|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9601006002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$261.25 |
| Rate for Payer: Aetna of VT Commercial |
$261.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$165.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$233.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$222.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$123.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$218.62
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cigna Commercial |
$220.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$220.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$220.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$123.75
|
| Rate for Payer: Multiplan Commercial |
$255.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$233.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$123.75
|
| Rate for Payer: United Healthcare Commercial |
$261.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$123.75
|
| Rate for Payer: United Healthcare VA CCN |
$123.75
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9601006002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$203.53 |
| Max. Negotiated Rate |
$261.25 |
| Rate for Payer: Aetna of VT Commercial |
$261.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$203.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$203.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$233.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$231.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$220.00
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cigna Commercial |
$220.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$220.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$220.00
|
| Rate for Payer: Multiplan Commercial |
$255.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$233.75
|
| Rate for Payer: United Healthcare Commercial |
$261.25
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9601006002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$102.35 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna of VT Commercial |
$258.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$105.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$143.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$117.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$165.74
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cigna Commercial |
$187.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$197.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$197.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$121.62
|
| Rate for Payer: Multiplan Commercial |
$255.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$145.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare Commercial |
$157.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare VA CCN |
$102.35
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
IP
|
$264.03
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
4501006001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.41 |
| Max. Negotiated Rate |
$250.83 |
| Rate for Payer: Aetna of VT Commercial |
$250.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$195.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$195.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$224.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$221.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$211.22
|
| Rate for Payer: Cash Price |
$132.01
|
| Rate for Payer: Cigna Commercial |
$211.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$211.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$211.22
|
| Rate for Payer: Multiplan Commercial |
$245.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$224.43
|
| Rate for Payer: United Healthcare Commercial |
$250.83
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$539.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9601006001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$238.72 |
| 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 |
$482.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$238.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$482.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$324.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$458.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$436.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$242.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$428.50
|
| 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: Martins Point Health Care Commercial |
$242.55
|
| Rate for Payer: Multiplan Commercial |
$501.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$458.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$242.55
|
| Rate for Payer: United Healthcare Commercial |
$512.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$242.55
|
| Rate for Payer: United Healthcare VA CCN |
$242.55
|
|
|
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
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9601006001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$102.35 |
| Max. Negotiated Rate |
$506.66 |
| Rate for Payer: Aetna of VT Commercial |
$506.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$482.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$105.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$482.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$143.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$117.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$165.74
|
| Rate for Payer: Cash Price |
$269.50
|
| Rate for Payer: Cash Price |
$269.50
|
| Rate for Payer: Cigna Commercial |
$187.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$197.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$197.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$121.62
|
| Rate for Payer: Multiplan Commercial |
$501.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$145.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare Commercial |
$157.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare VA CCN |
$102.35
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
5101006001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$102.35 |
| Max. Negotiated Rate |
$249.10 |
| Rate for Payer: Aetna of VT Commercial |
$249.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$105.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$143.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$117.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$165.74
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$187.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$197.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$197.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$121.62
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$145.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare Commercial |
$157.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare VA CCN |
$102.35
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9811006002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$261.25 |
| Rate for Payer: Aetna of VT Commercial |
$261.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$165.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$233.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$222.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$123.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$218.62
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cigna Commercial |
$220.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$220.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$220.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$123.75
|
| Rate for Payer: Multiplan Commercial |
$255.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$233.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$123.75
|
| Rate for Payer: United Healthcare Commercial |
$261.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$123.75
|
| Rate for Payer: United Healthcare VA CCN |
$123.75
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$265.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
5101006001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$117.37 |
| Max. Negotiated Rate |
$251.75 |
| Rate for Payer: Aetna of VT Commercial |
$251.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$117.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$159.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$214.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$210.68
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$212.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$119.25
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare VA CCN |
$119.25
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$264.03
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
4501006001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.94 |
| Max. Negotiated Rate |
$250.83 |
| Rate for Payer: Aetna of VT Commercial |
$250.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$236.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$116.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$236.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$158.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$224.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$213.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$118.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$209.90
|
| Rate for Payer: Cash Price |
$132.01
|
| Rate for Payer: Cigna Commercial |
$211.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$211.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$211.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$118.81
|
| Rate for Payer: Multiplan Commercial |
$245.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$224.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$118.81
|
| Rate for Payer: United Healthcare Commercial |
$250.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$118.81
|
| Rate for Payer: United Healthcare VA CCN |
$118.81
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Facility
|
IP
|
$265.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
5101006001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$196.13 |
| Max. Negotiated Rate |
$251.75 |
| Rate for Payer: Aetna of VT Commercial |
$251.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$222.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$212.00
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$212.00
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
|
|
I&D ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
9811006002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$102.35 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna of VT Commercial |
$258.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$105.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$246.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$143.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$117.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$165.74
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cigna Commercial |
$187.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$197.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$197.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$121.62
|
| Rate for Payer: Multiplan Commercial |
$255.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$145.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare Commercial |
$157.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.35
|
| Rate for Payer: United Healthcare VA CCN |
$102.35
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
9605642002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$103.28 |
| Max. Negotiated Rate |
$292.34 |
| Rate for Payer: Aetna of VT Commercial |
$292.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$278.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$106.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$278.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$144.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$247.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$247.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$118.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$247.15
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cigna Commercial |
$183.97
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.42
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.42
|
| Rate for Payer: Martins Point Health Care Commercial |
$174.27
|
| Rate for Payer: Multiplan Commercial |
$289.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$146.66
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.28
|
| Rate for Payer: United Healthcare Commercial |
$158.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.28
|
| Rate for Payer: United Healthcare VA CCN |
$103.28
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Facility
|
OP
|
$311.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
9605642002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$137.74 |
| Max. Negotiated Rate |
$295.45 |
| Rate for Payer: Aetna of VT Commercial |
$295.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$278.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$137.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$278.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$187.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$264.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$251.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$139.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$247.25
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cigna Commercial |
$248.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$248.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$248.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$139.95
|
| Rate for Payer: Multiplan Commercial |
$289.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$264.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$139.95
|
| Rate for Payer: United Healthcare Commercial |
$295.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$139.95
|
| Rate for Payer: United Healthcare VA CCN |
$139.95
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
9605642001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$103.28 |
| 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 |
$408.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$106.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$408.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$144.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$247.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$247.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$118.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$247.15
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cigna Commercial |
$183.97
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.42
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.42
|
| Rate for Payer: Martins Point Health Care Commercial |
$174.27
|
| Rate for Payer: Multiplan Commercial |
$424.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$146.66
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.28
|
| Rate for Payer: United Healthcare Commercial |
$158.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.28
|
| Rate for Payer: United Healthcare VA CCN |
$103.28
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Facility
|
IP
|
$311.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
9605642002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$230.17 |
| Max. Negotiated Rate |
$295.45 |
| Rate for Payer: Aetna of VT Commercial |
$295.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$230.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$230.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$264.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$261.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$248.80
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cigna Commercial |
$248.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$248.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$248.80
|
| Rate for Payer: Multiplan Commercial |
$289.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$264.35
|
| Rate for Payer: United Healthcare Commercial |
$295.45
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Facility
|
OP
|
$456.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
9605642001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$201.96 |
| Max. Negotiated Rate |
$433.20 |
| Rate for Payer: Aetna of VT Commercial |
$433.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$408.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$201.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$408.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$274.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$387.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$369.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$205.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$362.52
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cigna Commercial |
$364.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$364.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$364.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$205.20
|
| Rate for Payer: Multiplan Commercial |
$424.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$387.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$205.20
|
| Rate for Payer: United Healthcare Commercial |
$433.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$205.20
|
| Rate for Payer: United Healthcare VA CCN |
$205.20
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Facility
|
IP
|
$456.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
9605642001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$337.49 |
| Max. Negotiated Rate |
$433.20 |
| Rate for Payer: Aetna of VT Commercial |
$433.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$337.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$337.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$387.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$383.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$364.80
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cigna Commercial |
$364.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$364.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$364.80
|
| Rate for Payer: Multiplan Commercial |
$424.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$387.60
|
| Rate for Payer: United Healthcare Commercial |
$433.20
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
5105642001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$103.28 |
| Max. Negotiated Rate |
$284.42 |
| Rate for Payer: Aetna of VT Commercial |
$136.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$129.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$106.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$129.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$144.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$247.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$247.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$118.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$247.15
|
| Rate for Payer: Cash Price |
$72.50
|
| Rate for Payer: Cash Price |
$72.50
|
| Rate for Payer: Cigna Commercial |
$183.97
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.42
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.42
|
| Rate for Payer: Martins Point Health Care Commercial |
$174.27
|
| Rate for Payer: Multiplan Commercial |
$134.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$146.66
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.28
|
| Rate for Payer: United Healthcare Commercial |
$158.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.28
|
| Rate for Payer: United Healthcare VA CCN |
$103.28
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
5105642001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$64.22 |
| Max. Negotiated Rate |
$137.75 |
| Rate for Payer: Aetna of VT Commercial |
$137.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$129.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$64.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$129.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$87.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$123.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$117.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$65.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$115.28
|
| Rate for Payer: Cash Price |
$72.50
|
| Rate for Payer: Cigna Commercial |
$116.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$116.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$116.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$65.25
|
| Rate for Payer: Multiplan Commercial |
$134.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$123.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$65.25
|
| Rate for Payer: United Healthcare Commercial |
$137.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65.25
|
| Rate for Payer: United Healthcare VA CCN |
$65.25
|
|
|
I&D BARTHOLINS GLAND ABSCESS
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
5105642001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$107.31 |
| Max. Negotiated Rate |
$137.75 |
| Rate for Payer: Aetna of VT Commercial |
$137.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$107.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$107.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$123.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$116.00
|
| Rate for Payer: Cash Price |
$72.50
|
| Rate for Payer: Cigna Commercial |
$116.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$116.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$134.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$123.25
|
| Rate for Payer: United Healthcare Commercial |
$137.75
|
|
|
I&D COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9811018001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$167.26 |
| Max. Negotiated Rate |
$664.58 |
| Rate for Payer: Aetna of VT Commercial |
$664.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$633.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$172.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$633.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$234.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$328.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$328.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$192.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$328.11
|
| Rate for Payer: Cash Price |
$353.50
|
| Rate for Payer: Cash Price |
$353.50
|
| Rate for Payer: Cigna Commercial |
$305.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$406.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$406.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$246.60
|
| Rate for Payer: Multiplan Commercial |
$657.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$237.51
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$167.26
|
| Rate for Payer: United Healthcare Commercial |
$257.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$167.26
|
| Rate for Payer: United Healthcare VA CCN |
$167.26
|
|
|
I&D COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9811018001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$313.13 |
| Max. Negotiated Rate |
$671.65 |
| Rate for Payer: Aetna of VT Commercial |
$671.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$633.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$313.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$633.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$425.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$600.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$572.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$318.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$562.07
|
| Rate for Payer: Cash Price |
$353.50
|
| Rate for Payer: Cigna Commercial |
$565.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$565.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$565.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$318.15
|
| Rate for Payer: Multiplan Commercial |
$657.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$600.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$318.15
|
| Rate for Payer: United Healthcare Commercial |
$671.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$318.15
|
| Rate for Payer: United Healthcare VA CCN |
$318.15
|
|
|
I&D COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9811018002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$167.26 |
| Max. Negotiated Rate |
$664.58 |
| Rate for Payer: Aetna of VT Commercial |
$664.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$633.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$172.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$633.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$234.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$328.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$328.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$192.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$328.11
|
| Rate for Payer: Cash Price |
$353.50
|
| Rate for Payer: Cash Price |
$353.50
|
| Rate for Payer: Cigna Commercial |
$305.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$406.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$406.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$246.60
|
| Rate for Payer: Multiplan Commercial |
$657.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$237.51
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$167.26
|
| Rate for Payer: United Healthcare Commercial |
$257.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$167.26
|
| Rate for Payer: United Healthcare VA CCN |
$167.26
|
|
