|
EXCISION BREAST LESION
|
Professional
|
Both
|
$8,449.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
9601912501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$428.76 |
| Max. Negotiated Rate |
$7,942.06 |
| Rate for Payer: Aetna of VT Commercial |
$7,942.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$7,569.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$441.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$7,569.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$600.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$719.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$719.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$493.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$719.68
|
| Rate for Payer: Cash Price |
$4,224.50
|
| Rate for Payer: Cash Price |
$4,224.50
|
| Rate for Payer: Cigna Commercial |
$782.87
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$894.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$894.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$534.44
|
| Rate for Payer: Multiplan Commercial |
$7,857.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$608.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$428.76
|
| Rate for Payer: United Healthcare Commercial |
$659.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$428.76
|
| Rate for Payer: United Healthcare VA CCN |
$428.76
|
|
|
EXCISION BREAST LESION
|
Facility
|
OP
|
$8,449.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
9601912501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,742.06 |
| Max. Negotiated Rate |
$8,026.55 |
| Rate for Payer: Aetna of VT Commercial |
$8,026.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$7,569.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$3,742.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$7,569.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$5,086.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$7,181.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$6,843.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$3,802.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$6,716.95
|
| Rate for Payer: Cash Price |
$4,224.50
|
| Rate for Payer: Cigna Commercial |
$6,759.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$6,759.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$6,759.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$3,802.05
|
| Rate for Payer: Multiplan Commercial |
$7,857.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7,181.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$3,802.05
|
| Rate for Payer: United Healthcare Commercial |
$8,026.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,802.05
|
| Rate for Payer: United Healthcare VA CCN |
$3,802.05
|
|
|
EXCISION BREAST LESION
|
Facility
|
IP
|
$8,449.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
9601912501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$6,253.10 |
| Max. Negotiated Rate |
$8,026.55 |
| Rate for Payer: Aetna of VT Commercial |
$8,026.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$6,253.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$6,253.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$7,181.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$7,097.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$6,759.20
|
| Rate for Payer: Cash Price |
$4,224.50
|
| Rate for Payer: Cigna Commercial |
$6,759.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$6,759.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$6,759.20
|
| Rate for Payer: Multiplan Commercial |
$7,857.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7,181.65
|
| Rate for Payer: United Healthcare Commercial |
$8,026.55
|
|
|
EXCISION BREAST LESION
|
Facility
|
OP
|
$6,802.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
5101912501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3,012.61 |
| Max. Negotiated Rate |
$6,461.90 |
| Rate for Payer: Aetna of VT Commercial |
$6,461.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$6,093.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$3,012.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$6,093.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$4,094.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,781.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,509.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$3,060.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,407.59
|
| Rate for Payer: Cash Price |
$3,401.00
|
| Rate for Payer: Cigna Commercial |
$5,441.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,441.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,441.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$3,060.90
|
| Rate for Payer: Multiplan Commercial |
$6,325.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,781.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$3,060.90
|
| Rate for Payer: United Healthcare Commercial |
$6,461.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,060.90
|
| Rate for Payer: United Healthcare VA CCN |
$3,060.90
|
|
|
EXCISION BREAST LESION
|
Facility
|
OP
|
$1,648.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
9601912502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$729.90 |
| Max. Negotiated Rate |
$1,565.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,565.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,476.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$729.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,476.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$992.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,400.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,334.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$741.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,310.16
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cigna Commercial |
$1,318.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,318.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,318.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$741.60
|
| Rate for Payer: Multiplan Commercial |
$1,532.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,400.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$741.60
|
| Rate for Payer: United Healthcare Commercial |
$1,565.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$741.60
|
| Rate for Payer: United Healthcare VA CCN |
$741.60
|
|
|
EXCISION BREAST LESION
|
Facility
|
IP
|
$1,648.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
9601912502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,219.68 |
| Max. Negotiated Rate |
$1,565.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,565.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,219.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,219.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,400.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,384.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,318.40
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cigna Commercial |
$1,318.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,318.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,318.40
|
| Rate for Payer: Multiplan Commercial |
$1,532.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,400.80
|
| Rate for Payer: United Healthcare Commercial |
$1,565.60
|
|
|
EXCISION BREAST LESION
|
Professional
|
Both
|
$6,802.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
5101912501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$428.76 |
| Max. Negotiated Rate |
$6,393.88 |
| Rate for Payer: Aetna of VT Commercial |
$6,393.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$6,093.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$441.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$6,093.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$600.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$719.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$719.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$493.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$719.68
|
| Rate for Payer: Cash Price |
$3,401.00
|
| Rate for Payer: Cash Price |
$3,401.00
|
| Rate for Payer: Cigna Commercial |
$782.87
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$894.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$894.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$534.44
|
| Rate for Payer: Multiplan Commercial |
$6,325.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$608.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$428.76
|
| Rate for Payer: United Healthcare Commercial |
$659.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$428.76
|
| Rate for Payer: United Healthcare VA CCN |
$428.76
|
|
|
EXCISION BREAST LESION
|
Professional
|
Both
|
$1,648.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
9601912502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$428.76 |
| Max. Negotiated Rate |
$1,549.12 |
| Rate for Payer: Aetna of VT Commercial |
$1,549.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,476.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$441.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,476.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$600.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$719.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$719.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$493.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$719.68
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cigna Commercial |
$782.87
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$894.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$894.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$534.44
|
| Rate for Payer: Multiplan Commercial |
$1,532.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$608.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$428.76
|
| Rate for Payer: United Healthcare Commercial |
$659.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$428.76
|
| Rate for Payer: United Healthcare VA CCN |
$428.76
|
|
|
EXCISION OF ANAL LESION(S)
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
9824692201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$129.81 |
| Max. Negotiated Rate |
$760.46 |
| Rate for Payer: Aetna of VT Commercial |
$760.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$724.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$133.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$724.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$181.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$391.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$391.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$149.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$391.34
|
| Rate for Payer: Cash Price |
$404.50
|
| Rate for Payer: Cash Price |
$404.50
|
| Rate for Payer: Cigna Commercial |
$237.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$478.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$478.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$752.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$184.33
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.81
|
| Rate for Payer: United Healthcare Commercial |
$199.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.81
|
| Rate for Payer: United Healthcare VA CCN |
$129.81
|
|
|
EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$809.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
9824692201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$598.74 |
| Max. Negotiated Rate |
$768.55 |
| Rate for Payer: Aetna of VT Commercial |
$768.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$598.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$598.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$687.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$679.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$647.20
|
| Rate for Payer: Cash Price |
$404.50
|
| Rate for Payer: Cigna Commercial |
$647.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$647.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$647.20
|
| Rate for Payer: Multiplan Commercial |
$752.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$687.65
|
| Rate for Payer: United Healthcare Commercial |
$768.55
|
|
|
EXCISION OF ANAL LESION(S)
|
Facility
|
OP
|
$809.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
9824692201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$358.31 |
| Max. Negotiated Rate |
$768.55 |
| Rate for Payer: Aetna of VT Commercial |
$768.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$724.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$358.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$724.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$487.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$687.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$655.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$364.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$643.15
|
| Rate for Payer: Cash Price |
$404.50
|
| Rate for Payer: Cigna Commercial |
$647.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$647.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$647.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$364.05
|
| Rate for Payer: Multiplan Commercial |
$752.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$687.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$364.05
|
| Rate for Payer: United Healthcare Commercial |
$768.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$364.05
|
| Rate for Payer: United Healthcare VA CCN |
$364.05
|
|
|
EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$4,924.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
9605406001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,644.25 |
| Max. Negotiated Rate |
$4,677.80 |
| Rate for Payer: Aetna of VT Commercial |
$4,677.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,644.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,644.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,185.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,136.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,939.20
|
| Rate for Payer: Cash Price |
$2,462.00
|
| Rate for Payer: Cigna Commercial |
$3,939.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,939.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,939.20
|
| Rate for Payer: Multiplan Commercial |
$4,579.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,185.40
|
| Rate for Payer: United Healthcare Commercial |
$4,677.80
|
|
|
EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$4,924.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
9605406001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,180.84 |
| Max. Negotiated Rate |
$4,677.80 |
| Rate for Payer: Aetna of VT Commercial |
$4,677.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,411.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,180.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,411.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,964.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,185.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,988.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,215.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,914.58
|
| Rate for Payer: Cash Price |
$2,462.00
|
| Rate for Payer: Cigna Commercial |
$3,939.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,939.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,939.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,215.80
|
| Rate for Payer: Multiplan Commercial |
$4,579.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,185.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,215.80
|
| Rate for Payer: United Healthcare Commercial |
$4,677.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,215.80
|
| Rate for Payer: United Healthcare VA CCN |
$2,215.80
|
|
|
EXCISION OF PENIS LESION(S)
|
Professional
|
Both
|
$4,560.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
5105406001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.56 |
| Max. Negotiated Rate |
$4,286.40 |
| Rate for Payer: Aetna of VT Commercial |
$4,286.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,085.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$129.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,085.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$175.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$344.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$344.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$144.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$344.05
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cigna Commercial |
$217.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$303.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$303.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$186.59
|
| Rate for Payer: Multiplan Commercial |
$4,240.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$178.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$125.56
|
| Rate for Payer: United Healthcare Commercial |
$193.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$125.56
|
| Rate for Payer: United Healthcare VA CCN |
$125.56
|
|
|
EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$364.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
9605406002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$269.40 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna of VT Commercial |
$345.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$269.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$269.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$309.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$305.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$291.20
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cigna Commercial |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$291.20
|
| Rate for Payer: Multiplan Commercial |
$338.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$309.40
|
| Rate for Payer: United Healthcare Commercial |
$345.80
|
|
|
EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$364.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
9605406002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$161.22 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna of VT Commercial |
$345.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$161.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$219.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$309.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$294.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$163.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$289.38
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cigna Commercial |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$291.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$163.80
|
| Rate for Payer: Multiplan Commercial |
$338.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$309.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$163.80
|
| Rate for Payer: United Healthcare Commercial |
$345.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$163.80
|
| Rate for Payer: United Healthcare VA CCN |
$163.80
|
|
|
EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$4,560.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
5105406001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3,374.86 |
| Max. Negotiated Rate |
$4,332.00 |
| Rate for Payer: Aetna of VT Commercial |
$4,332.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,374.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,374.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,876.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,830.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,648.00
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cigna Commercial |
$3,648.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,648.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,648.00
|
| Rate for Payer: Multiplan Commercial |
$4,240.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,876.00
|
| Rate for Payer: United Healthcare Commercial |
$4,332.00
|
|
|
EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$4,560.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
5105406001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,019.62 |
| Max. Negotiated Rate |
$4,332.00 |
| Rate for Payer: Aetna of VT Commercial |
$4,332.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,085.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,019.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,085.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,745.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,876.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,693.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,052.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,625.20
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cigna Commercial |
$3,648.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,648.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,648.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,052.00
|
| Rate for Payer: Multiplan Commercial |
$4,240.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,876.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,052.00
|
| Rate for Payer: United Healthcare Commercial |
$4,332.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,052.00
|
| Rate for Payer: United Healthcare VA CCN |
$2,052.00
|
|
|
EXCISION OF PENIS LESION(S)
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
9605406002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$125.56 |
| Max. Negotiated Rate |
$344.05 |
| Rate for Payer: Aetna of VT Commercial |
$342.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$129.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$175.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$344.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$344.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$144.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$344.05
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cigna Commercial |
$217.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$303.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$303.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$186.59
|
| Rate for Payer: Multiplan Commercial |
$338.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$178.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$125.56
|
| Rate for Payer: United Healthcare Commercial |
$193.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$125.56
|
| Rate for Payer: United Healthcare VA CCN |
$125.56
|
|
|
EXCISION OF PENIS LESION(S)
|
Professional
|
Both
|
$4,924.00
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
9605406001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$125.56 |
| Max. Negotiated Rate |
$4,628.56 |
| Rate for Payer: Aetna of VT Commercial |
$4,628.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,411.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$129.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,411.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$175.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$344.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$344.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$144.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$344.05
|
| Rate for Payer: Cash Price |
$2,462.00
|
| Rate for Payer: Cash Price |
$2,462.00
|
| Rate for Payer: Cigna Commercial |
$217.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$303.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$303.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$186.59
|
| Rate for Payer: Multiplan Commercial |
$4,579.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$178.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$125.56
|
| Rate for Payer: United Healthcare Commercial |
$193.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$125.56
|
| Rate for Payer: United Healthcare VA CCN |
$125.56
|
|
|
EXCISION OF TONGUE FOLD
|
Facility
|
OP
|
$2,360.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
9604111501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,045.24 |
| Max. Negotiated Rate |
$2,242.00 |
| Rate for Payer: Aetna of VT Commercial |
$2,242.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,114.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,045.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,114.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,420.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,006.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,911.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,062.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,876.20
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cigna Commercial |
$1,888.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,888.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,888.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,062.00
|
| Rate for Payer: Multiplan Commercial |
$2,194.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,006.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,062.00
|
| Rate for Payer: United Healthcare Commercial |
$2,242.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,062.00
|
| Rate for Payer: United Healthcare VA CCN |
$1,062.00
|
|
|
EXCISION OF TONGUE FOLD
|
Professional
|
Both
|
$2,360.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
9604111501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$138.53 |
| Max. Negotiated Rate |
$2,218.40 |
| Rate for Payer: Aetna of VT Commercial |
$2,218.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,114.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$142.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,114.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$193.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$345.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$345.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$159.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$345.99
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cigna Commercial |
$221.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$397.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$397.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$244.53
|
| Rate for Payer: Multiplan Commercial |
$2,194.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.71
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.53
|
| Rate for Payer: United Healthcare Commercial |
$213.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.53
|
| Rate for Payer: United Healthcare VA CCN |
$138.53
|
|
|
EXCISION OF TONGUE FOLD
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
9604111502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$138.53 |
| Max. Negotiated Rate |
$1,331.04 |
| Rate for Payer: Aetna of VT Commercial |
$1,331.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,268.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$142.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,268.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$193.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$345.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$345.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$159.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$345.99
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cigna Commercial |
$221.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$397.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$397.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$244.53
|
| Rate for Payer: Multiplan Commercial |
$1,316.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.71
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.53
|
| Rate for Payer: United Healthcare Commercial |
$213.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.53
|
| Rate for Payer: United Healthcare VA CCN |
$138.53
|
|
|
EXCISION OF TONGUE FOLD
|
Facility
|
OP
|
$1,416.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
9604111502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$627.15 |
| Max. Negotiated Rate |
$1,345.20 |
| Rate for Payer: Aetna of VT Commercial |
$1,345.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,268.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$627.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,268.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$852.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,203.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,146.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$637.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,125.72
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cigna Commercial |
$1,132.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,132.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,132.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$637.20
|
| Rate for Payer: Multiplan Commercial |
$1,316.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,203.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$637.20
|
| Rate for Payer: United Healthcare Commercial |
$1,345.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$637.20
|
| Rate for Payer: United Healthcare VA CCN |
$637.20
|
|
|
EXCISION OF TONGUE FOLD
|
Facility
|
IP
|
$2,360.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
9604111501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,746.64 |
| Max. Negotiated Rate |
$2,242.00 |
| Rate for Payer: Aetna of VT Commercial |
$2,242.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,746.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,746.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,006.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,982.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,888.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cigna Commercial |
$1,888.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,888.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,888.00
|
| Rate for Payer: Multiplan Commercial |
$2,194.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,006.00
|
| Rate for Payer: United Healthcare Commercial |
$2,242.00
|
|
