|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
5103157501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$65.04 |
| Max. Negotiated Rate |
$313.96 |
| Rate for Payer: Aetna of VT Commercial |
$313.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$299.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$66.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$299.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$91.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$194.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$194.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$74.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$194.28
|
| Rate for Payer: Cash Price |
$167.00
|
| Rate for Payer: Cash Price |
$167.00
|
| Rate for Payer: Cigna Commercial |
$102.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$196.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$196.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.93
|
| Rate for Payer: Multiplan Commercial |
$310.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$92.36
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$65.04
|
| Rate for Payer: United Healthcare Commercial |
$100.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65.04
|
| Rate for Payer: United Healthcare VA CCN |
$65.04
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Facility
|
IP
|
$334.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
5103157501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$247.19 |
| Max. Negotiated Rate |
$317.30 |
| Rate for Payer: Aetna of VT Commercial |
$317.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$247.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$247.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$283.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$280.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$267.20
|
| Rate for Payer: Cash Price |
$167.00
|
| Rate for Payer: Cigna Commercial |
$267.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$267.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$267.20
|
| Rate for Payer: Multiplan Commercial |
$310.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$283.90
|
| Rate for Payer: United Healthcare Commercial |
$317.30
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
9813157502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$65.04 |
| Max. Negotiated Rate |
$297.98 |
| Rate for Payer: Aetna of VT Commercial |
$297.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$284.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$66.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$284.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$91.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$194.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$194.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$74.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$194.28
|
| Rate for Payer: Cash Price |
$158.50
|
| Rate for Payer: Cash Price |
$158.50
|
| Rate for Payer: Cigna Commercial |
$102.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$196.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$196.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.93
|
| Rate for Payer: Multiplan Commercial |
$294.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$92.36
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$65.04
|
| Rate for Payer: United Healthcare Commercial |
$100.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65.04
|
| Rate for Payer: United Healthcare VA CCN |
$65.04
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
9813157501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$234.61 |
| Max. Negotiated Rate |
$301.15 |
| Rate for Payer: Aetna of VT Commercial |
$301.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$234.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$234.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$269.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$266.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$253.60
|
| Rate for Payer: Cash Price |
$158.50
|
| Rate for Payer: Cigna Commercial |
$253.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$253.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$253.60
|
| Rate for Payer: Multiplan Commercial |
$294.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$269.45
|
| Rate for Payer: United Healthcare Commercial |
$301.15
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Facility
|
OP
|
$317.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
9813157502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$140.40 |
| Max. Negotiated Rate |
$301.15 |
| Rate for Payer: Aetna of VT Commercial |
$301.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$284.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$140.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$284.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$190.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$269.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$256.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$142.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$252.01
|
| Rate for Payer: Cash Price |
$158.50
|
| Rate for Payer: Cigna Commercial |
$253.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$253.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$253.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$142.65
|
| Rate for Payer: Multiplan Commercial |
$294.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$269.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$142.65
|
| Rate for Payer: United Healthcare Commercial |
$301.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$142.65
|
| Rate for Payer: United Healthcare VA CCN |
$142.65
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
9603157501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$65.04 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna of VT Commercial |
$611.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$583.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$66.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$583.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$91.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$194.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$194.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$74.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$194.28
|
| Rate for Payer: Cash Price |
$325.50
|
| Rate for Payer: Cash Price |
$325.50
|
| Rate for Payer: Cigna Commercial |
$102.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$196.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$196.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.93
|
| Rate for Payer: Multiplan Commercial |
$605.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$92.36
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$65.04
|
| Rate for Payer: United Healthcare Commercial |
$100.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65.04
|
| Rate for Payer: United Healthcare VA CCN |
$65.04
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Facility
|
IP
|
$651.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
9603157501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$481.81 |
| Max. Negotiated Rate |
$618.45 |
| Rate for Payer: Aetna of VT Commercial |
$618.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$481.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$481.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$553.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$546.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$520.80
|
| Rate for Payer: Cash Price |
$325.50
|
| Rate for Payer: Cigna Commercial |
$520.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$520.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$605.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$553.35
|
| Rate for Payer: United Healthcare Commercial |
$618.45
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Facility
|
OP
|
$333.98
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
4503157501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$147.92 |
| Max. Negotiated Rate |
$317.28 |
| Rate for Payer: Aetna of VT Commercial |
$317.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$299.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$147.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$299.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$201.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$283.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$270.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$150.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$265.51
|
| Rate for Payer: Cash Price |
$166.99
|
| Rate for Payer: Cigna Commercial |
$267.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$267.18
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$267.18
|
| Rate for Payer: Martins Point Health Care Commercial |
$150.29
|
| Rate for Payer: Multiplan Commercial |
$310.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$283.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$150.29
|
| Rate for Payer: United Healthcare Commercial |
$317.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$150.29
|
| Rate for Payer: United Healthcare VA CCN |
$150.29
|
|
|
LARYNGOSCOPY FLEX DIAGNOSTIC
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
9813157502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$234.61 |
| Max. Negotiated Rate |
$301.15 |
| Rate for Payer: Aetna of VT Commercial |
$301.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$234.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$234.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$269.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$266.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$253.60
|
| Rate for Payer: Cash Price |
$158.50
|
| Rate for Payer: Cigna Commercial |
$253.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$253.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$253.60
|
| Rate for Payer: Multiplan Commercial |
$294.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$269.45
|
| Rate for Payer: United Healthcare Commercial |
$301.15
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
IP
|
$1,320.70
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
4503151501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$977.45 |
| Max. Negotiated Rate |
$1,254.66 |
| Rate for Payer: Aetna of VT Commercial |
$1,254.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$977.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$977.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,122.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,109.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,056.56
|
| Rate for Payer: Cash Price |
$660.35
|
| Rate for Payer: Cigna Commercial |
$1,056.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,056.56
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,056.56
|
| Rate for Payer: Multiplan Commercial |
$1,228.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,122.60
|
| Rate for Payer: United Healthcare Commercial |
$1,254.66
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
OP
|
$1,320.70
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
4503151501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$584.94 |
| Max. Negotiated Rate |
$1,254.66 |
| Rate for Payer: Aetna of VT Commercial |
$1,254.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,183.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$584.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,183.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$795.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,122.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,069.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$594.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,049.96
|
| Rate for Payer: Cash Price |
$660.35
|
| Rate for Payer: Cigna Commercial |
$1,056.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,056.56
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,056.56
|
| Rate for Payer: Martins Point Health Care Commercial |
$594.32
|
| Rate for Payer: Multiplan Commercial |
$1,228.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,122.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$594.32
|
| Rate for Payer: United Healthcare Commercial |
$1,254.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$594.32
|
| Rate for Payer: United Healthcare VA CCN |
$594.32
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9813151502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$103.86 |
| Max. Negotiated Rate |
$542.38 |
| Rate for Payer: Aetna of VT Commercial |
$542.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$106.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$145.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$278.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$278.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$278.15
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$165.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$330.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$330.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$202.79
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$147.48
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.86
|
| Rate for Payer: United Healthcare Commercial |
$159.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.86
|
| Rate for Payer: United Healthcare VA CCN |
$103.86
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
IP
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9823151501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$427.04 |
| Max. Negotiated Rate |
$548.15 |
| Rate for Payer: Aetna of VT Commercial |
$548.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$427.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$427.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$490.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$484.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$461.60
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$461.60
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.45
|
| Rate for Payer: United Healthcare Commercial |
$548.15
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
OP
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9813151502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$255.55 |
| Max. Negotiated Rate |
$548.15 |
| Rate for Payer: Aetna of VT Commercial |
$548.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$255.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$347.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$490.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$467.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$259.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$458.71
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$461.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.65
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.65
|
| Rate for Payer: United Healthcare Commercial |
$548.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.65
|
| Rate for Payer: United Healthcare VA CCN |
$259.65
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9813151501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$103.86 |
| Max. Negotiated Rate |
$542.38 |
| Rate for Payer: Aetna of VT Commercial |
$542.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$106.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$145.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$278.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$278.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$278.15
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$165.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$330.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$330.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$202.79
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$147.48
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.86
|
| Rate for Payer: United Healthcare Commercial |
$159.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.86
|
| Rate for Payer: United Healthcare VA CCN |
$103.86
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
OP
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9813151501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$255.55 |
| Max. Negotiated Rate |
$548.15 |
| Rate for Payer: Aetna of VT Commercial |
$548.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$255.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$347.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$490.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$467.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$259.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$458.71
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$461.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.65
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.65
|
| Rate for Payer: United Healthcare Commercial |
$548.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.65
|
| Rate for Payer: United Healthcare VA CCN |
$259.65
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
IP
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9813151502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$427.04 |
| Max. Negotiated Rate |
$548.15 |
| Rate for Payer: Aetna of VT Commercial |
$548.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$427.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$427.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$490.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$484.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$461.60
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$461.60
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.45
|
| Rate for Payer: United Healthcare Commercial |
$548.15
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
IP
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9813151501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$427.04 |
| Max. Negotiated Rate |
$548.15 |
| Rate for Payer: Aetna of VT Commercial |
$548.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$427.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$427.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$490.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$484.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$461.60
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$461.60
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.45
|
| Rate for Payer: United Healthcare Commercial |
$548.15
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
OP
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9823151501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$255.55 |
| Max. Negotiated Rate |
$548.15 |
| Rate for Payer: Aetna of VT Commercial |
$548.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$255.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$347.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$490.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$467.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$259.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$458.71
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$461.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$461.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.65
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.65
|
| Rate for Payer: United Healthcare Commercial |
$548.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.65
|
| Rate for Payer: United Healthcare VA CCN |
$259.65
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
9823151501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$103.86 |
| Max. Negotiated Rate |
$542.38 |
| Rate for Payer: Aetna of VT Commercial |
$542.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$106.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$516.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$145.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$278.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$278.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$278.15
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cash Price |
$288.50
|
| Rate for Payer: Cigna Commercial |
$165.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$330.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$330.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$202.79
|
| Rate for Payer: Multiplan Commercial |
$536.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$147.48
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.86
|
| Rate for Payer: United Healthcare Commercial |
$159.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.86
|
| Rate for Payer: United Healthcare VA CCN |
$103.86
|
|
|
LARYNGOSCOPY W/BIOPSY
|
Facility
|
OP
|
$723.00
|
|
|
Service Code
|
CPT 31535
|
| Hospital Charge Code |
9823153501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$320.22 |
| Max. Negotiated Rate |
$686.85 |
| Rate for Payer: Aetna of VT Commercial |
$686.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$647.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$320.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$647.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$435.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$614.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$585.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$325.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$574.78
|
| Rate for Payer: Cash Price |
$361.50
|
| Rate for Payer: Cigna Commercial |
$578.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$578.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$578.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$325.35
|
| Rate for Payer: Multiplan Commercial |
$672.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$614.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$325.35
|
| Rate for Payer: United Healthcare Commercial |
$686.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$325.35
|
| Rate for Payer: United Healthcare VA CCN |
$325.35
|
|
|
LARYNGOSCOPY W/BIOPSY
|
Facility
|
IP
|
$723.00
|
|
|
Service Code
|
CPT 31535
|
| Hospital Charge Code |
9823153501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$535.09 |
| Max. Negotiated Rate |
$686.85 |
| Rate for Payer: Aetna of VT Commercial |
$686.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$535.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$535.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$614.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$607.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$578.40
|
| Rate for Payer: Cash Price |
$361.50
|
| Rate for Payer: Cigna Commercial |
$578.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$578.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$578.40
|
| Rate for Payer: Multiplan Commercial |
$672.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$614.55
|
| Rate for Payer: United Healthcare Commercial |
$686.85
|
|
|
LARYNGOSCOPY W/BIOPSY
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
CPT 31535
|
| Hospital Charge Code |
9823153501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$176.10 |
| Max. Negotiated Rate |
$679.62 |
| Rate for Payer: Aetna of VT Commercial |
$679.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$647.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$181.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$647.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$246.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$361.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$361.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$202.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$361.81
|
| Rate for Payer: Cash Price |
$361.50
|
| Rate for Payer: Cash Price |
$361.50
|
| Rate for Payer: Cigna Commercial |
$279.19
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$292.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$292.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$176.10
|
| Rate for Payer: Multiplan Commercial |
$672.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$250.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$176.10
|
| Rate for Payer: United Healthcare Commercial |
$270.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$176.10
|
| Rate for Payer: United Healthcare VA CCN |
$176.10
|
|
|
LASER FIBER #10493
|
Facility
|
IP
|
$414.00
|
|
| Hospital Charge Code |
2720074481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$306.40 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Aetna of VT Commercial |
$393.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$306.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$306.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$351.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$347.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$331.20
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cigna Commercial |
$331.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.20
|
| Rate for Payer: Multiplan Commercial |
$385.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$351.90
|
| Rate for Payer: United Healthcare Commercial |
$393.30
|
|
|
LASER FIBER #10493
|
Facility
|
OP
|
$414.00
|
|
| Hospital Charge Code |
2720074481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$183.36 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Aetna of VT Commercial |
$393.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$370.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$183.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$370.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$249.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$351.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$335.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$329.13
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cigna Commercial |
$331.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$186.30
|
| Rate for Payer: Multiplan Commercial |
$385.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$351.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$186.30
|
| Rate for Payer: United Healthcare Commercial |
$393.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$186.30
|
| Rate for Payer: United Healthcare VA CCN |
$186.30
|
|
