|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
5105706101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.42 |
| Max. Negotiated Rate |
$151.05 |
| Rate for Payer: Aetna of VT Commercial |
$151.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$70.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$95.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$128.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$71.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$126.41
|
| Rate for Payer: Cash Price |
$79.50
|
| Rate for Payer: Cigna Commercial |
$127.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$127.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$127.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$71.55
|
| Rate for Payer: Multiplan Commercial |
$147.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$135.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$71.55
|
| Rate for Payer: United Healthcare Commercial |
$151.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$71.55
|
| Rate for Payer: United Healthcare VA CCN |
$71.55
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
IP
|
$280.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9825706101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$207.23 |
| Max. Negotiated Rate |
$266.00 |
| Rate for Payer: Aetna of VT Commercial |
$266.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$235.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$224.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cigna Commercial |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$224.00
|
| Rate for Payer: Multiplan Commercial |
$260.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$238.00
|
| Rate for Payer: United Healthcare Commercial |
$266.00
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
5105706101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$109.17 |
| Max. Negotiated Rate |
$256.64 |
| Rate for Payer: Aetna of VT Commercial |
$149.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$112.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$152.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$207.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$207.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$125.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$207.64
|
| Rate for Payer: Cash Price |
$79.50
|
| Rate for Payer: Cash Price |
$79.50
|
| Rate for Payer: Cigna Commercial |
$192.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$256.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$256.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$157.35
|
| Rate for Payer: Multiplan Commercial |
$147.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$155.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$109.17
|
| Rate for Payer: United Healthcare Commercial |
$167.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109.17
|
| Rate for Payer: United Healthcare VA CCN |
$109.17
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
OP
|
$280.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9825706101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$124.01 |
| Max. Negotiated Rate |
$266.00 |
| Rate for Payer: Aetna of VT Commercial |
$266.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$250.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$124.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$250.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$168.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$226.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$222.60
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cigna Commercial |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$224.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$260.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$238.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$126.00
|
| Rate for Payer: United Healthcare Commercial |
$266.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.00
|
| Rate for Payer: United Healthcare VA CCN |
$126.00
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
OP
|
$438.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9605706101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$193.99 |
| Max. Negotiated Rate |
$416.10 |
| Rate for Payer: Aetna of VT Commercial |
$416.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$392.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$193.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$392.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$263.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$372.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$354.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$197.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$348.21
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$350.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$350.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$350.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$197.10
|
| Rate for Payer: Multiplan Commercial |
$407.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$372.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$197.10
|
| Rate for Payer: United Healthcare Commercial |
$416.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$197.10
|
| Rate for Payer: United Healthcare VA CCN |
$197.10
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
IP
|
$159.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
5105706101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$117.68 |
| Max. Negotiated Rate |
$151.05 |
| Rate for Payer: Aetna of VT Commercial |
$151.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$117.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$117.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$133.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$127.20
|
| Rate for Payer: Cash Price |
$79.50
|
| Rate for Payer: Cigna Commercial |
$127.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$127.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$127.20
|
| Rate for Payer: Multiplan Commercial |
$147.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$135.15
|
| Rate for Payer: United Healthcare Commercial |
$151.05
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
IP
|
$438.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9605706101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$324.16 |
| Max. Negotiated Rate |
$416.10 |
| Rate for Payer: Aetna of VT Commercial |
$416.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$324.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$324.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$372.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$367.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$350.40
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$350.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$350.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$350.40
|
| Rate for Payer: Multiplan Commercial |
$407.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$372.30
|
| Rate for Payer: United Healthcare Commercial |
$416.10
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9605706102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$109.17 |
| Max. Negotiated Rate |
$263.20 |
| Rate for Payer: Aetna of VT Commercial |
$263.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$250.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$112.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$250.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$152.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$207.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$207.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$125.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$207.64
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cigna Commercial |
$192.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$256.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$256.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$157.35
|
| Rate for Payer: Multiplan Commercial |
$260.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$155.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$109.17
|
| Rate for Payer: United Healthcare Commercial |
$167.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109.17
|
| Rate for Payer: United Healthcare VA CCN |
$109.17
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
OP
|
$280.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9605706102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$124.01 |
| Max. Negotiated Rate |
$266.00 |
| Rate for Payer: Aetna of VT Commercial |
$266.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$250.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$124.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$250.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$168.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$226.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$222.60
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cigna Commercial |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$224.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$260.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$238.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$126.00
|
| Rate for Payer: United Healthcare Commercial |
$266.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.00
|
| Rate for Payer: United Healthcare VA CCN |
$126.00
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Facility
|
IP
|
$280.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9605706102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$207.23 |
| Max. Negotiated Rate |
$266.00 |
| Rate for Payer: Aetna of VT Commercial |
$266.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$235.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$224.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cigna Commercial |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$224.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$224.00
|
| Rate for Payer: Multiplan Commercial |
$260.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$238.00
|
| Rate for Payer: United Healthcare Commercial |
$266.00
|
|
|
DESTROY VAG LESIONS SIMPLE
|
Professional
|
Both
|
$438.00
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
9605706101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$109.17 |
| Max. Negotiated Rate |
$411.72 |
| Rate for Payer: Aetna of VT Commercial |
$411.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$392.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$112.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$392.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$152.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$207.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$207.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$125.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$207.64
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$192.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$256.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$256.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$157.35
|
| Rate for Payer: Multiplan Commercial |
$407.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$155.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$109.17
|
| Rate for Payer: United Healthcare Commercial |
$167.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109.17
|
| Rate for Payer: United Healthcare VA CCN |
$109.17
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9825651501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$418.16 |
| Max. Negotiated Rate |
$536.75 |
| Rate for Payer: Aetna of VT Commercial |
$536.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$418.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$418.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$480.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$474.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$452.00
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cigna Commercial |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$452.00
|
| Rate for Payer: Multiplan Commercial |
$525.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$480.25
|
| Rate for Payer: United Healthcare Commercial |
$536.75
|
|
|
DESTROY VULVA LESION/S COMPL
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9825651501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$199.23 |
| Max. Negotiated Rate |
$531.10 |
| Rate for Payer: Aetna of VT Commercial |
$531.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$205.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$278.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$229.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$362.11
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cigna Commercial |
$352.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$426.87
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$426.87
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.62
|
| Rate for Payer: Multiplan Commercial |
$525.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$282.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare Commercial |
$306.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare VA CCN |
$199.23
|
|
|
DESTROY VULVA LESION/S COMPL
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9605651502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$199.23 |
| Max. Negotiated Rate |
$531.10 |
| Rate for Payer: Aetna of VT Commercial |
$531.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$205.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$278.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$229.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$362.11
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cigna Commercial |
$352.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$426.87
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$426.87
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.62
|
| Rate for Payer: Multiplan Commercial |
$525.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$282.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare Commercial |
$306.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare VA CCN |
$199.23
|
|
|
DESTROY VULVA LESION/S COMPL
|
Professional
|
Both
|
$6,858.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9605651501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$199.23 |
| Max. Negotiated Rate |
$6,446.52 |
| Rate for Payer: Aetna of VT Commercial |
$6,446.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$6,144.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$205.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$6,144.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$278.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$229.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$362.11
|
| Rate for Payer: Cash Price |
$3,429.00
|
| Rate for Payer: Cash Price |
$3,429.00
|
| Rate for Payer: Cigna Commercial |
$352.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$426.87
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$426.87
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.62
|
| Rate for Payer: Multiplan Commercial |
$6,377.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$282.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare Commercial |
$306.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare VA CCN |
$199.23
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9605651502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$418.16 |
| Max. Negotiated Rate |
$536.75 |
| Rate for Payer: Aetna of VT Commercial |
$536.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$418.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$418.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$480.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$474.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$452.00
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cigna Commercial |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$452.00
|
| Rate for Payer: Multiplan Commercial |
$525.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$480.25
|
| Rate for Payer: United Healthcare Commercial |
$536.75
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
OP
|
$6,294.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
5105651501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,787.61 |
| Max. Negotiated Rate |
$5,979.30 |
| Rate for Payer: Aetna of VT Commercial |
$5,979.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$5,638.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,787.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$5,638.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$3,788.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,349.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,098.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,832.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,003.73
|
| Rate for Payer: Cash Price |
$3,147.00
|
| Rate for Payer: Cigna Commercial |
$5,035.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,035.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,035.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,832.30
|
| Rate for Payer: Multiplan Commercial |
$5,853.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,349.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,832.30
|
| Rate for Payer: United Healthcare Commercial |
$5,979.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,832.30
|
| Rate for Payer: United Healthcare VA CCN |
$2,832.30
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9825651501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$250.24 |
| Max. Negotiated Rate |
$536.75 |
| Rate for Payer: Aetna of VT Commercial |
$536.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$250.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$340.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$480.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$457.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$254.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$449.18
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cigna Commercial |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$452.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$254.25
|
| Rate for Payer: Multiplan Commercial |
$525.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$480.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$254.25
|
| Rate for Payer: United Healthcare Commercial |
$536.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$254.25
|
| Rate for Payer: United Healthcare VA CCN |
$254.25
|
|
|
DESTROY VULVA LESION/S COMPL
|
Professional
|
Both
|
$6,294.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
5105651501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$199.23 |
| Max. Negotiated Rate |
$5,916.36 |
| Rate for Payer: Aetna of VT Commercial |
$5,916.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$5,638.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$205.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$5,638.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$278.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$229.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$362.11
|
| Rate for Payer: Cash Price |
$3,147.00
|
| Rate for Payer: Cash Price |
$3,147.00
|
| Rate for Payer: Cigna Commercial |
$352.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$426.87
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$426.87
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.62
|
| Rate for Payer: Multiplan Commercial |
$5,853.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$282.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare Commercial |
$306.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$199.23
|
| Rate for Payer: United Healthcare VA CCN |
$199.23
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
IP
|
$6,294.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
5105651501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$4,658.19 |
| Max. Negotiated Rate |
$5,979.30 |
| Rate for Payer: Aetna of VT Commercial |
$5,979.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,658.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,658.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,349.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,286.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,035.20
|
| Rate for Payer: Cash Price |
$3,147.00
|
| Rate for Payer: Cigna Commercial |
$5,035.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,035.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,035.20
|
| Rate for Payer: Multiplan Commercial |
$5,853.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,349.90
|
| Rate for Payer: United Healthcare Commercial |
$5,979.30
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
OP
|
$6,858.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9605651501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,037.41 |
| Max. Negotiated Rate |
$6,515.10 |
| Rate for Payer: Aetna of VT Commercial |
$6,515.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$6,144.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$3,037.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$6,144.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$4,128.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,829.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,554.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$3,086.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,452.11
|
| Rate for Payer: Cash Price |
$3,429.00
|
| Rate for Payer: Cigna Commercial |
$5,486.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,486.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,486.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$3,086.10
|
| Rate for Payer: Multiplan Commercial |
$6,377.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,829.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$3,086.10
|
| Rate for Payer: United Healthcare Commercial |
$6,515.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,086.10
|
| Rate for Payer: United Healthcare VA CCN |
$3,086.10
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
IP
|
$6,858.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9605651501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$5,075.61 |
| Max. Negotiated Rate |
$6,515.10 |
| Rate for Payer: Aetna of VT Commercial |
$6,515.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$5,075.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$5,075.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,829.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,760.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,486.40
|
| Rate for Payer: Cash Price |
$3,429.00
|
| Rate for Payer: Cigna Commercial |
$5,486.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,486.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,486.40
|
| Rate for Payer: Multiplan Commercial |
$6,377.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,829.30
|
| Rate for Payer: United Healthcare Commercial |
$6,515.10
|
|
|
DESTROY VULVA LESION/S COMPL
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
9605651502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$250.24 |
| Max. Negotiated Rate |
$536.75 |
| Rate for Payer: Aetna of VT Commercial |
$536.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$250.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$506.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$340.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$480.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$457.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$254.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$449.18
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cigna Commercial |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$452.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$452.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$254.25
|
| Rate for Payer: Multiplan Commercial |
$525.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$480.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$254.25
|
| Rate for Payer: United Healthcare Commercial |
$536.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$254.25
|
| Rate for Payer: United Healthcare VA CCN |
$254.25
|
|
|
DESTROY VULVA LESIONS SIM
|
Facility
|
IP
|
$4,689.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9605650101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,470.33 |
| Max. Negotiated Rate |
$4,454.55 |
| Rate for Payer: Aetna of VT Commercial |
$4,454.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,470.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,470.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,985.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,938.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,751.20
|
| Rate for Payer: Cash Price |
$2,344.50
|
| Rate for Payer: Cigna Commercial |
$3,751.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,751.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,751.20
|
| Rate for Payer: Multiplan Commercial |
$4,360.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,985.65
|
| Rate for Payer: United Healthcare Commercial |
$4,454.55
|
|
|
DESTROY VULVA LESIONS SIM
|
Facility
|
IP
|
$4,387.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
5105650101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3,246.82 |
| Max. Negotiated Rate |
$4,167.65 |
| Rate for Payer: Aetna of VT Commercial |
$4,167.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,246.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,246.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,728.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,685.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,509.60
|
| Rate for Payer: Cash Price |
$2,193.50
|
| Rate for Payer: Cigna Commercial |
$3,509.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,509.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,509.60
|
| Rate for Payer: Multiplan Commercial |
$4,079.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,728.95
|
| Rate for Payer: United Healthcare Commercial |
$4,167.65
|
|
