|
INSERT CATH PLEURA W/O IMAGE
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9823255601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$113.25 |
| Max. Negotiated Rate |
$1,099.07 |
| Rate for Payer: Aetna of VT Commercial |
$945.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$116.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$158.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$951.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$951.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$130.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$951.96
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$205.04
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,099.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,099.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$681.13
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$160.81
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$113.25
|
| Rate for Payer: United Healthcare Commercial |
$174.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$113.25
|
| Rate for Payer: United Healthcare VA CCN |
$113.25
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
IP
|
$662.79
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
4503255601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$490.53 |
| Max. Negotiated Rate |
$629.65 |
| Rate for Payer: Aetna of VT Commercial |
$629.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$490.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$490.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$563.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$556.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$530.23
|
| Rate for Payer: Cash Price |
$331.40
|
| Rate for Payer: Cigna Commercial |
$530.23
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.23
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.23
|
| Rate for Payer: Multiplan Commercial |
$616.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$563.37
|
| Rate for Payer: United Healthcare Commercial |
$629.65
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9813255602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$113.25 |
| Max. Negotiated Rate |
$1,099.07 |
| Rate for Payer: Aetna of VT Commercial |
$945.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$116.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$158.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$951.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$951.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$130.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$951.96
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$205.04
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,099.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,099.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$681.13
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$160.81
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$113.25
|
| Rate for Payer: United Healthcare Commercial |
$174.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$113.25
|
| Rate for Payer: United Healthcare VA CCN |
$113.25
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9813255602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$744.54 |
| Max. Negotiated Rate |
$955.70 |
| Rate for Payer: Aetna of VT Commercial |
$955.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$744.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$744.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$855.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$845.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$804.80
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$804.80
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$855.10
|
| Rate for Payer: United Healthcare Commercial |
$955.70
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
OP
|
$662.79
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
4503255601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$293.55 |
| Max. Negotiated Rate |
$629.65 |
| Rate for Payer: Aetna of VT Commercial |
$629.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$593.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$293.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$593.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$399.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$563.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$536.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$298.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$526.92
|
| Rate for Payer: Cash Price |
$331.40
|
| Rate for Payer: Cigna Commercial |
$530.23
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.23
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.23
|
| Rate for Payer: Martins Point Health Care Commercial |
$298.26
|
| Rate for Payer: Multiplan Commercial |
$616.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$563.37
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$298.26
|
| Rate for Payer: United Healthcare Commercial |
$629.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$298.26
|
| Rate for Payer: United Healthcare VA CCN |
$298.26
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9813255601
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$744.54 |
| Max. Negotiated Rate |
$955.70 |
| Rate for Payer: Aetna of VT Commercial |
$955.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$744.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$744.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$855.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$845.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$804.80
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$804.80
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$855.10
|
| Rate for Payer: United Healthcare Commercial |
$955.70
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9813255602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$445.56 |
| Max. Negotiated Rate |
$955.70 |
| Rate for Payer: Aetna of VT Commercial |
$955.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$445.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$605.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$855.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$814.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$452.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$799.77
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$804.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$452.70
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$855.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$452.70
|
| Rate for Payer: United Healthcare Commercial |
$955.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$452.70
|
| Rate for Payer: United Healthcare VA CCN |
$452.70
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9813255601
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$445.56 |
| Max. Negotiated Rate |
$955.70 |
| Rate for Payer: Aetna of VT Commercial |
$955.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$445.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$605.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$855.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$814.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$452.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$799.77
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$804.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$452.70
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$855.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$452.70
|
| Rate for Payer: United Healthcare Commercial |
$955.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$452.70
|
| Rate for Payer: United Healthcare VA CCN |
$452.70
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9823255601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$445.56 |
| Max. Negotiated Rate |
$955.70 |
| Rate for Payer: Aetna of VT Commercial |
$955.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$445.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$605.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$855.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$814.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$452.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$799.77
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$804.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$452.70
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$855.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$452.70
|
| Rate for Payer: United Healthcare Commercial |
$955.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$452.70
|
| Rate for Payer: United Healthcare VA CCN |
$452.70
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9823255601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$744.54 |
| Max. Negotiated Rate |
$955.70 |
| Rate for Payer: Aetna of VT Commercial |
$955.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$744.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$744.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$855.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$845.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$804.80
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$804.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$804.80
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$855.10
|
| Rate for Payer: United Healthcare Commercial |
$955.70
|
|
|
INSERT CATH PLEURA W/O IMAGE
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
9813255601
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$113.25 |
| Max. Negotiated Rate |
$1,099.07 |
| Rate for Payer: Aetna of VT Commercial |
$945.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$116.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$901.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$158.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$951.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$951.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$130.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$951.96
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cash Price |
$503.00
|
| Rate for Payer: Cigna Commercial |
$205.04
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,099.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,099.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$681.13
|
| Rate for Payer: Multiplan Commercial |
$935.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$160.81
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$113.25
|
| Rate for Payer: United Healthcare Commercial |
$174.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$113.25
|
| Rate for Payer: United Healthcare VA CCN |
$113.25
|
|
|
INSERT CERVICAL DILATOR
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9605920001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$43.18 |
| Max. Negotiated Rate |
$843.18 |
| Rate for Payer: Aetna of VT Commercial |
$843.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$803.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$61.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$803.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$83.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$68.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$129.77
|
| Rate for Payer: Cash Price |
$448.50
|
| Rate for Payer: Cash Price |
$448.50
|
| Rate for Payer: Cigna Commercial |
$43.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$122.73
|
| Rate for Payer: Multiplan Commercial |
$834.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare Commercial |
$91.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare VA CCN |
$59.78
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$157.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9605920002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$116.20 |
| Max. Negotiated Rate |
$149.15 |
| Rate for Payer: Aetna of VT Commercial |
$149.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$116.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$116.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$133.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$131.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$125.60
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cigna Commercial |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$125.60
|
| Rate for Payer: Multiplan Commercial |
$146.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$133.45
|
| Rate for Payer: United Healthcare Commercial |
$149.15
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$897.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9605920001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$663.87 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna of VT Commercial |
$852.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$663.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$663.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$762.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$753.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$717.60
|
| Rate for Payer: Cash Price |
$448.50
|
| Rate for Payer: Cigna Commercial |
$717.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$717.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$717.60
|
| Rate for Payer: Multiplan Commercial |
$834.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$762.45
|
| Rate for Payer: United Healthcare Commercial |
$852.15
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$157.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9605920002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$69.54 |
| Max. Negotiated Rate |
$149.15 |
| Rate for Payer: Aetna of VT Commercial |
$149.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$69.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$94.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$133.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$127.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$70.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$124.81
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cigna Commercial |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$125.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$70.65
|
| Rate for Payer: Multiplan Commercial |
$146.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$133.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$70.65
|
| Rate for Payer: United Healthcare Commercial |
$149.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$70.65
|
| Rate for Payer: United Healthcare VA CCN |
$70.65
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$897.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9605920001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$397.28 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna of VT Commercial |
$852.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$803.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$397.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$803.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$539.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$762.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$726.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$403.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$713.12
|
| Rate for Payer: Cash Price |
$448.50
|
| Rate for Payer: Cigna Commercial |
$717.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$717.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$717.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$403.65
|
| Rate for Payer: Multiplan Commercial |
$834.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$762.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$403.65
|
| Rate for Payer: United Healthcare Commercial |
$852.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$403.65
|
| Rate for Payer: United Healthcare VA CCN |
$403.65
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$157.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9825920001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$116.20 |
| Max. Negotiated Rate |
$149.15 |
| Rate for Payer: Aetna of VT Commercial |
$149.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$116.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$116.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$133.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$131.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$125.60
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cigna Commercial |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$125.60
|
| Rate for Payer: Multiplan Commercial |
$146.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$133.45
|
| Rate for Payer: United Healthcare Commercial |
$149.15
|
|
|
INSERT CERVICAL DILATOR
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9605920002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$43.18 |
| Max. Negotiated Rate |
$204.69 |
| Rate for Payer: Aetna of VT Commercial |
$147.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$61.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$83.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$68.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$129.77
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cigna Commercial |
$43.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$122.73
|
| Rate for Payer: Multiplan Commercial |
$146.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare Commercial |
$91.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare VA CCN |
$59.78
|
|
|
INSERT CERVICAL DILATOR
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
5105920001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.18 |
| Max. Negotiated Rate |
$696.54 |
| Rate for Payer: Aetna of VT Commercial |
$696.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$663.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$61.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$663.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$83.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$68.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$129.77
|
| Rate for Payer: Cash Price |
$370.50
|
| Rate for Payer: Cash Price |
$370.50
|
| Rate for Payer: Cigna Commercial |
$43.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$122.73
|
| Rate for Payer: Multiplan Commercial |
$689.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare Commercial |
$91.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare VA CCN |
$59.78
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$157.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9825920001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$69.54 |
| Max. Negotiated Rate |
$149.15 |
| Rate for Payer: Aetna of VT Commercial |
$149.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$69.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$94.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$133.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$127.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$70.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$124.81
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cigna Commercial |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$125.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$125.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$70.65
|
| Rate for Payer: Multiplan Commercial |
$146.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$133.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$70.65
|
| Rate for Payer: United Healthcare Commercial |
$149.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$70.65
|
| Rate for Payer: United Healthcare VA CCN |
$70.65
|
|
|
INSERT CERVICAL DILATOR
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
9825920001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$43.18 |
| Max. Negotiated Rate |
$204.69 |
| Rate for Payer: Aetna of VT Commercial |
$147.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$61.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$83.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$129.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$68.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$129.77
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cigna Commercial |
$43.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$122.73
|
| Rate for Payer: Multiplan Commercial |
$146.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare Commercial |
$91.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59.78
|
| Rate for Payer: United Healthcare VA CCN |
$59.78
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$741.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
5105920001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$328.19 |
| Max. Negotiated Rate |
$703.95 |
| Rate for Payer: Aetna of VT Commercial |
$703.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$663.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$328.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$663.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$446.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$629.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$600.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$333.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$589.10
|
| Rate for Payer: Cash Price |
$370.50
|
| Rate for Payer: Cigna Commercial |
$592.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$592.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$592.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$333.45
|
| Rate for Payer: Multiplan Commercial |
$689.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$629.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$333.45
|
| Rate for Payer: United Healthcare Commercial |
$703.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$333.45
|
| Rate for Payer: United Healthcare VA CCN |
$333.45
|
|
|
INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$741.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
5105920001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$548.41 |
| Max. Negotiated Rate |
$703.95 |
| Rate for Payer: Aetna of VT Commercial |
$703.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$548.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$548.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$629.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$622.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$592.80
|
| Rate for Payer: Cash Price |
$370.50
|
| Rate for Payer: Cigna Commercial |
$592.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$592.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$592.80
|
| Rate for Payer: Multiplan Commercial |
$689.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$629.85
|
| Rate for Payer: United Healthcare Commercial |
$703.95
|
|
|
INSERT ELECTRD/PM CATH SNGL
|
Facility
|
OP
|
$575.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
9813321002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$254.67 |
| Max. Negotiated Rate |
$546.25 |
| Rate for Payer: Aetna of VT Commercial |
$546.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$515.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$254.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$515.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$346.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$488.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$465.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$258.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$457.12
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cigna Commercial |
$460.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$460.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$460.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$258.75
|
| Rate for Payer: Multiplan Commercial |
$534.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$488.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$258.75
|
| Rate for Payer: United Healthcare Commercial |
$546.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$258.75
|
| Rate for Payer: United Healthcare VA CCN |
$258.75
|
|
|
INSERT ELECTRD/PM CATH SNGL
|
Facility
|
IP
|
$575.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
9823321001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$425.56 |
| Max. Negotiated Rate |
$546.25 |
| Rate for Payer: Aetna of VT Commercial |
$546.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$425.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$425.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$488.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$483.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$460.00
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cigna Commercial |
$460.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$460.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$534.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$488.75
|
| Rate for Payer: United Healthcare Commercial |
$546.25
|
|
