|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9811006102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$290.86 |
| Max. Negotiated Rate |
$373.35 |
| Rate for Payer: Aetna of VT Commercial |
$373.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$334.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$330.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$314.40
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$314.40
|
| Rate for Payer: Multiplan Commercial |
$365.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.05
|
| Rate for Payer: United Healthcare Commercial |
$373.35
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9601006101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$174.53 |
| Max. Negotiated Rate |
$794.30 |
| Rate for Payer: Aetna of VT Commercial |
$794.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$757.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$179.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$757.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$244.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$200.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.53
|
| Rate for Payer: Cash Price |
$422.50
|
| Rate for Payer: Cash Price |
$422.50
|
| Rate for Payer: Cigna Commercial |
$320.76
|
| 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 |
$202.80
|
| Rate for Payer: Multiplan Commercial |
$785.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$247.83
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$174.53
|
| Rate for Payer: United Healthcare Commercial |
$268.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$174.53
|
| Rate for Payer: United Healthcare VA CCN |
$174.53
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
OP
|
$845.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9601006101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$374.25 |
| Max. Negotiated Rate |
$802.75 |
| Rate for Payer: Aetna of VT Commercial |
$802.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$757.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$374.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$757.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$508.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$718.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$684.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$380.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$671.77
|
| Rate for Payer: Cash Price |
$422.50
|
| Rate for Payer: Cigna Commercial |
$676.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$676.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$676.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$380.25
|
| Rate for Payer: Multiplan Commercial |
$785.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$718.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$380.25
|
| Rate for Payer: United Healthcare Commercial |
$802.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$380.25
|
| Rate for Payer: United Healthcare VA CCN |
$380.25
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
OP
|
$451.20
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
4501006101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$199.84 |
| Max. Negotiated Rate |
$428.64 |
| Rate for Payer: Aetna of VT Commercial |
$428.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$404.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$199.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$404.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$271.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$383.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$365.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$203.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$358.70
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cigna Commercial |
$360.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$360.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$360.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$203.04
|
| Rate for Payer: Multiplan Commercial |
$419.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$383.52
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$203.04
|
| Rate for Payer: United Healthcare Commercial |
$428.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$203.04
|
| Rate for Payer: United Healthcare VA CCN |
$203.04
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9811006101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$290.86 |
| Max. Negotiated Rate |
$373.35 |
| Rate for Payer: Aetna of VT Commercial |
$373.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$334.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$330.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$314.40
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$314.40
|
| Rate for Payer: Multiplan Commercial |
$365.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.05
|
| Rate for Payer: United Healthcare Commercial |
$373.35
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Professional
|
Both
|
$393.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9811006101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$174.53 |
| Max. Negotiated Rate |
$369.42 |
| Rate for Payer: Aetna of VT Commercial |
$369.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$352.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$179.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$352.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$244.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$200.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.53
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$320.76
|
| 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 |
$202.80
|
| Rate for Payer: Multiplan Commercial |
$365.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$247.83
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$174.53
|
| Rate for Payer: United Healthcare Commercial |
$268.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$174.53
|
| Rate for Payer: United Healthcare VA CCN |
$174.53
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
5101006101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$174.53 |
| Max. Negotiated Rate |
$424.88 |
| Rate for Payer: Aetna of VT Commercial |
$424.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$179.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$244.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$200.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.53
|
| Rate for Payer: Cash Price |
$226.00
|
| Rate for Payer: Cash Price |
$226.00
|
| Rate for Payer: Cigna Commercial |
$320.76
|
| 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 |
$202.80
|
| Rate for Payer: Multiplan Commercial |
$420.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$247.83
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$174.53
|
| Rate for Payer: United Healthcare Commercial |
$268.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$174.53
|
| Rate for Payer: United Healthcare VA CCN |
$174.53
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
OP
|
$393.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9811006101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$174.06 |
| Max. Negotiated Rate |
$373.35 |
| Rate for Payer: Aetna of VT Commercial |
$373.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$352.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$174.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$352.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$236.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$334.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$318.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$176.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$312.44
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$314.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$176.85
|
| Rate for Payer: Multiplan Commercial |
$365.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$176.85
|
| Rate for Payer: United Healthcare Commercial |
$373.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$176.85
|
| Rate for Payer: United Healthcare VA CCN |
$176.85
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9601006102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$290.86 |
| Max. Negotiated Rate |
$373.35 |
| Rate for Payer: Aetna of VT Commercial |
$373.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$334.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$330.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$314.40
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$314.40
|
| Rate for Payer: Multiplan Commercial |
$365.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.05
|
| Rate for Payer: United Healthcare Commercial |
$373.35
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
OP
|
$393.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
9601006102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$174.06 |
| Max. Negotiated Rate |
$373.35 |
| Rate for Payer: Aetna of VT Commercial |
$373.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$352.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$174.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$352.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$236.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$334.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$318.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$176.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$312.44
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$314.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$314.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$176.85
|
| Rate for Payer: Multiplan Commercial |
$365.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$176.85
|
| Rate for Payer: United Healthcare Commercial |
$373.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$176.85
|
| Rate for Payer: United Healthcare VA CCN |
$176.85
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
IP
|
$451.20
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
4501006101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$333.93 |
| Max. Negotiated Rate |
$428.64 |
| Rate for Payer: Aetna of VT Commercial |
$428.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$333.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$333.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$383.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$379.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$360.96
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cigna Commercial |
$360.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$360.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$360.96
|
| Rate for Payer: Multiplan Commercial |
$419.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$383.52
|
| Rate for Payer: United Healthcare Commercial |
$428.64
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
OP
|
$452.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
5101006101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$200.19 |
| Max. Negotiated Rate |
$429.40 |
| Rate for Payer: Aetna of VT Commercial |
$429.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$200.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$272.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$384.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$366.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$203.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$359.34
|
| Rate for Payer: Cash Price |
$226.00
|
| Rate for Payer: Cigna Commercial |
$361.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$361.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$361.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$203.40
|
| Rate for Payer: Multiplan Commercial |
$420.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$384.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$203.40
|
| Rate for Payer: United Healthcare Commercial |
$429.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$203.40
|
| Rate for Payer: United Healthcare VA CCN |
$203.40
|
|
|
I&D ABSCESS COMPLICATED/MULTI
|
Facility
|
IP
|
$452.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
5101006101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$334.53 |
| Max. Negotiated Rate |
$429.40 |
| Rate for Payer: Aetna of VT Commercial |
$429.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$334.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$334.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$384.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$379.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$361.60
|
| Rate for Payer: Cash Price |
$226.00
|
| Rate for Payer: Cigna Commercial |
$361.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$361.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$361.60
|
| Rate for Payer: Multiplan Commercial |
$420.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$384.20
|
| Rate for Payer: United Healthcare Commercial |
$429.40
|
|
|
I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9814270002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$129.53 |
| Max. Negotiated Rate |
$406.08 |
| Rate for Payer: Aetna of VT Commercial |
$406.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$133.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$181.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$287.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$287.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$287.36
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$205.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$297.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$297.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$181.88
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$183.93
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.53
|
| Rate for Payer: United Healthcare Commercial |
$199.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.53
|
| Rate for Payer: United Healthcare VA CCN |
$129.53
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9814270002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$191.33 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna of VT Commercial |
$410.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$191.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$260.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$367.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$349.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$194.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$343.44
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$345.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$194.40
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$367.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$194.40
|
| Rate for Payer: United Healthcare Commercial |
$410.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$194.40
|
| Rate for Payer: United Healthcare VA CCN |
$194.40
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9814270001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$191.33 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna of VT Commercial |
$410.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$191.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$260.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$367.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$349.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$194.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$343.44
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$345.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$194.40
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$367.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$194.40
|
| Rate for Payer: United Healthcare Commercial |
$410.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$194.40
|
| Rate for Payer: United Healthcare VA CCN |
$194.40
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9824270001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$319.72 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna of VT Commercial |
$410.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$319.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$319.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$367.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$345.60
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$345.60
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$367.20
|
| Rate for Payer: United Healthcare Commercial |
$410.40
|
|
|
I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9824270001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$129.53 |
| Max. Negotiated Rate |
$406.08 |
| Rate for Payer: Aetna of VT Commercial |
$406.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$133.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$181.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$287.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$287.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$287.36
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$205.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$297.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$297.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$181.88
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$183.93
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.53
|
| Rate for Payer: United Healthcare Commercial |
$199.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.53
|
| Rate for Payer: United Healthcare VA CCN |
$129.53
|
|
|
I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9814270001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$129.53 |
| Max. Negotiated Rate |
$406.08 |
| Rate for Payer: Aetna of VT Commercial |
$406.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$133.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$181.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$287.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$287.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$287.36
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$205.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$297.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$297.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$181.88
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$183.93
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.53
|
| Rate for Payer: United Healthcare Commercial |
$199.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.53
|
| Rate for Payer: United Healthcare VA CCN |
$129.53
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9814270002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$319.72 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna of VT Commercial |
$410.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$319.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$319.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$367.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$345.60
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$345.60
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$367.20
|
| Rate for Payer: United Healthcare Commercial |
$410.40
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9824270001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$191.33 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna of VT Commercial |
$410.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$191.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$387.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$260.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$367.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$349.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$194.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$343.44
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$345.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$194.40
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$367.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$194.40
|
| Rate for Payer: United Healthcare Commercial |
$410.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$194.40
|
| Rate for Payer: United Healthcare VA CCN |
$194.40
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$372.46
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
4504270001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$275.66 |
| Max. Negotiated Rate |
$353.84 |
| Rate for Payer: Aetna of VT Commercial |
$353.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$275.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$275.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$316.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$312.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$297.97
|
| Rate for Payer: Cash Price |
$186.23
|
| Rate for Payer: Cigna Commercial |
$297.97
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$297.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$297.97
|
| Rate for Payer: Multiplan Commercial |
$346.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$316.59
|
| Rate for Payer: United Healthcare Commercial |
$353.84
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$432.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
9814270001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$319.72 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna of VT Commercial |
$410.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$319.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$319.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$367.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$362.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$345.60
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cigna Commercial |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$345.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$345.60
|
| Rate for Payer: Multiplan Commercial |
$401.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$367.20
|
| Rate for Payer: United Healthcare Commercial |
$410.40
|
|
|
I&D ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$372.46
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
4504270001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.96 |
| Max. Negotiated Rate |
$353.84 |
| Rate for Payer: Aetna of VT Commercial |
$353.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$333.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$164.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$333.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$224.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$316.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$301.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$167.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$296.11
|
| Rate for Payer: Cash Price |
$186.23
|
| Rate for Payer: Cigna Commercial |
$297.97
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$297.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$297.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$167.61
|
| Rate for Payer: Multiplan Commercial |
$346.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$316.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$167.61
|
| Rate for Payer: United Healthcare Commercial |
$353.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$167.61
|
| Rate for Payer: United Healthcare VA CCN |
$167.61
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
IP
|
$539.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9601006001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$398.91 |
| Max. Negotiated Rate |
$512.05 |
| Rate for Payer: Aetna of VT Commercial |
$512.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$398.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$398.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$458.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$452.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$431.20
|
| Rate for Payer: Cash Price |
$269.50
|
| Rate for Payer: Cigna Commercial |
$431.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$431.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$431.20
|
| Rate for Payer: Multiplan Commercial |
$501.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$458.15
|
| Rate for Payer: United Healthcare Commercial |
$512.05
|
|
