|
ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$1,840.52
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
4504908301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$815.17 |
| Max. Negotiated Rate |
$1,748.49 |
| Rate for Payer: Aetna of VT Commercial |
$1,748.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,648.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$815.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,648.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,107.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,564.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,490.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$828.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,463.21
|
| Rate for Payer: Cash Price |
$920.26
|
| Rate for Payer: Cigna Commercial |
$1,472.42
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,472.42
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,472.42
|
| Rate for Payer: Martins Point Health Care Commercial |
$828.23
|
| Rate for Payer: Multiplan Commercial |
$1,711.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,564.44
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$828.23
|
| Rate for Payer: United Healthcare Commercial |
$1,748.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$828.23
|
| Rate for Payer: United Healthcare VA CCN |
$828.23
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9824908301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$339.71 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$385.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$367.20
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$1,841.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
5104908301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,362.52 |
| Max. Negotiated Rate |
$1,748.95 |
| Rate for Payer: Aetna of VT Commercial |
$1,748.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,362.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,362.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,564.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,546.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,472.80
|
| Rate for Payer: Cash Price |
$920.50
|
| Rate for Payer: Cigna Commercial |
$1,472.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,472.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,472.80
|
| Rate for Payer: Multiplan Commercial |
$1,712.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,564.85
|
| Rate for Payer: United Healthcare Commercial |
$1,748.95
|
|
|
ABD PARACENTESIS W/IMAGING
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9604908301
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$2,161.06 |
| Rate for Payer: Aetna of VT Commercial |
$2,161.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,059.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,059.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$137.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$113.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$1,149.50
|
| Rate for Payer: Cash Price |
$1,149.50
|
| Rate for Payer: Cigna Commercial |
$179.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$440.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$440.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$272.65
|
| Rate for Payer: Multiplan Commercial |
$2,138.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$139.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare Commercial |
$151.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare VA CCN |
$98.56
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9604908302
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$339.71 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$385.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$367.20
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9604908302
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$203.29 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$203.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$276.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$371.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$206.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$364.90
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$206.55
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare VA CCN |
$206.55
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9814908302
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$203.29 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$203.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$276.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$371.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$206.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$364.90
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$206.55
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare VA CCN |
$206.55
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9824908301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$203.29 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$203.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$276.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$371.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$206.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$364.90
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$206.55
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare VA CCN |
$206.55
|
|
|
ABD PARACENTESIS W/IMAGING
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9824908301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$454.64 |
| Rate for Payer: Aetna of VT Commercial |
$431.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$137.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$113.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$179.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$440.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$440.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$272.65
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$139.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare Commercial |
$151.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare VA CCN |
$98.56
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$2,299.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9604908301
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,701.49 |
| Max. Negotiated Rate |
$2,184.05 |
| Rate for Payer: Aetna of VT Commercial |
$2,184.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,701.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,701.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,954.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,931.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,839.20
|
| Rate for Payer: Cash Price |
$1,149.50
|
| Rate for Payer: Cigna Commercial |
$1,839.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,839.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,839.20
|
| Rate for Payer: Multiplan Commercial |
$2,138.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,954.15
|
| Rate for Payer: United Healthcare Commercial |
$2,184.05
|
|
|
ABD PARACENTESIS W/IMAGING
|
Professional
|
Both
|
$1,841.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
5104908301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$1,730.54 |
| Rate for Payer: Aetna of VT Commercial |
$1,730.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,649.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,649.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$137.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$113.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$920.50
|
| Rate for Payer: Cash Price |
$920.50
|
| Rate for Payer: Cigna Commercial |
$179.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$440.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$440.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$272.65
|
| Rate for Payer: Multiplan Commercial |
$1,712.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$139.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare Commercial |
$151.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare VA CCN |
$98.56
|
|
|
ABD PARACENTESIS W/IMAGING
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9814908301
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$454.64 |
| Rate for Payer: Aetna of VT Commercial |
$431.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$137.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$113.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$179.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$440.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$440.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$272.65
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$139.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare Commercial |
$151.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare VA CCN |
$98.56
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$1,841.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
5104908301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$815.38 |
| Max. Negotiated Rate |
$1,748.95 |
| Rate for Payer: Aetna of VT Commercial |
$1,748.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,649.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$815.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,649.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,108.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,564.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,491.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$828.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,463.60
|
| Rate for Payer: Cash Price |
$920.50
|
| Rate for Payer: Cigna Commercial |
$1,472.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,472.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,472.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$828.45
|
| Rate for Payer: Multiplan Commercial |
$1,712.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,564.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$828.45
|
| Rate for Payer: United Healthcare Commercial |
$1,748.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$828.45
|
| Rate for Payer: United Healthcare VA CCN |
$828.45
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9814908301
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$203.29 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$203.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$276.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$371.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$206.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$364.90
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$206.55
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$206.55
|
| Rate for Payer: United Healthcare VA CCN |
$206.55
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9814908302
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$339.71 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$385.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$367.20
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
|
|
ABD PARACENTESIS W/IMAGING
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9814908302
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$454.64 |
| Rate for Payer: Aetna of VT Commercial |
$431.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$137.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$113.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$179.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$440.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$440.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$272.65
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$139.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare Commercial |
$151.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare VA CCN |
$98.56
|
|
|
ABD PARACENTESIS W/IMAGING
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9604908302
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$454.64 |
| Rate for Payer: Aetna of VT Commercial |
$431.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$411.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$137.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$113.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$179.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$440.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$440.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$272.65
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$139.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare Commercial |
$151.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.56
|
| Rate for Payer: United Healthcare VA CCN |
$98.56
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$2,299.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9604908301
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,018.23 |
| Max. Negotiated Rate |
$2,184.05 |
| Rate for Payer: Aetna of VT Commercial |
$2,184.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,059.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,018.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,059.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,384.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,954.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,862.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,034.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,827.70
|
| Rate for Payer: Cash Price |
$1,149.50
|
| Rate for Payer: Cigna Commercial |
$1,839.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,839.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,839.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,034.55
|
| Rate for Payer: Multiplan Commercial |
$2,138.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,954.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,034.55
|
| Rate for Payer: United Healthcare Commercial |
$2,184.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,034.55
|
| Rate for Payer: United Healthcare VA CCN |
$1,034.55
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$1,840.52
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
4504908301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,362.17 |
| Max. Negotiated Rate |
$1,748.49 |
| Rate for Payer: Aetna of VT Commercial |
$1,748.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,362.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,362.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,564.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,546.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,472.42
|
| Rate for Payer: Cash Price |
$920.26
|
| Rate for Payer: Cigna Commercial |
$1,472.42
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,472.42
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,472.42
|
| Rate for Payer: Multiplan Commercial |
$1,711.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,564.44
|
| Rate for Payer: United Healthcare Commercial |
$1,748.49
|
|
|
ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
9814908301
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$339.71 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna of VT Commercial |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$339.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$385.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$367.20
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$367.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$367.20
|
| Rate for Payer: Multiplan Commercial |
$426.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$390.15
|
| Rate for Payer: United Healthcare Commercial |
$436.05
|
|
|
ABORTION D&C &/EVAC
|
Facility
|
IP
|
$1,970.00
|
|
|
Service Code
|
CPT 59856
|
| Hospital Charge Code |
9695985601
|
|
Hospital Revenue Code
|
969
|
| Min. Negotiated Rate |
$1,458.00 |
| Max. Negotiated Rate |
$1,871.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,871.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,458.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,458.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,674.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,654.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,576.00
|
| Rate for Payer: Cash Price |
$985.00
|
| Rate for Payer: Cigna Commercial |
$1,576.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,576.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,576.00
|
| Rate for Payer: Multiplan Commercial |
$1,832.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,674.50
|
| Rate for Payer: United Healthcare Commercial |
$1,871.50
|
|
|
ABORTION D&C &/EVAC
|
Facility
|
OP
|
$1,970.00
|
|
|
Service Code
|
CPT 59856
|
| Hospital Charge Code |
9695985601
|
|
Hospital Revenue Code
|
969
|
| Min. Negotiated Rate |
$872.51 |
| Max. Negotiated Rate |
$1,871.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,871.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,764.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$872.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,764.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,185.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,674.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,595.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$886.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,566.15
|
| Rate for Payer: Cash Price |
$985.00
|
| Rate for Payer: Cigna Commercial |
$1,576.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,576.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,576.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$886.50
|
| Rate for Payer: Multiplan Commercial |
$1,832.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,674.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$886.50
|
| Rate for Payer: United Healthcare Commercial |
$1,871.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$886.50
|
| Rate for Payer: United Healthcare VA CCN |
$886.50
|
|
|
ABORTION D&C &/EVAC
|
Professional
|
Both
|
$1,970.00
|
|
|
Service Code
|
CPT 59856
|
| Hospital Charge Code |
9695985601
|
|
Hospital Revenue Code
|
969
|
| Min. Negotiated Rate |
$449.55 |
| Max. Negotiated Rate |
$1,851.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,851.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,764.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$463.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,764.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$629.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$781.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$781.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$516.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$781.10
|
| Rate for Payer: Cash Price |
$985.00
|
| Rate for Payer: Cash Price |
$985.00
|
| Rate for Payer: Cigna Commercial |
$493.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$775.05
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$775.05
|
| Rate for Payer: Martins Point Health Care Commercial |
$486.00
|
| Rate for Payer: Multiplan Commercial |
$1,832.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$638.36
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$449.55
|
| Rate for Payer: United Healthcare Commercial |
$691.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$449.55
|
| Rate for Payer: United Healthcare VA CCN |
$449.55
|
|
|
ABORTION DILATION & CURETTAGE
|
Facility
|
IP
|
$783.00
|
|
|
Service Code
|
CPT 59840
|
| Hospital Charge Code |
9825984001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$579.50 |
| Max. Negotiated Rate |
$743.85 |
| Rate for Payer: Aetna of VT Commercial |
$743.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$579.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$579.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$665.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$657.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$626.40
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cigna Commercial |
$626.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$626.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$626.40
|
| Rate for Payer: Multiplan Commercial |
$728.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$665.55
|
| Rate for Payer: United Healthcare Commercial |
$743.85
|
|
|
ABORTION DILATION & CURETTAGE
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
CPT 59840
|
| Hospital Charge Code |
9605984002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$202.06 |
| Max. Negotiated Rate |
$736.02 |
| Rate for Payer: Aetna of VT Commercial |
$736.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$701.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$208.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$701.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$282.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$394.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$394.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$232.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$394.98
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cigna Commercial |
$223.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$386.25
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$386.25
|
| Rate for Payer: Martins Point Health Care Commercial |
$252.99
|
| Rate for Payer: Multiplan Commercial |
$728.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$286.93
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$202.06
|
| Rate for Payer: United Healthcare Commercial |
$310.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$202.06
|
| Rate for Payer: United Healthcare VA CCN |
$202.06
|
|
