|
REMOVAL OF NAIL PLATE
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
5101173001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$175.89 |
| Rate for Payer: Aetna of VT Commercial |
$144.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$137.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$52.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$137.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$71.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$144.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$144.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$58.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$144.49
|
| Rate for Payer: Cash Price |
$77.00
|
| Rate for Payer: Cash Price |
$77.00
|
| Rate for Payer: Cigna Commercial |
$56.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$175.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$175.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$108.86
|
| Rate for Payer: Multiplan Commercial |
$143.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$72.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$50.72
|
| Rate for Payer: United Healthcare Commercial |
$78.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50.72
|
| Rate for Payer: United Healthcare VA CCN |
$50.72
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
OP
|
$202.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
9811173001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$89.47 |
| Max. Negotiated Rate |
$191.90 |
| Rate for Payer: Aetna of VT Commercial |
$191.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$180.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$180.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$121.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$163.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$90.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$160.59
|
| Rate for Payer: Cash Price |
$101.00
|
| Rate for Payer: Cigna Commercial |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$161.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$90.90
|
| Rate for Payer: Multiplan Commercial |
$187.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$90.90
|
| Rate for Payer: United Healthcare Commercial |
$191.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$90.90
|
| Rate for Payer: United Healthcare VA CCN |
$90.90
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
OP
|
$202.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
9601173002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$89.47 |
| Max. Negotiated Rate |
$191.90 |
| Rate for Payer: Aetna of VT Commercial |
$191.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$180.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$180.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$121.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$163.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$90.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$160.59
|
| Rate for Payer: Cash Price |
$101.00
|
| Rate for Payer: Cigna Commercial |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$161.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$90.90
|
| Rate for Payer: Multiplan Commercial |
$187.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$90.90
|
| Rate for Payer: United Healthcare Commercial |
$191.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$90.90
|
| Rate for Payer: United Healthcare VA CCN |
$90.90
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
OP
|
$355.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
9601173001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$157.23 |
| Max. Negotiated Rate |
$337.25 |
| Rate for Payer: Aetna of VT Commercial |
$337.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$157.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$213.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$301.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$287.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$159.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$282.23
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$284.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$284.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$159.75
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$301.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$159.75
|
| Rate for Payer: United Healthcare Commercial |
$337.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.75
|
| Rate for Payer: United Healthcare VA CCN |
$159.75
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
IP
|
$202.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
9601173002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$149.50 |
| Max. Negotiated Rate |
$191.90 |
| Rate for Payer: Aetna of VT Commercial |
$191.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$149.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$149.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$169.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$161.60
|
| Rate for Payer: Cash Price |
$101.00
|
| Rate for Payer: Cigna Commercial |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$161.60
|
| Rate for Payer: Multiplan Commercial |
$187.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.70
|
| Rate for Payer: United Healthcare Commercial |
$191.90
|
|
|
REMOVAL OF NAIL PLATE
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
9601173001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$333.70 |
| Rate for Payer: Aetna of VT Commercial |
$333.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$52.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$318.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$71.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$144.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$144.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$58.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$144.49
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cash Price |
$177.50
|
| Rate for Payer: Cigna Commercial |
$56.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$175.89
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$175.89
|
| Rate for Payer: Martins Point Health Care Commercial |
$108.86
|
| Rate for Payer: Multiplan Commercial |
$330.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$72.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$50.72
|
| Rate for Payer: United Healthcare Commercial |
$78.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50.72
|
| Rate for Payer: United Healthcare VA CCN |
$50.72
|
|
|
REMOVAL OF NERVE LESION
|
Facility
|
OP
|
$3,062.00
|
|
|
Service Code
|
CPT 64790
|
| Hospital Charge Code |
9826479001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,356.16 |
| Max. Negotiated Rate |
$2,908.90 |
| Rate for Payer: Aetna of VT Commercial |
$2,908.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,743.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,356.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,743.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,843.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,602.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,480.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,377.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,434.29
|
| Rate for Payer: Cash Price |
$1,531.00
|
| Rate for Payer: Cigna Commercial |
$2,449.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,449.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,449.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,377.90
|
| Rate for Payer: Multiplan Commercial |
$2,847.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,602.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,377.90
|
| Rate for Payer: United Healthcare Commercial |
$2,908.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,377.90
|
| Rate for Payer: United Healthcare VA CCN |
$1,377.90
|
|
|
REMOVAL OF NERVE LESION
|
Facility
|
IP
|
$3,062.00
|
|
|
Service Code
|
CPT 64790
|
| Hospital Charge Code |
9826479001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,266.19 |
| Max. Negotiated Rate |
$2,908.90 |
| Rate for Payer: Aetna of VT Commercial |
$2,908.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,266.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,266.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,602.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,572.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,449.60
|
| Rate for Payer: Cash Price |
$1,531.00
|
| Rate for Payer: Cigna Commercial |
$2,449.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,449.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,449.60
|
| Rate for Payer: Multiplan Commercial |
$2,847.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,602.70
|
| Rate for Payer: United Healthcare Commercial |
$2,908.90
|
|
|
REMOVAL OF NERVE LESION
|
Professional
|
Both
|
$3,062.00
|
|
|
Service Code
|
CPT 64790
|
| Hospital Charge Code |
9826479001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$792.83 |
| Max. Negotiated Rate |
$2,878.28 |
| Rate for Payer: Aetna of VT Commercial |
$2,878.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,743.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$816.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,743.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,109.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,333.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,333.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$911.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,333.84
|
| Rate for Payer: Cash Price |
$1,531.00
|
| Rate for Payer: Cash Price |
$1,531.00
|
| Rate for Payer: Cigna Commercial |
$1,096.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,342.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,342.33
|
| Rate for Payer: Martins Point Health Care Commercial |
$792.83
|
| Rate for Payer: Multiplan Commercial |
$2,847.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,125.82
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$792.83
|
| Rate for Payer: United Healthcare Commercial |
$1,219.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$792.83
|
| Rate for Payer: United Healthcare VA CCN |
$792.83
|
|
|
REMOVAL OF OVARIAN CYST(S)
|
Facility
|
IP
|
$1,877.00
|
|
|
Service Code
|
CPT 58925
|
| Hospital Charge Code |
9825892501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,389.17 |
| Max. Negotiated Rate |
$1,783.15 |
| Rate for Payer: Aetna of VT Commercial |
$1,783.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,389.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,389.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,595.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,576.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,501.60
|
| Rate for Payer: Cash Price |
$938.50
|
| Rate for Payer: Cigna Commercial |
$1,501.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,501.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,501.60
|
| Rate for Payer: Multiplan Commercial |
$1,745.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,595.45
|
| Rate for Payer: United Healthcare Commercial |
$1,783.15
|
|
|
REMOVAL OF OVARIAN CYST(S)
|
Facility
|
OP
|
$1,877.00
|
|
|
Service Code
|
CPT 58925
|
| Hospital Charge Code |
9825892501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$831.32 |
| Max. Negotiated Rate |
$1,783.15 |
| Rate for Payer: Aetna of VT Commercial |
$1,783.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,681.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$831.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,681.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,129.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,595.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,520.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$844.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,492.21
|
| Rate for Payer: Cash Price |
$938.50
|
| Rate for Payer: Cigna Commercial |
$1,501.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,501.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,501.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$844.65
|
| Rate for Payer: Multiplan Commercial |
$1,745.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,595.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$844.65
|
| Rate for Payer: United Healthcare Commercial |
$1,783.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$844.65
|
| Rate for Payer: United Healthcare VA CCN |
$844.65
|
|
|
REMOVAL OF OVARIAN CYST(S)
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
CPT 58925
|
| Hospital Charge Code |
9825892501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$712.84 |
| Max. Negotiated Rate |
$1,764.38 |
| Rate for Payer: Aetna of VT Commercial |
$1,764.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,681.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$734.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,681.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$997.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,179.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,179.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$819.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,179.14
|
| Rate for Payer: Cash Price |
$938.50
|
| Rate for Payer: Cash Price |
$938.50
|
| Rate for Payer: Cigna Commercial |
$1,254.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,194.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,194.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$712.85
|
| Rate for Payer: Multiplan Commercial |
$1,745.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,012.23
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$712.84
|
| Rate for Payer: United Healthcare Commercial |
$1,096.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$712.84
|
| Rate for Payer: United Healthcare VA CCN |
$712.84
|
|
|
REMOVAL OF OVARY/TUBE(S)
|
Professional
|
Both
|
$1,998.00
|
|
|
Service Code
|
CPT 58720
|
| Hospital Charge Code |
9825872001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$707.50 |
| Max. Negotiated Rate |
$1,878.12 |
| Rate for Payer: Aetna of VT Commercial |
$1,878.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,790.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$728.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,790.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$990.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,184.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,184.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$813.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,184.34
|
| Rate for Payer: Cash Price |
$999.00
|
| Rate for Payer: Cash Price |
$999.00
|
| Rate for Payer: Cigna Commercial |
$1,248.12
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,180.84
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,180.84
|
| Rate for Payer: Martins Point Health Care Commercial |
$707.51
|
| Rate for Payer: Multiplan Commercial |
$1,858.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,004.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$707.50
|
| Rate for Payer: United Healthcare Commercial |
$1,088.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$707.50
|
| Rate for Payer: United Healthcare VA CCN |
$707.50
|
|
|
REMOVAL OF OVARY/TUBE(S)
|
Facility
|
OP
|
$1,998.00
|
|
|
Service Code
|
CPT 58720
|
| Hospital Charge Code |
9825872001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$884.91 |
| Max. Negotiated Rate |
$1,898.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,898.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,790.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$884.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,790.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,202.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,698.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,618.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$899.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,588.41
|
| Rate for Payer: Cash Price |
$999.00
|
| Rate for Payer: Cigna Commercial |
$1,598.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,598.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,598.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$899.10
|
| Rate for Payer: Multiplan Commercial |
$1,858.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,698.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$899.10
|
| Rate for Payer: United Healthcare Commercial |
$1,898.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$899.10
|
| Rate for Payer: United Healthcare VA CCN |
$899.10
|
|
|
REMOVAL OF OVARY/TUBE(S)
|
Facility
|
IP
|
$1,998.00
|
|
|
Service Code
|
CPT 58720
|
| Hospital Charge Code |
9825872001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,478.72 |
| Max. Negotiated Rate |
$1,898.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,898.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,478.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,478.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,698.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,678.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,598.40
|
| Rate for Payer: Cash Price |
$999.00
|
| Rate for Payer: Cigna Commercial |
$1,598.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,598.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,598.40
|
| Rate for Payer: Multiplan Commercial |
$1,858.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,698.30
|
| Rate for Payer: United Healthcare Commercial |
$1,898.10
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
5101120001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.50 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna of VT Commercial |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$94.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$46.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$94.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$63.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$85.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$83.47
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$84.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$84.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$84.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$47.25
|
| Rate for Payer: Multiplan Commercial |
$97.65
|
| Rate for Payer: MVP Health Care of NY Commercial |
$89.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$47.25
|
| Rate for Payer: United Healthcare Commercial |
$99.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$47.25
|
| Rate for Payer: United Healthcare VA CCN |
$47.25
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
5101120001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.71 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna of VT Commercial |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$77.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$77.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$88.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$84.00
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$84.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$84.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$97.65
|
| Rate for Payer: MVP Health Care of NY Commercial |
$89.25
|
| Rate for Payer: United Healthcare Commercial |
$99.75
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
IP
|
$185.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
9601120002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$136.92 |
| Max. Negotiated Rate |
$175.75 |
| Rate for Payer: Aetna of VT Commercial |
$175.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$157.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$155.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$148.00
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cigna Commercial |
$148.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$148.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$148.00
|
| Rate for Payer: Multiplan Commercial |
$172.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$157.25
|
| Rate for Payer: United Healthcare Commercial |
$175.75
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
IP
|
$289.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
9601120001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$213.89 |
| Max. Negotiated Rate |
$274.55 |
| Rate for Payer: Aetna of VT Commercial |
$274.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$213.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$213.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$245.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$242.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$231.20
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cigna Commercial |
$231.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$231.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$231.20
|
| Rate for Payer: Multiplan Commercial |
$268.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$245.65
|
| Rate for Payer: United Healthcare Commercial |
$274.55
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
IP
|
$185.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
9811120001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$136.92 |
| Max. Negotiated Rate |
$175.75 |
| Rate for Payer: Aetna of VT Commercial |
$175.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$157.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$155.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$148.00
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cigna Commercial |
$148.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$148.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$148.00
|
| Rate for Payer: Multiplan Commercial |
$172.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$157.25
|
| Rate for Payer: United Healthcare Commercial |
$175.75
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
OP
|
$104.12
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
4501120001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$46.11 |
| Max. Negotiated Rate |
$98.91 |
| Rate for Payer: Aetna of VT Commercial |
$98.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$93.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$46.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$93.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$62.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$88.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$84.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$46.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$82.78
|
| Rate for Payer: Cash Price |
$52.06
|
| Rate for Payer: Cigna Commercial |
$83.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$83.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$83.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$46.85
|
| Rate for Payer: Multiplan Commercial |
$96.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$88.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$46.85
|
| Rate for Payer: United Healthcare Commercial |
$98.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$46.85
|
| Rate for Payer: United Healthcare VA CCN |
$46.85
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
9811120002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$173.90 |
| Rate for Payer: Aetna of VT Commercial |
$173.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$76.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$103.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$117.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$117.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$84.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$117.51
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cigna Commercial |
$82.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$143.49
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$143.49
|
| Rate for Payer: Martins Point Health Care Commercial |
$88.57
|
| Rate for Payer: Multiplan Commercial |
$172.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$104.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$73.80
|
| Rate for Payer: United Healthcare Commercial |
$113.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$73.80
|
| Rate for Payer: United Healthcare VA CCN |
$73.80
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
IP
|
$104.12
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
4501120001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$77.06 |
| Max. Negotiated Rate |
$98.91 |
| Rate for Payer: Aetna of VT Commercial |
$98.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$77.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$77.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$88.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$87.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$83.30
|
| Rate for Payer: Cash Price |
$52.06
|
| Rate for Payer: Cigna Commercial |
$83.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$83.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$83.30
|
| Rate for Payer: Multiplan Commercial |
$96.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$88.50
|
| Rate for Payer: United Healthcare Commercial |
$98.91
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
9811120001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$173.90 |
| Rate for Payer: Aetna of VT Commercial |
$173.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$76.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$103.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$117.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$117.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$84.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$117.51
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cigna Commercial |
$82.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$143.49
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$143.49
|
| Rate for Payer: Martins Point Health Care Commercial |
$88.57
|
| Rate for Payer: Multiplan Commercial |
$172.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$104.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$73.80
|
| Rate for Payer: United Healthcare Commercial |
$113.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$73.80
|
| Rate for Payer: United Healthcare VA CCN |
$73.80
|
|
|
REMOVAL OF SKIN TAGS <W/15
|
Facility
|
OP
|
$185.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
9811120001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$81.94 |
| Max. Negotiated Rate |
$175.75 |
| Rate for Payer: Aetna of VT Commercial |
$175.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$81.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$111.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$157.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$149.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$83.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$147.07
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cigna Commercial |
$148.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$148.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$148.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$83.25
|
| Rate for Payer: Multiplan Commercial |
$172.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$157.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$83.25
|
| Rate for Payer: United Healthcare Commercial |
$175.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$83.25
|
| Rate for Payer: United Healthcare VA CCN |
$83.25
|
|
