|
INCISION OF RECTAL ABSCESS
|
Facility
|
OP
|
$1,353.00
|
|
|
Service Code
|
CPT 46060
|
| Hospital Charge Code |
9824606001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$599.24 |
| Max. Negotiated Rate |
$1,285.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,285.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,212.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$599.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,212.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$814.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,150.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,095.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$608.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,075.63
|
| Rate for Payer: Cash Price |
$676.50
|
| Rate for Payer: Cigna Commercial |
$1,082.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,082.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,082.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$608.85
|
| Rate for Payer: Multiplan Commercial |
$1,258.29
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,150.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$608.85
|
| Rate for Payer: United Healthcare Commercial |
$1,285.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$608.85
|
| Rate for Payer: United Healthcare VA CCN |
$608.85
|
|
|
INCISION OF RECTAL ABSCESS
|
Facility
|
IP
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9604604002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$806.71 |
| Max. Negotiated Rate |
$1,035.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,035.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$806.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$806.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$926.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$915.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$872.00
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$872.00
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$926.50
|
| Rate for Payer: United Healthcare Commercial |
$1,035.50
|
|
|
INCISION OF RECTAL ABSCESS
|
Professional
|
Both
|
$3,875.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9604604001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$3,642.50 |
| Rate for Payer: Aetna of VT Commercial |
$3,642.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,471.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$415.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,471.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$564.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$463.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$713.92
|
| Rate for Payer: Cash Price |
$1,937.50
|
| Rate for Payer: Cash Price |
$1,937.50
|
| Rate for Payer: Cigna Commercial |
$731.98
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$867.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$867.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$525.42
|
| Rate for Payer: Multiplan Commercial |
$3,603.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$572.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare Commercial |
$619.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare VA CCN |
$403.03
|
|
|
INCISION OF RECTAL ABSCESS
|
Facility
|
IP
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9814604002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$806.71 |
| Max. Negotiated Rate |
$1,035.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,035.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$806.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$806.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$926.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$915.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$872.00
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$872.00
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$926.50
|
| Rate for Payer: United Healthcare Commercial |
$1,035.50
|
|
|
INCISION OF RECTAL ABSCESS
|
Professional
|
Both
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9814604002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$1,024.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,024.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$415.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$564.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$463.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$713.92
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$731.98
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$867.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$867.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$525.42
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$572.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare Commercial |
$619.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare VA CCN |
$403.03
|
|
|
INCISION OF RECTAL ABSCESS
|
Facility
|
IP
|
$2,785.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
5104604001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,061.18 |
| Max. Negotiated Rate |
$2,645.75 |
| Rate for Payer: Aetna of VT Commercial |
$2,645.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,061.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,061.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,367.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,339.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,228.00
|
| Rate for Payer: Cash Price |
$1,392.50
|
| Rate for Payer: Cigna Commercial |
$2,228.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,228.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,228.00
|
| Rate for Payer: Multiplan Commercial |
$2,590.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,367.25
|
| Rate for Payer: United Healthcare Commercial |
$2,645.75
|
|
|
INCISION OF RECTAL ABSCESS
|
Professional
|
Both
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9604604002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$1,024.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,024.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$415.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$564.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$713.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$463.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$713.92
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$731.98
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$867.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$867.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$525.42
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$572.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare Commercial |
$619.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$403.03
|
| Rate for Payer: United Healthcare VA CCN |
$403.03
|
|
|
INCISION OF RECTAL ABSCESS
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
CPT 46060
|
| Hospital Charge Code |
9824606001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$461.40 |
| Max. Negotiated Rate |
$1,271.82 |
| Rate for Payer: Aetna of VT Commercial |
$1,271.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,212.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$475.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,212.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$645.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$617.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$617.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$530.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$617.31
|
| Rate for Payer: Cash Price |
$676.50
|
| Rate for Payer: Cash Price |
$676.50
|
| Rate for Payer: Cigna Commercial |
$839.45
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$764.78
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$764.78
|
| Rate for Payer: Martins Point Health Care Commercial |
$461.40
|
| Rate for Payer: Multiplan Commercial |
$1,258.29
|
| Rate for Payer: MVP Health Care of NY Commercial |
$655.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$461.40
|
| Rate for Payer: United Healthcare Commercial |
$709.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$461.40
|
| Rate for Payer: United Healthcare VA CCN |
$461.40
|
|
|
INCISION OF RECTAL ABSCESS
|
Facility
|
IP
|
$2,784.67
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
4504604001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,060.93 |
| Max. Negotiated Rate |
$2,645.44 |
| Rate for Payer: Aetna of VT Commercial |
$2,645.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,060.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,060.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,366.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,339.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,227.74
|
| Rate for Payer: Cash Price |
$1,392.34
|
| Rate for Payer: Cigna Commercial |
$2,227.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,227.74
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,227.74
|
| Rate for Payer: Multiplan Commercial |
$2,589.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,366.97
|
| Rate for Payer: United Healthcare Commercial |
$2,645.44
|
|
|
INCISION OF RECTAL ABSCESS
|
Facility
|
OP
|
$1,090.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
9814604002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$482.76 |
| Max. Negotiated Rate |
$1,035.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,035.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$482.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$976.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$656.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$926.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$882.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$490.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$866.55
|
| Rate for Payer: Cash Price |
$545.00
|
| Rate for Payer: Cigna Commercial |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$872.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$872.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$490.50
|
| Rate for Payer: Multiplan Commercial |
$1,013.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$926.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$490.50
|
| Rate for Payer: United Healthcare Commercial |
$1,035.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$490.50
|
| Rate for Payer: United Healthcare VA CCN |
$490.50
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
IP
|
$3,399.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
5102500001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,515.60 |
| Max. Negotiated Rate |
$3,229.05 |
| Rate for Payer: Aetna of VT Commercial |
$3,229.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,515.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,515.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,889.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,855.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,719.20
|
| Rate for Payer: Cash Price |
$1,699.50
|
| Rate for Payer: Cigna Commercial |
$2,719.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,719.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,719.20
|
| Rate for Payer: Multiplan Commercial |
$3,161.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,889.15
|
| Rate for Payer: United Healthcare Commercial |
$3,229.05
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
IP
|
$1,160.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9602500002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$858.52 |
| Max. Negotiated Rate |
$1,102.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$858.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$858.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$986.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$974.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$928.00
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$928.00
|
| Rate for Payer: Multiplan Commercial |
$1,078.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$986.00
|
| Rate for Payer: United Healthcare Commercial |
$1,102.00
|
|
|
INCISION OF TENDON SHEATH
|
Professional
|
Both
|
$1,160.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9822500001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$337.24 |
| Max. Negotiated Rate |
$1,090.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,090.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$347.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$472.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$387.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$533.15
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$637.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$554.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$554.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.24
|
| Rate for Payer: Multiplan Commercial |
$1,078.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$478.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare Commercial |
$518.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare VA CCN |
$337.24
|
|
|
INCISION OF TENDON SHEATH
|
Professional
|
Both
|
$4,558.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9602500001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$337.24 |
| Max. Negotiated Rate |
$4,284.52 |
| Rate for Payer: Aetna of VT Commercial |
$4,284.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,083.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$347.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,083.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$472.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$387.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$533.15
|
| Rate for Payer: Cash Price |
$2,279.00
|
| Rate for Payer: Cash Price |
$2,279.00
|
| Rate for Payer: Cigna Commercial |
$637.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$554.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$554.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.24
|
| Rate for Payer: Multiplan Commercial |
$4,238.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$478.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare Commercial |
$518.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare VA CCN |
$337.24
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
OP
|
$1,160.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9822500001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$513.76 |
| Max. Negotiated Rate |
$1,102.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$513.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$698.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$986.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$939.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$522.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$922.20
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$928.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$522.00
|
| Rate for Payer: Multiplan Commercial |
$1,078.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$986.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$522.00
|
| Rate for Payer: United Healthcare Commercial |
$1,102.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$522.00
|
| Rate for Payer: United Healthcare VA CCN |
$522.00
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
OP
|
$1,160.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9602500002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$513.76 |
| Max. Negotiated Rate |
$1,102.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$513.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$698.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$986.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$939.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$522.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$922.20
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$928.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$522.00
|
| Rate for Payer: Multiplan Commercial |
$1,078.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$986.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$522.00
|
| Rate for Payer: United Healthcare Commercial |
$1,102.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$522.00
|
| Rate for Payer: United Healthcare VA CCN |
$522.00
|
|
|
INCISION OF TENDON SHEATH
|
Professional
|
Both
|
$3,399.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
5102500001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$337.24 |
| Max. Negotiated Rate |
$3,195.06 |
| Rate for Payer: Aetna of VT Commercial |
$3,195.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$347.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$472.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$387.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$533.15
|
| Rate for Payer: Cash Price |
$1,699.50
|
| Rate for Payer: Cash Price |
$1,699.50
|
| Rate for Payer: Cigna Commercial |
$637.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$554.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$554.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.24
|
| Rate for Payer: Multiplan Commercial |
$3,161.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$478.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare Commercial |
$518.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare VA CCN |
$337.24
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9602500001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,018.74 |
| Max. Negotiated Rate |
$4,330.10 |
| Rate for Payer: Aetna of VT Commercial |
$4,330.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,083.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,018.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,083.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,743.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,874.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,691.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,051.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,623.61
|
| Rate for Payer: Cash Price |
$2,279.00
|
| Rate for Payer: Cigna Commercial |
$3,646.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,646.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,646.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,051.10
|
| Rate for Payer: Multiplan Commercial |
$4,238.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,874.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,051.10
|
| Rate for Payer: United Healthcare Commercial |
$4,330.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,051.10
|
| Rate for Payer: United Healthcare VA CCN |
$2,051.10
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
IP
|
$4,558.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9602500001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,373.38 |
| Max. Negotiated Rate |
$4,330.10 |
| Rate for Payer: Aetna of VT Commercial |
$4,330.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,373.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,373.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,874.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,828.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,646.40
|
| Rate for Payer: Cash Price |
$2,279.00
|
| Rate for Payer: Cigna Commercial |
$3,646.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,646.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,646.40
|
| Rate for Payer: Multiplan Commercial |
$4,238.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,874.30
|
| Rate for Payer: United Healthcare Commercial |
$4,330.10
|
|
|
INCISION OF TENDON SHEATH
|
Professional
|
Both
|
$1,160.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9602500002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$337.24 |
| Max. Negotiated Rate |
$1,090.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,090.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$347.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,039.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$472.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$533.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$387.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$533.15
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$637.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$554.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$554.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.24
|
| Rate for Payer: Multiplan Commercial |
$1,078.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$478.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare Commercial |
$518.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.24
|
| Rate for Payer: United Healthcare VA CCN |
$337.24
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
OP
|
$3,399.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
5102500001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,505.42 |
| Max. Negotiated Rate |
$3,229.05 |
| Rate for Payer: Aetna of VT Commercial |
$3,229.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,505.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,046.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,889.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,753.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,529.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,702.20
|
| Rate for Payer: Cash Price |
$1,699.50
|
| Rate for Payer: Cigna Commercial |
$2,719.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,719.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,719.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,529.55
|
| Rate for Payer: Multiplan Commercial |
$3,161.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,889.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,529.55
|
| Rate for Payer: United Healthcare Commercial |
$3,229.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,529.55
|
| Rate for Payer: United Healthcare VA CCN |
$1,529.55
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
IP
|
$1,160.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
9822500001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$858.52 |
| Max. Negotiated Rate |
$1,102.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$858.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$858.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$986.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$974.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$928.00
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$928.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$928.00
|
| Rate for Payer: Multiplan Commercial |
$1,078.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$986.00
|
| Rate for Payer: United Healthcare Commercial |
$1,102.00
|
|
|
INCISION OF TOE TENDON
|
Facility
|
OP
|
$2,274.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
9602801001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,007.15 |
| Max. Negotiated Rate |
$2,160.30 |
| Rate for Payer: Aetna of VT Commercial |
$2,160.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,037.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,007.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,037.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,368.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,932.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,841.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,023.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,807.83
|
| Rate for Payer: Cash Price |
$1,137.00
|
| Rate for Payer: Cigna Commercial |
$1,819.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,819.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,819.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,023.30
|
| Rate for Payer: Multiplan Commercial |
$2,114.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,932.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,023.30
|
| Rate for Payer: United Healthcare Commercial |
$2,160.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,023.30
|
| Rate for Payer: United Healthcare VA CCN |
$1,023.30
|
|
|
INCISION OF TOE TENDON
|
Facility
|
IP
|
$521.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
9822801001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$385.59 |
| Max. Negotiated Rate |
$494.95 |
| Rate for Payer: Aetna of VT Commercial |
$494.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$385.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$385.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$442.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$437.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$416.80
|
| Rate for Payer: Cash Price |
$260.50
|
| Rate for Payer: Cigna Commercial |
$416.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$416.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$416.80
|
| Rate for Payer: Multiplan Commercial |
$484.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$442.85
|
| Rate for Payer: United Healthcare Commercial |
$494.95
|
|
|
INCISION OF TOE TENDON
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
5102801001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$202.08 |
| 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 |
$208.14
|
| 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 |
$282.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$419.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$419.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$232.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$419.76
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cigna Commercial |
$381.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$226.16
|
| Rate for Payer: Multiplan Commercial |
$1,631.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$286.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$202.08
|
| Rate for Payer: United Healthcare Commercial |
$310.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$202.08
|
| Rate for Payer: United Healthcare VA CCN |
$202.08
|
|
