|
DRAINAGE OF RECTAL ABSCESS
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
9814500501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$241.38 |
| Max. Negotiated Rate |
$517.75 |
| Rate for Payer: Aetna of VT Commercial |
$517.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$488.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$241.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$488.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$328.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$463.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$441.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$245.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$433.27
|
| Rate for Payer: Cash Price |
$272.50
|
| Rate for Payer: Cigna Commercial |
$436.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$436.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$436.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$245.25
|
| Rate for Payer: Multiplan Commercial |
$506.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$463.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$245.25
|
| Rate for Payer: United Healthcare Commercial |
$517.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$245.25
|
| Rate for Payer: United Healthcare VA CCN |
$245.25
|
|
|
DRAINAGE OF RECTAL ABSCESS
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
9824500501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$157.08 |
| Max. Negotiated Rate |
$512.30 |
| Rate for Payer: Aetna of VT Commercial |
$512.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$488.27
|
| 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 |
$488.27
|
| 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 |
$272.50
|
| Rate for Payer: Cash Price |
$272.50
|
| 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 |
$506.85
|
| 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
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
IP
|
$495.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9815470001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$366.35 |
| Max. Negotiated Rate |
$470.25 |
| Rate for Payer: Aetna of VT Commercial |
$470.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$366.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$366.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$415.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$396.00
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cigna Commercial |
$396.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$396.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$396.00
|
| Rate for Payer: Multiplan Commercial |
$460.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$420.75
|
| Rate for Payer: United Healthcare Commercial |
$470.25
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
OP
|
$466.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9815470002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$206.39 |
| Max. Negotiated Rate |
$442.70 |
| Rate for Payer: Aetna of VT Commercial |
$442.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$206.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$280.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$396.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$377.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$209.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$370.47
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cigna Commercial |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$372.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$209.70
|
| Rate for Payer: Multiplan Commercial |
$433.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$396.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$209.70
|
| Rate for Payer: United Healthcare Commercial |
$442.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$209.70
|
| Rate for Payer: United Healthcare VA CCN |
$209.70
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
IP
|
$466.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9825470001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$344.89 |
| Max. Negotiated Rate |
$442.70 |
| Rate for Payer: Aetna of VT Commercial |
$442.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$344.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$344.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$396.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$391.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$372.80
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cigna Commercial |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$372.80
|
| Rate for Payer: Multiplan Commercial |
$433.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$396.10
|
| Rate for Payer: United Healthcare Commercial |
$442.70
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
OP
|
$922.43
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
4505470001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$408.54 |
| Max. Negotiated Rate |
$876.31 |
| Rate for Payer: Aetna of VT Commercial |
$876.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$826.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$408.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$826.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$555.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$784.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$747.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$415.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$733.33
|
| Rate for Payer: Cash Price |
$461.21
|
| Rate for Payer: Cigna Commercial |
$737.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$737.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$737.94
|
| Rate for Payer: Martins Point Health Care Commercial |
$415.09
|
| Rate for Payer: Multiplan Commercial |
$857.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$784.07
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$415.09
|
| Rate for Payer: United Healthcare Commercial |
$876.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$415.09
|
| Rate for Payer: United Healthcare VA CCN |
$415.09
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
IP
|
$466.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9815470002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$344.89 |
| Max. Negotiated Rate |
$442.70 |
| Rate for Payer: Aetna of VT Commercial |
$442.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$344.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$344.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$396.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$391.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$372.80
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cigna Commercial |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$372.80
|
| Rate for Payer: Multiplan Commercial |
$433.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$396.10
|
| Rate for Payer: United Healthcare Commercial |
$442.70
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
IP
|
$922.43
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
4505470001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$682.69 |
| Max. Negotiated Rate |
$876.31 |
| Rate for Payer: Aetna of VT Commercial |
$876.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$682.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$682.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$784.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$774.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$737.94
|
| Rate for Payer: Cash Price |
$461.21
|
| Rate for Payer: Cigna Commercial |
$737.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$737.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$737.94
|
| Rate for Payer: Multiplan Commercial |
$857.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$784.07
|
| Rate for Payer: United Healthcare Commercial |
$876.31
|
|
|
DRAINAGE OF SCROTUM
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9825470001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$201.40 |
| Max. Negotiated Rate |
$524.67 |
| Rate for Payer: Aetna of VT Commercial |
$438.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$207.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$281.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$524.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$524.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$231.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$524.67
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cigna Commercial |
$349.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$333.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$333.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.40
|
| Rate for Payer: Multiplan Commercial |
$433.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$285.99
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$201.40
|
| Rate for Payer: United Healthcare Commercial |
$309.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$201.40
|
| Rate for Payer: United Healthcare VA CCN |
$201.40
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
OP
|
$466.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9825470001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$206.39 |
| Max. Negotiated Rate |
$442.70 |
| Rate for Payer: Aetna of VT Commercial |
$442.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$206.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$280.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$396.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$377.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$209.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$370.47
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cigna Commercial |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$372.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$372.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$209.70
|
| Rate for Payer: Multiplan Commercial |
$433.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$396.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$209.70
|
| Rate for Payer: United Healthcare Commercial |
$442.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$209.70
|
| Rate for Payer: United Healthcare VA CCN |
$209.70
|
|
|
DRAINAGE OF SCROTUM
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9815470002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$201.40 |
| Max. Negotiated Rate |
$524.67 |
| Rate for Payer: Aetna of VT Commercial |
$438.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$207.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$417.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$281.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$524.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$524.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$231.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$524.67
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cash Price |
$233.00
|
| Rate for Payer: Cigna Commercial |
$349.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$333.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$333.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.40
|
| Rate for Payer: Multiplan Commercial |
$433.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$285.99
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$201.40
|
| Rate for Payer: United Healthcare Commercial |
$309.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$201.40
|
| Rate for Payer: United Healthcare VA CCN |
$201.40
|
|
|
DRAINAGE OF SCROTUM
|
Facility
|
OP
|
$495.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9815470001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$470.25 |
| Rate for Payer: Aetna of VT Commercial |
$470.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$443.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$219.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$443.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$400.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$222.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$393.52
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cigna Commercial |
$396.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$396.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$396.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$222.75
|
| Rate for Payer: Multiplan Commercial |
$460.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$420.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$222.75
|
| Rate for Payer: United Healthcare Commercial |
$470.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$222.75
|
| Rate for Payer: United Healthcare VA CCN |
$222.75
|
|
|
DRAINAGE OF SCROTUM
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
9815470001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$201.40 |
| Max. Negotiated Rate |
$524.67 |
| Rate for Payer: Aetna of VT Commercial |
$465.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$443.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$207.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$443.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$281.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$524.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$524.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$231.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$524.67
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cigna Commercial |
$349.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$333.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$333.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.40
|
| Rate for Payer: Multiplan Commercial |
$460.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$285.99
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$201.40
|
| Rate for Payer: United Healthcare Commercial |
$309.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$201.40
|
| Rate for Payer: United Healthcare VA CCN |
$201.40
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,216.96
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
3615510001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,640.77 |
| Max. Negotiated Rate |
$2,106.11 |
| Rate for Payer: Aetna of VT Commercial |
$2,106.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,640.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,640.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,884.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,862.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,773.57
|
| Rate for Payer: Cash Price |
$1,108.48
|
| Rate for Payer: Cigna Commercial |
$1,773.57
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,773.57
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,773.57
|
| Rate for Payer: Multiplan Commercial |
$2,061.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,884.42
|
| Rate for Payer: United Healthcare Commercial |
$2,106.11
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,216.96
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
4505510001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,640.77 |
| Max. Negotiated Rate |
$2,106.11 |
| Rate for Payer: Aetna of VT Commercial |
$2,106.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,640.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,640.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,884.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,862.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,773.57
|
| Rate for Payer: Cash Price |
$1,108.48
|
| Rate for Payer: Cigna Commercial |
$1,773.57
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,773.57
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,773.57
|
| Rate for Payer: Multiplan Commercial |
$2,061.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,884.42
|
| Rate for Payer: United Healthcare Commercial |
$2,106.11
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$454.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9825510001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$336.01 |
| Max. Negotiated Rate |
$431.30 |
| Rate for Payer: Aetna of VT Commercial |
$431.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$336.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$336.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$385.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$381.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$363.20
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cigna Commercial |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$363.20
|
| Rate for Payer: Multiplan Commercial |
$422.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$385.90
|
| Rate for Payer: United Healthcare Commercial |
$431.30
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,216.96
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
3615510001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$981.89 |
| Max. Negotiated Rate |
$2,106.11 |
| Rate for Payer: Aetna of VT Commercial |
$2,106.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,986.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$981.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,986.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,334.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,884.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,795.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$997.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,762.48
|
| Rate for Payer: Cash Price |
$1,108.48
|
| Rate for Payer: Cigna Commercial |
$1,773.57
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,773.57
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,773.57
|
| Rate for Payer: Martins Point Health Care Commercial |
$997.63
|
| Rate for Payer: Multiplan Commercial |
$2,061.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,241.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$997.63
|
| Rate for Payer: United Healthcare Commercial |
$2,106.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$997.63
|
| Rate for Payer: United Healthcare VA CCN |
$997.63
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9815510002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$159.16 |
| Max. Negotiated Rate |
$426.76 |
| Rate for Payer: Aetna of VT Commercial |
$426.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$163.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$222.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$401.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$401.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$183.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$401.44
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cigna Commercial |
$276.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$358.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$358.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$218.91
|
| Rate for Payer: Multiplan Commercial |
$422.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$226.01
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.16
|
| Rate for Payer: United Healthcare Commercial |
$244.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.16
|
| Rate for Payer: United Healthcare VA CCN |
$159.16
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9815510001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$210.82 |
| Max. Negotiated Rate |
$452.20 |
| Rate for Payer: Aetna of VT Commercial |
$452.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$426.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$210.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$426.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$286.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$404.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$385.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$214.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$378.42
|
| Rate for Payer: Cash Price |
$238.00
|
| Rate for Payer: Cigna Commercial |
$380.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$380.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$380.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$214.20
|
| Rate for Payer: Multiplan Commercial |
$442.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$404.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$214.20
|
| Rate for Payer: United Healthcare Commercial |
$452.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$214.20
|
| Rate for Payer: United Healthcare VA CCN |
$214.20
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9815510001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$352.29 |
| Max. Negotiated Rate |
$452.20 |
| Rate for Payer: Aetna of VT Commercial |
$452.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$352.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$352.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$404.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$399.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$380.80
|
| Rate for Payer: Cash Price |
$238.00
|
| Rate for Payer: Cigna Commercial |
$380.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$380.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$380.80
|
| Rate for Payer: Multiplan Commercial |
$442.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$404.60
|
| Rate for Payer: United Healthcare Commercial |
$452.20
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$454.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9825510001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$201.08 |
| Max. Negotiated Rate |
$431.30 |
| Rate for Payer: Aetna of VT Commercial |
$431.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$201.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$273.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$385.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$367.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$204.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$360.93
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cigna Commercial |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$363.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$204.30
|
| Rate for Payer: Multiplan Commercial |
$422.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$385.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$204.30
|
| Rate for Payer: United Healthcare Commercial |
$431.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$204.30
|
| Rate for Payer: United Healthcare VA CCN |
$204.30
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9825510001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$159.16 |
| Max. Negotiated Rate |
$426.76 |
| Rate for Payer: Aetna of VT Commercial |
$426.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$163.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$222.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$401.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$401.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$183.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$401.44
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cigna Commercial |
$276.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$358.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$358.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$218.91
|
| Rate for Payer: Multiplan Commercial |
$422.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$226.01
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.16
|
| Rate for Payer: United Healthcare Commercial |
$244.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.16
|
| Rate for Payer: United Healthcare VA CCN |
$159.16
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$454.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9815510002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$336.01 |
| Max. Negotiated Rate |
$431.30 |
| Rate for Payer: Aetna of VT Commercial |
$431.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$336.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$336.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$385.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$381.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$363.20
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cigna Commercial |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$363.20
|
| Rate for Payer: Multiplan Commercial |
$422.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$385.90
|
| Rate for Payer: United Healthcare Commercial |
$431.30
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$454.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9815510002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$201.08 |
| Max. Negotiated Rate |
$431.30 |
| Rate for Payer: Aetna of VT Commercial |
$431.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$201.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$406.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$273.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$385.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$367.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$204.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$360.93
|
| Rate for Payer: Cash Price |
$227.00
|
| Rate for Payer: Cigna Commercial |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$363.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$363.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$204.30
|
| Rate for Payer: Multiplan Commercial |
$422.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$385.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$204.30
|
| Rate for Payer: United Healthcare Commercial |
$431.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$204.30
|
| Rate for Payer: United Healthcare VA CCN |
$204.30
|
|
|
DRAINAGE SCROTAL WALL ABSCESS
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
9815510001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$159.16 |
| Max. Negotiated Rate |
$447.44 |
| Rate for Payer: Aetna of VT Commercial |
$447.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$426.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$163.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$426.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$222.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$401.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$401.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$183.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$401.44
|
| Rate for Payer: Cash Price |
$238.00
|
| Rate for Payer: Cash Price |
$238.00
|
| Rate for Payer: Cigna Commercial |
$276.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$358.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$358.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$218.91
|
| Rate for Payer: Multiplan Commercial |
$442.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$226.01
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.16
|
| Rate for Payer: United Healthcare Commercial |
$244.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.16
|
| Rate for Payer: United Healthcare VA CCN |
$159.16
|
|
