|
ASSAY OF LEAD
|
Facility
|
IP
|
$128.53
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
3008365501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$95.13 |
| Max. Negotiated Rate |
$122.10 |
| Rate for Payer: Aetna of VT Commercial |
$122.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$95.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$95.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$109.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$107.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$102.82
|
| Rate for Payer: Cash Price |
$64.26
|
| Rate for Payer: Cigna Commercial |
$102.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$102.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$102.82
|
| Rate for Payer: Multiplan Commercial |
$119.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$109.25
|
| Rate for Payer: United Healthcare Commercial |
$122.10
|
|
|
ASSAY OF LIPASE
|
Facility
|
IP
|
$82.97
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
3008369001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.41 |
| Max. Negotiated Rate |
$78.82 |
| Rate for Payer: Aetna of VT Commercial |
$78.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$61.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$61.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$70.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$69.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$66.38
|
| Rate for Payer: Cash Price |
$41.48
|
| Rate for Payer: Cigna Commercial |
$66.38
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$66.38
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$66.38
|
| Rate for Payer: Multiplan Commercial |
$77.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$70.52
|
| Rate for Payer: United Healthcare Commercial |
$78.82
|
|
|
ASSAY OF LIPASE
|
Facility
|
OP
|
$82.97
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
3008369001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$78.82 |
| Rate for Payer: Aetna of VT Commercial |
$78.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$33.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$33.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$49.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$70.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$67.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$37.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$65.96
|
| Rate for Payer: Cash Price |
$41.48
|
| Rate for Payer: Cash Price |
$41.48
|
| Rate for Payer: Cigna Commercial |
$66.38
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$66.38
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$66.38
|
| Rate for Payer: Martins Point Health Care Commercial |
$37.34
|
| Rate for Payer: Multiplan Commercial |
$77.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$70.52
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$37.34
|
| Rate for Payer: United Healthcare Commercial |
$78.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.89
|
| Rate for Payer: United Healthcare VA CCN |
$37.34
|
|
|
ASSAY OF LIPOPROTEIN
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
3008371801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna of VT Commercial |
$94.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$73.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$73.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$83.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.20
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna Commercial |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.20
|
| Rate for Payer: Multiplan Commercial |
$92.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.15
|
| Rate for Payer: United Healthcare Commercial |
$94.05
|
|
|
ASSAY OF LIPOPROTEIN
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
3008371801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna of VT Commercial |
$94.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$40.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$43.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$40.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$59.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$80.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$44.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$78.70
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna Commercial |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$44.55
|
| Rate for Payer: Multiplan Commercial |
$92.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$44.55
|
| Rate for Payer: United Healthcare Commercial |
$94.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.19
|
| Rate for Payer: United Healthcare VA CCN |
$44.55
|
|
|
ASSAY OF LIPOPROTEIN
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
3008371801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$93.06 |
| Rate for Payer: Aetna of VT Commercial |
$93.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$40.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$8.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$40.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$11.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$14.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$14.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$9.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$14.00
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna Commercial |
$9.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$8.19
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$8.19
|
| Rate for Payer: Martins Point Health Care Commercial |
$8.08
|
| Rate for Payer: Multiplan Commercial |
$92.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$8.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$8.19
|
| Rate for Payer: United Healthcare Commercial |
$12.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.19
|
| Rate for Payer: United Healthcare VA CCN |
$8.19
|
|
|
ASSAY OF LIPOPROTEIN(A)
|
Facility
|
IP
|
$200.60
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
3008369501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$148.46 |
| Max. Negotiated Rate |
$190.57 |
| Rate for Payer: Aetna of VT Commercial |
$190.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$148.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$148.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$170.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$168.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$160.48
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cigna Commercial |
$160.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$160.48
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$160.48
|
| Rate for Payer: Multiplan Commercial |
$186.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.51
|
| Rate for Payer: United Healthcare Commercial |
$190.57
|
|
|
ASSAY OF LIPOPROTEIN(A)
|
Professional
|
Both
|
$200.60
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
3008369501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$188.56 |
| Rate for Payer: Aetna of VT Commercial |
$188.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$70.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$14.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$70.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$20.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$24.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$24.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$16.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$24.46
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cigna Commercial |
$17.45
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$14.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$14.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$14.12
|
| Rate for Payer: Multiplan Commercial |
$186.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$14.32
|
| Rate for Payer: United Healthcare Commercial |
$22.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.32
|
| Rate for Payer: United Healthcare VA CCN |
$14.32
|
|
|
ASSAY OF LIPOPROTEIN(A)
|
Facility
|
OP
|
$200.60
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
3008369501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.32 |
| Max. Negotiated Rate |
$190.57 |
| Rate for Payer: Aetna of VT Commercial |
$190.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$70.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$88.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$70.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$120.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$170.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$162.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$90.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$159.48
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cigna Commercial |
$160.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$160.48
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$160.48
|
| Rate for Payer: Martins Point Health Care Commercial |
$90.27
|
| Rate for Payer: Multiplan Commercial |
$186.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.51
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$90.27
|
| Rate for Payer: United Healthcare Commercial |
$190.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.32
|
| Rate for Payer: United Healthcare VA CCN |
$90.27
|
|
|
ASSAY OF MAGNESIUM
|
Facility
|
IP
|
$98.75
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
3008373501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.08 |
| Max. Negotiated Rate |
$93.81 |
| Rate for Payer: Aetna of VT Commercial |
$93.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$73.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$73.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$83.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$82.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.00
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cigna Commercial |
$79.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.00
|
| Rate for Payer: Multiplan Commercial |
$91.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$83.94
|
| Rate for Payer: United Healthcare Commercial |
$93.81
|
|
|
ASSAY OF MAGNESIUM
|
Facility
|
OP
|
$98.75
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
3008373501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$93.81 |
| Rate for Payer: Aetna of VT Commercial |
$93.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$33.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$43.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$33.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$59.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$83.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$79.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$44.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$78.51
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cigna Commercial |
$79.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$44.44
|
| Rate for Payer: Multiplan Commercial |
$91.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$83.94
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$44.44
|
| Rate for Payer: United Healthcare Commercial |
$93.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.70
|
| Rate for Payer: United Healthcare VA CCN |
$44.44
|
|
|
ASSAY OF MERCURY QUANTITATIVE
|
Facility
|
IP
|
$161.30
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
3008382501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$119.38 |
| Max. Negotiated Rate |
$153.24 |
| Rate for Payer: Aetna of VT Commercial |
$153.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$119.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$119.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$137.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$135.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$129.04
|
| Rate for Payer: Cash Price |
$80.65
|
| Rate for Payer: Cigna Commercial |
$129.04
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$129.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$129.04
|
| Rate for Payer: Multiplan Commercial |
$150.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$137.10
|
| Rate for Payer: United Healthcare Commercial |
$153.24
|
|
|
ASSAY OF MERCURY QUANTITATIVE
|
Professional
|
Both
|
$161.30
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
3008382501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$151.62 |
| Rate for Payer: Aetna of VT Commercial |
$151.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$80.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$80.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$22.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$18.70
|
| Rate for Payer: Cash Price |
$80.65
|
| Rate for Payer: Cash Price |
$80.65
|
| Rate for Payer: Cigna Commercial |
$19.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$16.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$16.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$16.03
|
| Rate for Payer: Multiplan Commercial |
$150.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$16.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$16.26
|
| Rate for Payer: United Healthcare Commercial |
$25.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.26
|
| Rate for Payer: United Healthcare VA CCN |
$16.26
|
|
|
ASSAY OF MERCURY QUANTITATIVE
|
Facility
|
OP
|
$161.30
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
3008382501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.26 |
| Max. Negotiated Rate |
$153.24 |
| Rate for Payer: Aetna of VT Commercial |
$153.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$80.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$71.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$80.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$97.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$137.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$130.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$72.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$128.23
|
| Rate for Payer: Cash Price |
$80.65
|
| Rate for Payer: Cash Price |
$80.65
|
| Rate for Payer: Cigna Commercial |
$129.04
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$129.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$129.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$72.58
|
| Rate for Payer: Multiplan Commercial |
$150.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$137.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$72.58
|
| Rate for Payer: United Healthcare Commercial |
$153.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.26
|
| Rate for Payer: United Healthcare VA CCN |
$72.58
|
|
|
ASSAY OF NUCLEOTIDASE 5'-
|
Facility
|
IP
|
$1,364.88
|
|
|
Service Code
|
CPT 83915
|
| Hospital Charge Code |
3008391501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1,010.15 |
| Max. Negotiated Rate |
$1,296.64 |
| Rate for Payer: Aetna of VT Commercial |
$1,296.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,010.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,010.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,160.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,146.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,091.90
|
| Rate for Payer: Cash Price |
$682.44
|
| Rate for Payer: Cigna Commercial |
$1,091.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,091.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,091.90
|
| Rate for Payer: Multiplan Commercial |
$1,269.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,160.15
|
| Rate for Payer: United Healthcare Commercial |
$1,296.64
|
|
|
ASSAY OF NUCLEOTIDASE 5'-
|
Professional
|
Both
|
$1,364.88
|
|
|
Service Code
|
CPT 83915
|
| Hospital Charge Code |
3008391501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$1,282.99 |
| Rate for Payer: Aetna of VT Commercial |
$1,282.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$54.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$11.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$54.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$15.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$19.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$19.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$12.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$19.07
|
| Rate for Payer: Cash Price |
$682.44
|
| Rate for Payer: Cash Price |
$682.44
|
| Rate for Payer: Cigna Commercial |
$13.49
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$11.15
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$11.15
|
| Rate for Payer: Martins Point Health Care Commercial |
$10.99
|
| Rate for Payer: Multiplan Commercial |
$1,269.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$11.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$11.15
|
| Rate for Payer: United Healthcare Commercial |
$17.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.15
|
| Rate for Payer: United Healthcare VA CCN |
$11.15
|
|
|
ASSAY OF NUCLEOTIDASE 5'-
|
Facility
|
OP
|
$1,364.88
|
|
|
Service Code
|
CPT 83915
|
| Hospital Charge Code |
3008391501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$1,296.64 |
| Rate for Payer: Aetna of VT Commercial |
$1,296.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$54.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$604.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$54.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$821.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,160.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,105.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$614.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,085.08
|
| Rate for Payer: Cash Price |
$682.44
|
| Rate for Payer: Cash Price |
$682.44
|
| Rate for Payer: Cigna Commercial |
$1,091.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,091.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,091.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$614.20
|
| Rate for Payer: Multiplan Commercial |
$1,269.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,160.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$614.20
|
| Rate for Payer: United Healthcare Commercial |
$1,296.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.15
|
| Rate for Payer: United Healthcare VA CCN |
$614.20
|
|
|
ASSAY OF OSMOLALITY BLOOD
|
Facility
|
OP
|
$118.04
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
3008393001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$112.14 |
| Rate for Payer: Aetna of VT Commercial |
$112.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$32.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$52.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$32.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$71.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$100.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$95.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$53.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$93.84
|
| Rate for Payer: Cash Price |
$59.02
|
| Rate for Payer: Cash Price |
$59.02
|
| Rate for Payer: Cigna Commercial |
$94.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$94.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$94.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$53.12
|
| Rate for Payer: Multiplan Commercial |
$109.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$100.33
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$53.12
|
| Rate for Payer: United Healthcare Commercial |
$112.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.61
|
| Rate for Payer: United Healthcare VA CCN |
$53.12
|
|
|
ASSAY OF OSMOLALITY BLOOD
|
Professional
|
Both
|
$118.04
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
3008393001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$110.96 |
| Rate for Payer: Aetna of VT Commercial |
$110.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$32.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$6.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$32.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$9.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$11.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$11.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$7.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$11.30
|
| Rate for Payer: Cash Price |
$59.02
|
| Rate for Payer: Cash Price |
$59.02
|
| Rate for Payer: Cigna Commercial |
$7.93
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$6.61
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$6.61
|
| Rate for Payer: Martins Point Health Care Commercial |
$6.52
|
| Rate for Payer: Multiplan Commercial |
$109.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$6.61
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$6.61
|
| Rate for Payer: United Healthcare Commercial |
$10.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.61
|
| Rate for Payer: United Healthcare VA CCN |
$6.61
|
|
|
ASSAY OF OSMOLALITY BLOOD
|
Facility
|
IP
|
$118.04
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
3008393001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.36 |
| Max. Negotiated Rate |
$112.14 |
| Rate for Payer: Aetna of VT Commercial |
$112.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$87.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$87.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$100.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$99.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$94.43
|
| Rate for Payer: Cash Price |
$59.02
|
| Rate for Payer: Cigna Commercial |
$94.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$94.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$94.43
|
| Rate for Payer: Multiplan Commercial |
$109.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$100.33
|
| Rate for Payer: United Healthcare Commercial |
$112.14
|
|
|
ASSAY OF PARATHORMONE
|
Facility
|
IP
|
$291.13
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
3008397001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$215.47 |
| Max. Negotiated Rate |
$276.57 |
| Rate for Payer: Aetna of VT Commercial |
$276.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$215.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$247.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$244.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$232.90
|
| Rate for Payer: Cash Price |
$145.56
|
| Rate for Payer: Cigna Commercial |
$232.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$232.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$232.90
|
| Rate for Payer: Multiplan Commercial |
$270.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$247.46
|
| Rate for Payer: United Healthcare Commercial |
$276.57
|
|
|
ASSAY OF PARATHORMONE
|
Facility
|
OP
|
$291.13
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
3008397001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$276.57 |
| Rate for Payer: Aetna of VT Commercial |
$276.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$203.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$128.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$203.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$175.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$247.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$235.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$131.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$231.45
|
| Rate for Payer: Cash Price |
$145.56
|
| Rate for Payer: Cash Price |
$145.56
|
| Rate for Payer: Cigna Commercial |
$232.90
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$232.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$232.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$131.01
|
| Rate for Payer: Multiplan Commercial |
$270.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$247.46
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$131.01
|
| Rate for Payer: United Healthcare Commercial |
$276.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.28
|
| Rate for Payer: United Healthcare VA CCN |
$131.01
|
|
|
ASSAY OF PARATHORMONE
|
Professional
|
Both
|
$291.13
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
3008397001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.70 |
| Max. Negotiated Rate |
$273.66 |
| Rate for Payer: Aetna of VT Commercial |
$273.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$203.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$42.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$203.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$57.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$70.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$70.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$47.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$70.57
|
| Rate for Payer: Cash Price |
$145.56
|
| Rate for Payer: Cash Price |
$145.56
|
| Rate for Payer: Cigna Commercial |
$49.98
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$41.28
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$41.28
|
| Rate for Payer: Martins Point Health Care Commercial |
$40.70
|
| Rate for Payer: Multiplan Commercial |
$270.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$41.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$41.28
|
| Rate for Payer: United Healthcare Commercial |
$63.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.28
|
| Rate for Payer: United Healthcare VA CCN |
$41.28
|
|
|
ASSAY OF PHENOBARBITAL
|
Professional
|
Both
|
$146.83
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
3008018401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.09 |
| Max. Negotiated Rate |
$138.02 |
| Rate for Payer: Aetna of VT Commercial |
$138.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$75.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$15.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$75.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$21.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$26.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$26.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$17.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$26.16
|
| Rate for Payer: Cash Price |
$73.42
|
| Rate for Payer: Cash Price |
$73.42
|
| Rate for Payer: Cigna Commercial |
$18.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$15.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$15.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$15.09
|
| Rate for Payer: Multiplan Commercial |
$136.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$15.30
|
| Rate for Payer: United Healthcare Commercial |
$23.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.30
|
| Rate for Payer: United Healthcare VA CCN |
$15.30
|
|
|
ASSAY OF PHENOBARBITAL
|
Facility
|
OP
|
$146.83
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
3008018401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.30 |
| Max. Negotiated Rate |
$139.49 |
| Rate for Payer: Aetna of VT Commercial |
$139.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$75.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$75.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$88.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$124.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$118.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$66.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$116.73
|
| Rate for Payer: Cash Price |
$73.42
|
| Rate for Payer: Cash Price |
$73.42
|
| Rate for Payer: Cigna Commercial |
$117.46
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$117.46
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$117.46
|
| Rate for Payer: Martins Point Health Care Commercial |
$66.07
|
| Rate for Payer: Multiplan Commercial |
$136.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$124.81
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$66.07
|
| Rate for Payer: United Healthcare Commercial |
$139.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.30
|
| Rate for Payer: United Healthcare VA CCN |
$66.07
|
|
