|
DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
9603150502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$97.88 |
| Max. Negotiated Rate |
$209.95 |
| Rate for Payer: Aetna of VT Commercial |
$209.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$97.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$133.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$187.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$179.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$175.69
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cigna Commercial |
$176.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$176.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$176.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$99.45
|
| Rate for Payer: Multiplan Commercial |
$205.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$187.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$99.45
|
| Rate for Payer: United Healthcare Commercial |
$209.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$99.45
|
| Rate for Payer: United Healthcare VA CCN |
$99.45
|
|
|
DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
OP
|
$549.05
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
4503150501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$243.17 |
| Max. Negotiated Rate |
$521.60 |
| Rate for Payer: Aetna of VT Commercial |
$521.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$491.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$243.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$491.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$330.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$466.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$444.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$247.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$436.49
|
| Rate for Payer: Cash Price |
$274.52
|
| Rate for Payer: Cigna Commercial |
$439.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$439.24
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$439.24
|
| Rate for Payer: Martins Point Health Care Commercial |
$247.07
|
| Rate for Payer: Multiplan Commercial |
$510.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$466.69
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$247.07
|
| Rate for Payer: United Healthcare Commercial |
$521.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$247.07
|
| Rate for Payer: United Healthcare VA CCN |
$247.07
|
|
|
DIAGNOSTIC LARYNGOSCOPY
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
9813150501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$207.74 |
| Rate for Payer: Aetna of VT Commercial |
$207.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$48.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$66.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$117.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$117.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$54.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$117.67
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cigna Commercial |
$74.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$135.78
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$135.78
|
| Rate for Payer: Martins Point Health Care Commercial |
$83.85
|
| Rate for Payer: Multiplan Commercial |
$205.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$67.08
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$47.24
|
| Rate for Payer: United Healthcare Commercial |
$72.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$47.24
|
| Rate for Payer: United Healthcare VA CCN |
$47.24
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
IP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9814533001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$330.82 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$375.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$357.60
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
5104533001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$1,422.22 |
| Rate for Payer: Aetna of VT Commercial |
$1,422.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,355.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$54.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,355.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$74.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$237.39
|
| Rate for Payer: Cash Price |
$756.50
|
| Rate for Payer: Cash Price |
$756.50
|
| Rate for Payer: Cigna Commercial |
$96.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$286.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$286.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$177.10
|
| Rate for Payer: Multiplan Commercial |
$1,407.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$75.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare Commercial |
$81.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare VA CCN |
$53.12
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
IP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9604533002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$330.82 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$375.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$357.60
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Professional
|
Both
|
$1,960.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9604533001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$1,842.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,842.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,755.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$54.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,755.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$74.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$237.39
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cigna Commercial |
$96.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$286.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$286.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$177.10
|
| Rate for Payer: Multiplan Commercial |
$1,822.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$75.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare Commercial |
$81.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare VA CCN |
$53.12
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
OP
|
$1,960.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9604533001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$868.08 |
| Max. Negotiated Rate |
$1,862.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,755.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$868.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,755.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,179.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,666.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,587.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$882.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,558.20
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cigna Commercial |
$1,568.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,568.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,568.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$882.00
|
| Rate for Payer: Multiplan Commercial |
$1,822.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,666.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$882.00
|
| Rate for Payer: United Healthcare Commercial |
$1,862.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$882.00
|
| Rate for Payer: United Healthcare VA CCN |
$882.00
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
IP
|
$1,960.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9604533001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,450.60 |
| Max. Negotiated Rate |
$1,862.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,450.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,450.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,666.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,646.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,568.00
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cigna Commercial |
$1,568.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,568.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,568.00
|
| Rate for Payer: Multiplan Commercial |
$1,822.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,666.00
|
| Rate for Payer: United Healthcare Commercial |
$1,862.00
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
5104533001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,119.77 |
| Max. Negotiated Rate |
$1,437.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,437.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,119.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,119.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,286.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,270.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,210.40
|
| Rate for Payer: Cash Price |
$756.50
|
| Rate for Payer: Cigna Commercial |
$1,210.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,210.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,210.40
|
| Rate for Payer: Multiplan Commercial |
$1,407.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,286.05
|
| Rate for Payer: United Healthcare Commercial |
$1,437.35
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9604533002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$420.18 |
| Rate for Payer: Aetna of VT Commercial |
$420.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$54.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$74.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$237.39
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$96.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$286.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$286.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$177.10
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$75.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare Commercial |
$81.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare VA CCN |
$53.12
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
IP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9824533001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$330.82 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$375.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$357.60
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
IP
|
$1,512.74
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
4504533001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,119.58 |
| Max. Negotiated Rate |
$1,437.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,437.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,119.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,119.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,285.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,270.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,210.19
|
| Rate for Payer: Cash Price |
$756.37
|
| Rate for Payer: Cigna Commercial |
$1,210.19
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,210.19
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,210.19
|
| Rate for Payer: Multiplan Commercial |
$1,406.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,285.83
|
| Rate for Payer: United Healthcare Commercial |
$1,437.10
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
OP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9814533001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$197.98 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$197.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$269.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$201.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$355.37
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.15
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare VA CCN |
$201.15
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
5104533001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$670.11 |
| Max. Negotiated Rate |
$1,437.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,437.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,355.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$670.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,355.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$910.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,286.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,225.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$680.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,202.84
|
| Rate for Payer: Cash Price |
$756.50
|
| Rate for Payer: Cigna Commercial |
$1,210.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,210.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,210.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$680.85
|
| Rate for Payer: Multiplan Commercial |
$1,407.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,286.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$680.85
|
| Rate for Payer: United Healthcare Commercial |
$1,437.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$680.85
|
| Rate for Payer: United Healthcare VA CCN |
$680.85
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
9824533001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$157.08 |
| Max. Negotiated Rate |
$492.19 |
| Rate for Payer: Aetna of VT Commercial |
$420.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$161.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$219.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$407.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$407.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$180.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$407.99
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$282.09
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$492.19
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$492.19
|
| Rate for Payer: Martins Point Health Care Commercial |
$300.01
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$223.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$157.08
|
| Rate for Payer: United Healthcare Commercial |
$241.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$157.08
|
| Rate for Payer: United Healthcare VA CCN |
$157.08
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
OP
|
$1,512.74
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
4504533001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$669.99 |
| Max. Negotiated Rate |
$1,437.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,437.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,355.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$669.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,355.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$910.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,285.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,225.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$680.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,202.63
|
| Rate for Payer: Cash Price |
$756.37
|
| Rate for Payer: Cigna Commercial |
$1,210.19
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,210.19
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,210.19
|
| Rate for Payer: Martins Point Health Care Commercial |
$680.73
|
| Rate for Payer: Multiplan Commercial |
$1,406.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,285.83
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$680.73
|
| Rate for Payer: United Healthcare Commercial |
$1,437.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$680.73
|
| Rate for Payer: United Healthcare VA CCN |
$680.73
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
OP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9604533002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$197.98 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$197.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$269.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$201.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$355.37
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.15
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare VA CCN |
$201.15
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
OP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9814533002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$197.98 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$197.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$269.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$201.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$355.37
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.15
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare VA CCN |
$201.15
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
OP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9824533001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$197.98 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$197.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$269.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$201.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$355.37
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.15
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$201.15
|
| Rate for Payer: United Healthcare VA CCN |
$201.15
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9814533001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$420.18 |
| Rate for Payer: Aetna of VT Commercial |
$420.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$54.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$74.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$237.39
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$96.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$286.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$286.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$177.10
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$75.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare Commercial |
$81.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare VA CCN |
$53.12
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9814533002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$420.18 |
| Rate for Payer: Aetna of VT Commercial |
$420.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$54.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$400.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$74.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$237.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$237.39
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$96.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$286.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$286.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$177.10
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$75.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare Commercial |
$81.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare VA CCN |
$53.12
|
|
|
DIAGNOSTIC SIGMOIDOSCOPY
|
Facility
|
IP
|
$447.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
9814533002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$330.82 |
| Max. Negotiated Rate |
$424.65 |
| Rate for Payer: Aetna of VT Commercial |
$424.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$375.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$357.60
|
| Rate for Payer: Cash Price |
$223.50
|
| Rate for Payer: Cigna Commercial |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$357.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$357.60
|
| Rate for Payer: Multiplan Commercial |
$415.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.95
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
|
|
DIHYDROTESTOSTERONE (DHT)
|
Facility
|
IP
|
$191.26
|
|
|
Service Code
|
CPT 82642
|
| Hospital Charge Code |
3008264201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$141.55 |
| Max. Negotiated Rate |
$181.70 |
| Rate for Payer: Aetna of VT Commercial |
$181.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$141.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$141.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$162.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$160.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$153.01
|
| Rate for Payer: Cash Price |
$95.63
|
| Rate for Payer: Cigna Commercial |
$153.01
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$153.01
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$153.01
|
| Rate for Payer: Multiplan Commercial |
$177.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$162.57
|
| Rate for Payer: United Healthcare Commercial |
$181.70
|
|
|
DIHYDROTESTOSTERONE (DHT)
|
Professional
|
Both
|
$191.26
|
|
|
Service Code
|
CPT 82642
|
| Hospital Charge Code |
3008264201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.87 |
| Max. Negotiated Rate |
$179.78 |
| Rate for Payer: Aetna of VT Commercial |
$179.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$144.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$30.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$144.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$40.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$40.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$33.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$40.26
|
| Rate for Payer: Cash Price |
$95.63
|
| Rate for Payer: Cash Price |
$95.63
|
| Rate for Payer: Cigna Commercial |
$35.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$29.28
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$29.28
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.87
|
| Rate for Payer: Multiplan Commercial |
$177.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$29.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$29.28
|
| Rate for Payer: United Healthcare Commercial |
$45.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.28
|
| Rate for Payer: United Healthcare VA CCN |
$29.28
|
|
