|
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
|
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
|
|
|
I&D PERIANAL ABSCESS SUPERFIC
|
Professional
|
Both
|
$1,372.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
5104605001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$96.17 |
| Max. Negotiated Rate |
$1,289.68 |
| Rate for Payer: Aetna of VT Commercial |
$1,289.68
|
| 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 |
$99.06
|
| 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 |
$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 |
$686.00
|
| Rate for Payer: Cash Price |
$686.00
|
| 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 |
$1,275.96
|
| 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
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9604605002
|
|
Hospital Revenue Code
|
960
|
| 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 PILONIDAL CYST COMPLICATED
|
Facility
|
IP
|
$740.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
9811008102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$547.67 |
| Max. Negotiated Rate |
$703.00 |
| Rate for Payer: Aetna of VT Commercial |
$703.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$547.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$547.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$629.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$621.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$592.00
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cigna Commercial |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$592.00
|
| Rate for Payer: Multiplan Commercial |
$688.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$629.00
|
| Rate for Payer: United Healthcare Commercial |
$703.00
|
|
|
I&D PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$740.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
9811008101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$159.27 |
| Max. Negotiated Rate |
$695.60 |
| Rate for Payer: Aetna of VT Commercial |
$695.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$164.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$222.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$428.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$428.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$183.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$428.36
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cigna Commercial |
$292.29
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$522.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$522.53
|
| Rate for Payer: Martins Point Health Care Commercial |
$319.22
|
| Rate for Payer: Multiplan Commercial |
$688.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$226.16
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.27
|
| Rate for Payer: United Healthcare Commercial |
$245.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.27
|
| Rate for Payer: United Healthcare VA CCN |
$159.27
|
|
|
I&D PILONIDAL CYST COMPLICATED
|
Facility
|
IP
|
$740.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
9811008101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$547.67 |
| Max. Negotiated Rate |
$703.00 |
| Rate for Payer: Aetna of VT Commercial |
$703.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$547.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$547.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$629.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$621.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$592.00
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cigna Commercial |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$592.00
|
| Rate for Payer: Multiplan Commercial |
$688.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$629.00
|
| Rate for Payer: United Healthcare Commercial |
$703.00
|
|
|
I&D PILONIDAL CYST COMPLICATED
|
Facility
|
IP
|
$634.67
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
4501008101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$469.72 |
| Max. Negotiated Rate |
$602.94 |
| Rate for Payer: Aetna of VT Commercial |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$469.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$469.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$539.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$533.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$507.74
|
| Rate for Payer: Cash Price |
$317.34
|
| Rate for Payer: Cigna Commercial |
$507.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.74
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.74
|
| Rate for Payer: Multiplan Commercial |
$590.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$539.47
|
| Rate for Payer: United Healthcare Commercial |
$602.94
|
|
|
I&D PILONIDAL CYST COMPLICATED
|
Facility
|
OP
|
$740.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
9811008101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$327.75 |
| Max. Negotiated Rate |
$703.00 |
| Rate for Payer: Aetna of VT Commercial |
$703.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$327.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$445.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$629.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$599.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$588.30
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cigna Commercial |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$592.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$333.00
|
| Rate for Payer: Multiplan Commercial |
$688.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$629.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$333.00
|
| Rate for Payer: United Healthcare Commercial |
$703.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$333.00
|
| Rate for Payer: United Healthcare VA CCN |
$333.00
|
|
|
I&D PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$740.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
9811008102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$159.27 |
| Max. Negotiated Rate |
$695.60 |
| Rate for Payer: Aetna of VT Commercial |
$695.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$164.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$222.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$428.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$428.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$183.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$428.36
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cigna Commercial |
$292.29
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$522.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$522.53
|
| Rate for Payer: Martins Point Health Care Commercial |
$319.22
|
| Rate for Payer: Multiplan Commercial |
$688.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$226.16
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.27
|
| Rate for Payer: United Healthcare Commercial |
$245.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.27
|
| Rate for Payer: United Healthcare VA CCN |
$159.27
|
|
|
I&D PILONIDAL CYST COMPLICATED
|
Facility
|
OP
|
$634.67
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
4501008101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.10 |
| Max. Negotiated Rate |
$602.94 |
| Rate for Payer: Aetna of VT Commercial |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$568.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$281.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$568.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$382.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$539.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$514.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$504.56
|
| Rate for Payer: Cash Price |
$317.34
|
| Rate for Payer: Cigna Commercial |
$507.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.74
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.74
|
| Rate for Payer: Martins Point Health Care Commercial |
$285.60
|
| Rate for Payer: Multiplan Commercial |
$590.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$539.47
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$285.60
|
| Rate for Payer: United Healthcare Commercial |
$602.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$285.60
|
| Rate for Payer: United Healthcare VA CCN |
$285.60
|
|
|
I&D PILONIDAL CYST COMPLICATED
|
Facility
|
OP
|
$740.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
9811008102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$327.75 |
| Max. Negotiated Rate |
$703.00 |
| Rate for Payer: Aetna of VT Commercial |
$703.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$327.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$662.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$445.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$629.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$599.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$588.30
|
| Rate for Payer: Cash Price |
$370.00
|
| Rate for Payer: Cigna Commercial |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$592.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$592.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$333.00
|
| Rate for Payer: Multiplan Commercial |
$688.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$629.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$333.00
|
| Rate for Payer: United Healthcare Commercial |
$703.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$333.00
|
| Rate for Payer: United Healthcare VA CCN |
$333.00
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
9811008002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$99.67 |
| Max. Negotiated Rate |
$379.04 |
| Rate for Payer: Aetna of VT Commercial |
$333.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$102.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$139.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$317.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$317.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$114.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$317.29
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$182.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$379.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$379.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$233.92
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$141.53
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$99.67
|
| Rate for Payer: United Healthcare Commercial |
$153.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$99.67
|
| Rate for Payer: United Healthcare VA CCN |
$99.67
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
9811008001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$99.67 |
| Max. Negotiated Rate |
$379.04 |
| Rate for Payer: Aetna of VT Commercial |
$333.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$102.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$139.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$317.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$317.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$114.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$317.29
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$182.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$379.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$379.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$233.92
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$141.53
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$99.67
|
| Rate for Payer: United Healthcare Commercial |
$153.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$99.67
|
| Rate for Payer: United Healthcare VA CCN |
$99.67
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$355.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
9811008002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$157.23 |
| Max. Negotiated Rate |
$337.25 |
| Rate for Payer: Aetna of VT Commercial |
$337.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$157.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$213.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$301.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$287.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$159.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$282.23
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$159.75
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$301.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.75
|
| Rate for Payer: United Healthcare Commercial |
$337.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.75
|
| Rate for Payer: United Healthcare VA CCN |
$159.75
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$355.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
9811008002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$262.74 |
| Max. Negotiated Rate |
$337.25 |
| Rate for Payer: Aetna of VT Commercial |
$337.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$262.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$262.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$301.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$298.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$284.00
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.00
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$301.75
|
| Rate for Payer: United Healthcare Commercial |
$337.25
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$355.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
9811008001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$157.23 |
| Max. Negotiated Rate |
$337.25 |
| Rate for Payer: Aetna of VT Commercial |
$337.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$157.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$213.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$301.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$287.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$159.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$282.23
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$159.75
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$301.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.75
|
| Rate for Payer: United Healthcare Commercial |
$337.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.75
|
| Rate for Payer: United Healthcare VA CCN |
$159.75
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$631.18
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
4501008001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$279.55 |
| Max. Negotiated Rate |
$599.62 |
| Rate for Payer: Aetna of VT Commercial |
$599.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$565.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$565.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$379.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$536.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$511.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$284.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$501.79
|
| Rate for Payer: Cash Price |
$315.59
|
| Rate for Payer: Cigna Commercial |
$504.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$504.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$504.94
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.03
|
| Rate for Payer: Multiplan Commercial |
$587.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$536.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$284.03
|
| Rate for Payer: United Healthcare Commercial |
$599.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$284.03
|
| Rate for Payer: United Healthcare VA CCN |
$284.03
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$631.18
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
4501008001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$467.14 |
| Max. Negotiated Rate |
$599.62 |
| Rate for Payer: Aetna of VT Commercial |
$599.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$467.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$467.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$536.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$530.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$504.94
|
| Rate for Payer: Cash Price |
$315.59
|
| Rate for Payer: Cigna Commercial |
$504.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$504.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$504.94
|
| Rate for Payer: Multiplan Commercial |
$587.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$536.50
|
| Rate for Payer: United Healthcare Commercial |
$599.62
|
|
|
I&D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$355.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
9811008001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$262.74 |
| Max. Negotiated Rate |
$337.25 |
| Rate for Payer: Aetna of VT Commercial |
$337.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$262.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$262.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$301.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$298.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$284.00
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.00
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$301.75
|
| Rate for Payer: United Healthcare Commercial |
$337.25
|
|
|
I&D SHOULDER DEEP ABSCESS/HEM
|
Facility
|
IP
|
$944.00
|
|
|
Service Code
|
CPT 23030
|
| Hospital Charge Code |
9822303001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$698.65 |
| Max. Negotiated Rate |
$896.80 |
| Rate for Payer: Aetna of VT Commercial |
$896.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$698.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$698.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$802.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$792.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$755.20
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cigna Commercial |
$755.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$755.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$755.20
|
| Rate for Payer: Multiplan Commercial |
$877.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$802.40
|
| Rate for Payer: United Healthcare Commercial |
$896.80
|
|
|
I&D SHOULDER DEEP ABSCESS/HEM
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
CPT 23030
|
| Hospital Charge Code |
9822303001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$240.72 |
| Max. Negotiated Rate |
$887.36 |
| Rate for Payer: Aetna of VT Commercial |
$887.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$845.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$247.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$845.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$337.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$779.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$779.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$276.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$779.29
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cigna Commercial |
$455.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$677.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$677.86
|
| Rate for Payer: Martins Point Health Care Commercial |
$413.53
|
| Rate for Payer: Multiplan Commercial |
$877.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$341.82
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$240.72
|
| Rate for Payer: United Healthcare Commercial |
$370.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$240.72
|
| Rate for Payer: United Healthcare VA CCN |
$240.72
|
|
|
I&D SHOULDER DEEP ABSCESS/HEM
|
Facility
|
OP
|
$944.00
|
|
|
Service Code
|
CPT 23030
|
| Hospital Charge Code |
9822303001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$418.10 |
| Max. Negotiated Rate |
$896.80 |
| Rate for Payer: Aetna of VT Commercial |
$896.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$845.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$418.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$845.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$568.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$802.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$764.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$424.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$750.48
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cigna Commercial |
$755.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$755.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$755.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$424.80
|
| Rate for Payer: Multiplan Commercial |
$877.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$802.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$424.80
|
| Rate for Payer: United Healthcare Commercial |
$896.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$424.80
|
| Rate for Payer: United Healthcare VA CCN |
$424.80
|
|
|
I&D UPPER ARM/ELBOW BURSA
|
Facility
|
OP
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9822393101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$314.90 |
| Max. Negotiated Rate |
$675.45 |
| Rate for Payer: Aetna of VT Commercial |
$675.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$314.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$428.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$604.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$575.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$319.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$565.25
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cigna Commercial |
$568.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$568.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$568.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$319.95
|
| Rate for Payer: Multiplan Commercial |
$661.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$604.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$319.95
|
| Rate for Payer: United Healthcare Commercial |
$675.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$319.95
|
| Rate for Payer: United Healthcare VA CCN |
$319.95
|
|
|
I&D UPPER ARM/ELBOW BURSA
|
Professional
|
Both
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9822393101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$153.71 |
| Max. Negotiated Rate |
$668.34 |
| Rate for Payer: Aetna of VT Commercial |
$668.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$158.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$215.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$375.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$375.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$176.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$375.11
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cigna Commercial |
$292.52
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$463.39
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$463.39
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.44
|
| Rate for Payer: Multiplan Commercial |
$661.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$218.27
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$153.71
|
| Rate for Payer: United Healthcare Commercial |
$236.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$153.71
|
| Rate for Payer: United Healthcare VA CCN |
$153.71
|
|
