|
DESTROY VULVA LESIONS SIM
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9825650101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Aetna of VT Commercial |
$286.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$133.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$181.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$256.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$244.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$135.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$240.09
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$241.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$241.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$241.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$135.90
|
| Rate for Payer: Multiplan Commercial |
$280.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$256.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$135.90
|
| Rate for Payer: United Healthcare Commercial |
$286.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$135.90
|
| Rate for Payer: United Healthcare VA CCN |
$135.90
|
|
|
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
|
Professional
|
Both
|
$4,689.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9605650101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$126.44 |
| Max. Negotiated Rate |
$4,407.66 |
| Rate for Payer: Aetna of VT Commercial |
$4,407.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,200.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$130.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,200.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$177.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$238.31
|
| Rate for Payer: Cash Price |
$2,344.50
|
| Rate for Payer: Cash Price |
$2,344.50
|
| Rate for Payer: Cigna Commercial |
$223.71
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$294.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$294.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$180.72
|
| Rate for Payer: Multiplan Commercial |
$4,360.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.54
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare Commercial |
$194.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare VA CCN |
$126.44
|
|
|
DESTROY VULVA LESIONS SIM
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9605650102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$223.51 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Aetna of VT Commercial |
$286.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$223.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$223.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$256.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$253.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$241.60
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$241.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$241.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$241.60
|
| Rate for Payer: Multiplan Commercial |
$280.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$256.70
|
| Rate for Payer: United Healthcare Commercial |
$286.90
|
|
|
DESTROY VULVA LESIONS SIM
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9825650101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$126.44 |
| Max. Negotiated Rate |
$294.69 |
| Rate for Payer: Aetna of VT Commercial |
$283.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$130.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$177.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$238.31
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$223.71
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$294.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$294.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$180.72
|
| Rate for Payer: Multiplan Commercial |
$280.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.54
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare Commercial |
$194.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare VA CCN |
$126.44
|
|
|
DESTROY VULVA LESIONS SIM
|
Professional
|
Both
|
$4,387.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
5105650101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.44 |
| Max. Negotiated Rate |
$4,123.78 |
| Rate for Payer: Aetna of VT Commercial |
$4,123.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,930.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$130.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,930.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$177.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$238.31
|
| Rate for Payer: Cash Price |
$2,193.50
|
| Rate for Payer: Cash Price |
$2,193.50
|
| Rate for Payer: Cigna Commercial |
$223.71
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$294.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$294.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$180.72
|
| Rate for Payer: Multiplan Commercial |
$4,079.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.54
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare Commercial |
$194.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare VA CCN |
$126.44
|
|
|
DESTROY VULVA LESIONS SIM
|
Facility
|
OP
|
$4,387.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
5105650101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,943.00 |
| 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 |
$3,930.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,943.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,930.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,640.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,728.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,553.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,974.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,487.66
|
| 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: Martins Point Health Care Commercial |
$1,974.15
|
| Rate for Payer: Multiplan Commercial |
$4,079.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,728.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,974.15
|
| Rate for Payer: United Healthcare Commercial |
$4,167.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,974.15
|
| Rate for Payer: United Healthcare VA CCN |
$1,974.15
|
|
|
DESTROY VULVA LESIONS SIM
|
Facility
|
OP
|
$4,689.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9605650101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,076.76 |
| 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 |
$4,200.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,076.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,200.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,822.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,985.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,798.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,110.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,727.76
|
| 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: Martins Point Health Care Commercial |
$2,110.05
|
| Rate for Payer: Multiplan Commercial |
$4,360.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,985.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,110.05
|
| Rate for Payer: United Healthcare Commercial |
$4,454.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,110.05
|
| Rate for Payer: United Healthcare VA CCN |
$2,110.05
|
|
|
DESTROY VULVA LESIONS SIM
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9605650102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$126.44 |
| Max. Negotiated Rate |
$294.69 |
| Rate for Payer: Aetna of VT Commercial |
$283.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$130.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$177.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$238.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$238.31
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$223.71
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$294.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$294.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$180.72
|
| Rate for Payer: Multiplan Commercial |
$280.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.54
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare Commercial |
$194.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.44
|
| Rate for Payer: United Healthcare VA CCN |
$126.44
|
|
|
DESTROY VULVA LESIONS SIM
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
9605650102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Aetna of VT Commercial |
$286.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$133.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$270.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$181.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$256.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$244.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$135.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$240.09
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$241.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$241.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$241.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$135.90
|
| Rate for Payer: Multiplan Commercial |
$280.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$256.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$135.90
|
| Rate for Payer: United Healthcare Commercial |
$286.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$135.90
|
| Rate for Payer: United Healthcare VA CCN |
$135.90
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
OP
|
$884.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9821710601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$391.52 |
| Max. Negotiated Rate |
$839.80 |
| Rate for Payer: Aetna of VT Commercial |
$839.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$391.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$532.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$751.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$716.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$397.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$702.78
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cigna Commercial |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$707.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$397.80
|
| Rate for Payer: Multiplan Commercial |
$822.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$751.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$397.80
|
| Rate for Payer: United Healthcare Commercial |
$839.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$397.80
|
| Rate for Payer: United Healthcare VA CCN |
$397.80
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9601710602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$263.56 |
| Max. Negotiated Rate |
$830.96 |
| Rate for Payer: Aetna of VT Commercial |
$830.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$271.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$368.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$303.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$567.14
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cigna Commercial |
$295.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$536.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$536.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$329.41
|
| Rate for Payer: Multiplan Commercial |
$822.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$374.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare Commercial |
$405.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare VA CCN |
$263.56
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
IP
|
$884.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9601710602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$654.25 |
| Max. Negotiated Rate |
$839.80 |
| Rate for Payer: Aetna of VT Commercial |
$839.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$654.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$654.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$751.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$742.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$707.20
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cigna Commercial |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$707.20
|
| Rate for Payer: Multiplan Commercial |
$822.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$751.40
|
| Rate for Payer: United Healthcare Commercial |
$839.80
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
5101710601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$263.56 |
| Max. Negotiated Rate |
$567.14 |
| 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 |
$271.47
|
| 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 |
$368.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$303.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$567.14
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cash Price |
$282.50
|
| Rate for Payer: Cigna Commercial |
$295.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$536.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$536.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$329.41
|
| Rate for Payer: Multiplan Commercial |
$525.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$374.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare Commercial |
$405.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare VA CCN |
$263.56
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
OP
|
$884.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9601710602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$391.52 |
| Max. Negotiated Rate |
$839.80 |
| Rate for Payer: Aetna of VT Commercial |
$839.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$391.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$532.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$751.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$716.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$397.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$702.78
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cigna Commercial |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$707.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$397.80
|
| Rate for Payer: Multiplan Commercial |
$822.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$751.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$397.80
|
| Rate for Payer: United Healthcare Commercial |
$839.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$397.80
|
| Rate for Payer: United Healthcare VA CCN |
$397.80
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9601710601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$263.56 |
| Max. Negotiated Rate |
$1,361.12 |
| Rate for Payer: Aetna of VT Commercial |
$1,361.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,297.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$271.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,297.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$368.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$303.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$567.14
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cigna Commercial |
$295.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$536.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$536.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$329.41
|
| Rate for Payer: Multiplan Commercial |
$1,346.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$374.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare Commercial |
$405.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare VA CCN |
$263.56
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
IP
|
$1,448.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9601710601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,071.66 |
| Max. Negotiated Rate |
$1,375.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,375.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,071.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,071.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,230.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,216.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,158.40
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cigna Commercial |
$1,158.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,158.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,158.40
|
| Rate for Payer: Multiplan Commercial |
$1,346.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,230.80
|
| Rate for Payer: United Healthcare Commercial |
$1,375.60
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
OP
|
$1,448.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9601710601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$641.32 |
| Max. Negotiated Rate |
$1,375.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,375.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,297.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$641.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,297.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$871.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,230.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,172.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$651.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,151.16
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cigna Commercial |
$1,158.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,158.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,158.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$651.60
|
| Rate for Payer: Multiplan Commercial |
$1,346.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,230.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$651.60
|
| Rate for Payer: United Healthcare Commercial |
$1,375.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$651.60
|
| Rate for Payer: United Healthcare VA CCN |
$651.60
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
5101710601
|
|
Hospital Revenue Code
|
510
|
| 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
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9821710601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$263.56 |
| Max. Negotiated Rate |
$830.96 |
| Rate for Payer: Aetna of VT Commercial |
$830.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$271.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$368.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$567.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$303.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$567.14
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cigna Commercial |
$295.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$536.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$536.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$329.41
|
| Rate for Payer: Multiplan Commercial |
$822.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$374.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare Commercial |
$405.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$263.56
|
| Rate for Payer: United Healthcare VA CCN |
$263.56
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
IP
|
$884.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
9821710601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$654.25 |
| Max. Negotiated Rate |
$839.80 |
| Rate for Payer: Aetna of VT Commercial |
$839.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$654.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$654.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$751.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$742.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$707.20
|
| Rate for Payer: Cash Price |
$442.00
|
| Rate for Payer: Cigna Commercial |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$707.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$707.20
|
| Rate for Payer: Multiplan Commercial |
$822.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$751.40
|
| Rate for Payer: United Healthcare Commercial |
$839.80
|
|
|
DESTRUC CUTAN VASC PROLIF<10CM
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 17106
|
| Hospital Charge Code |
5101710601
|
|
Hospital Revenue Code
|
510
|
| 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
|
|
|
DESTRUCT B9 LESION 1-14
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
9821711001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$66.37 |
| Max. Negotiated Rate |
$174.86 |
| Rate for Payer: Aetna of VT Commercial |
$110.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$105.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$68.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$105.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$92.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$167.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$167.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$76.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$167.47
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Cigna Commercial |
$74.23
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$174.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$174.86
|
| Rate for Payer: Martins Point Health Care Commercial |
$108.45
|
| Rate for Payer: Multiplan Commercial |
$109.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$94.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$66.37
|
| Rate for Payer: United Healthcare Commercial |
$102.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$66.37
|
| Rate for Payer: United Healthcare VA CCN |
$66.37
|
|
|
DESTRUCT B9 LESION 1-14
|
Facility
|
IP
|
$118.00
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
9821711001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$87.33 |
| Max. Negotiated Rate |
$112.10 |
| Rate for Payer: Aetna of VT Commercial |
$112.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$87.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$87.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$100.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$99.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$94.40
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Cigna Commercial |
$94.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$94.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$94.40
|
| Rate for Payer: Multiplan Commercial |
$109.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$100.30
|
| Rate for Payer: United Healthcare Commercial |
$112.10
|
|
|
DESTRUCT B9 LESION 1-14
|
Facility
|
OP
|
$118.00
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
9821711001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$52.26 |
| Max. Negotiated Rate |
$112.10 |
| Rate for Payer: Aetna of VT Commercial |
$112.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$105.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$52.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$105.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$71.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$100.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$95.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$53.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$93.81
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Cigna Commercial |
$94.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$94.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$94.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$53.10
|
| Rate for Payer: Multiplan Commercial |
$109.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$100.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$53.10
|
| Rate for Payer: United Healthcare Commercial |
$112.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.10
|
| Rate for Payer: United Healthcare VA CCN |
$53.10
|
|
