|
ASSAY OF ASCORBIC ACID
|
Facility
|
IP
|
$220.17
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
3008218001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$209.16 |
| Rate for Payer: Aetna of VT Commercial |
$209.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$162.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$162.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$187.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$184.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$176.14
|
| Rate for Payer: Cash Price |
$110.08
|
| Rate for Payer: Cigna Commercial |
$176.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$176.14
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$176.14
|
| Rate for Payer: Multiplan Commercial |
$204.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$187.14
|
| Rate for Payer: United Healthcare Commercial |
$209.16
|
|
|
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
|
|
|
ASSAY OF BLOOD FATTY ACIDS
|
Facility
|
IP
|
$132.45
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
3008272501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$98.03 |
| Max. Negotiated Rate |
$125.83 |
| Rate for Payer: Aetna of VT Commercial |
$125.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$98.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$98.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$112.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$111.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$105.96
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cigna Commercial |
$105.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$105.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$105.96
|
| Rate for Payer: Multiplan Commercial |
$123.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$112.58
|
| Rate for Payer: United Healthcare Commercial |
$125.83
|
|
|
ASSAY OF BLOOD FATTY ACIDS
|
Facility
|
OP
|
$132.45
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
3008272501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$125.83 |
| Rate for Payer: Aetna of VT Commercial |
$125.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$92.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$58.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$92.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$79.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$112.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$107.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$59.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$105.30
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cigna Commercial |
$105.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$105.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$105.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$59.60
|
| Rate for Payer: Multiplan Commercial |
$123.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$112.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$59.60
|
| Rate for Payer: United Healthcare Commercial |
$125.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.77
|
| Rate for Payer: United Healthcare VA CCN |
$59.60
|
|
|
ASSAY OF BLOOD LIPOPROTEIN
|
Facility
|
IP
|
$116.84
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
3008372101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$86.47 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: United Healthcare Commercial |
$111.00
|
| Rate for Payer: Aetna of VT Commercial |
$111.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$86.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$86.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$99.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$98.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$93.47
|
| Rate for Payer: Cash Price |
$58.42
|
| Rate for Payer: Cigna Commercial |
$93.47
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$93.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$93.47
|
| Rate for Payer: Multiplan Commercial |
$108.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$99.31
|
|
|
ASSAY OF BLOOD LIPOPROTEIN
|
Facility
|
OP
|
$116.84
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
3008372101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: Aetna of VT Commercial |
$111.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$51.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$70.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$99.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$94.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$92.89
|
| Rate for Payer: Cash Price |
$58.42
|
| Rate for Payer: Cash Price |
$58.42
|
| Rate for Payer: Cigna Commercial |
$93.47
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$93.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$93.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$52.58
|
| Rate for Payer: Multiplan Commercial |
$108.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$99.31
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$52.58
|
| Rate for Payer: United Healthcare Commercial |
$111.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.50
|
| Rate for Payer: United Healthcare VA CCN |
$52.58
|
|
|
ASSAY OF BLOOD LIPOPROTEIN
|
Professional
|
Both
|
$116.84
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
3008372101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$109.83 |
| Rate for Payer: Aetna of VT Commercial |
$109.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$14.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$17.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$17.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$12.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$17.95
|
| Rate for Payer: Cash Price |
$58.42
|
| Rate for Payer: Cash Price |
$58.42
|
| Rate for Payer: Cigna Commercial |
$12.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$10.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$10.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$10.35
|
| Rate for Payer: Multiplan Commercial |
$108.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$10.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$10.50
|
| Rate for Payer: United Healthcare Commercial |
$16.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.50
|
| Rate for Payer: United Healthcare VA CCN |
$10.50
|
|
|
ASSAY OF BLOOD PKU
|
Facility
|
IP
|
$40.33
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
3008403001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.85 |
| Max. Negotiated Rate |
$38.31 |
| Rate for Payer: Aetna of VT Commercial |
$38.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$29.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$29.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$34.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$33.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$32.26
|
| Rate for Payer: Cash Price |
$20.16
|
| Rate for Payer: Cigna Commercial |
$32.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$32.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$32.26
|
| Rate for Payer: Multiplan Commercial |
$37.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$34.28
|
| Rate for Payer: United Healthcare Commercial |
$38.31
|
|
|
ASSAY OF BLOOD PKU
|
Professional
|
Both
|
$40.33
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
3008403001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$37.91 |
| Rate for Payer: Aetna of VT Commercial |
$37.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$27.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$5.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$27.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$7.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$9.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$9.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$6.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$9.41
|
| Rate for Payer: Cash Price |
$20.16
|
| Rate for Payer: Cash Price |
$20.16
|
| Rate for Payer: Cigna Commercial |
$6.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$5.42
|
| Rate for Payer: Multiplan Commercial |
$37.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$5.50
|
| Rate for Payer: United Healthcare Commercial |
$8.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.50
|
| Rate for Payer: United Healthcare VA CCN |
$5.50
|
|
|
ASSAY OF BLOOD PKU
|
Facility
|
OP
|
$40.33
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
3008403001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$38.31 |
| Rate for Payer: Aetna of VT Commercial |
$38.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$27.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$17.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$27.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$24.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$34.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$32.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$18.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$32.06
|
| Rate for Payer: Cash Price |
$20.16
|
| Rate for Payer: Cash Price |
$20.16
|
| Rate for Payer: Cigna Commercial |
$32.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$32.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$32.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.15
|
| Rate for Payer: Multiplan Commercial |
$37.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$34.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$18.15
|
| Rate for Payer: United Healthcare Commercial |
$38.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.50
|
| Rate for Payer: United Healthcare VA CCN |
$18.15
|
|
|
ASSAY OF BLOOD/URIC ACID
|
Facility
|
OP
|
$62.94
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
3008455001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$59.79 |
| Rate for Payer: Aetna of VT Commercial |
$59.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$27.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$37.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$53.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$50.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$28.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$50.04
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cigna Commercial |
$50.35
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$50.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$50.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.32
|
| Rate for Payer: Multiplan Commercial |
$58.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$53.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$28.32
|
| Rate for Payer: United Healthcare Commercial |
$59.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.52
|
| Rate for Payer: United Healthcare VA CCN |
$28.32
|
|
|
ASSAY OF BLOOD/URIC ACID
|
Facility
|
IP
|
$62.94
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
3008455001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.58 |
| Max. Negotiated Rate |
$59.79 |
| Rate for Payer: Aetna of VT Commercial |
$59.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$46.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$46.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$53.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$52.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$50.35
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cigna Commercial |
$50.35
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$50.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$50.35
|
| Rate for Payer: Multiplan Commercial |
$58.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$53.50
|
| Rate for Payer: United Healthcare Commercial |
$59.79
|
|
|
ASSAY OF BREATH ETHANOL
|
Professional
|
Both
|
$46.89
|
|
| Hospital Charge Code |
3008207501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.76 |
| Max. Negotiated Rate |
$44.08 |
| Rate for Payer: Aetna of VT Commercial |
$44.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$42.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$42.01
|
| Rate for Payer: Cash Price |
$23.44
|
| Rate for Payer: Multiplan Commercial |
$43.61
|
| Rate for Payer: United Healthcare Commercial |
$39.86
|
| Rate for Payer: United Healthcare VA CCN |
$18.76
|
|
|
ASSAY OF CADMIUM
|
Facility
|
OP
|
$228.51
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3008230001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$217.08 |
| Rate for Payer: Aetna of VT Commercial |
$217.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$137.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$194.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$185.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$102.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$181.67
|
| Rate for Payer: Cash Price |
$114.25
|
| Rate for Payer: Cash Price |
$114.25
|
| Rate for Payer: Cigna Commercial |
$182.81
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$182.81
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$182.81
|
| Rate for Payer: Martins Point Health Care Commercial |
$102.83
|
| Rate for Payer: Multiplan Commercial |
$212.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$194.23
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$102.83
|
| Rate for Payer: United Healthcare Commercial |
$217.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.64
|
| Rate for Payer: United Healthcare VA CCN |
$102.83
|
|
|
ASSAY OF CADMIUM
|
Professional
|
Both
|
$228.51
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3008230001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.31 |
| Max. Negotiated Rate |
$214.80 |
| Rate for Payer: Aetna of VT Commercial |
$214.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$24.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$33.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$27.19
|
| Rate for Payer: Cash Price |
$114.25
|
| Rate for Payer: Cash Price |
$114.25
|
| Rate for Payer: Cigna Commercial |
$28.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$23.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$23.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$23.31
|
| Rate for Payer: Multiplan Commercial |
$212.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$23.64
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$23.64
|
| Rate for Payer: United Healthcare Commercial |
$36.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.64
|
| Rate for Payer: United Healthcare VA CCN |
$23.64
|
|
|
ASSAY OF CADMIUM
|
Facility
|
IP
|
$228.51
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3008230001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.12 |
| Max. Negotiated Rate |
$217.08 |
| Rate for Payer: Aetna of VT Commercial |
$217.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$169.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$169.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$194.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$191.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$182.81
|
| Rate for Payer: Cash Price |
$114.25
|
| Rate for Payer: Cigna Commercial |
$182.81
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$182.81
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$182.81
|
| Rate for Payer: Multiplan Commercial |
$212.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$194.23
|
| Rate for Payer: United Healthcare Commercial |
$217.08
|
|
|
ASSAY OF CALCITONIN
|
Facility
|
OP
|
$564.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
3008230801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.79 |
| Max. Negotiated Rate |
$535.80 |
| Rate for Payer: Aetna of VT Commercial |
$535.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$132.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$249.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$132.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$339.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$479.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$456.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$253.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$448.38
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cigna Commercial |
$451.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$451.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$451.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$253.80
|
| Rate for Payer: Multiplan Commercial |
$524.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$479.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$253.80
|
| Rate for Payer: United Healthcare Commercial |
$535.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.79
|
| Rate for Payer: United Healthcare VA CCN |
$253.80
|
|
|
ASSAY OF CALCITONIN
|
Facility
|
IP
|
$564.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
3008230801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$417.42 |
| Max. Negotiated Rate |
$535.80 |
| Rate for Payer: Aetna of VT Commercial |
$535.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$417.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$417.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$479.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$473.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$451.20
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cigna Commercial |
$451.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$451.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$451.20
|
| Rate for Payer: Multiplan Commercial |
$524.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$479.40
|
| Rate for Payer: United Healthcare Commercial |
$535.80
|
|
|
ASSAY OF CALCITONIN
|
Professional
|
Both
|
$564.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
3008230801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$530.16 |
| Rate for Payer: Aetna of VT Commercial |
$530.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$132.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$27.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$132.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$37.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$45.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$45.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$30.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$45.80
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cigna Commercial |
$32.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$26.79
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$26.79
|
| Rate for Payer: Martins Point Health Care Commercial |
$26.41
|
| Rate for Payer: Multiplan Commercial |
$524.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$26.79
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$26.79
|
| Rate for Payer: United Healthcare Commercial |
$41.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.79
|
| Rate for Payer: United Healthcare VA CCN |
$26.79
|
|
|
ASSAY OF CALCIUM IN URINE
|
Facility
|
IP
|
$92.28
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3008234001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$68.30 |
| Max. Negotiated Rate |
$87.67 |
| Rate for Payer: Aetna of VT Commercial |
$87.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$68.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$68.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$78.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$77.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$73.82
|
| Rate for Payer: Cash Price |
$46.14
|
| Rate for Payer: Cigna Commercial |
$73.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$73.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$73.82
|
| Rate for Payer: Multiplan Commercial |
$85.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$78.44
|
| Rate for Payer: United Healthcare Commercial |
$87.67
|
|
|
ASSAY OF CALCIUM IN URINE
|
Facility
|
OP
|
$92.28
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3008234001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$87.67 |
| Rate for Payer: Aetna of VT Commercial |
$87.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$29.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$40.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$29.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$55.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$78.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$74.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$41.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$73.36
|
| Rate for Payer: Cash Price |
$46.14
|
| Rate for Payer: Cash Price |
$46.14
|
| Rate for Payer: Cigna Commercial |
$73.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$73.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$73.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$41.53
|
| Rate for Payer: Multiplan Commercial |
$85.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$78.44
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$41.53
|
| Rate for Payer: United Healthcare Commercial |
$87.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Healthcare VA CCN |
$41.53
|
|
|
ASSAY OF CALCIUM IN URINE
|
Professional
|
Both
|
$92.28
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3008234001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$86.74 |
| Rate for Payer: Aetna of VT Commercial |
$86.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$29.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$6.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$29.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$8.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$10.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$10.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$6.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$10.29
|
| Rate for Payer: Cash Price |
$46.14
|
| Rate for Payer: Cash Price |
$46.14
|
| Rate for Payer: Cigna Commercial |
$7.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$6.03
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$6.03
|
| Rate for Payer: Martins Point Health Care Commercial |
$5.95
|
| Rate for Payer: Multiplan Commercial |
$85.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$6.03
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$6.03
|
| Rate for Payer: United Healthcare Commercial |
$9.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Healthcare VA CCN |
$6.03
|
|
|
ASSAY OF CARNITINE
|
Professional
|
Both
|
$346.91
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
3008237901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.63 |
| Max. Negotiated Rate |
$326.10 |
| Rate for Payer: Aetna of VT Commercial |
$326.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$83.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$17.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$83.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$23.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$25.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$25.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$25.32
|
| Rate for Payer: Cash Price |
$173.46
|
| Rate for Payer: Cash Price |
$173.46
|
| Rate for Payer: Cigna Commercial |
$20.63
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$16.87
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$16.87
|
| Rate for Payer: Martins Point Health Care Commercial |
$16.63
|
| Rate for Payer: Multiplan Commercial |
$322.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$16.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$16.87
|
| Rate for Payer: United Healthcare Commercial |
$25.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.87
|
| Rate for Payer: United Healthcare VA CCN |
$16.87
|
|
|
ASSAY OF CARNITINE
|
Facility
|
OP
|
$346.91
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
3008237901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.87 |
| Max. Negotiated Rate |
$329.56 |
| Rate for Payer: Aetna of VT Commercial |
$329.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$83.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$153.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$83.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$208.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$294.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$281.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$156.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$275.79
|
| Rate for Payer: Cash Price |
$173.46
|
| Rate for Payer: Cash Price |
$173.46
|
| Rate for Payer: Cigna Commercial |
$277.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$277.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$277.53
|
| Rate for Payer: Martins Point Health Care Commercial |
$156.11
|
| Rate for Payer: Multiplan Commercial |
$322.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$294.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$156.11
|
| Rate for Payer: United Healthcare Commercial |
$329.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.87
|
| Rate for Payer: United Healthcare VA CCN |
$156.11
|
|
|
ASSAY OF CARNITINE
|
Facility
|
IP
|
$346.91
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
3008237901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$256.75 |
| Max. Negotiated Rate |
$329.56 |
| Rate for Payer: Aetna of VT Commercial |
$329.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$256.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$256.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$294.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$291.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.53
|
| Rate for Payer: Cash Price |
$173.46
|
| Rate for Payer: Cigna Commercial |
$277.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$277.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$277.53
|
| Rate for Payer: Multiplan Commercial |
$322.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$294.87
|
| Rate for Payer: United Healthcare Commercial |
$329.56
|
|
