|
INSERT BLADDER CATH COMPLEX
|
Facility
|
OP
|
$337.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
9815170302
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$149.26 |
| Max. Negotiated Rate |
$320.15 |
| Rate for Payer: Aetna of VT Commercial |
$320.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$301.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$149.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$301.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$202.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$286.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$272.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$151.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$267.92
|
| Rate for Payer: Cash Price |
$168.50
|
| Rate for Payer: Cigna Commercial |
$269.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$269.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$269.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$151.65
|
| Rate for Payer: Multiplan Commercial |
$313.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$286.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$151.65
|
| Rate for Payer: United Healthcare Commercial |
$320.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$151.65
|
| Rate for Payer: United Healthcare VA CCN |
$151.65
|
|
|
INSERT BLADDER CATH COMPLEX
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
9815170302
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$70.63 |
| Max. Negotiated Rate |
$316.78 |
| Rate for Payer: Aetna of VT Commercial |
$316.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$301.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$72.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$301.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$98.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$249.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$249.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$249.53
|
| Rate for Payer: Cash Price |
$168.50
|
| Rate for Payer: Cash Price |
$168.50
|
| Rate for Payer: Cigna Commercial |
$122.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$227.83
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$227.83
|
| Rate for Payer: Martins Point Health Care Commercial |
$140.01
|
| Rate for Payer: Multiplan Commercial |
$313.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$100.29
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$70.63
|
| Rate for Payer: United Healthcare Commercial |
$108.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$70.63
|
| Rate for Payer: United Healthcare VA CCN |
$70.63
|
|
|
INSERT BLADDER CATH COMPLEX
|
Facility
|
OP
|
$337.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
9825170301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$149.26 |
| Max. Negotiated Rate |
$320.15 |
| Rate for Payer: Aetna of VT Commercial |
$320.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$301.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$149.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$301.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$202.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$286.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$272.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$151.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$267.92
|
| Rate for Payer: Cash Price |
$168.50
|
| Rate for Payer: Cigna Commercial |
$269.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$269.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$269.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$151.65
|
| Rate for Payer: Multiplan Commercial |
$313.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$286.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$151.65
|
| Rate for Payer: United Healthcare Commercial |
$320.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$151.65
|
| Rate for Payer: United Healthcare VA CCN |
$151.65
|
|
|
INSERT BLADDER CATH COMPLEX
|
Facility
|
IP
|
$337.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
9825170301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$249.41 |
| Max. Negotiated Rate |
$320.15 |
| Rate for Payer: Aetna of VT Commercial |
$320.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$249.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$249.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$286.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$283.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$269.60
|
| Rate for Payer: Cash Price |
$168.50
|
| Rate for Payer: Cigna Commercial |
$269.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$269.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$269.60
|
| Rate for Payer: Multiplan Commercial |
$313.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$286.45
|
| Rate for Payer: United Healthcare Commercial |
$320.15
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$192.32
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
7205170101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.18 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna of VT Commercial |
$182.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$172.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$85.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$172.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$115.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$163.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$155.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$86.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$152.89
|
| Rate for Payer: Cash Price |
$96.16
|
| Rate for Payer: Cigna Commercial |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$153.86
|
| Rate for Payer: Martins Point Health Care Commercial |
$86.54
|
| Rate for Payer: Multiplan Commercial |
$178.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$163.47
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$86.54
|
| Rate for Payer: United Healthcare Commercial |
$182.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$86.54
|
| Rate for Payer: United Healthcare VA CCN |
$86.54
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9605170102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$83.27 |
| Max. Negotiated Rate |
$178.60 |
| Rate for Payer: Aetna of VT Commercial |
$178.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$83.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$113.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$159.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$152.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$84.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$149.46
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$150.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$84.60
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$159.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$84.60
|
| Rate for Payer: United Healthcare Commercial |
$178.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$84.60
|
| Rate for Payer: United Healthcare VA CCN |
$84.60
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9605170102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$139.14 |
| Max. Negotiated Rate |
$178.60 |
| Rate for Payer: Aetna of VT Commercial |
$178.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$139.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$139.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$159.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$157.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$150.40
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$150.40
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$159.80
|
| Rate for Payer: United Healthcare Commercial |
$178.60
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$192.32
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
7225170101
|
|
Hospital Revenue Code
|
722
|
| Min. Negotiated Rate |
$142.34 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna of VT Commercial |
$182.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$163.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$161.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$153.86
|
| Rate for Payer: Cash Price |
$96.16
|
| Rate for Payer: Cigna Commercial |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$153.86
|
| Rate for Payer: Multiplan Commercial |
$178.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$163.47
|
| Rate for Payer: United Healthcare Commercial |
$182.70
|
|
|
INSERT BLADDER CATHETER
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9605170102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$176.72 |
| Rate for Payer: Aetna of VT Commercial |
$176.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$23.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$32.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.63
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$41.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$67.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$67.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$41.59
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$33.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare Commercial |
$35.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare VA CCN |
$23.28
|
|
|
INSERT BLADDER CATHETER
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9605170101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$357.20 |
| Rate for Payer: Aetna of VT Commercial |
$357.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$340.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$23.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$340.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$32.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.63
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: Cigna Commercial |
$41.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$67.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$67.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$41.59
|
| Rate for Payer: Multiplan Commercial |
$353.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$33.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare Commercial |
$35.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare VA CCN |
$23.28
|
|
|
INSERT BLADDER CATHETER
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9815170101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$176.72 |
| Rate for Payer: Aetna of VT Commercial |
$176.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$23.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$32.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.63
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$41.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$67.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$67.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$41.59
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$33.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare Commercial |
$35.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare VA CCN |
$23.28
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$193.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
5105170101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$85.48 |
| Max. Negotiated Rate |
$183.35 |
| Rate for Payer: Aetna of VT Commercial |
$183.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$172.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$85.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$172.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$116.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$164.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$156.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$86.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$153.44
|
| Rate for Payer: Cash Price |
$96.50
|
| Rate for Payer: Cigna Commercial |
$154.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$154.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$154.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$86.85
|
| Rate for Payer: Multiplan Commercial |
$179.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$164.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$86.85
|
| Rate for Payer: United Healthcare Commercial |
$183.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$86.85
|
| Rate for Payer: United Healthcare VA CCN |
$86.85
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9815170102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$83.27 |
| Max. Negotiated Rate |
$178.60 |
| Rate for Payer: Aetna of VT Commercial |
$178.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$83.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$113.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$159.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$152.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$84.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$149.46
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$150.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$84.60
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$159.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$84.60
|
| Rate for Payer: United Healthcare Commercial |
$178.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$84.60
|
| Rate for Payer: United Healthcare VA CCN |
$84.60
|
|
|
INSERT BLADDER CATHETER
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
5105170101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$181.42 |
| Rate for Payer: Aetna of VT Commercial |
$181.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$172.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$23.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$172.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$32.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.63
|
| Rate for Payer: Cash Price |
$96.50
|
| Rate for Payer: Cash Price |
$96.50
|
| Rate for Payer: Cigna Commercial |
$41.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$67.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$67.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$41.59
|
| Rate for Payer: Multiplan Commercial |
$179.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$33.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare Commercial |
$35.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare VA CCN |
$23.28
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$193.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
5105170101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$142.84 |
| Max. Negotiated Rate |
$183.35 |
| Rate for Payer: Aetna of VT Commercial |
$183.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$164.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$162.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$154.40
|
| Rate for Payer: Cash Price |
$96.50
|
| Rate for Payer: Cigna Commercial |
$154.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$154.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$154.40
|
| Rate for Payer: Multiplan Commercial |
$179.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$164.05
|
| Rate for Payer: United Healthcare Commercial |
$183.35
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$380.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9605170101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$281.24 |
| Max. Negotiated Rate |
$361.00 |
| Rate for Payer: Aetna of VT Commercial |
$361.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$281.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$281.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$323.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$319.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$304.00
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: Cigna Commercial |
$304.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$304.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$304.00
|
| Rate for Payer: Multiplan Commercial |
$353.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$323.00
|
| Rate for Payer: United Healthcare Commercial |
$361.00
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$192.32
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
7205170101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.34 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna of VT Commercial |
$182.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$163.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$161.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$153.86
|
| Rate for Payer: Cash Price |
$96.16
|
| Rate for Payer: Cigna Commercial |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$153.86
|
| Rate for Payer: Multiplan Commercial |
$178.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$163.47
|
| Rate for Payer: United Healthcare Commercial |
$182.70
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9815170101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$139.14 |
| Max. Negotiated Rate |
$178.60 |
| Rate for Payer: Aetna of VT Commercial |
$178.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$139.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$139.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$159.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$157.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$150.40
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$150.40
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$159.80
|
| Rate for Payer: United Healthcare Commercial |
$178.60
|
|
|
INSERT BLADDER CATHETER
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9815170102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$176.72 |
| Rate for Payer: Aetna of VT Commercial |
$176.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$23.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$32.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$79.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.63
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$41.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$67.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$67.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$41.59
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$33.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare Commercial |
$35.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.28
|
| Rate for Payer: United Healthcare VA CCN |
$23.28
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$192.32
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
4505170101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.34 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna of VT Commercial |
$182.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$163.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$161.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$153.86
|
| Rate for Payer: Cash Price |
$96.16
|
| Rate for Payer: Cigna Commercial |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$153.86
|
| Rate for Payer: Multiplan Commercial |
$178.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$163.47
|
| Rate for Payer: United Healthcare Commercial |
$182.70
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9815170101
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$83.27 |
| Max. Negotiated Rate |
$178.60 |
| Rate for Payer: Aetna of VT Commercial |
$178.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$83.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$168.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$113.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$159.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$152.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$84.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$149.46
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$150.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$84.60
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$159.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$84.60
|
| Rate for Payer: United Healthcare Commercial |
$178.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$84.60
|
| Rate for Payer: United Healthcare VA CCN |
$84.60
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$192.32
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
7225170101
|
|
Hospital Revenue Code
|
722
|
| Min. Negotiated Rate |
$85.18 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna of VT Commercial |
$182.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$172.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$85.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$172.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$115.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$163.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$155.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$86.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$152.89
|
| Rate for Payer: Cash Price |
$96.16
|
| Rate for Payer: Cigna Commercial |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$153.86
|
| Rate for Payer: Martins Point Health Care Commercial |
$86.54
|
| Rate for Payer: Multiplan Commercial |
$178.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$163.47
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$86.54
|
| Rate for Payer: United Healthcare Commercial |
$182.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$86.54
|
| Rate for Payer: United Healthcare VA CCN |
$86.54
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9815170102
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$139.14 |
| Max. Negotiated Rate |
$178.60 |
| Rate for Payer: Aetna of VT Commercial |
$178.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$139.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$139.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$159.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$157.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$150.40
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$150.40
|
| Rate for Payer: Multiplan Commercial |
$174.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$159.80
|
| Rate for Payer: United Healthcare Commercial |
$178.60
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$192.32
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
4505170101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$85.18 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna of VT Commercial |
$182.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$172.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$85.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$172.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$115.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$163.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$155.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$86.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$152.89
|
| Rate for Payer: Cash Price |
$96.16
|
| Rate for Payer: Cigna Commercial |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$153.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$153.86
|
| Rate for Payer: Martins Point Health Care Commercial |
$86.54
|
| Rate for Payer: Multiplan Commercial |
$178.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$163.47
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$86.54
|
| Rate for Payer: United Healthcare Commercial |
$182.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$86.54
|
| Rate for Payer: United Healthcare VA CCN |
$86.54
|
|
|
INSERT BLADDER CATHETER
|
Facility
|
OP
|
$380.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
9605170101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$168.30 |
| Max. Negotiated Rate |
$361.00 |
| Rate for Payer: Aetna of VT Commercial |
$361.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$340.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$340.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$228.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$323.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$302.10
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: Cigna Commercial |
$304.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$304.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$304.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$171.00
|
| Rate for Payer: Multiplan Commercial |
$353.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$323.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$171.00
|
| Rate for Payer: United Healthcare Commercial |
$361.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$171.00
|
| Rate for Payer: United Healthcare VA CCN |
$171.00
|
|
