|
ASSAY NEPHELOMETRY NOT SPEC
|
Facility
|
OP
|
$223.34
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
3008388301
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$212.17 |
| Rate for Payer: Aetna of VT Commercial |
$212.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$67.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$98.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$67.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$134.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$180.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$100.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$177.56
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cigna Commercial |
$178.67
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$178.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$178.67
|
| Rate for Payer: Martins Point Health Care Commercial |
$100.50
|
| Rate for Payer: Multiplan Commercial |
$207.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$189.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$100.50
|
| Rate for Payer: United Healthcare Commercial |
$212.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.60
|
| Rate for Payer: United Healthcare VA CCN |
$100.50
|
|
|
ASSAY NEPHELOMETRY NOT SPEC
|
Professional
|
Both
|
$223.34
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
3008388301
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.41 |
| Max. Negotiated Rate |
$209.94 |
| Rate for Payer: Aetna of VT Commercial |
$209.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$67.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$67.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$19.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$23.24
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cigna Commercial |
$16.66
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$13.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$13.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$13.41
|
| Rate for Payer: Multiplan Commercial |
$207.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$13.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$13.60
|
| Rate for Payer: United Healthcare Commercial |
$20.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.60
|
| Rate for Payer: United Healthcare VA CCN |
$13.60
|
|
|
ASSAY OF 5-HIAA
|
Facility
|
OP
|
$97.20
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
3008349701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.90 |
| Max. Negotiated Rate |
$92.34 |
| Rate for Payer: Aetna of VT Commercial |
$92.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$63.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$43.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$63.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$58.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$82.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$78.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$43.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$77.27
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cigna Commercial |
$77.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$77.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$77.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$43.74
|
| Rate for Payer: Multiplan Commercial |
$90.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$82.62
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$43.74
|
| Rate for Payer: United Healthcare Commercial |
$92.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.90
|
| Rate for Payer: United Healthcare VA CCN |
$43.74
|
|
|
ASSAY OF 5-HIAA
|
Professional
|
Both
|
$97.20
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
3008349701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.72 |
| Max. Negotiated Rate |
$91.37 |
| Rate for Payer: Aetna of VT Commercial |
$91.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$63.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$13.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$63.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$18.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$22.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$22.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$14.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$22.06
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cigna Commercial |
$15.47
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$12.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$12.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$12.72
|
| Rate for Payer: Multiplan Commercial |
$90.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$12.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$12.90
|
| Rate for Payer: United Healthcare Commercial |
$19.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.90
|
| Rate for Payer: United Healthcare VA CCN |
$12.90
|
|
|
ASSAY OF 5-HIAA
|
Facility
|
IP
|
$97.20
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
3008349701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$71.94 |
| Max. Negotiated Rate |
$92.34 |
| Rate for Payer: Aetna of VT Commercial |
$92.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$71.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$71.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$82.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$81.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$77.76
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cigna Commercial |
$77.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$77.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$77.76
|
| Rate for Payer: Multiplan Commercial |
$90.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$82.62
|
| Rate for Payer: United Healthcare Commercial |
$92.34
|
|
|
ASSAY OF ALDOLASE
|
Facility
|
OP
|
$141.66
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
3008208501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$134.58 |
| Rate for Payer: Aetna of VT Commercial |
$134.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$47.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$62.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$47.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$85.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$120.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$114.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$112.62
|
| Rate for Payer: Cash Price |
$70.83
|
| Rate for Payer: Cash Price |
$70.83
|
| Rate for Payer: Cigna Commercial |
$113.33
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$113.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$113.33
|
| Rate for Payer: Martins Point Health Care Commercial |
$63.75
|
| Rate for Payer: Multiplan Commercial |
$131.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.41
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$63.75
|
| Rate for Payer: United Healthcare Commercial |
$134.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.71
|
| Rate for Payer: United Healthcare VA CCN |
$63.75
|
|
|
ASSAY OF ALDOLASE
|
Facility
|
IP
|
$141.66
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
3008208501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$104.84 |
| Max. Negotiated Rate |
$134.58 |
| Rate for Payer: Aetna of VT Commercial |
$134.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$104.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$104.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$120.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$118.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$113.33
|
| Rate for Payer: Cash Price |
$70.83
|
| Rate for Payer: Cigna Commercial |
$113.33
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$113.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$113.33
|
| Rate for Payer: Multiplan Commercial |
$131.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.41
|
| Rate for Payer: United Healthcare Commercial |
$134.58
|
|
|
ASSAY OF ALDOLASE
|
Professional
|
Both
|
$141.66
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
3008208501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.57 |
| Max. Negotiated Rate |
$133.16 |
| Rate for Payer: Aetna of VT Commercial |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$47.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$47.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$13.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$16.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$16.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$16.59
|
| Rate for Payer: Cash Price |
$70.83
|
| Rate for Payer: Cash Price |
$70.83
|
| Rate for Payer: Cigna Commercial |
$11.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$9.71
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$9.71
|
| Rate for Payer: Martins Point Health Care Commercial |
$9.57
|
| Rate for Payer: Multiplan Commercial |
$131.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.71
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$9.71
|
| Rate for Payer: United Healthcare Commercial |
$14.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.71
|
| Rate for Payer: United Healthcare VA CCN |
$9.71
|
|
|
ASSAY OF ALDOSTERONE
|
Professional
|
Both
|
$437.38
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
3008208801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.18 |
| Max. Negotiated Rate |
$411.14 |
| Rate for Payer: Aetna of VT Commercial |
$411.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$200.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$41.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$200.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$57.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$69.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$69.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$46.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$69.65
|
| Rate for Payer: Cash Price |
$218.69
|
| Rate for Payer: Cash Price |
$218.69
|
| Rate for Payer: Cigna Commercial |
$49.19
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$40.75
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$40.75
|
| Rate for Payer: Martins Point Health Care Commercial |
$40.18
|
| Rate for Payer: Multiplan Commercial |
$406.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$40.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$40.75
|
| Rate for Payer: United Healthcare Commercial |
$62.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.75
|
| Rate for Payer: United Healthcare VA CCN |
$40.75
|
|
|
ASSAY OF ALDOSTERONE
|
Facility
|
IP
|
$437.38
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
3008208801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$323.70 |
| Max. Negotiated Rate |
$415.51 |
| Rate for Payer: Aetna of VT Commercial |
$415.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$323.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$323.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$371.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$367.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$349.90
|
| Rate for Payer: Cash Price |
$218.69
|
| Rate for Payer: Cigna Commercial |
$349.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$349.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$349.90
|
| Rate for Payer: Multiplan Commercial |
$406.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$371.77
|
| Rate for Payer: United Healthcare Commercial |
$415.51
|
|
|
ASSAY OF ALDOSTERONE
|
Facility
|
OP
|
$437.38
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
3008208801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.75 |
| Max. Negotiated Rate |
$415.51 |
| Rate for Payer: Aetna of VT Commercial |
$415.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$200.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$193.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$200.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$263.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$371.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$354.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$196.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$347.72
|
| Rate for Payer: Cash Price |
$218.69
|
| Rate for Payer: Cash Price |
$218.69
|
| Rate for Payer: Cigna Commercial |
$349.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$349.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$349.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$196.82
|
| Rate for Payer: Multiplan Commercial |
$406.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$371.77
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$196.82
|
| Rate for Payer: United Healthcare Commercial |
$415.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.75
|
| Rate for Payer: United Healthcare VA CCN |
$196.82
|
|
|
ASSAY OF ALUMINUM
|
Facility
|
IP
|
$159.24
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
3008210801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$117.85 |
| Max. Negotiated Rate |
$151.28 |
| Rate for Payer: Aetna of VT Commercial |
$151.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$117.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$117.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$135.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$133.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$127.39
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cigna Commercial |
$127.39
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$127.39
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$127.39
|
| Rate for Payer: Multiplan Commercial |
$148.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$135.35
|
| Rate for Payer: United Healthcare Commercial |
$151.28
|
|
|
ASSAY OF ALUMINUM
|
Professional
|
Both
|
$159.24
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
3008210801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.12 |
| Max. Negotiated Rate |
$149.69 |
| Rate for Payer: Aetna of VT Commercial |
$149.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$125.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$26.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$125.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$35.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$29.30
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cigna Commercial |
$30.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$25.48
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$25.48
|
| Rate for Payer: Martins Point Health Care Commercial |
$25.12
|
| Rate for Payer: Multiplan Commercial |
$148.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.48
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$25.48
|
| Rate for Payer: United Healthcare Commercial |
$39.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.48
|
| Rate for Payer: United Healthcare VA CCN |
$25.48
|
|
|
ASSAY OF ALUMINUM
|
Facility
|
OP
|
$159.24
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
3008210801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$151.28 |
| Rate for Payer: Aetna of VT Commercial |
$151.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$125.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$70.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$125.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$95.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$135.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$128.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$71.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$126.60
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cigna Commercial |
$127.39
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$127.39
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$127.39
|
| Rate for Payer: Martins Point Health Care Commercial |
$71.66
|
| Rate for Payer: Multiplan Commercial |
$148.09
|
| Rate for Payer: MVP Health Care of NY Commercial |
$135.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$71.66
|
| Rate for Payer: United Healthcare Commercial |
$151.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.48
|
| Rate for Payer: United Healthcare VA CCN |
$71.66
|
|
|
ASSAY OF AMMONIA
|
Facility
|
OP
|
$231.36
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
3008214001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$219.79 |
| Rate for Payer: Aetna of VT Commercial |
$219.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$71.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$102.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$71.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$139.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$196.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$187.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$104.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$183.93
|
| Rate for Payer: Cash Price |
$115.68
|
| Rate for Payer: Cash Price |
$115.68
|
| Rate for Payer: Cigna Commercial |
$185.09
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$185.09
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$185.09
|
| Rate for Payer: Martins Point Health Care Commercial |
$104.11
|
| Rate for Payer: Multiplan Commercial |
$215.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.66
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$104.11
|
| Rate for Payer: United Healthcare Commercial |
$219.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.57
|
| Rate for Payer: United Healthcare VA CCN |
$104.11
|
|
|
ASSAY OF AMMONIA
|
Facility
|
IP
|
$231.36
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
3008214001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$219.79 |
| Rate for Payer: Aetna of VT Commercial |
$219.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$171.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$171.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$196.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$194.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$185.09
|
| Rate for Payer: Cash Price |
$115.68
|
| Rate for Payer: Cigna Commercial |
$185.09
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$185.09
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$185.09
|
| Rate for Payer: Multiplan Commercial |
$215.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.66
|
| Rate for Payer: United Healthcare Commercial |
$219.79
|
|
|
ASSAY OF AMYLASE
|
Facility
|
OP
|
$99.50
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3008215001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna of VT Commercial |
$94.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$31.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$44.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$31.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$59.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$84.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$80.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$44.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.10
|
| Rate for Payer: Cash Price |
$49.75
|
| Rate for Payer: Cash Price |
$49.75
|
| Rate for Payer: Cigna Commercial |
$79.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$44.77
|
| Rate for Payer: Multiplan Commercial |
$92.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$44.77
|
| Rate for Payer: United Healthcare Commercial |
$94.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.48
|
| Rate for Payer: United Healthcare VA CCN |
$44.77
|
|
|
ASSAY OF AMYLASE
|
Facility
|
IP
|
$99.50
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3008215001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.64 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna of VT Commercial |
$94.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$84.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$83.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.60
|
| Rate for Payer: Cash Price |
$49.75
|
| Rate for Payer: Cigna Commercial |
$79.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.60
|
| Rate for Payer: Multiplan Commercial |
$92.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.58
|
| Rate for Payer: United Healthcare Commercial |
$94.53
|
|
|
ASSAY OF ANDROSTENEDIONE
|
Facility
|
OP
|
$314.34
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
3008215701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.28 |
| Max. Negotiated Rate |
$298.62 |
| Rate for Payer: Aetna of VT Commercial |
$298.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$144.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$139.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$144.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$189.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$267.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$254.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$141.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$249.90
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Cigna Commercial |
$251.47
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$251.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$251.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$141.45
|
| Rate for Payer: Multiplan Commercial |
$292.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$267.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$141.45
|
| Rate for Payer: United Healthcare Commercial |
$298.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.28
|
| Rate for Payer: United Healthcare VA CCN |
$141.45
|
|
|
ASSAY OF ANDROSTENEDIONE
|
Facility
|
IP
|
$314.34
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
3008215701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$232.64 |
| Max. Negotiated Rate |
$298.62 |
| Rate for Payer: Aetna of VT Commercial |
$298.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$232.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$232.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$267.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$264.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$251.47
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Cigna Commercial |
$251.47
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$251.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$251.47
|
| Rate for Payer: Multiplan Commercial |
$292.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$267.19
|
| Rate for Payer: United Healthcare Commercial |
$298.62
|
|
|
ASSAY OF ANDROSTENEDIONE
|
Professional
|
Both
|
$314.34
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
3008215701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.87 |
| Max. Negotiated Rate |
$295.48 |
| Rate for Payer: Aetna of VT Commercial |
$295.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$144.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$30.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$144.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$50.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$50.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$33.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$50.05
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Cigna Commercial |
$35.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$29.28
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$29.28
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.87
|
| Rate for Payer: Multiplan Commercial |
$292.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$29.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$29.28
|
| Rate for Payer: United Healthcare Commercial |
$45.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.28
|
| Rate for Payer: United Healthcare VA CCN |
$29.28
|
|
|
ASSAY OF ARSENIC
|
Facility
|
IP
|
$202.66
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3008217501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$149.99 |
| Max. Negotiated Rate |
$192.53 |
| Rate for Payer: Aetna of VT Commercial |
$192.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$149.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$149.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$170.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$162.13
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cigna Commercial |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$162.13
|
| Rate for Payer: Multiplan Commercial |
$188.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$172.26
|
| Rate for Payer: United Healthcare Commercial |
$192.53
|
|
|
ASSAY OF ARSENIC
|
Professional
|
Both
|
$202.66
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3008217501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$190.50 |
| Rate for Payer: Aetna of VT Commercial |
$190.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$93.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$19.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$93.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$26.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$21.82
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cigna Commercial |
$23.01
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$18.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$18.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.70
|
| Rate for Payer: Multiplan Commercial |
$188.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$18.97
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare Commercial |
$29.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare VA CCN |
$18.97
|
|
|
ASSAY OF ARSENIC
|
Facility
|
OP
|
$202.66
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3008217501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.97 |
| Max. Negotiated Rate |
$192.53 |
| Rate for Payer: Aetna of VT Commercial |
$192.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$93.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$93.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$122.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$164.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$91.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$161.11
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cigna Commercial |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$162.13
|
| Rate for Payer: Martins Point Health Care Commercial |
$91.20
|
| Rate for Payer: Multiplan Commercial |
$188.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$172.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.20
|
| Rate for Payer: United Healthcare Commercial |
$192.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare VA CCN |
$91.20
|
|
|
ASSAY OF ASCORBIC ACID
|
Professional
|
Both
|
$220.17
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
3008218001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$206.96 |
| Rate for Payer: Aetna of VT Commercial |
$206.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$48.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$48.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$13.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$16.91
|
| Rate for Payer: Cash Price |
$110.08
|
| Rate for Payer: Cash Price |
$110.08
|
| Rate for Payer: Cigna Commercial |
$11.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$9.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$9.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$9.75
|
| Rate for Payer: Multiplan Commercial |
$204.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$9.89
|
| Rate for Payer: United Healthcare Commercial |
$15.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.89
|
| Rate for Payer: United Healthcare VA CCN |
$9.89
|
|
