|
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
|
|
|
I&D COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$445.65
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
4501018001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$197.38 |
| Max. Negotiated Rate |
$423.37 |
| Rate for Payer: Aetna of VT Commercial |
$423.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$399.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$197.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$399.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$268.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$378.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$360.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$200.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$354.29
|
| Rate for Payer: Cash Price |
$222.82
|
| Rate for Payer: Cigna Commercial |
$356.52
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$356.52
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$356.52
|
| Rate for Payer: Martins Point Health Care Commercial |
$200.54
|
| Rate for Payer: Multiplan Commercial |
$414.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$378.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$200.54
|
| Rate for Payer: United Healthcare Commercial |
$423.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$200.54
|
| Rate for Payer: United Healthcare VA CCN |
$200.54
|
|
|
I&D COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$445.65
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
4501018001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$329.83 |
| Max. Negotiated Rate |
$423.37 |
| Rate for Payer: Aetna of VT Commercial |
$423.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$329.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$329.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$378.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$374.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$356.52
|
| Rate for Payer: Cash Price |
$222.82
|
| Rate for Payer: Cigna Commercial |
$356.52
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$356.52
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$356.52
|
| Rate for Payer: Multiplan Commercial |
$414.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$378.80
|
| Rate for Payer: United Healthcare Commercial |
$423.37
|
|
|
I&D COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9811018002
|
|
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
|
Facility
|
IP
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9811018001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$523.25 |
| 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 |
$523.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$523.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$600.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$593.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$565.60
|
| 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: Multiplan Commercial |
$657.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$600.95
|
| Rate for Payer: United Healthcare Commercial |
$671.65
|
|
|
I&D COMPLX PO WOUND INFECTION
|
Facility
|
IP
|
$1,152.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9601018001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$852.60 |
| Max. Negotiated Rate |
$1,094.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,094.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$852.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$852.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$979.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$967.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$921.60
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cigna Commercial |
$921.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$921.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$921.60
|
| Rate for Payer: Multiplan Commercial |
$1,071.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$979.20
|
| Rate for Payer: United Healthcare Commercial |
$1,094.40
|
|
|
I&D COMPLX PO WOUND INFECTION
|
Facility
|
OP
|
$446.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
5101018001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$197.53 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna of VT Commercial |
$423.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$399.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$197.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$399.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$268.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$361.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$200.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$354.57
|
| Rate for Payer: Cash Price |
$223.00
|
| Rate for Payer: Cigna Commercial |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$356.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$200.70
|
| Rate for Payer: Multiplan Commercial |
$414.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$200.70
|
| Rate for Payer: United Healthcare Commercial |
$423.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$200.70
|
| Rate for Payer: United Healthcare VA CCN |
$200.70
|
|
|
I&D COMPLX PO WOUND INFECTION
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
5101018001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$167.26 |
| Max. Negotiated Rate |
$419.24 |
| Rate for Payer: Aetna of VT Commercial |
$419.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$399.57
|
| 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 |
$399.57
|
| 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 |
$223.00
|
| Rate for Payer: Cash Price |
$223.00
|
| 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 |
$414.78
|
| 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 COMPLX PO WOUND INFECTION
|
Professional
|
Both
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9601018002
|
|
Hospital Revenue Code
|
960
|
| 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 COMPLX PO WOUND INFECTION
|
Facility
|
IP
|
$446.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
5101018001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$330.08 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna of VT Commercial |
$423.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$330.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$330.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$379.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$374.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$356.80
|
| Rate for Payer: Cash Price |
$223.00
|
| Rate for Payer: Cigna Commercial |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$356.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$356.80
|
| Rate for Payer: Multiplan Commercial |
$414.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$379.10
|
| Rate for Payer: United Healthcare Commercial |
$423.70
|
|
|
I&D COMPLX PO WOUND INFECTION
|
Facility
|
IP
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9601018002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$523.25 |
| 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 |
$523.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$523.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$600.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$593.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$565.60
|
| 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: Multiplan Commercial |
$657.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$600.95
|
| Rate for Payer: United Healthcare Commercial |
$671.65
|
|
|
I&D COMPLX PO WOUND INFECTION
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9601018001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$167.26 |
| Max. Negotiated Rate |
$1,082.88 |
| Rate for Payer: Aetna of VT Commercial |
$1,082.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,032.08
|
| 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 |
$1,032.08
|
| 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 |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| 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 |
$1,071.36
|
| 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 COMPLX PO WOUND INFECTION
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9601018001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$510.22 |
| Max. Negotiated Rate |
$1,094.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,094.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,032.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$510.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,032.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$693.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$979.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$933.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$518.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$915.84
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cigna Commercial |
$921.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$921.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$921.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$518.40
|
| Rate for Payer: Multiplan Commercial |
$1,071.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$979.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$518.40
|
| Rate for Payer: United Healthcare Commercial |
$1,094.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$518.40
|
| Rate for Payer: United Healthcare VA CCN |
$518.40
|
|
|
I&D COMPLX PO WOUND INFECTION
|
Facility
|
OP
|
$707.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
9601018002
|
|
Hospital Revenue Code
|
960
|
| 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 ISCHIORECTAL&/PERIRECTAL
|
Facility
|
IP
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9824604001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$806.71 |
| Max. Negotiated Rate |
$1,035.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,035.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$806.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$806.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$926.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$915.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$872.00
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$872.00
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$926.50
|
| Rate for Payer: United Healthcare Commercial |
$1,035.50
|
|
|
I&D ISCHIORECTAL&/PERIRECTAL
|
Facility
|
OP
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9824604001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$482.76 |
| Max. Negotiated Rate |
$1,035.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,035.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$482.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$656.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$926.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$882.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$490.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$866.55
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$872.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$490.50
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$926.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$490.50
|
| Rate for Payer: United Healthcare Commercial |
$1,035.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$490.50
|
| Rate for Payer: United Healthcare VA CCN |
$490.50
|
|
|
I&D ISCHIORECTAL&/PERIRECTAL
|
Professional
|
Both
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9824604001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$1,024.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,024.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$415.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$564.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$463.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$713.92
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$731.98
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$867.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$867.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$525.42
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$572.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare Commercial |
$619.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare VA CCN |
$403.03
|
|
|
I&D PERIANAL ABSCESS SUPERFI
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9824605001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$96.17 |
| Max. Negotiated Rate |
$396.68 |
| Rate for Payer: Aetna of VT Commercial |
$396.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$378.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$99.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$378.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$134.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$294.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$294.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$294.93
|
| Rate for Payer: Cash Price |
$211.00
|
| Rate for Payer: Cash Price |
$211.00
|
| Rate for Payer: Cigna Commercial |
$175.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$362.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$362.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$222.72
|
| Rate for Payer: Multiplan Commercial |
$392.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$136.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$96.17
|
| Rate for Payer: United Healthcare Commercial |
$147.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$96.17
|
| Rate for Payer: United Healthcare VA CCN |
$96.17
|
|
|
I&D PERIANAL ABSCESS SUPERFI
|
Facility
|
OP
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9824605001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$186.90 |
| Max. Negotiated Rate |
$400.90 |
| Rate for Payer: Aetna of VT Commercial |
$400.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$378.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$186.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$378.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$254.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$358.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$341.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$189.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$335.49
|
| Rate for Payer: Cash Price |
$211.00
|
| Rate for Payer: Cigna Commercial |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$337.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$189.90
|
| Rate for Payer: Multiplan Commercial |
$392.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$358.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.90
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.90
|
| Rate for Payer: United Healthcare VA CCN |
$189.90
|
|
|
I&D PERIANAL ABSCESS SUPERFI
|
Facility
|
IP
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9824605001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$312.32 |
| Max. Negotiated Rate |
$400.90 |
| Rate for Payer: Aetna of VT Commercial |
$400.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$312.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$312.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$358.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$354.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$337.60
|
| Rate for Payer: Cash Price |
$211.00
|
| Rate for Payer: Cigna Commercial |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$337.60
|
| Rate for Payer: Multiplan Commercial |
$392.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$358.70
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
I&D PERIANAL ABSCESS SUPERFIC
|
Facility
|
OP
|
$1,372.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
5104605001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$607.66 |
| Max. Negotiated Rate |
$1,303.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,303.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,229.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$607.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,229.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$825.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,166.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,111.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$617.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,090.74
|
| Rate for Payer: Cash Price |
$686.00
|
| Rate for Payer: Cigna Commercial |
$1,097.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,097.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,097.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$617.40
|
| Rate for Payer: Multiplan Commercial |
$1,275.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,166.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$617.40
|
| Rate for Payer: United Healthcare Commercial |
$1,303.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$617.40
|
| Rate for Payer: United Healthcare VA CCN |
$617.40
|
|
|
I&D PERIANAL ABSCESS SUPERFIC
|
Facility
|
OP
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9604605002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$186.90 |
| Max. Negotiated Rate |
$400.90 |
| Rate for Payer: Aetna of VT Commercial |
$400.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$378.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$186.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$378.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$254.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$358.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$341.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$189.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$335.49
|
| Rate for Payer: Cash Price |
$211.00
|
| Rate for Payer: Cigna Commercial |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$337.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$189.90
|
| Rate for Payer: Multiplan Commercial |
$392.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$358.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.90
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.90
|
| Rate for Payer: United Healthcare VA CCN |
$189.90
|
|
|
I&D PERIANAL ABSCESS SUPERFIC
|
Facility
|
IP
|
$1,794.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9604605001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,327.74 |
| Max. Negotiated Rate |
$1,704.30 |
| Rate for Payer: Aetna of VT Commercial |
$1,704.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,327.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,327.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,524.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,506.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,435.20
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$1,435.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,435.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,435.20
|
| Rate for Payer: Multiplan Commercial |
$1,668.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,524.90
|
| Rate for Payer: United Healthcare Commercial |
$1,704.30
|
|
|
I&D PERIANAL ABSCESS SUPERFIC
|
Professional
|
Both
|
$1,794.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9604605001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$96.17 |
| Max. Negotiated Rate |
$1,686.36 |
| Rate for Payer: Aetna of VT Commercial |
$1,686.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,607.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$99.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,607.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$134.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$294.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$294.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$294.93
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$175.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$362.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$362.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$222.72
|
| Rate for Payer: Multiplan Commercial |
$1,668.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$136.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$96.17
|
| Rate for Payer: United Healthcare Commercial |
$147.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$96.17
|
| Rate for Payer: United Healthcare VA CCN |
$96.17
|
|
|
I&D PERIANAL ABSCESS SUPERFIC
|
Facility
|
IP
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9604605002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$312.32 |
| Max. Negotiated Rate |
$400.90 |
| Rate for Payer: Aetna of VT Commercial |
$400.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$312.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$312.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$358.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$354.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$337.60
|
| Rate for Payer: Cash Price |
$211.00
|
| Rate for Payer: Cigna Commercial |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$337.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$337.60
|
| Rate for Payer: Multiplan Commercial |
$392.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$358.70
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
