CPT 72114
The standard charge for X-ray complete lumbar spine (with bending), 6 or more views is $320.00. 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
$320.00Insurance Discount
-$128.00Price Negotiated by Insurer
$192.00Deductible 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 & PELVIS W/ DYE
$1,076.00CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$1,000.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$456.40LACTIC ACID
$53.30MAGNESIUM
$24.70OBSERVATION ROOM 1 HR-MED SURG
$3,588.00X-RAY EXAM CHEST, 1 VIEW
$18.90X-RAY EXAM OF PELVIS, 1-2 VIEWS
$18.90This 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
$320.00Insurance Discount
-$172.80Price Negotiated by Insurer
$147.20Deductible 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.
AEROBIC/ANAEROBIC CULTURE
$35.42AUTOM URINE DIP W MICRO
$7.82CBC WITH DIFF (AUTO)
$19.78COMPREHENSIVE METABOLIC PANEL
$24.84CPK TOTAL
$17.48CT ABD & PELVIS W/ DYE
$123.28CULTURE URINE ROUTINE
$24.84EMERGENCY DEPT VISIT LVL 5
$700.58IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$203.32IVP SINGLE DRUG OR SUBSTANCE
$299.92LACTIC ACID
$37.72LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.98MAGNESIUM
$17.48NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$67.28X-RAY EXAM CHEST, 1 VIEW
$12.42X-RAY EXAM OF PELVIS, 1-2 VIEWS
$12.42This 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
$320.00Insurance Discount
-$192.00Price Negotiated by Insurer
$128.00Deductible 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
$30.80AUTOM URINE DIP W MICRO
$6.80CBC WITH DIFF (AUTO)
$17.20COMPREHENSIVE METABOLIC PANEL
$21.60CPK TOTAL
$15.20CT ABD & PELVIS W/ DYE
$107.20CULTURE URINE ROUTINE
$21.60EMERGENCY DEPT VISIT LVL 5
$609.20IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$176.80IVP SINGLE DRUG OR SUBSTANCE
$260.80LACTIC ACID
$32.80LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.20MAGNESIUM
$15.20NORMAL SALINE INFUSION 1000 CC
$7.83OBSERVATION ROOM 1 HR-MED SURG
$58.50X-RAY EXAM CHEST, 1 VIEW
$10.80X-RAY EXAM OF PELVIS, 1-2 VIEWS
$10.80This 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
$320.00Insurance Discount
-$80.00Price Negotiated by Insurer
$240.00Deductible 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 & PELVIS W/ DYE
$201.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,142.25IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$489.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$9.75MAGNESIUM
$28.50NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$109.70X-RAY EXAM CHEST, 1 VIEW
$20.25X-RAY EXAM OF PELVIS, 1-2 VIEWS
$20.25This 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
$320.00Insurance Discount
-$201.60Price Negotiated by Insurer
$118.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AEROBIC/ANAEROBIC CULTURE
$28.49AUTOM URINE DIP W MICRO
$6.29CBC WITH DIFF (AUTO)
$15.91COMPREHENSIVE METABOLIC PANEL
$19.98CPK TOTAL
$14.06CT ABD & PELVIS W/ DYE
$99.16CULTURE URINE ROUTINE
$19.98EMERGENCY DEPT VISIT LVL 5
$563.51IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$163.54IVP SINGLE DRUG OR SUBSTANCE
$241.24LACTIC ACID
$30.34LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.81MAGNESIUM
$14.06NORMAL SALINE INFUSION 1000 CC
$7.24OBSERVATION ROOM 1 HR-MED SURG
$54.12X-RAY EXAM CHEST, 1 VIEW
$9.99X-RAY EXAM OF PELVIS, 1-2 VIEWS
$9.99This 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
$320.00Insurance Discount
-$96.00Price Negotiated by Insurer
$224.00Deductible 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
$46.20AUTOM URINE DIP W MICRO
$10.20CBC WITH DIFF (AUTO)
$25.80COMPREHENSIVE METABOLIC PANEL
$32.40CPK TOTAL
$22.80CULTURE URINE ROUTINE
$32.40EMERGENCY DEPT VISIT LVL 5
$1,206.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$265.20IVP SINGLE DRUG OR SUBSTANCE
$521.60LACTIC ACID
$49.20LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$1.66MAGNESIUM
$22.80NORMAL SALINE INFUSION 1000 CC
$2.19OBSERVATION ROOM 1 HR-MED SURG
$2,700.00This 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
$320.00Insurance Discount
-$64.00Price Negotiated by Insurer
$256.00Deductible 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 & PELVIS W/ DYE
$214.40CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,218.40IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$521.60LACTIC ACID
$65.60LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$10.40MAGNESIUM
$30.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$117.01X-RAY EXAM CHEST, 1 VIEW
$21.60X-RAY EXAM OF PELVIS, 1-2 VIEWS
$21.60This 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
$320.00Insurance Discount
-$64.00Price Negotiated by Insurer
$256.00Deductible 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 & PELVIS W/ DYE
$214.40CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,218.40IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$521.60LACTIC ACID
$65.60LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$10.40MAGNESIUM
$30.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$117.01X-RAY EXAM CHEST, 1 VIEW
$21.60X-RAY EXAM OF PELVIS, 1-2 VIEWS
$21.60This 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
$320.00Insurance Discount
-$64.00Price Negotiated by Insurer
$256.00Deductible 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 & PELVIS W/ DYE
$214.40CULTURE URINE ROUTINE
$43.20EMERGENCY DEPT VISIT LVL 5
$1,218.40IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$353.60IVP SINGLE DRUG OR SUBSTANCE
$521.60LACTIC ACID
$65.60LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$10.40MAGNESIUM
$30.40NORMAL SALINE INFUSION 1000 CC
$15.66OBSERVATION ROOM 1 HR-MED SURG
$117.01X-RAY EXAM CHEST, 1 VIEW
$21.60X-RAY EXAM OF PELVIS, 1-2 VIEWS
$21.60This 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
$320.00Insurance Discount
-$211.20Price Negotiated by Insurer
$108.80Deductible 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 & PELVIS W/ DYE
$91.12CULTURE URINE ROUTINE
$18.36EMERGENCY DEPT VISIT LVL 5
$517.82IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$150.28IVP SINGLE DRUG OR SUBSTANCE
$221.68LACTIC ACID
$27.88LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$4.42MAGNESIUM
$12.92NORMAL SALINE INFUSION 1000 CC
$6.65OBSERVATION ROOM 1 HR-MED SURG
$49.73X-RAY EXAM CHEST, 1 VIEW
$9.18X-RAY EXAM OF PELVIS, 1-2 VIEWS
$9.18This 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
$320.00Insurance Discount
-$112.00Price Negotiated by Insurer
$208.00Deductible 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
$46.20AUTOM URINE DIP W MICRO
$10.20CBC WITH DIFF (AUTO)
$25.80COMPREHENSIVE METABOLIC PANEL
$32.40CPK TOTAL
$22.80CULTURE URINE ROUTINE
$32.40EMERGENCY DEPT VISIT LVL 5
$1,085.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$265.20IVP SINGLE DRUG OR SUBSTANCE
$469.44LACTIC ACID
$49.20LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$1.66MAGNESIUM
$22.80NORMAL SALINE INFUSION 1000 CC
$2.19OBSERVATION ROOM 1 HR-MED SURG
$2,430.00This 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
$320.00Insurance Discount
-$192.00Price Negotiated by Insurer
$128.00Deductible 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
$30.80AUTOM URINE DIP W MICRO
$6.80CBC WITH DIFF (AUTO)
$17.20COMPREHENSIVE METABOLIC PANEL
$21.60CPK TOTAL
$15.20CT ABD & PELVIS W/ DYE
$107.20CULTURE URINE ROUTINE
$21.60EMERGENCY DEPT VISIT LVL 5
$609.20IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$176.80IVP SINGLE DRUG OR SUBSTANCE
$260.80LACTIC ACID
$32.80LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.20MAGNESIUM
$15.20NORMAL SALINE INFUSION 1000 CC
$7.83OBSERVATION ROOM 1 HR-MED SURG
$58.50X-RAY EXAM CHEST, 1 VIEW
$10.80X-RAY EXAM OF PELVIS, 1-2 VIEWS
$10.80This 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
$320.00Insurance Discount
-$112.00Price Negotiated by Insurer
$208.00Deductible 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 & PELVIS W/ DYE
$174.20CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$989.95IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$423.80LACTIC ACID
$53.30LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$8.45MAGNESIUM
$24.70NORMAL SALINE INFUSION 1000 CC
$12.72OBSERVATION ROOM 1 HR-MED SURG
$95.07X-RAY EXAM CHEST, 1 VIEW
$17.55X-RAY EXAM OF PELVIS, 1-2 VIEWS
$17.55This 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
$320.00Insurance Discount
-$192.00Price Negotiated by Insurer
$128.00Deductible 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
$30.80AUTOM URINE DIP W MICRO
$6.80CBC WITH DIFF (AUTO)
$17.20COMPREHENSIVE METABOLIC PANEL
$21.60CPK TOTAL
$15.20CT ABD & PELVIS W/ DYE
$107.20CULTURE URINE ROUTINE
$21.60EMERGENCY DEPT VISIT LVL 5
$609.20IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$176.80IVP SINGLE DRUG OR SUBSTANCE
$260.80LACTIC ACID
$32.80LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.20MAGNESIUM
$15.20NORMAL SALINE INFUSION 1000 CC
$7.83OBSERVATION ROOM 1 HR-MED SURG
$58.50X-RAY EXAM CHEST, 1 VIEW
$10.80X-RAY EXAM OF PELVIS, 1-2 VIEWS
$10.80This 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
$320.00Insurance Discount
-$192.00Price Negotiated by Insurer
$128.00Deductible 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
$30.80AUTOM URINE DIP W MICRO
$6.80CBC WITH DIFF (AUTO)
$17.20COMPREHENSIVE METABOLIC PANEL
$21.60CPK TOTAL
$15.20CT ABD & PELVIS W/ DYE
$107.20CULTURE URINE ROUTINE
$21.60EMERGENCY DEPT VISIT LVL 5
$609.20IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$176.80IVP SINGLE DRUG OR SUBSTANCE
$260.80LACTIC ACID
$32.80LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.20MAGNESIUM
$15.20NORMAL SALINE INFUSION 1000 CC
$7.83OBSERVATION ROOM 1 HR-MED SURG
$58.50X-RAY EXAM CHEST, 1 VIEW
$10.80X-RAY EXAM OF PELVIS, 1-2 VIEWS
$10.80This 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
$320.00Insurance Discount
-$128.00Price Negotiated by Insurer
$192.00Deductible 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 & PELVIS W/ DYE
$1,076.00CULTURE URINE ROUTINE
$35.10EMERGENCY DEPT VISIT LVL 5
$1,000.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$287.30IVP SINGLE DRUG OR SUBSTANCE
$456.40LACTIC ACID
$53.30MAGNESIUM
$24.70OBSERVATION ROOM 1 HR-MED SURG
$3,588.00X-RAY EXAM CHEST, 1 VIEW
$18.90X-RAY EXAM OF PELVIS, 1-2 VIEWS
$18.90This 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
$320.00Insurance Discount
-$172.80Price Negotiated by Insurer
$147.20Deductible 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.
AEROBIC/ANAEROBIC CULTURE
$35.42AUTOM URINE DIP W MICRO
$7.82CBC WITH DIFF (AUTO)
$19.78COMPREHENSIVE METABOLIC PANEL
$24.84CPK TOTAL
$17.48CT ABD & PELVIS W/ DYE
$123.28CULTURE URINE ROUTINE
$24.84EMERGENCY DEPT VISIT LVL 5
$700.58IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$203.32IVP SINGLE DRUG OR SUBSTANCE
$299.92LACTIC ACID
$37.72LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.98MAGNESIUM
$17.48NORMAL SALINE INFUSION 1000 CC
$9.00OBSERVATION ROOM 1 HR-MED SURG
$67.28X-RAY EXAM CHEST, 1 VIEW
$12.42X-RAY EXAM OF PELVIS, 1-2 VIEWS
$12.42This 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
$320.00Insurance Discount
-$80.00Price Negotiated by Insurer
$240.00Deductible 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 & PELVIS W/ DYE
$201.00CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,234.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$489.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$9.75MAGNESIUM
$28.50NORMAL SALINE INFUSION 1000 CC
$14.68OBSERVATION ROOM 1 HR-MED SURG
$2,786.00X-RAY EXAM CHEST, 1 VIEW
$20.25X-RAY EXAM OF PELVIS, 1-2 VIEWS
$20.25This 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
$320.00Insurance Discount
-$139.84Price Negotiated by Insurer
$180.16Deductible 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 & PELVIS W/ DYE
$150.88CULTURE URINE ROUTINE
$30.40EMERGENCY DEPT VISIT LVL 5
$925.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$248.85IVP SINGLE DRUG OR SUBSTANCE
$367.08LACTIC ACID
$46.17LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$7.32MAGNESIUM
$21.39NORMAL SALINE INFUSION 1000 CC
$11.02OBSERVATION ROOM 1 HR-MED SURG
$2,090.00X-RAY EXAM CHEST, 1 VIEW
$15.20X-RAY EXAM OF PELVIS, 1-2 VIEWS
$15.20This 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
$320.00Insurance Discount
-$185.60Price Negotiated by Insurer
$134.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AEROBIC/ANAEROBIC CULTURE
$32.34AUTOM URINE DIP W MICRO
$7.14CBC WITH DIFF (AUTO)
$18.06COMPREHENSIVE METABOLIC PANEL
$22.68CPK TOTAL
$15.96CT ABD & PELVIS W/ DYE
$112.56CULTURE URINE ROUTINE
$22.68EMERGENCY DEPT VISIT LVL 5
$639.66IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$185.64IVP SINGLE DRUG OR SUBSTANCE
$273.84LACTIC ACID
$34.44LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.46MAGNESIUM
$15.96NORMAL SALINE INFUSION 1000 CC
$8.22OBSERVATION ROOM 1 HR-MED SURG
$61.43X-RAY EXAM CHEST, 1 VIEW
$11.34X-RAY EXAM OF PELVIS, 1-2 VIEWS
$11.34This 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
$320.00Price Negotiated by Insurer
$402.00Deductible 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
$28.50CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,009.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$489.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$1.40MAGNESIUM
$28.50NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,228.00This 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
$320.00Insurance Discount
-$272.00Price Negotiated by Insurer
$48.00Deductible 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
$11.55AUTOM URINE DIP W MICRO
$2.55CBC WITH DIFF (AUTO)
$6.45COMPREHENSIVE METABOLIC PANEL
$8.10CPK TOTAL
$5.70CT ABD & PELVIS W/ DYE
$40.20CULTURE URINE ROUTINE
$8.10EMERGENCY DEPT VISIT LVL 5
$228.45IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$66.30IVP SINGLE DRUG OR SUBSTANCE
$97.80LACTIC ACID
$12.30LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$1.95MAGNESIUM
$5.70NORMAL SALINE INFUSION 1000 CC
$2.94OBSERVATION ROOM 1 HR-MED SURG
$21.94X-RAY EXAM CHEST, 1 VIEW
$4.05X-RAY EXAM OF PELVIS, 1-2 VIEWS
$4.05This 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
$320.00Price Negotiated by Insurer
$402.00Deductible 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
$28.50CULTURE URINE ROUTINE
$40.50EMERGENCY DEPT VISIT LVL 5
$1,009.00IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$331.50IVP SINGLE DRUG OR SUBSTANCE
$489.00LACTIC ACID
$61.50LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$1.40MAGNESIUM
$28.50NORMAL SALINE INFUSION 1000 CC
$4.19OBSERVATION ROOM 1 HR-MED SURG
$3,228.00This 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
$320.00Insurance Discount
-$192.00Price Negotiated by Insurer
$128.00Deductible 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
$30.80AUTOM URINE DIP W MICRO
$6.80CBC WITH DIFF (AUTO)
$17.20COMPREHENSIVE METABOLIC PANEL
$21.60CPK TOTAL
$15.20CT ABD & PELVIS W/ DYE
$107.20CULTURE URINE ROUTINE
$21.60EMERGENCY DEPT VISIT LVL 5
$609.20IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$176.80IVP SINGLE DRUG OR SUBSTANCE
$260.80LACTIC ACID
$32.80LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$5.20MAGNESIUM
$15.20NORMAL SALINE INFUSION 1000 CC
$7.83OBSERVATION ROOM 1 HR-MED SURG
$58.50X-RAY EXAM CHEST, 1 VIEW
$10.80X-RAY EXAM OF PELVIS, 1-2 VIEWS
$10.80This 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
$320.00Insurance Discount
-$144.00Price Negotiated by Insurer
$176.00Deductible 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
$42.35AUTOM URINE DIP W MICRO
$9.35CBC WITH DIFF (AUTO)
$23.65COMPREHENSIVE METABOLIC PANEL
$29.70CPK TOTAL
$20.90CT ABD & PELVIS W/ DYE
$147.40CULTURE URINE ROUTINE
$29.70EMERGENCY DEPT VISIT LVL 5
$837.65IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ
$243.10IVP SINGLE DRUG OR SUBSTANCE
$358.60LACTIC ACID
$45.10LORazepam 2 MG/ML CARPUJECT 2 mg, 1 mL
$7.15MAGNESIUM
$20.90NORMAL SALINE INFUSION 1000 CC
$10.76OBSERVATION ROOM 1 HR-MED SURG
$80.44X-RAY EXAM CHEST, 1 VIEW
$14.85X-RAY EXAM OF PELVIS, 1-2 VIEWS
$14.85This 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.