|
DRAINAGE ABSCESS PALATE UVULA
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
9814200002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$437.10 |
| Rate for Payer: Aetna of VT Commercial |
$437.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$416.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$107.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$416.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$145.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$254.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$254.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$254.93
|
| Rate for Payer: Cash Price |
$232.50
|
| Rate for Payer: Cash Price |
$232.50
|
| Rate for Payer: Cigna Commercial |
$165.61
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$246.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$246.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$151.38
|
| Rate for Payer: Multiplan Commercial |
$432.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$147.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$104.16
|
| Rate for Payer: United Healthcare Commercial |
$160.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$104.16
|
| Rate for Payer: United Healthcare VA CCN |
$104.16
|
|
|
DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
OP
|
$271.94
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
4504200001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.44 |
| Max. Negotiated Rate |
$258.34 |
| Rate for Payer: Aetna of VT Commercial |
$258.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$243.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$120.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$243.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$163.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$231.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$220.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$216.19
|
| Rate for Payer: Cash Price |
$135.97
|
| Rate for Payer: Cigna Commercial |
$217.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$217.55
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$217.55
|
| Rate for Payer: Martins Point Health Care Commercial |
$122.37
|
| Rate for Payer: Multiplan Commercial |
$252.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$231.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$122.37
|
| Rate for Payer: United Healthcare Commercial |
$258.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Healthcare VA CCN |
$122.37
|
|
|
DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
IP
|
$465.00
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
9814200001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$344.15 |
| Max. Negotiated Rate |
$441.75 |
| Rate for Payer: Aetna of VT Commercial |
$441.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$344.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$344.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$395.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$390.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$372.00
|
| Rate for Payer: Cash Price |
$232.50
|
| Rate for Payer: Cigna Commercial |
$372.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$372.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$372.00
|
| Rate for Payer: Multiplan Commercial |
$432.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$395.25
|
| Rate for Payer: United Healthcare Commercial |
$441.75
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9814230002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$310.84 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of VT Commercial |
$399.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$310.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$310.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$352.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$336.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$336.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$357.00
|
| Rate for Payer: United Healthcare Commercial |
$399.00
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9814230001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$310.84 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of VT Commercial |
$399.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$310.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$310.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$352.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$336.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$336.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$357.00
|
| Rate for Payer: United Healthcare Commercial |
$399.00
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9824230001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$310.84 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of VT Commercial |
$399.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$310.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$310.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$352.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$336.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$336.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$357.00
|
| Rate for Payer: United Healthcare Commercial |
$399.00
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9824230001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$186.02 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of VT Commercial |
$399.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$186.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$252.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$340.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$333.90
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$336.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$357.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.00
|
| Rate for Payer: United Healthcare Commercial |
$399.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.00
|
| Rate for Payer: United Healthcare VA CCN |
$189.00
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9814230002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$148.72 |
| Max. Negotiated Rate |
$394.80 |
| Rate for Payer: Aetna of VT Commercial |
$394.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$153.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$208.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$320.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$320.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$171.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$320.41
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$236.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$203.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$211.18
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$148.72
|
| Rate for Payer: United Healthcare Commercial |
$228.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$148.72
|
| Rate for Payer: United Healthcare VA CCN |
$148.72
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9814230001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$148.72 |
| Max. Negotiated Rate |
$394.80 |
| Rate for Payer: Aetna of VT Commercial |
$394.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$153.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$208.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$320.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$320.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$171.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$320.41
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$236.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$203.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$211.18
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$148.72
|
| Rate for Payer: United Healthcare Commercial |
$228.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$148.72
|
| Rate for Payer: United Healthcare VA CCN |
$148.72
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9814230001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$186.02 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of VT Commercial |
$399.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$186.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$252.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$340.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$333.90
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$336.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$357.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.00
|
| Rate for Payer: United Healthcare Commercial |
$399.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.00
|
| Rate for Payer: United Healthcare VA CCN |
$189.00
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9824230001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$148.72 |
| Max. Negotiated Rate |
$394.80 |
| Rate for Payer: Aetna of VT Commercial |
$394.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$153.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$208.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$320.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$320.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$171.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$320.41
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$236.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$203.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$211.18
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$148.72
|
| Rate for Payer: United Healthcare Commercial |
$228.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$148.72
|
| Rate for Payer: United Healthcare VA CCN |
$148.72
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
OP
|
$4,523.75
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
4504230001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,003.57 |
| Max. Negotiated Rate |
$4,297.56 |
| Rate for Payer: Aetna of VT Commercial |
$4,297.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,052.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,003.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,052.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,723.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,845.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,664.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,035.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,596.38
|
| Rate for Payer: Cash Price |
$2,261.88
|
| Rate for Payer: Cigna Commercial |
$3,619.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,619.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,619.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,035.69
|
| Rate for Payer: Multiplan Commercial |
$4,207.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,845.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,035.69
|
| Rate for Payer: United Healthcare Commercial |
$4,297.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,035.69
|
| Rate for Payer: United Healthcare VA CCN |
$2,035.69
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
9814230002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$186.02 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of VT Commercial |
$399.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$186.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$376.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$252.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$340.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$333.90
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$336.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$390.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$357.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.00
|
| Rate for Payer: United Healthcare Commercial |
$399.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.00
|
| Rate for Payer: United Healthcare VA CCN |
$189.00
|
|
|
DRAINAGE ABSCESS PAROTID SIMPL
|
Facility
|
IP
|
$4,523.75
|
|
|
Service Code
|
CPT 42300
|
| Hospital Charge Code |
4504230001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,348.03 |
| Max. Negotiated Rate |
$4,297.56 |
| Rate for Payer: Aetna of VT Commercial |
$4,297.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,348.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,348.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,845.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,799.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,619.00
|
| Rate for Payer: Cash Price |
$2,261.88
|
| Rate for Payer: Cigna Commercial |
$3,619.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,619.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,619.00
|
| Rate for Payer: Multiplan Commercial |
$4,207.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,845.19
|
| Rate for Payer: United Healthcare Commercial |
$4,297.56
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
OP
|
$610.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9812601001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$270.17 |
| Max. Negotiated Rate |
$579.50 |
| Rate for Payer: Aetna of VT Commercial |
$579.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$546.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$270.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$546.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$367.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$518.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$494.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$274.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$484.95
|
| Rate for Payer: Cash Price |
$305.00
|
| Rate for Payer: Cigna Commercial |
$488.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$488.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$488.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$274.50
|
| Rate for Payer: Multiplan Commercial |
$567.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$518.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$274.50
|
| Rate for Payer: United Healthcare Commercial |
$579.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$274.50
|
| Rate for Payer: United Healthcare VA CCN |
$274.50
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
OP
|
$933.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9602601001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$413.23 |
| Max. Negotiated Rate |
$886.35 |
| Rate for Payer: Aetna of VT Commercial |
$886.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$835.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$413.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$835.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$561.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$793.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$755.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$419.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$741.74
|
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: Cigna Commercial |
$746.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$746.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$746.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$419.85
|
| Rate for Payer: Multiplan Commercial |
$867.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$793.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$419.85
|
| Rate for Payer: United Healthcare Commercial |
$886.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$419.85
|
| Rate for Payer: United Healthcare VA CCN |
$419.85
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
IP
|
$610.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9812601001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$451.46 |
| Max. Negotiated Rate |
$579.50 |
| Rate for Payer: Aetna of VT Commercial |
$579.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$451.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$451.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$518.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$512.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$488.00
|
| Rate for Payer: Cash Price |
$305.00
|
| Rate for Payer: Cigna Commercial |
$488.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$488.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$488.00
|
| Rate for Payer: Multiplan Commercial |
$567.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$518.50
|
| Rate for Payer: United Healthcare Commercial |
$579.50
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
IP
|
$933.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9602601001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$690.51 |
| Max. Negotiated Rate |
$886.35 |
| Rate for Payer: Aetna of VT Commercial |
$886.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$690.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$690.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$793.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$783.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$746.40
|
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: Cigna Commercial |
$746.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$746.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$746.40
|
| Rate for Payer: Multiplan Commercial |
$867.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$793.05
|
| Rate for Payer: United Healthcare Commercial |
$886.35
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
5102601001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$134.50 |
| Max. Negotiated Rate |
$516.36 |
| Rate for Payer: Aetna of VT Commercial |
$327.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$311.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$138.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$311.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$188.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$434.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$434.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$154.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$434.24
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$516.36
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$516.36
|
| Rate for Payer: Martins Point Health Care Commercial |
$318.54
|
| Rate for Payer: Multiplan Commercial |
$323.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$190.99
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$134.50
|
| Rate for Payer: United Healthcare Commercial |
$206.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$134.50
|
| Rate for Payer: United Healthcare VA CCN |
$134.50
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
IP
|
$347.64
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
4502601001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$257.29 |
| Max. Negotiated Rate |
$330.26 |
| Rate for Payer: Aetna of VT Commercial |
$330.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$257.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$257.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$295.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$292.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$278.11
|
| Rate for Payer: Cash Price |
$173.82
|
| Rate for Payer: Cigna Commercial |
$278.11
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$278.11
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$278.11
|
| Rate for Payer: Multiplan Commercial |
$323.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$295.49
|
| Rate for Payer: United Healthcare Commercial |
$330.26
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$933.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9602601001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$134.50 |
| Max. Negotiated Rate |
$877.02 |
| Rate for Payer: Aetna of VT Commercial |
$877.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$835.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$138.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$835.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$188.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$434.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$434.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$154.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$434.24
|
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$516.36
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$516.36
|
| Rate for Payer: Martins Point Health Care Commercial |
$318.54
|
| Rate for Payer: Multiplan Commercial |
$867.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$190.99
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$134.50
|
| Rate for Payer: United Healthcare Commercial |
$206.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$134.50
|
| Rate for Payer: United Healthcare VA CCN |
$134.50
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
OP
|
$347.64
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
4502601001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$153.97 |
| Max. Negotiated Rate |
$330.26 |
| Rate for Payer: Aetna of VT Commercial |
$330.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$311.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$153.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$311.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$209.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$295.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$281.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$156.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$276.37
|
| Rate for Payer: Cash Price |
$173.82
|
| Rate for Payer: Cigna Commercial |
$278.11
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$278.11
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$278.11
|
| Rate for Payer: Martins Point Health Care Commercial |
$156.44
|
| Rate for Payer: Multiplan Commercial |
$323.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$295.49
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$156.44
|
| Rate for Payer: United Healthcare Commercial |
$330.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$156.44
|
| Rate for Payer: United Healthcare VA CCN |
$156.44
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
IP
|
$586.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9812601002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$433.70 |
| Max. Negotiated Rate |
$556.70 |
| Rate for Payer: Aetna of VT Commercial |
$556.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$433.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$433.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$498.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$492.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$468.80
|
| Rate for Payer: Cash Price |
$293.00
|
| Rate for Payer: Cigna Commercial |
$468.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$468.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$468.80
|
| Rate for Payer: Multiplan Commercial |
$544.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$498.10
|
| Rate for Payer: United Healthcare Commercial |
$556.70
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$610.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9812601001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$134.50 |
| Max. Negotiated Rate |
$573.40 |
| Rate for Payer: Aetna of VT Commercial |
$573.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$546.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$138.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$546.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$188.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$434.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$434.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$154.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$434.24
|
| Rate for Payer: Cash Price |
$305.00
|
| Rate for Payer: Cash Price |
$305.00
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$516.36
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$516.36
|
| Rate for Payer: Martins Point Health Care Commercial |
$318.54
|
| Rate for Payer: Multiplan Commercial |
$567.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$190.99
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$134.50
|
| Rate for Payer: United Healthcare Commercial |
$206.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$134.50
|
| Rate for Payer: United Healthcare VA CCN |
$134.50
|
|
|
DRAINAGE FINGER ABSCESS SIMPLE
|
Facility
|
IP
|
$586.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
9602601002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$433.70 |
| Max. Negotiated Rate |
$556.70 |
| Rate for Payer: Aetna of VT Commercial |
$556.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$433.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$433.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$498.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$492.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$468.80
|
| Rate for Payer: Cash Price |
$293.00
|
| Rate for Payer: Cigna Commercial |
$468.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$468.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$468.80
|
| Rate for Payer: Multiplan Commercial |
$544.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$498.10
|
| Rate for Payer: United Healthcare Commercial |
$556.70
|
|
