CPT J0702
The standard charge for Injection to treat reaction to a drug is $130.81. 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
$130.81Insurance Discount
-$58.86Price Negotiated by Insurer
$71.95Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$3.40INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$1,857.00INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$1,857.00MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$3.40This 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
$130.81Insurance Discount
-$70.64Price Negotiated by Insurer
$60.17Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.84MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.84This 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
$130.81Insurance Discount
-$123.93Price Negotiated by Insurer
$6.88Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$0.99INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$2,017.33INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$2,017.33MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$0.14This 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
$130.81Insurance Discount
-$123.93Price Negotiated by Insurer
$6.88Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$0.99INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$2,521.93INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$2,521.93MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$0.14This 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
$130.81Insurance Discount
-$82.41Price Negotiated by Insurer
$48.40Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.29MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.29This 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
$130.81Insurance Discount
-$65.41Price Negotiated by Insurer
$65.40Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$3.09INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$636.00INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$636.00MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$3.09This 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
$130.81Insurance Discount
-$32.70Price Negotiated by Insurer
$98.11Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
FENTANYL CITRATE INJ 0.05 MG
$4.64MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$4.64This 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
$130.81Insurance Discount
-$25.51Price Negotiated by Insurer
$105.30Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$4.97MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$4.97This 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
$130.81Insurance Discount
-$82.41Price Negotiated by Insurer
$48.40Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.29MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.29This 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
$130.81Insurance Discount
-$123.93Price Negotiated by Insurer
$6.88Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$0.99MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$0.14This 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
$130.81Insurance Discount
-$26.16Price Negotiated by Insurer
$104.65Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$4.94MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$4.94This 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
$130.81Insurance Discount
-$26.16Price Negotiated by Insurer
$104.65Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$4.94MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$4.94This 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
$130.81Insurance Discount
-$26.16Price Negotiated by Insurer
$104.65Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$4.94MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$4.94This 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
$130.81Insurance Discount
-$86.33Price Negotiated by Insurer
$44.48Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.10MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.10This 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
$130.81Insurance Discount
-$123.93Price Negotiated by Insurer
$6.88Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$0.99MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$0.14This 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
$130.81Insurance Discount
-$80.96Price Negotiated by Insurer
$49.85Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.36MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.36This 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
$130.81Insurance Discount
-$45.78Price Negotiated by Insurer
$85.03Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
FENTANYL CITRATE INJ 0.05 MG
$4.02MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$4.02This 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
$130.81Insurance Discount
-$82.41Price Negotiated by Insurer
$48.40Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.29MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.29This 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
$130.81Insurance Discount
-$82.41Price Negotiated by Insurer
$48.40Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.29MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.29This 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
$130.81Insurance Discount
-$58.86Price Negotiated by Insurer
$71.95Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$3.40INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$1,857.00INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$1,857.00MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$3.40This 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
$130.81Insurance Discount
-$70.64Price Negotiated by Insurer
$60.17Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.84MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.84This 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
$130.81Insurance Discount
-$32.70Price Negotiated by Insurer
$98.11Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
FENTANYL CITRATE INJ 0.05 MG
$4.64MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$4.64This 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
$130.81Insurance Discount
-$57.16Price Negotiated by Insurer
$73.65Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$3.48MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$3.48This 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
$130.81Insurance Discount
-$79.99Price Negotiated by Insurer
$50.82Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.40MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.40This 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
$130.81Insurance Discount
-$119.33Price Negotiated by Insurer
$11.48Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$1.39INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$1,775.00INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$1,775.00MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$0.23This 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
$130.81Insurance Discount
-$123.92Price Negotiated by Insurer
$6.89Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$0.99INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$50.93INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$868.45MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$0.14This 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
$130.81Insurance Discount
-$119.33Price Negotiated by Insurer
$11.48Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$1.39INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
$1,775.00INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SINGLE LEVEL
$1,775.00MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$0.23This 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
$130.81Insurance Discount
-$82.41Price Negotiated by Insurer
$48.40Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$2.29MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$2.29This 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
$130.81Insurance Discount
-$58.86Price Negotiated by Insurer
$71.95Deductible 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.
FENTANYL CITRATE INJ 0.05 MG
$3.40MIDAZOLAM HYDROCHLORIDE INJ, PER 1 MG
$3.40This 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.