|
PUNCH BX SKIN SINGLE LESION
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
9601110402
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$101.87 |
| Max. Negotiated Rate |
$218.50 |
| Rate for Payer: Aetna of VT Commercial |
$218.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$206.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$206.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$138.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$195.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$103.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$182.85
|
| Rate for Payer: Cash Price |
$115.00
|
| Rate for Payer: Cigna Commercial |
$184.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$184.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$184.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$103.50
|
| Rate for Payer: Multiplan Commercial |
$213.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$195.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.50
|
| Rate for Payer: United Healthcare Commercial |
$218.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.50
|
| Rate for Payer: United Healthcare VA CCN |
$103.50
|
|
|
PUNCH BX SKIN SINGLE LESION
|
Professional
|
Both
|
$503.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
9601110401
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$43.62 |
| Max. Negotiated Rate |
$472.82 |
| Rate for Payer: Aetna of VT Commercial |
$472.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$450.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$44.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$450.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$61.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$179.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$50.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$179.15
|
| Rate for Payer: Cash Price |
$251.50
|
| Rate for Payer: Cash Price |
$251.50
|
| Rate for Payer: Cigna Commercial |
$49.01
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$189.78
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$189.78
|
| Rate for Payer: Martins Point Health Care Commercial |
$117.18
|
| Rate for Payer: Multiplan Commercial |
$467.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$61.94
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$43.62
|
| Rate for Payer: United Healthcare Commercial |
$67.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43.62
|
| Rate for Payer: United Healthcare VA CCN |
$43.62
|
|
|
PUNCH BX SKIN SINGLE LESION
|
Facility
|
OP
|
$503.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
9601110401
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$222.78 |
| Max. Negotiated Rate |
$477.85 |
| Rate for Payer: Aetna of VT Commercial |
$477.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$450.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$222.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$450.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$302.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$427.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$407.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$226.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$399.88
|
| Rate for Payer: Cash Price |
$251.50
|
| Rate for Payer: Cigna Commercial |
$402.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$402.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$402.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$226.35
|
| Rate for Payer: Multiplan Commercial |
$467.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$427.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$226.35
|
| Rate for Payer: United Healthcare Commercial |
$477.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$226.35
|
| Rate for Payer: United Healthcare VA CCN |
$226.35
|
|
|
PUNCTUR ASPIRATION CYST BREAST
|
Facility
|
IP
|
$0.03
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
4501900001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Aetna of VT Commercial |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.02
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna Commercial |
$0.02
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.02
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.02
|
| Rate for Payer: Multiplan Commercial |
$0.03
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.03
|
| Rate for Payer: United Healthcare Commercial |
$0.03
|
|
|
PUNCTUR ASPIRATION CYST BREAST
|
Facility
|
OP
|
$0.03
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
4501900001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Aetna of VT Commercial |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.02
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna Commercial |
$0.02
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.02
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.02
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.03
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.03
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.01
|
| Rate for Payer: United Healthcare Commercial |
$0.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.01
|
| Rate for Payer: United Healthcare VA CCN |
$0.01
|
|
|
PUNCTUR ASPIRATION CYST BREAST
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
9811900001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$172.55 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$40.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$54.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$172.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$45.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$172.55
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$71.16
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$149.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$149.67
|
| Rate for Payer: Martins Point Health Care Commercial |
$91.82
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$55.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$39.14
|
| Rate for Payer: United Healthcare Commercial |
$60.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.14
|
| Rate for Payer: United Healthcare VA CCN |
$39.14
|
|
|
PUNCTUR ASPIRATION CYST BREAST
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
9811900001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
PUNCTUR ASPIRATION CYST BREAST
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
9811900001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
PUNCTURE ASPIRATION CYST BREAS
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
9821900001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$213.15 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Aetna of VT Commercial |
$273.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$241.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$230.40
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$230.40
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.80
|
| Rate for Payer: United Healthcare Commercial |
$273.60
|
|
|
PUNCTURE ASPIRATION CYST BREAS
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
9821900001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$39.14 |
| Max. Negotiated Rate |
$270.72 |
| Rate for Payer: Aetna of VT Commercial |
$270.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$40.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$54.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$172.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$45.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$172.55
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$71.16
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$149.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$149.67
|
| Rate for Payer: Martins Point Health Care Commercial |
$91.82
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$55.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$39.14
|
| Rate for Payer: United Healthcare Commercial |
$60.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.14
|
| Rate for Payer: United Healthcare VA CCN |
$39.14
|
|
|
PUNCTURE ASPIRATION CYST BREAS
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
9821900001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$127.56 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Aetna of VT Commercial |
$273.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$127.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$173.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$233.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$129.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$228.96
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$230.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$129.60
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.60
|
| Rate for Payer: United Healthcare Commercial |
$273.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.60
|
| Rate for Payer: United Healthcare VA CCN |
$129.60
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
IP
|
$255.40
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
4501016001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$189.02 |
| Max. Negotiated Rate |
$242.63 |
| Rate for Payer: Aetna of VT Commercial |
$242.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$189.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$189.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$217.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$214.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$204.32
|
| Rate for Payer: Cash Price |
$127.70
|
| Rate for Payer: Cigna Commercial |
$204.32
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.32
|
| Rate for Payer: Multiplan Commercial |
$237.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$217.09
|
| Rate for Payer: United Healthcare Commercial |
$242.63
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9601016002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$91.94 |
| Max. Negotiated Rate |
$385.40 |
| Rate for Payer: Aetna of VT Commercial |
$385.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$94.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$128.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$105.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$174.31
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$168.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$201.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$201.10
|
| Rate for Payer: Martins Point Health Care Commercial |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$130.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare Commercial |
$141.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare VA CCN |
$91.94
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9601016002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$181.59 |
| Max. Negotiated Rate |
$389.50 |
| Rate for Payer: Aetna of VT Commercial |
$389.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$181.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$246.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$348.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$332.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$184.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$325.95
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$328.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$184.50
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$348.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$184.50
|
| Rate for Payer: United Healthcare Commercial |
$389.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$184.50
|
| Rate for Payer: United Healthcare VA CCN |
$184.50
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9601016002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$303.44 |
| Max. Negotiated Rate |
$389.50 |
| Rate for Payer: Aetna of VT Commercial |
$389.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$303.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$303.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$348.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$344.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$328.00
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$328.00
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$348.50
|
| Rate for Payer: United Healthcare Commercial |
$389.50
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9601016001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$91.94 |
| Max. Negotiated Rate |
$625.10 |
| Rate for Payer: Aetna of VT Commercial |
$625.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$595.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$94.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$595.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$128.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$105.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$174.31
|
| Rate for Payer: Cash Price |
$332.50
|
| Rate for Payer: Cash Price |
$332.50
|
| Rate for Payer: Cigna Commercial |
$168.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$201.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$201.10
|
| Rate for Payer: Martins Point Health Care Commercial |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$618.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$130.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare Commercial |
$141.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare VA CCN |
$91.94
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9811016001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$91.94 |
| Max. Negotiated Rate |
$385.40 |
| Rate for Payer: Aetna of VT Commercial |
$385.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$94.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$128.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$105.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$174.31
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$168.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$201.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$201.10
|
| Rate for Payer: Martins Point Health Care Commercial |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$130.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare Commercial |
$141.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare VA CCN |
$91.94
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9811016001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$303.44 |
| Max. Negotiated Rate |
$389.50 |
| Rate for Payer: Aetna of VT Commercial |
$389.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$303.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$303.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$348.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$344.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$328.00
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$328.00
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$348.50
|
| Rate for Payer: United Healthcare Commercial |
$389.50
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
5101016001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$91.94 |
| Max. Negotiated Rate |
$240.64 |
| Rate for Payer: Aetna of VT Commercial |
$240.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$229.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$94.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$229.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$128.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$105.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$174.31
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cigna Commercial |
$168.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$201.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$201.10
|
| Rate for Payer: Martins Point Health Care Commercial |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$238.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$130.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare Commercial |
$141.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare VA CCN |
$91.94
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
5101016001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$189.47 |
| Max. Negotiated Rate |
$243.20 |
| Rate for Payer: Aetna of VT Commercial |
$243.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$189.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$189.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$217.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$215.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$204.80
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cigna Commercial |
$204.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.80
|
| Rate for Payer: Multiplan Commercial |
$238.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$217.60
|
| Rate for Payer: United Healthcare Commercial |
$243.20
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9811016001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$181.59 |
| Max. Negotiated Rate |
$389.50 |
| Rate for Payer: Aetna of VT Commercial |
$389.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$181.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$246.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$348.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$332.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$184.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$325.95
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$328.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$184.50
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$348.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$184.50
|
| Rate for Payer: United Healthcare Commercial |
$389.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$184.50
|
| Rate for Payer: United Healthcare VA CCN |
$184.50
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9811016002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$91.94 |
| Max. Negotiated Rate |
$385.40 |
| Rate for Payer: Aetna of VT Commercial |
$385.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$94.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$367.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$128.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$174.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$105.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$174.31
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$168.08
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$201.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$201.10
|
| Rate for Payer: Martins Point Health Care Commercial |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$130.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare Commercial |
$141.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.94
|
| Rate for Payer: United Healthcare VA CCN |
$91.94
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
9811016002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$303.44 |
| Max. Negotiated Rate |
$389.50 |
| Rate for Payer: Aetna of VT Commercial |
$389.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$303.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$303.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$348.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$344.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$328.00
|
| Rate for Payer: Cash Price |
$205.00
|
| Rate for Payer: Cigna Commercial |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$328.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$328.00
|
| Rate for Payer: Multiplan Commercial |
$381.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$348.50
|
| Rate for Payer: United Healthcare Commercial |
$389.50
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
OP
|
$255.40
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
4501016001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.12 |
| Max. Negotiated Rate |
$242.63 |
| Rate for Payer: Aetna of VT Commercial |
$242.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$228.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$113.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$228.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$153.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$217.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$206.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$114.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$203.04
|
| Rate for Payer: Cash Price |
$127.70
|
| Rate for Payer: Cigna Commercial |
$204.32
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$114.93
|
| Rate for Payer: Multiplan Commercial |
$237.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$217.09
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$114.93
|
| Rate for Payer: United Healthcare Commercial |
$242.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$114.93
|
| Rate for Payer: United Healthcare VA CCN |
$114.93
|
|
|
PUNCTURE DRAINAGE OF LESION
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
5101016001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$113.38 |
| Max. Negotiated Rate |
$243.20 |
| Rate for Payer: Aetna of VT Commercial |
$243.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$229.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$113.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$229.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$154.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$217.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$207.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$203.52
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cigna Commercial |
$204.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$204.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$204.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$115.20
|
| Rate for Payer: Multiplan Commercial |
$238.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$217.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$115.20
|
| Rate for Payer: United Healthcare Commercial |
$243.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$115.20
|
| Rate for Payer: United Healthcare VA CCN |
$115.20
|
|
