|
ANESTH N BLOCK/INJ PRONE
|
Facility
|
OP
|
$210.77
|
|
| Hospital Charge Code |
9630199202
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$200.23 |
| Rate for Payer: Aetna of VT Commercial |
$200.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$93.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$126.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$170.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$94.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$167.56
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Cigna Commercial |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$94.85
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$94.85
|
| Rate for Payer: United Healthcare Commercial |
$200.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$94.85
|
| Rate for Payer: United Healthcare VA CCN |
$94.85
|
|
|
ANESTH N BLOCK/INJ PRONE
|
Professional
|
Both
|
$210.77
|
|
| Hospital Charge Code |
3700199201
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$84.31 |
| Max. Negotiated Rate |
$198.12 |
| Rate for Payer: Aetna of VT Commercial |
$198.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$188.83
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: United Healthcare Commercial |
$179.15
|
| Rate for Payer: United Healthcare VA CCN |
$84.31
|
|
|
ANESTH N BLOCK/INJ PRONE
|
Facility
|
IP
|
$210.77
|
|
| Hospital Charge Code |
9630199202
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$155.99 |
| Max. Negotiated Rate |
$200.23 |
| Rate for Payer: Aetna of VT Commercial |
$200.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$155.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$155.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$177.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$168.62
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Cigna Commercial |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.62
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.15
|
| Rate for Payer: United Healthcare Commercial |
$200.23
|
|
|
ANESTH N BLOCK/INJ PRONE
|
Professional
|
Both
|
$210.77
|
|
| Hospital Charge Code |
9630199202
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$84.31 |
| Max. Negotiated Rate |
$198.12 |
| Rate for Payer: Aetna of VT Commercial |
$198.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$188.83
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: United Healthcare Commercial |
$179.15
|
| Rate for Payer: United Healthcare VA CCN |
$84.31
|
|
|
ANESTH NERVE BLOCK/INJ
|
Facility
|
IP
|
$210.77
|
|
| Hospital Charge Code |
9630199102
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$155.99 |
| Max. Negotiated Rate |
$200.23 |
| Rate for Payer: Aetna of VT Commercial |
$200.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$155.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$155.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$177.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$168.62
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Cigna Commercial |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.62
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.15
|
| Rate for Payer: United Healthcare Commercial |
$200.23
|
|
|
ANESTH NERVE BLOCK/INJ
|
Professional
|
Both
|
$210.77
|
|
| Hospital Charge Code |
3700199101
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$84.31 |
| Max. Negotiated Rate |
$198.12 |
| Rate for Payer: Aetna of VT Commercial |
$198.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$188.83
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: United Healthcare Commercial |
$179.15
|
| Rate for Payer: United Healthcare VA CCN |
$84.31
|
|
|
ANESTH NERVE BLOCK/INJ
|
Facility
|
IP
|
$210.77
|
|
| Hospital Charge Code |
3700199101
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$155.99 |
| Max. Negotiated Rate |
$200.23 |
| Rate for Payer: Aetna of VT Commercial |
$200.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$155.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$155.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$177.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$168.62
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Cigna Commercial |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.62
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.15
|
| Rate for Payer: United Healthcare Commercial |
$200.23
|
|
|
ANESTH NERVE BLOCK/INJ
|
Facility
|
OP
|
$210.77
|
|
| Hospital Charge Code |
9630199102
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$200.23 |
| Rate for Payer: Aetna of VT Commercial |
$200.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$93.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$126.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$170.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$94.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$167.56
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Cigna Commercial |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$94.85
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$94.85
|
| Rate for Payer: United Healthcare Commercial |
$200.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$94.85
|
| Rate for Payer: United Healthcare VA CCN |
$94.85
|
|
|
ANESTH NERVE BLOCK/INJ
|
Professional
|
Both
|
$210.77
|
|
| Hospital Charge Code |
9630199102
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$84.31 |
| Max. Negotiated Rate |
$198.12 |
| Rate for Payer: Aetna of VT Commercial |
$198.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$188.83
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: United Healthcare Commercial |
$179.15
|
| Rate for Payer: United Healthcare VA CCN |
$84.31
|
|
|
ANESTH NERVE BLOCK/INJ
|
Facility
|
OP
|
$210.77
|
|
| Hospital Charge Code |
3700199101
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$200.23 |
| Rate for Payer: Aetna of VT Commercial |
$200.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$93.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$188.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$126.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$170.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$94.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$167.56
|
| Rate for Payer: Cash Price |
$105.39
|
| Rate for Payer: Cigna Commercial |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$94.85
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$94.85
|
| Rate for Payer: United Healthcare Commercial |
$200.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$94.85
|
| Rate for Payer: United Healthcare VA CCN |
$94.85
|
|
|
ANGIOTENSIN I ENZYME TEST
|
Professional
|
Both
|
$226.45
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
3008216401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$212.86 |
| Rate for Payer: Aetna of VT Commercial |
$212.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$71.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$15.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$71.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$20.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$24.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$24.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$16.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$24.95
|
| Rate for Payer: Cash Price |
$113.22
|
| Rate for Payer: Cash Price |
$113.22
|
| Rate for Payer: Cigna Commercial |
$17.85
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$14.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$14.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$210.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$14.60
|
| Rate for Payer: United Healthcare Commercial |
$22.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.60
|
| Rate for Payer: United Healthcare VA CCN |
$14.60
|
|
|
ANGIOTENSIN I ENZYME TEST
|
Facility
|
IP
|
$226.45
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
3008216401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$167.60 |
| Max. Negotiated Rate |
$215.13 |
| Rate for Payer: Aetna of VT Commercial |
$215.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$167.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$167.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$192.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$190.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$181.16
|
| Rate for Payer: Cash Price |
$113.22
|
| Rate for Payer: Cigna Commercial |
$181.16
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$181.16
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$181.16
|
| Rate for Payer: Multiplan Commercial |
$210.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$192.48
|
| Rate for Payer: United Healthcare Commercial |
$215.13
|
|
|
ANGIOTENSIN I ENZYME TEST
|
Facility
|
OP
|
$226.45
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
3008216401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$215.13 |
| Rate for Payer: Aetna of VT Commercial |
$215.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$71.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$100.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$71.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$136.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$192.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$183.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$101.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$180.03
|
| Rate for Payer: Cash Price |
$113.22
|
| Rate for Payer: Cash Price |
$113.22
|
| Rate for Payer: Cigna Commercial |
$181.16
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$181.16
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$181.16
|
| Rate for Payer: Martins Point Health Care Commercial |
$101.90
|
| Rate for Payer: Multiplan Commercial |
$210.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$192.48
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$101.90
|
| Rate for Payer: United Healthcare Commercial |
$215.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.60
|
| Rate for Payer: United Healthcare VA CCN |
$101.90
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
IP
|
$2,500.00
|
|
|
Service Code
|
CPT 29891
|
| Hospital Charge Code |
9822989101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,850.25 |
| Max. Negotiated Rate |
$2,375.00 |
| Rate for Payer: Aetna of VT Commercial |
$2,375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,850.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,850.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,125.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,100.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,000.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$2,000.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,000.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,000.00
|
| Rate for Payer: Multiplan Commercial |
$2,325.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,125.00
|
| Rate for Payer: United Healthcare Commercial |
$2,375.00
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Professional
|
Both
|
$628.00
|
|
|
Service Code
|
CPT 29898
|
| Hospital Charge Code |
9822989801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$531.80 |
| Max. Negotiated Rate |
$1,030.53 |
| Rate for Payer: Aetna of VT Commercial |
$590.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$562.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$547.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$562.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$744.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,030.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,030.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$611.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,030.53
|
| Rate for Payer: Cash Price |
$314.00
|
| Rate for Payer: Cash Price |
$314.00
|
| Rate for Payer: Cigna Commercial |
$1,008.31
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$878.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$878.94
|
| Rate for Payer: Martins Point Health Care Commercial |
$531.80
|
| Rate for Payer: Multiplan Commercial |
$584.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$755.16
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$531.80
|
| Rate for Payer: United Healthcare Commercial |
$818.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$531.80
|
| Rate for Payer: United Healthcare VA CCN |
$531.80
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Professional
|
Both
|
$2,136.00
|
|
|
Service Code
|
CPT 29894
|
| Hospital Charge Code |
9822989401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$479.97 |
| Max. Negotiated Rate |
$2,007.84 |
| Rate for Payer: Aetna of VT Commercial |
$2,007.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,913.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$494.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,913.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$671.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$943.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$943.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$551.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$943.50
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cigna Commercial |
$907.09
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$795.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$795.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$479.97
|
| Rate for Payer: Multiplan Commercial |
$1,986.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$681.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$479.97
|
| Rate for Payer: United Healthcare Commercial |
$738.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$479.97
|
| Rate for Payer: United Healthcare VA CCN |
$479.97
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
OP
|
$2,500.00
|
|
|
Service Code
|
CPT 29891
|
| Hospital Charge Code |
9822989101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,107.25 |
| Max. Negotiated Rate |
$2,375.00 |
| Rate for Payer: Aetna of VT Commercial |
$2,375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,239.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,107.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,239.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,505.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,125.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,025.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,125.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,987.50
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$2,000.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,000.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,000.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,125.00
|
| Rate for Payer: Multiplan Commercial |
$2,325.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,125.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,125.00
|
| Rate for Payer: United Healthcare Commercial |
$2,375.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,125.00
|
| Rate for Payer: United Healthcare VA CCN |
$1,125.00
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
CPT 29895
|
| Hospital Charge Code |
9822989501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$437.81 |
| Max. Negotiated Rate |
$1,916.66 |
| Rate for Payer: Aetna of VT Commercial |
$1,916.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,826.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$450.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,826.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$612.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$926.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$926.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$503.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$926.21
|
| Rate for Payer: Cash Price |
$1,019.50
|
| Rate for Payer: Cash Price |
$1,019.50
|
| Rate for Payer: Cigna Commercial |
$834.33
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$721.57
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$721.57
|
| Rate for Payer: Martins Point Health Care Commercial |
$437.81
|
| Rate for Payer: Multiplan Commercial |
$1,896.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$437.82
|
| Rate for Payer: United Healthcare Commercial |
$673.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$437.82
|
| Rate for Payer: United Healthcare VA CCN |
$437.82
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
IP
|
$2,136.00
|
|
|
Service Code
|
CPT 29894
|
| Hospital Charge Code |
9822989401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,580.85 |
| Max. Negotiated Rate |
$2,029.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,029.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,580.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,580.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,815.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,794.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,708.80
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cigna Commercial |
$1,708.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,708.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,708.80
|
| Rate for Payer: Multiplan Commercial |
$1,986.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,815.60
|
| Rate for Payer: United Healthcare Commercial |
$2,029.20
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
OP
|
$2,136.00
|
|
|
Service Code
|
CPT 29894
|
| Hospital Charge Code |
9822989401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$946.03 |
| Max. Negotiated Rate |
$2,029.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,029.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,913.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$946.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,913.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,285.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,815.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,730.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$961.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,698.12
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cigna Commercial |
$1,708.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,708.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,708.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$961.20
|
| Rate for Payer: Multiplan Commercial |
$1,986.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,815.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$961.20
|
| Rate for Payer: United Healthcare Commercial |
$2,029.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$961.20
|
| Rate for Payer: United Healthcare VA CCN |
$961.20
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
IP
|
$2,083.00
|
|
|
Service Code
|
CPT 29897
|
| Hospital Charge Code |
9822989701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,541.63 |
| Max. Negotiated Rate |
$1,978.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,978.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,541.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,541.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,770.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,749.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,666.40
|
| Rate for Payer: Cash Price |
$1,041.50
|
| Rate for Payer: Cigna Commercial |
$1,666.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,666.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,666.40
|
| Rate for Payer: Multiplan Commercial |
$1,937.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,770.55
|
| Rate for Payer: United Healthcare Commercial |
$1,978.85
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
CPT 29895
|
| Hospital Charge Code |
9822989501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$903.07 |
| Max. Negotiated Rate |
$1,937.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,937.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,826.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$903.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,826.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,227.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,733.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,651.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$917.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,621.01
|
| Rate for Payer: Cash Price |
$1,019.50
|
| Rate for Payer: Cigna Commercial |
$1,631.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,631.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,631.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$917.55
|
| Rate for Payer: Multiplan Commercial |
$1,896.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,733.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$917.55
|
| Rate for Payer: United Healthcare Commercial |
$1,937.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$917.55
|
| Rate for Payer: United Healthcare VA CCN |
$917.55
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
OP
|
$2,083.00
|
|
|
Service Code
|
CPT 29897
|
| Hospital Charge Code |
9822989701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$922.56 |
| Max. Negotiated Rate |
$1,978.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,978.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,866.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$922.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,866.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,253.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,770.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,687.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$937.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,655.98
|
| Rate for Payer: Cash Price |
$1,041.50
|
| Rate for Payer: Cigna Commercial |
$1,666.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,666.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,666.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$937.35
|
| Rate for Payer: Multiplan Commercial |
$1,937.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,770.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$937.35
|
| Rate for Payer: United Healthcare Commercial |
$1,978.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$937.35
|
| Rate for Payer: United Healthcare VA CCN |
$937.35
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
CPT 29895
|
| Hospital Charge Code |
9822989501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,509.06 |
| Max. Negotiated Rate |
$1,937.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,937.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,509.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,509.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,733.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,712.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,019.50
|
| Rate for Payer: Cigna Commercial |
$1,631.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,631.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,631.20
|
| Rate for Payer: Multiplan Commercial |
$1,896.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,733.15
|
| Rate for Payer: United Healthcare Commercial |
$1,937.05
|
|
|
ANKLE ARTHROSCOPY/SURGERY
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
CPT 29891
|
| Hospital Charge Code |
9822989101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$640.53 |
| Max. Negotiated Rate |
$2,350.00 |
| Rate for Payer: Aetna of VT Commercial |
$2,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,239.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$659.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,239.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$896.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$966.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$966.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$736.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$966.14
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$1,212.44
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,060.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,060.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$640.53
|
| Rate for Payer: Multiplan Commercial |
$2,325.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$909.57
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$640.54
|
| Rate for Payer: United Healthcare Commercial |
$985.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$640.54
|
| Rate for Payer: United Healthcare VA CCN |
$640.54
|
|
