|
I&D UPPER ARM/ELBOW BURSA
|
Facility
|
IP
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9812393101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$526.21 |
| 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 |
$526.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$526.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$604.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$597.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$568.80
|
| 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: Multiplan Commercial |
$661.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$675.45
|
|
|
I&D UPPER ARM/ELBOW BURSA
|
Professional
|
Both
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9812393101
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
|
I&D UPPER ARM/ELBOW BURSA
|
Facility
|
IP
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9822393101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$526.21 |
| 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 |
$526.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$526.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$604.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$597.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$568.80
|
| 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: Multiplan Commercial |
$661.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$675.45
|
|
|
I&D UPPER ARM/ELBOW BURSA
|
Facility
|
IP
|
$804.45
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
4502393101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$595.37 |
| Max. Negotiated Rate |
$764.23 |
| Rate for Payer: Aetna of VT Commercial |
$764.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$595.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$595.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$683.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$675.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$643.56
|
| Rate for Payer: Cash Price |
$402.22
|
| Rate for Payer: Cigna Commercial |
$643.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$643.56
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$643.56
|
| Rate for Payer: Multiplan Commercial |
$748.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$683.78
|
| Rate for Payer: United Healthcare Commercial |
$764.23
|
|
|
I&D UPPER ARM/ELBOW BURSA
|
Facility
|
OP
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9812393102
|
|
Hospital Revenue Code
|
981
|
| 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
|
Facility
|
OP
|
$804.45
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
4502393101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$356.29 |
| Max. Negotiated Rate |
$764.23 |
| Rate for Payer: Aetna of VT Commercial |
$764.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$720.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$356.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$720.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$484.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$683.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$651.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$362.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$639.54
|
| Rate for Payer: Cash Price |
$402.22
|
| Rate for Payer: Cigna Commercial |
$643.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$643.56
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$643.56
|
| Rate for Payer: Martins Point Health Care Commercial |
$362.00
|
| Rate for Payer: Multiplan Commercial |
$748.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$683.78
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$362.00
|
| Rate for Payer: United Healthcare Commercial |
$764.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$362.00
|
| Rate for Payer: United Healthcare VA CCN |
$362.00
|
|
|
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
|
Facility
|
IP
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9812393102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$526.21 |
| 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 |
$526.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$526.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$604.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$597.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$568.80
|
| 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: Multiplan Commercial |
$661.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$675.45
|
|
|
I&D UPPER ARM/ELBOW BURSA
|
Facility
|
OP
|
$711.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
9812393101
|
|
Hospital Revenue Code
|
981
|
| 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 VAGINAL HEMATOMA PP
|
Professional
|
Both
|
$484.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
9825702201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$169.26 |
| Max. Negotiated Rate |
$454.96 |
| Rate for Payer: Aetna of VT Commercial |
$454.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$433.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$174.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$433.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$236.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$194.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.93
|
| Rate for Payer: Cash Price |
$242.00
|
| Rate for Payer: Cash Price |
$242.00
|
| Rate for Payer: Cigna Commercial |
$299.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$281.83
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$281.83
|
| Rate for Payer: Martins Point Health Care Commercial |
$169.26
|
| Rate for Payer: Multiplan Commercial |
$450.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$240.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$169.26
|
| Rate for Payer: United Healthcare Commercial |
$260.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$169.26
|
| Rate for Payer: United Healthcare VA CCN |
$169.26
|
|
|
I & D VAGINAL HEMATOMA PP
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
9825702201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$214.36 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Aetna of VT Commercial |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$433.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$214.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$433.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$291.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$411.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$392.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$217.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$384.78
|
| Rate for Payer: Cash Price |
$242.00
|
| Rate for Payer: Cigna Commercial |
$387.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$387.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$387.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$217.80
|
| Rate for Payer: Multiplan Commercial |
$450.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$411.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$217.80
|
| Rate for Payer: United Healthcare Commercial |
$459.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$217.80
|
| Rate for Payer: United Healthcare VA CCN |
$217.80
|
|
|
I & D VAGINAL HEMATOMA PP
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
9825702201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$358.21 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Aetna of VT Commercial |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$358.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$358.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$411.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$406.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.20
|
| Rate for Payer: Cash Price |
$242.00
|
| Rate for Payer: Cigna Commercial |
$387.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$387.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$387.20
|
| Rate for Payer: Multiplan Commercial |
$450.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$411.40
|
| Rate for Payer: United Healthcare Commercial |
$459.80
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$290.78
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
4505640501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$215.21 |
| Max. Negotiated Rate |
$276.24 |
| Rate for Payer: Aetna of VT Commercial |
$276.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$215.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$215.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$247.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$244.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$232.62
|
| Rate for Payer: Cash Price |
$145.39
|
| Rate for Payer: Cigna Commercial |
$232.62
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$232.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$232.62
|
| Rate for Payer: Multiplan Commercial |
$270.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$247.16
|
| Rate for Payer: United Healthcare Commercial |
$276.24
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
5105640501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$215.37 |
| Max. Negotiated Rate |
$276.45 |
| Rate for Payer: Aetna of VT Commercial |
$276.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$215.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$215.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$247.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$244.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$232.80
|
| Rate for Payer: Cash Price |
$145.50
|
| Rate for Payer: Cigna Commercial |
$232.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$232.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$232.80
|
| Rate for Payer: Multiplan Commercial |
$270.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$247.35
|
| Rate for Payer: United Healthcare Commercial |
$276.45
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9825640501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$119.85 |
| Max. Negotiated Rate |
$277.30 |
| Rate for Payer: Aetna of VT Commercial |
$277.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$167.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$137.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$189.63
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$212.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$225.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$225.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.88
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare Commercial |
$184.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare VA CCN |
$119.85
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
5105640501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$119.85 |
| Max. Negotiated Rate |
$273.54 |
| Rate for Payer: Aetna of VT Commercial |
$273.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$260.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$260.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$167.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$137.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$189.63
|
| Rate for Payer: Cash Price |
$145.50
|
| Rate for Payer: Cash Price |
$145.50
|
| Rate for Payer: Cigna Commercial |
$212.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$225.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$225.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.88
|
| Rate for Payer: Multiplan Commercial |
$270.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare Commercial |
$184.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare VA CCN |
$119.85
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9605640502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Aetna of VT Commercial |
$280.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$250.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$247.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$236.00
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$236.00
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$250.75
|
| Rate for Payer: United Healthcare Commercial |
$280.25
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9605640502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$130.66 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Aetna of VT Commercial |
$280.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$130.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$177.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$250.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$238.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$132.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$234.53
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$236.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$132.75
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$250.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$132.75
|
| Rate for Payer: United Healthcare Commercial |
$280.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$132.75
|
| Rate for Payer: United Healthcare VA CCN |
$132.75
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9815640501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9815640501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$225.26 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$167.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$137.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$189.63
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$212.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$225.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$225.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.88
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare Commercial |
$184.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare VA CCN |
$119.85
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9815640502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$119.85 |
| Max. Negotiated Rate |
$277.30 |
| Rate for Payer: Aetna of VT Commercial |
$277.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$167.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$137.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$189.63
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$212.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$225.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$225.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.88
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare Commercial |
$184.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare VA CCN |
$119.85
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9825640501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Aetna of VT Commercial |
$280.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$250.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$247.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$236.00
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$236.00
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$250.75
|
| Rate for Payer: United Healthcare Commercial |
$280.25
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$586.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9605640501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$119.85 |
| Max. Negotiated Rate |
$550.84 |
| Rate for Payer: Aetna of VT Commercial |
$550.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$167.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$189.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$137.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$189.63
|
| Rate for Payer: Cash Price |
$293.00
|
| Rate for Payer: Cash Price |
$293.00
|
| Rate for Payer: Cigna Commercial |
$212.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$225.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$225.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.88
|
| Rate for Payer: Multiplan Commercial |
$544.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare Commercial |
$184.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.85
|
| Rate for Payer: United Healthcare VA CCN |
$119.85
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$586.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9605640501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$259.54 |
| Max. Negotiated Rate |
$556.70 |
| Rate for Payer: Aetna of VT Commercial |
$556.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$259.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$352.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$498.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$474.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$263.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$465.87
|
| Rate for Payer: Cash Price |
$293.00
|
| Rate for Payer: Cigna Commercial |
$468.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$468.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$468.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$263.70
|
| Rate for Payer: Multiplan Commercial |
$544.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$498.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$263.70
|
| Rate for Payer: United Healthcare Commercial |
$556.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$263.70
|
| Rate for Payer: United Healthcare VA CCN |
$263.70
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
9815640501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
