT ABD & PELV W/ DYE
$573.56CULTURE URINE ROUTINE
$20.58EMERGENCY DEPT VISIT LVL 5
$533.54IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$168.45IVP SINGLE DRUG OR SUBSTANCE
$190.55LACTIC ACID
$31.25LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.95MAGNESIUM
$14.48MRI LUMBAR SPINE W/O DYE
$907.40MRI THORACIC SPINE W/O DYE
$868.15NORMAL SALINE INFUSION 1000 CC
$7.46OBSERVATION ROOM 1 HR-MED SURG
$54.12X-RAY EXAM CHEST 1 VIEW
$99.09X-RAY EXAM OF PELVIS 1-2 VIEWS
$120.05X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$120.05This 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.
AEROBIC/ANAEROBIC CULTURE
$50.05AUTOM URINE DIP W MICRO
$11.05CBC WITH DIFF (AUTO)
$27.95COMPREHENSIVE METABOLIC PANEL
$35.10CPK TOTAL
$24.70CT ABD & PELV W/ DYE
$978.25CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$910.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$325.00LACTIC ACID
$53.30LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$8.45MAGNESIUM
$24.70MRI LUMBAR SPINE W/O DYE
$1,547.65MRI THORACIC SPINE W/O DYE
$1,480.70NORMAL SALINE INFUSION 1000 CC
$12.72OBSERVATION ROOM 1 HR-MED SURG
$92.30X-RAY EXAM CHEST 1 VIEW
$169.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$204.75X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$204.75This 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.
AEROBIC/ANAEROBIC CULTURE
$28.49AUTOM URINE DIP W MICRO
$6.29CBC WITH DIFF (AUTO)
$15.91COMPREHENSIVE METABOLIC PANEL
$19.98CPK TOTAL
$14.06CT ABD & PELV W/ DYE
$556.85CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00LACTIC ACID
$30.34LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.81MAGNESIUM
$14.06MRI LUMBAR SPINE W/O DYE
$880.97MRI THORACIC SPINE W/O DYE
$842.86NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54X-RAY EXAM CHEST 1 VIEW
$96.20X-RAY EXAM OF PELVIS 1-2 VIEWS
$116.55X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$116.55This 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.
AEROBIC/ANAEROBIC CULTURE
$28.49AUTOM URINE DIP W MICRO
$6.29CBC WITH DIFF (AUTO)
$15.91COMPREHENSIVE METABOLIC PANEL
$19.98CPK TOTAL
$14.06CT ABD & PELV W/ DYE
$556.85CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00LACTIC ACID
$30.34LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.81MAGNESIUM
$14.06MRI LUMBAR SPINE W/O DYE
$880.97MRI THORACIC SPINE W/O DYE
$842.86NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54X-RAY EXAM CHEST 1 VIEW
$96.20X-RAY EXAM OF PELVIS 1-2 VIEWS
$116.55X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$116.55This 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.
AEROBIC/ANAEROBIC CULTURE
$50.05AUTOM URINE DIP W MICRO
$11.05CBC WITH DIFF (AUTO)
$27.95COMPREHENSIVE METABOLIC PANEL
$35.10CPK TOTAL
$24.70CT ABD & PELV W/ DYE
$1,036.00CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$955.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$350.00LACTIC ACID
$53.30LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$7.15MAGNESIUM
$24.70MRI LUMBAR SPINE W/O DYE
$1,738.00MRI THORACIC SPINE W/O DYE
$1,738.00NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$3,629.00X-RAY EXAM CHEST 1 VIEW
$156.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$189.00X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$189.00This 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.
AEROBIC/ANAEROBIC CULTURE
$35.42AUTOM URINE DIP W MICRO
$7.82CBC WITH DIFF (AUTO)
$19.78COMPREHENSIVE METABOLIC PANEL
$24.84CPK TOTAL
$17.48CT ABD & PELV W/ DYE
$692.30CULTURE URINE ROUTINE
$24.84EMERGENCY DEPT VISIT LVL 5
$644.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$203.32IVP SINGLE DRUG OR SUBSTANCE
$230.00LACTIC ACID
$37.72LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.98MAGNESIUM
$17.48MRI LUMBAR SPINE W/O DYE
$1,095.26MRI THORACIC SPINE W/O DYE
$1,047.88NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$65.32X-RAY EXAM CHEST 1 VIEW
$119.60X-RAY EXAM OF PELVIS 1-2 VIEWS
$144.90X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$144.90This 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.
AEROBIC/ANAEROBIC CULTURE
$57.75AUTOM URINE DIP W MICRO
$12.75CBC WITH DIFF (AUTO)
$32.25COMPREHENSIVE METABOLIC PANEL
$40.50CPK TOTAL
$28.50CT ABD & PELV W/ DYE
$1,128.75CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,174.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$9.75MAGNESIUM
$28.50MRI LUMBAR SPINE W/O DYE
$1,270.00MRI THORACIC SPINE W/O DYE
$1,270.00NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$2,652.00X-RAY EXAM CHEST 1 VIEW
$195.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$236.25X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$236.25This 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.
AEROBIC/ANAEROBIC CULTURE
$43.35AUTOM URINE DIP W MICRO
$9.57CBC WITH DIFF (AUTO)
$24.21COMPREHENSIVE METABOLIC PANEL
$30.40CPK TOTAL
$21.39CT ABD & PELV W/ DYE
$847.32CULTURE URINE ROUTINE
$30.40EMERGENCY DEPT VISIT LVL 5
$881.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$248.85IVP SINGLE DRUG OR SUBSTANCE
$281.50LACTIC ACID
$46.17LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$7.32MAGNESIUM
$21.39MRI LUMBAR SPINE W/O DYE
$918.00MRI THORACIC SPINE W/O DYE
$918.00NORMAL SALINE INFUSION 1000 CC
$11.02OBSERVATION ROOM 1 HR-MED SURG
$1,989.00X-RAY EXAM CHEST 1 VIEW
$146.38X-RAY EXAM OF PELVIS 1-2 VIEWS
$177.34X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$177.34This 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.
AEROBIC/ANAEROBIC CULTURE
$29.91AUTOM URINE DIP W MICRO
$6.60CBC WITH DIFF (AUTO)
$16.71COMPREHENSIVE METABOLIC PANEL
$20.98CPK TOTAL
$14.76CT ABD & PELV W/ DYE
$584.69CULTURE URINE ROUTINE
$20.98EMERGENCY DEPT VISIT LVL 5
$543.90IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$171.72IVP SINGLE DRUG OR SUBSTANCE
$194.25LACTIC ACID
$31.86LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.05MAGNESIUM
$14.76MRI LUMBAR SPINE W/O DYE
$925.02MRI THORACIC SPINE W/O DYE
$885.00NORMAL SALINE INFUSION 1000 CC
$7.60OBSERVATION ROOM 1 HR-MED SURG
$55.17X-RAY EXAM CHEST 1 VIEW
$101.01X-RAY EXAM OF PELVIS 1-2 VIEWS
$122.38X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$122.38This 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
$315.00Price 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.
AEROBIC/ANAEROBIC CULTURE
$57.75AUTOM URINE DIP W MICRO
$12.75CBC WITH DIFF (AUTO)
$32.25COMPREHENSIVE METABOLIC PANEL
$40.50CPK TOTAL
$28.50CT ABD & PELV W/ DYE
$775.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$980.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$1.40MAGNESIUM
$28.50MRI LUMBAR SPINE W/O DYE
$2,260.00MRI THORACIC SPINE W/O DYE
$2,260.00NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,134.00X-RAY EXAM CHEST 1 VIEW
$390.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$390.00X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$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
-$284.70Price 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.
AEROBIC/ANAEROBIC CULTURE
$8.23AUTOM URINE DIP W MICRO
$3.17CBC WITH DIFF (AUTO)
$3.20COMPREHENSIVE METABOLIC PANEL
$10.10CPK TOTAL
$5.08CT ABD & PELV W/ DYE
$109.01CULTURE URINE ROUTINE
$8.07EMERGENCY DEPT VISIT LVL 5
$611.99IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$85.59IVP SINGLE DRUG OR SUBSTANCE
$204.22LACTIC ACID
$9.39LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$0.96MAGNESIUM
$5.08MRI LUMBAR SPINE W/O DYE
$505.00MRI THORACIC SPINE W/O DYE
$505.00X-RAY EXAM CHEST 1 VIEW
$10.10X-RAY EXAM OF PELVIS 1-2 VIEWS
$12.63X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$15.15This 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.
AEROBIC/ANAEROBIC CULTURE
$57.75AUTOM URINE DIP W MICRO
$12.75CBC WITH DIFF (AUTO)
$32.25COMPREHENSIVE METABOLIC PANEL
$40.50CPK TOTAL
$28.50CT ABD & PELV W/ DYE
$775.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$980.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$375.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$1.40MAGNESIUM
$28.50MRI LUMBAR SPINE W/O DYE
$2,260.00MRI THORACIC SPINE W/O DYE
$2,260.00NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,134.00X-RAY EXAM CHEST 1 VIEW
$390.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$390.00X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$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.
AEROBIC/ANAEROBIC CULTURE
$28.49AUTOM URINE DIP W MICRO
$6.29CBC WITH DIFF (AUTO)
$15.91COMPREHENSIVE METABOLIC PANEL
$19.98CPK TOTAL
$14.06CT ABD & PELV W/ DYE
$556.85CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$518.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$185.00LACTIC ACID
$30.34LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.81MAGNESIUM
$14.06MRI LUMBAR SPINE W/O DYE
$880.97MRI THORACIC SPINE W/O DYE
$842.86NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$52.54X-RAY EXAM CHEST 1 VIEW
$96.20X-RAY EXAM OF PELVIS 1-2 VIEWS
$116.55X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$116.55This 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.
AEROBIC/ANAEROBIC CULTURE
$42.35AUTOM URINE DIP W MICRO
$9.35CBC WITH DIFF (AUTO)
$23.65COMPREHENSIVE METABOLIC PANEL
$29.70CPK TOTAL
$20.90CT ABD & PELV W/ DYE
$827.75CULTURE URINE ROUTINE
$29.70EMERGENCY DEPT VISIT LVL 5
$770.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$243.10IVP SINGLE DRUG OR SUBSTANCE
$275.00LACTIC ACID
$45.10LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$7.15MAGNESIUM
$20.90MRI LUMBAR SPINE W/O DYE
$1,309.55MRI THORACIC SPINE W/O DYE
$1,252.90NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$78.10X-RAY EXAM CHEST 1 VIEW
$143.00X-RAY EXAM OF PELVIS 1-2 VIEWS
$173.25X-RAY EXAM OF THORACIC SPINE 2 VIEWS
$173.25This 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.