|
INCISION OF ANAL ABSCESS
|
Facility
|
IP
|
$1,371.66
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
4504605001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,015.17 |
| Max. Negotiated Rate |
$1,303.08 |
| Rate for Payer: Aetna of VT Commercial |
$1,303.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,015.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,015.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,165.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,152.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,097.33
|
| Rate for Payer: Cash Price |
$685.83
|
| Rate for Payer: Cigna Commercial |
$1,097.33
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,097.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,097.33
|
| Rate for Payer: Multiplan Commercial |
$1,275.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,165.91
|
| Rate for Payer: United Healthcare Commercial |
$1,303.08
|
|
|
INCISION OF ANAL ABSCESS
|
Facility
|
IP
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9814605002
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
|
INCISION OF ANAL ABSCESS
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
9814605001
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
|
INCISION OF ANAL ABSCESS
|
Facility
|
OP
|
$1,371.66
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
4504605001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$607.51 |
| Max. Negotiated Rate |
$1,303.08 |
| Rate for Payer: Aetna of VT Commercial |
$1,303.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,228.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$607.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,228.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$825.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,165.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,111.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$617.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,090.47
|
| Rate for Payer: Cash Price |
$685.83
|
| Rate for Payer: Cigna Commercial |
$1,097.33
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,097.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,097.33
|
| Rate for Payer: Martins Point Health Care Commercial |
$617.25
|
| Rate for Payer: Multiplan Commercial |
$1,275.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,165.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$617.25
|
| Rate for Payer: United Healthcare Commercial |
$1,303.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$617.25
|
| Rate for Payer: United Healthcare VA CCN |
$617.25
|
|
|
INCISION OF ANAL SPHINCTER
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
CPT 46080
|
| Hospital Charge Code |
9824608001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$147.06 |
| Max. Negotiated Rate |
$579.98 |
| Rate for Payer: Aetna of VT Commercial |
$579.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$552.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$151.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$552.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$205.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$356.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$356.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$169.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$356.67
|
| Rate for Payer: Cash Price |
$308.50
|
| Rate for Payer: Cash Price |
$308.50
|
| Rate for Payer: Cigna Commercial |
$268.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$441.79
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$441.79
|
| Rate for Payer: Martins Point Health Care Commercial |
$268.80
|
| Rate for Payer: Multiplan Commercial |
$573.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$208.83
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$147.06
|
| Rate for Payer: United Healthcare Commercial |
$226.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$147.06
|
| Rate for Payer: United Healthcare VA CCN |
$147.06
|
|
|
INCISION OF ANAL SPHINCTER
|
Facility
|
OP
|
$617.00
|
|
|
Service Code
|
CPT 46080
|
| Hospital Charge Code |
9824608001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$273.27 |
| Max. Negotiated Rate |
$586.15 |
| Rate for Payer: Aetna of VT Commercial |
$586.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$552.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$273.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$552.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$371.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$524.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$499.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$277.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$490.51
|
| Rate for Payer: Cash Price |
$308.50
|
| Rate for Payer: Cigna Commercial |
$493.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$493.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$493.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$277.65
|
| Rate for Payer: Multiplan Commercial |
$573.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$524.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$277.65
|
| Rate for Payer: United Healthcare Commercial |
$586.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$277.65
|
| Rate for Payer: United Healthcare VA CCN |
$277.65
|
|
|
INCISION OF ANAL SPHINCTER
|
Facility
|
IP
|
$617.00
|
|
|
Service Code
|
CPT 46080
|
| Hospital Charge Code |
9824608001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$456.64 |
| Max. Negotiated Rate |
$586.15 |
| Rate for Payer: Aetna of VT Commercial |
$586.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$456.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$456.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$524.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$518.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$493.60
|
| Rate for Payer: Cash Price |
$308.50
|
| Rate for Payer: Cigna Commercial |
$493.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$493.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$493.60
|
| Rate for Payer: Multiplan Commercial |
$573.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$524.45
|
| Rate for Payer: United Healthcare Commercial |
$586.15
|
|
|
INCISION OF EYELID FOLD
|
Facility
|
IP
|
$680.00
|
|
|
Service Code
|
CPT 67715
|
| Hospital Charge Code |
9826771501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$503.27 |
| Max. Negotiated Rate |
$646.00 |
| Rate for Payer: Aetna of VT Commercial |
$646.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$503.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$503.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$578.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$571.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$544.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cigna Commercial |
$544.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$544.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$544.00
|
| Rate for Payer: Multiplan Commercial |
$632.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$578.00
|
| Rate for Payer: United Healthcare Commercial |
$646.00
|
|
|
INCISION OF EYELID FOLD
|
Facility
|
OP
|
$680.00
|
|
|
Service Code
|
CPT 67715
|
| Hospital Charge Code |
9826771501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$301.17 |
| Max. Negotiated Rate |
$646.00 |
| Rate for Payer: Aetna of VT Commercial |
$646.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$609.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$301.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$609.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$409.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$578.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$550.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$540.60
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cigna Commercial |
$544.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$544.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$544.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$306.00
|
| Rate for Payer: Multiplan Commercial |
$632.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$578.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$306.00
|
| Rate for Payer: United Healthcare Commercial |
$646.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$306.00
|
| Rate for Payer: United Healthcare VA CCN |
$306.00
|
|
|
INCISION OF EYELID FOLD
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
CPT 67715
|
| Hospital Charge Code |
9826771501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$101.74 |
| Max. Negotiated Rate |
$639.20 |
| Rate for Payer: Aetna of VT Commercial |
$639.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$609.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$104.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$609.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$142.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$447.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$447.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$447.93
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cigna Commercial |
$187.28
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$396.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$396.53
|
| Rate for Payer: Martins Point Health Care Commercial |
$245.32
|
| Rate for Payer: Multiplan Commercial |
$632.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$144.47
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$101.74
|
| Rate for Payer: United Healthcare Commercial |
$156.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$101.74
|
| Rate for Payer: United Healthcare VA CCN |
$101.74
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
OP
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9822823401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$388.42 |
| Max. Negotiated Rate |
$833.15 |
| Rate for Payer: Aetna of VT Commercial |
$833.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$388.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$527.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$745.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$710.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$394.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$697.22
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$701.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$394.65
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$745.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$394.65
|
| Rate for Payer: United Healthcare Commercial |
$833.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$394.65
|
| Rate for Payer: United Healthcare VA CCN |
$394.65
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
OP
|
$1,754.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9602823401
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$776.85 |
| Max. Negotiated Rate |
$1,666.30 |
| Rate for Payer: Aetna of VT Commercial |
$1,666.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,571.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$776.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,571.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,055.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,490.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,420.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$789.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,394.43
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cigna Commercial |
$1,403.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,403.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,403.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$789.30
|
| Rate for Payer: Multiplan Commercial |
$1,631.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,490.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$789.30
|
| Rate for Payer: United Healthcare Commercial |
$1,666.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$789.30
|
| Rate for Payer: United Healthcare VA CCN |
$789.30
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
IP
|
$1,754.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9602823401
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,298.14 |
| Max. Negotiated Rate |
$1,666.30 |
| Rate for Payer: Aetna of VT Commercial |
$1,666.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,298.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,298.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,490.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,473.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,403.20
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cigna Commercial |
$1,403.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,403.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,403.20
|
| Rate for Payer: Multiplan Commercial |
$1,631.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,490.90
|
| Rate for Payer: United Healthcare Commercial |
$1,666.30
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
IP
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9822823401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$649.07 |
| Max. Negotiated Rate |
$833.15 |
| Rate for Payer: Aetna of VT Commercial |
$833.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$649.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$649.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$745.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$736.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$701.60
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$701.60
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$745.45
|
| Rate for Payer: United Healthcare Commercial |
$833.15
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
OP
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9602823402
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$388.42 |
| Max. Negotiated Rate |
$833.15 |
| Rate for Payer: Aetna of VT Commercial |
$833.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$388.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$527.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$745.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$710.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$394.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$697.22
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$701.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$394.65
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$745.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$394.65
|
| Rate for Payer: United Healthcare Commercial |
$833.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$394.65
|
| Rate for Payer: United Healthcare VA CCN |
$394.65
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
IP
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
5102823401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$649.07 |
| Max. Negotiated Rate |
$833.15 |
| Rate for Payer: Aetna of VT Commercial |
$833.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$649.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$649.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$745.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$736.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$701.60
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$701.60
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$745.45
|
| Rate for Payer: United Healthcare Commercial |
$833.15
|
|
|
INCISION OF FOOT TENDON
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9822823401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$261.87 |
| Max. Negotiated Rate |
$824.38 |
| Rate for Payer: Aetna of VT Commercial |
$824.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$269.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$366.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$301.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$643.10
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$494.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$632.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$632.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$390.03
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$371.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare Commercial |
$402.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare VA CCN |
$261.87
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
OP
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
5102823401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$388.42 |
| Max. Negotiated Rate |
$833.15 |
| Rate for Payer: Aetna of VT Commercial |
$833.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$388.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$527.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$745.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$710.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$394.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$697.22
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$701.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$394.65
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$745.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$394.65
|
| Rate for Payer: United Healthcare Commercial |
$833.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$394.65
|
| Rate for Payer: United Healthcare VA CCN |
$394.65
|
|
|
INCISION OF FOOT TENDON
|
Facility
|
IP
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9602823402
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$649.07 |
| Max. Negotiated Rate |
$833.15 |
| Rate for Payer: Aetna of VT Commercial |
$833.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$649.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$649.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$745.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$736.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$701.60
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$701.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$701.60
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$745.45
|
| Rate for Payer: United Healthcare Commercial |
$833.15
|
|
|
INCISION OF FOOT TENDON
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
5102823401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$261.87 |
| Max. Negotiated Rate |
$824.38 |
| Rate for Payer: Aetna of VT Commercial |
$824.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$269.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$366.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$301.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$643.10
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$494.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$632.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$632.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$390.03
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$371.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare Commercial |
$402.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare VA CCN |
$261.87
|
|
|
INCISION OF FOOT TENDON
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9602823401
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$261.87 |
| Max. Negotiated Rate |
$1,648.76 |
| Rate for Payer: Aetna of VT Commercial |
$1,648.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,571.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$269.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,571.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$366.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$301.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$643.10
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cigna Commercial |
$494.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$632.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$632.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$390.03
|
| Rate for Payer: Multiplan Commercial |
$1,631.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$371.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare Commercial |
$402.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare VA CCN |
$261.87
|
|
|
INCISION OF FOOT TENDON
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
9602823402
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$261.87 |
| Max. Negotiated Rate |
$824.38 |
| Rate for Payer: Aetna of VT Commercial |
$824.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$269.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$785.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$366.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$643.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$301.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$643.10
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cash Price |
$438.50
|
| Rate for Payer: Cigna Commercial |
$494.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$632.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$632.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$390.03
|
| Rate for Payer: Multiplan Commercial |
$815.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$371.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare Commercial |
$402.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$261.87
|
| Rate for Payer: United Healthcare VA CCN |
$261.87
|
|
|
INCISION OF FOOT TENDON(S)
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
CPT 28230
|
| Hospital Charge Code |
9822823001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$274.79 |
| Max. Negotiated Rate |
$767.98 |
| Rate for Payer: Aetna of VT Commercial |
$767.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$731.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$283.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$731.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$384.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$687.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$687.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$316.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$687.21
|
| Rate for Payer: Cash Price |
$408.50
|
| Rate for Payer: Cash Price |
$408.50
|
| Rate for Payer: Cigna Commercial |
$519.28
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$665.51
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$665.51
|
| Rate for Payer: Martins Point Health Care Commercial |
$410.01
|
| Rate for Payer: Multiplan Commercial |
$759.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$274.79
|
| Rate for Payer: United Healthcare Commercial |
$422.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$274.79
|
| Rate for Payer: United Healthcare VA CCN |
$274.79
|
|
|
INCISION OF FOOT TENDON(S)
|
Facility
|
OP
|
$817.00
|
|
|
Service Code
|
CPT 28230
|
| Hospital Charge Code |
9822823001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$361.85 |
| Max. Negotiated Rate |
$776.15 |
| Rate for Payer: Aetna of VT Commercial |
$776.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$731.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$361.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$731.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$491.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$694.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$661.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$367.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$649.51
|
| Rate for Payer: Cash Price |
$408.50
|
| Rate for Payer: Cigna Commercial |
$653.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$653.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$653.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$367.65
|
| Rate for Payer: Multiplan Commercial |
$759.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$694.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$367.65
|
| Rate for Payer: United Healthcare Commercial |
$776.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$367.65
|
| Rate for Payer: United Healthcare VA CCN |
$367.65
|
|
|
INCISION OF FOOT TENDON(S)
|
Facility
|
IP
|
$817.00
|
|
|
Service Code
|
CPT 28230
|
| Hospital Charge Code |
9822823001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$604.66 |
| Max. Negotiated Rate |
$776.15 |
| Rate for Payer: Aetna of VT Commercial |
$776.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$604.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$604.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$694.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$686.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$653.60
|
| Rate for Payer: Cash Price |
$408.50
|
| Rate for Payer: Cigna Commercial |
$653.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$653.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$653.60
|
| Rate for Payer: Multiplan Commercial |
$759.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$694.45
|
| Rate for Payer: United Healthcare Commercial |
$776.15
|
|
