|
COLPOSCOPY VAG W/VAG/CERVIX BX
|
Facility
|
OP
|
$227.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
5105742101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$215.65 |
| Rate for Payer: Aetna of VT Commercial |
$215.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$203.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$100.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$203.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$136.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$192.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$183.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$102.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$180.47
|
| Rate for Payer: Cash Price |
$113.50
|
| Rate for Payer: Cigna Commercial |
$181.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$181.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$181.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$102.15
|
| Rate for Payer: Multiplan Commercial |
$211.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$192.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$102.15
|
| Rate for Payer: United Healthcare Commercial |
$215.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.15
|
| Rate for Payer: United Healthcare VA CCN |
$102.15
|
|
|
COLPOSCOPY VAG W/VAG/CERVIX BX
|
Facility
|
OP
|
$381.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
9605742102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$168.74 |
| Max. Negotiated Rate |
$361.95 |
| Rate for Payer: Aetna of VT Commercial |
$361.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$341.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$168.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$341.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$229.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$323.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$308.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$171.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$302.89
|
| Rate for Payer: Cash Price |
$190.50
|
| Rate for Payer: Cigna Commercial |
$304.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$304.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$304.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$171.45
|
| Rate for Payer: Multiplan Commercial |
$354.33
|
| Rate for Payer: MVP Health Care of NY Commercial |
$323.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$171.45
|
| Rate for Payer: United Healthcare Commercial |
$361.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$171.45
|
| Rate for Payer: United Healthcare VA CCN |
$171.45
|
|
|
COLPOSCOPY VAG W/VAG/CERVIX BX
|
Facility
|
IP
|
$608.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
9605742101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$449.98 |
| Max. Negotiated Rate |
$577.60 |
| Rate for Payer: Aetna of VT Commercial |
$577.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$449.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$449.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$516.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$510.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$486.40
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cigna Commercial |
$486.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$486.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$486.40
|
| Rate for Payer: Multiplan Commercial |
$565.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$516.80
|
| Rate for Payer: United Healthcare Commercial |
$577.60
|
|
|
COLPOSCOPY VAG W/VAG/CERVIX BX
|
Facility
|
OP
|
$608.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
9605742101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$269.28 |
| Max. Negotiated Rate |
$577.60 |
| Rate for Payer: Aetna of VT Commercial |
$577.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$544.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$269.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$544.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$366.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$516.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$492.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$273.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$483.36
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cigna Commercial |
$486.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$486.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$486.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$273.60
|
| Rate for Payer: Multiplan Commercial |
$565.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$516.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$273.60
|
| Rate for Payer: United Healthcare Commercial |
$577.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$273.60
|
| Rate for Payer: United Healthcare VA CCN |
$273.60
|
|
|
COLPOSCOPY VULVA
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
9605682002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$225.73 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Aetna of VT Commercial |
$289.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$225.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$225.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$259.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$256.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$244.00
|
| Rate for Payer: Cash Price |
$152.50
|
| Rate for Payer: Cigna Commercial |
$244.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$244.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$244.00
|
| Rate for Payer: Multiplan Commercial |
$283.65
|
| Rate for Payer: MVP Health Care of NY Commercial |
$259.25
|
| Rate for Payer: United Healthcare Commercial |
$289.75
|
|
|
COLPOSCOPY VULVA
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
9605682002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$135.08 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Aetna of VT Commercial |
$289.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$273.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$135.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$273.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$183.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$259.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$247.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$137.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$242.47
|
| Rate for Payer: Cash Price |
$152.50
|
| Rate for Payer: Cigna Commercial |
$244.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$244.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$244.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$137.25
|
| Rate for Payer: Multiplan Commercial |
$283.65
|
| Rate for Payer: MVP Health Care of NY Commercial |
$259.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$137.25
|
| Rate for Payer: United Healthcare Commercial |
$289.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$137.25
|
| Rate for Payer: United Healthcare VA CCN |
$137.25
|
|
|
COLPOSCOPY VULVA
|
Facility
|
OP
|
$446.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
9605682001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$197.53 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna of VT Commercial |
$423.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$399.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$197.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$399.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$268.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$361.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$200.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$354.57
|
| Rate for Payer: Cash Price |
$223.00
|
| Rate for Payer: Cigna Commercial |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$356.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$200.70
|
| Rate for Payer: Multiplan Commercial |
$414.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$200.70
|
| Rate for Payer: United Healthcare Commercial |
$423.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$200.70
|
| Rate for Payer: United Healthcare VA CCN |
$200.70
|
|
|
COLPOSCOPY VULVA
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
5105682001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.92 |
| Max. Negotiated Rate |
$193.89 |
| Rate for Payer: Aetna of VT Commercial |
$133.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$127.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$80.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$127.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$109.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$192.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$192.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$89.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$192.39
|
| Rate for Payer: Cash Price |
$71.00
|
| Rate for Payer: Cash Price |
$71.00
|
| Rate for Payer: Cigna Commercial |
$136.95
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$193.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$193.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$117.75
|
| Rate for Payer: Multiplan Commercial |
$132.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$110.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$77.92
|
| Rate for Payer: United Healthcare Commercial |
$119.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$77.92
|
| Rate for Payer: United Healthcare VA CCN |
$77.92
|
|
|
COLPOSCOPY VULVA
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
9605682002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$77.92 |
| Max. Negotiated Rate |
$286.70 |
| Rate for Payer: Aetna of VT Commercial |
$286.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$273.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$80.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$273.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$109.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$192.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$192.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$89.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$192.39
|
| Rate for Payer: Cash Price |
$152.50
|
| Rate for Payer: Cash Price |
$152.50
|
| Rate for Payer: Cigna Commercial |
$136.95
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$193.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$193.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$117.75
|
| Rate for Payer: Multiplan Commercial |
$283.65
|
| Rate for Payer: MVP Health Care of NY Commercial |
$110.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$77.92
|
| Rate for Payer: United Healthcare Commercial |
$119.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$77.92
|
| Rate for Payer: United Healthcare VA CCN |
$77.92
|
|
|
COLPOSCOPY VULVA
|
Facility
|
IP
|
$142.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
5105682001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$105.09 |
| Max. Negotiated Rate |
$134.90 |
| Rate for Payer: Aetna of VT Commercial |
$134.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$105.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$105.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$120.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$119.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$113.60
|
| Rate for Payer: Cash Price |
$71.00
|
| Rate for Payer: Cigna Commercial |
$113.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$113.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$113.60
|
| Rate for Payer: Multiplan Commercial |
$132.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.70
|
| Rate for Payer: United Healthcare Commercial |
$134.90
|
|
|
COLPOSCOPY VULVA
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
9605682001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$77.92 |
| Max. Negotiated Rate |
$419.24 |
| Rate for Payer: Aetna of VT Commercial |
$419.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$399.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$80.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$399.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$109.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$192.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$192.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$89.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$192.39
|
| Rate for Payer: Cash Price |
$223.00
|
| Rate for Payer: Cash Price |
$223.00
|
| Rate for Payer: Cigna Commercial |
$136.95
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$193.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$193.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$117.75
|
| Rate for Payer: Multiplan Commercial |
$414.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$110.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$77.92
|
| Rate for Payer: United Healthcare Commercial |
$119.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$77.92
|
| Rate for Payer: United Healthcare VA CCN |
$77.92
|
|
|
COLPOSCOPY VULVA
|
Facility
|
OP
|
$142.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
5105682001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$62.89 |
| Max. Negotiated Rate |
$134.90 |
| Rate for Payer: Aetna of VT Commercial |
$134.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$127.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$62.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$127.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$85.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$120.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$115.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$63.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$112.89
|
| Rate for Payer: Cash Price |
$71.00
|
| Rate for Payer: Cigna Commercial |
$113.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$113.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$113.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$63.90
|
| Rate for Payer: Multiplan Commercial |
$132.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$63.90
|
| Rate for Payer: United Healthcare Commercial |
$134.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63.90
|
| Rate for Payer: United Healthcare VA CCN |
$63.90
|
|
|
COLPOSCOPY VULVA
|
Facility
|
IP
|
$446.00
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
9605682001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$330.08 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna of VT Commercial |
$423.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$330.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$330.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$374.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$356.80
|
| Rate for Payer: Cash Price |
$223.00
|
| Rate for Payer: Cigna Commercial |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$356.80
|
| Rate for Payer: Multiplan Commercial |
$414.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.10
|
| Rate for Payer: United Healthcare Commercial |
$423.70
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$307.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9605682102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$135.97 |
| Max. Negotiated Rate |
$291.65 |
| Rate for Payer: Aetna of VT Commercial |
$291.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$135.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$184.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$248.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$138.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$244.06
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$245.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$138.15
|
| Rate for Payer: Multiplan Commercial |
$285.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$260.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.15
|
| Rate for Payer: United Healthcare Commercial |
$291.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.15
|
| Rate for Payer: United Healthcare VA CCN |
$138.15
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$307.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9605682102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$227.21 |
| Max. Negotiated Rate |
$291.65 |
| Rate for Payer: Aetna of VT Commercial |
$291.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$227.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$227.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$257.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$245.60
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$245.60
|
| Rate for Payer: Multiplan Commercial |
$285.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$260.95
|
| Rate for Payer: United Healthcare Commercial |
$291.65
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9605682101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$104.62 |
| Max. Negotiated Rate |
$466.24 |
| Rate for Payer: Aetna of VT Commercial |
$466.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$444.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$107.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$444.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$146.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$120.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$260.10
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cigna Commercial |
$184.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$156.98
|
| Rate for Payer: Multiplan Commercial |
$461.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$148.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare Commercial |
$160.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare VA CCN |
$104.62
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$496.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9605682101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$219.68 |
| Max. Negotiated Rate |
$471.20 |
| Rate for Payer: Aetna of VT Commercial |
$471.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$444.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$219.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$444.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$298.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$421.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$401.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$223.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$394.32
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cigna Commercial |
$396.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$396.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$396.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$223.20
|
| Rate for Payer: Multiplan Commercial |
$461.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$421.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$223.20
|
| Rate for Payer: United Healthcare Commercial |
$471.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$223.20
|
| Rate for Payer: United Healthcare VA CCN |
$223.20
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9605682102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$104.62 |
| Max. Negotiated Rate |
$288.58 |
| Rate for Payer: Aetna of VT Commercial |
$288.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$107.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$146.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$120.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$260.10
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$184.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$156.98
|
| Rate for Payer: Multiplan Commercial |
$285.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$148.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare Commercial |
$160.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare VA CCN |
$104.62
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$307.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9825682101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$135.97 |
| Max. Negotiated Rate |
$291.65 |
| Rate for Payer: Aetna of VT Commercial |
$291.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$135.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$184.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$248.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$138.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$244.06
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$245.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$138.15
|
| Rate for Payer: Multiplan Commercial |
$285.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$260.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.15
|
| Rate for Payer: United Healthcare Commercial |
$291.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.15
|
| Rate for Payer: United Healthcare VA CCN |
$138.15
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$307.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9825682101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$227.21 |
| Max. Negotiated Rate |
$291.65 |
| Rate for Payer: Aetna of VT Commercial |
$291.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$227.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$227.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$257.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$245.60
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$245.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$245.60
|
| Rate for Payer: Multiplan Commercial |
$285.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$260.95
|
| Rate for Payer: United Healthcare Commercial |
$291.65
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9825682101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$104.62 |
| Max. Negotiated Rate |
$288.58 |
| Rate for Payer: Aetna of VT Commercial |
$288.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$107.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$146.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$120.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$260.10
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$184.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$156.98
|
| Rate for Payer: Multiplan Commercial |
$285.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$148.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare Commercial |
$160.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare VA CCN |
$104.62
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
5105682101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$84.15 |
| Max. Negotiated Rate |
$180.50 |
| Rate for Payer: Aetna of VT Commercial |
$180.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$170.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$170.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$114.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$161.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$153.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$85.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$151.05
|
| Rate for Payer: Cash Price |
$95.00
|
| Rate for Payer: Cigna Commercial |
$152.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$152.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$152.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$85.50
|
| Rate for Payer: Multiplan Commercial |
$176.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$161.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$85.50
|
| Rate for Payer: United Healthcare Commercial |
$180.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$85.50
|
| Rate for Payer: United Healthcare VA CCN |
$85.50
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
5105682101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$104.62 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna of VT Commercial |
$178.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$170.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$107.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$170.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$146.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$260.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$120.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$260.10
|
| Rate for Payer: Cash Price |
$95.00
|
| Rate for Payer: Cash Price |
$95.00
|
| Rate for Payer: Cigna Commercial |
$184.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$156.98
|
| Rate for Payer: Multiplan Commercial |
$176.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$148.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare Commercial |
$160.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$104.62
|
| Rate for Payer: United Healthcare VA CCN |
$104.62
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
5105682101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$140.62 |
| Max. Negotiated Rate |
$180.50 |
| Rate for Payer: Aetna of VT Commercial |
$180.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$140.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$140.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$161.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$159.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$152.00
|
| Rate for Payer: Cash Price |
$95.00
|
| Rate for Payer: Cigna Commercial |
$152.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$152.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$152.00
|
| Rate for Payer: Multiplan Commercial |
$176.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$161.50
|
| Rate for Payer: United Healthcare Commercial |
$180.50
|
|
|
COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$496.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
9605682101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$367.09 |
| Max. Negotiated Rate |
$471.20 |
| Rate for Payer: Aetna of VT Commercial |
$471.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$367.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$367.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$421.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$416.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$396.80
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cigna Commercial |
$396.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$396.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$396.80
|
| Rate for Payer: Multiplan Commercial |
$461.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$421.60
|
| Rate for Payer: United Healthcare Commercial |
$471.20
|
|
