|
REMOVAL OF SUPPORT IMPLANT
|
Professional
|
Both
|
$876.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
9602067002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$138.07 |
| Max. Negotiated Rate |
$823.44 |
| Rate for Payer: Aetna of VT Commercial |
$823.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$784.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$142.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$784.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$193.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$667.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$667.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$158.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$667.77
|
| Rate for Payer: Cash Price |
$438.00
|
| Rate for Payer: Cash Price |
$438.00
|
| Rate for Payer: Cigna Commercial |
$261.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$539.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$539.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$333.04
|
| Rate for Payer: Multiplan Commercial |
$814.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.07
|
| Rate for Payer: United Healthcare Commercial |
$212.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.07
|
| Rate for Payer: United Healthcare VA CCN |
$138.07
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
IP
|
$872.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
5102067001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$645.37 |
| Max. Negotiated Rate |
$828.40 |
| Rate for Payer: Aetna of VT Commercial |
$828.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$645.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$645.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$741.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$732.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$697.60
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Cigna Commercial |
$697.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$697.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$697.60
|
| Rate for Payer: Multiplan Commercial |
$810.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$741.20
|
| Rate for Payer: United Healthcare Commercial |
$828.40
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
OP
|
$1,747.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
9602067001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$773.75 |
| Max. Negotiated Rate |
$1,659.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,659.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,565.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$773.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,565.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,051.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,484.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,415.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$786.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,388.87
|
| Rate for Payer: Cash Price |
$873.50
|
| Rate for Payer: Cigna Commercial |
$1,397.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,397.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,397.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$786.15
|
| Rate for Payer: Multiplan Commercial |
$1,624.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,484.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$786.15
|
| Rate for Payer: United Healthcare Commercial |
$1,659.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$786.15
|
| Rate for Payer: United Healthcare VA CCN |
$786.15
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
OP
|
$876.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
9602067002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$387.98 |
| Max. Negotiated Rate |
$832.20 |
| Rate for Payer: Aetna of VT Commercial |
$832.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$784.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$387.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$784.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$527.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$744.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$709.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$394.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$696.42
|
| Rate for Payer: Cash Price |
$438.00
|
| Rate for Payer: Cigna Commercial |
$700.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$700.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$700.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$394.20
|
| Rate for Payer: Multiplan Commercial |
$814.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$744.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$394.20
|
| Rate for Payer: United Healthcare Commercial |
$832.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$394.20
|
| Rate for Payer: United Healthcare VA CCN |
$394.20
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
OP
|
$872.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
5102067001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$386.21 |
| Max. Negotiated Rate |
$828.40 |
| Rate for Payer: Aetna of VT Commercial |
$828.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$781.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$386.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$781.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$524.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$741.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$706.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$392.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$693.24
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Cigna Commercial |
$697.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$697.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$697.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$392.40
|
| Rate for Payer: Multiplan Commercial |
$810.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$741.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$392.40
|
| Rate for Payer: United Healthcare Commercial |
$828.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$392.40
|
| Rate for Payer: United Healthcare VA CCN |
$392.40
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
IP
|
$1,747.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
9602067001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,292.95 |
| Max. Negotiated Rate |
$1,659.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,659.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,292.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,292.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,484.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,467.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,397.60
|
| Rate for Payer: Cash Price |
$873.50
|
| Rate for Payer: Cigna Commercial |
$1,397.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,397.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,397.60
|
| Rate for Payer: Multiplan Commercial |
$1,624.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,484.95
|
| Rate for Payer: United Healthcare Commercial |
$1,659.65
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Professional
|
Both
|
$1,747.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
9602067001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$138.07 |
| Max. Negotiated Rate |
$1,642.18 |
| Rate for Payer: Aetna of VT Commercial |
$1,642.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,565.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$142.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,565.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$193.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$667.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$667.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$158.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$667.77
|
| Rate for Payer: Cash Price |
$873.50
|
| Rate for Payer: Cash Price |
$873.50
|
| Rate for Payer: Cigna Commercial |
$261.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$539.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$539.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$333.04
|
| Rate for Payer: Multiplan Commercial |
$1,624.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.07
|
| Rate for Payer: United Healthcare Commercial |
$212.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.07
|
| Rate for Payer: United Healthcare VA CCN |
$138.07
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
IP
|
$876.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
9602067002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$648.33 |
| Max. Negotiated Rate |
$832.20 |
| Rate for Payer: Aetna of VT Commercial |
$832.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$648.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$648.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$744.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$735.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$700.80
|
| Rate for Payer: Cash Price |
$438.00
|
| Rate for Payer: Cigna Commercial |
$700.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$700.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$700.80
|
| Rate for Payer: Multiplan Commercial |
$814.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$744.60
|
| Rate for Payer: United Healthcare Commercial |
$832.20
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
5102067001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$138.07 |
| Max. Negotiated Rate |
$819.68 |
| Rate for Payer: Aetna of VT Commercial |
$819.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$781.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$142.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$781.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$193.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$667.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$667.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$158.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$667.77
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Cigna Commercial |
$261.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$539.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$539.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$333.04
|
| Rate for Payer: Multiplan Commercial |
$810.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.07
|
| Rate for Payer: United Healthcare Commercial |
$212.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.07
|
| Rate for Payer: United Healthcare VA CCN |
$138.07
|
|
|
REMOVAL OF TENDON LESION
|
Professional
|
Both
|
$1,283.00
|
|
|
Service Code
|
CPT 27630
|
| Hospital Charge Code |
9822763001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$344.49 |
| Max. Negotiated Rate |
$1,206.02 |
| Rate for Payer: Aetna of VT Commercial |
$1,206.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,149.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$354.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,149.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$482.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$904.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$904.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$396.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$904.09
|
| Rate for Payer: Cash Price |
$641.50
|
| Rate for Payer: Cash Price |
$641.50
|
| Rate for Payer: Cigna Commercial |
$649.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$837.29
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$837.29
|
| Rate for Payer: Martins Point Health Care Commercial |
$513.12
|
| Rate for Payer: Multiplan Commercial |
$1,193.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$489.18
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$344.49
|
| Rate for Payer: United Healthcare Commercial |
$529.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$344.49
|
| Rate for Payer: United Healthcare VA CCN |
$344.49
|
|
|
REMOVAL OF TENDON LESION
|
Facility
|
OP
|
$1,283.00
|
|
|
Service Code
|
CPT 27630
|
| Hospital Charge Code |
9822763001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$568.24 |
| Max. Negotiated Rate |
$1,218.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,218.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,149.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$568.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,149.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$772.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,090.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,039.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$577.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,019.99
|
| Rate for Payer: Cash Price |
$641.50
|
| Rate for Payer: Cigna Commercial |
$1,026.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,026.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,026.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$577.35
|
| Rate for Payer: Multiplan Commercial |
$1,193.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,090.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$577.35
|
| Rate for Payer: United Healthcare Commercial |
$1,218.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$577.35
|
| Rate for Payer: United Healthcare VA CCN |
$577.35
|
|
|
REMOVAL OF TENDON LESION
|
Facility
|
IP
|
$1,283.00
|
|
|
Service Code
|
CPT 27630
|
| Hospital Charge Code |
9822763001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$949.55 |
| Max. Negotiated Rate |
$1,218.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,218.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$949.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$949.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,090.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,077.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,026.40
|
| Rate for Payer: Cash Price |
$641.50
|
| Rate for Payer: Cigna Commercial |
$1,026.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,026.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,026.40
|
| Rate for Payer: Multiplan Commercial |
$1,193.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,090.55
|
| Rate for Payer: United Healthcare Commercial |
$1,218.85
|
|
|
REMOVAL OF TESTIS
|
Professional
|
Both
|
$1,857.00
|
|
|
Service Code
|
CPT 54530
|
| Hospital Charge Code |
9825453001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$480.45 |
| Max. Negotiated Rate |
$1,745.58 |
| Rate for Payer: Aetna of VT Commercial |
$1,745.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,663.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$494.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,663.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$672.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$873.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$873.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$552.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$873.58
|
| Rate for Payer: Cash Price |
$928.50
|
| Rate for Payer: Cash Price |
$928.50
|
| Rate for Payer: Cigna Commercial |
$835.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$792.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$792.54
|
| Rate for Payer: Martins Point Health Care Commercial |
$480.45
|
| Rate for Payer: Multiplan Commercial |
$1,727.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$682.24
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$480.45
|
| Rate for Payer: United Healthcare Commercial |
$739.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$480.45
|
| Rate for Payer: United Healthcare VA CCN |
$480.45
|
|
|
REMOVAL OF TESTIS
|
Facility
|
IP
|
$1,857.00
|
|
|
Service Code
|
CPT 54530
|
| Hospital Charge Code |
9825453001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,374.37 |
| Max. Negotiated Rate |
$1,764.15 |
| Rate for Payer: Aetna of VT Commercial |
$1,764.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,374.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,374.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,578.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,559.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,485.60
|
| Rate for Payer: Cash Price |
$928.50
|
| Rate for Payer: Cigna Commercial |
$1,485.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,485.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,485.60
|
| Rate for Payer: Multiplan Commercial |
$1,727.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,578.45
|
| Rate for Payer: United Healthcare Commercial |
$1,764.15
|
|
|
REMOVAL OF TESTIS
|
Facility
|
OP
|
$1,857.00
|
|
|
Service Code
|
CPT 54530
|
| Hospital Charge Code |
9825453001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$822.47 |
| Max. Negotiated Rate |
$1,764.15 |
| Rate for Payer: Aetna of VT Commercial |
$1,764.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,663.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$822.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,663.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,117.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,578.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,504.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$835.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,476.32
|
| Rate for Payer: Cash Price |
$928.50
|
| Rate for Payer: Cigna Commercial |
$1,485.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,485.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,485.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$835.65
|
| Rate for Payer: Multiplan Commercial |
$1,727.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,578.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$835.65
|
| Rate for Payer: United Healthcare Commercial |
$1,764.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$835.65
|
| Rate for Payer: United Healthcare VA CCN |
$835.65
|
|
|
REMOVAL OF THYROID
|
Facility
|
OP
|
$1,019.00
|
|
|
Service Code
|
CPT 60240
|
| Hospital Charge Code |
9826024001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$451.32 |
| Max. Negotiated Rate |
$968.05 |
| Rate for Payer: Aetna of VT Commercial |
$968.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$912.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$451.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$912.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$613.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$866.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$825.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$458.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$810.11
|
| Rate for Payer: Cash Price |
$509.50
|
| Rate for Payer: Cigna Commercial |
$815.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$815.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$815.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$458.55
|
| Rate for Payer: Multiplan Commercial |
$947.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$866.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$458.55
|
| Rate for Payer: United Healthcare Commercial |
$968.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$458.55
|
| Rate for Payer: United Healthcare VA CCN |
$458.55
|
|
|
REMOVAL OF THYROID
|
Professional
|
Both
|
$1,019.00
|
|
|
Service Code
|
CPT 60240
|
| Hospital Charge Code |
9826024001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$846.88 |
| Max. Negotiated Rate |
$1,681.94 |
| Rate for Payer: Aetna of VT Commercial |
$957.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$912.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$872.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$912.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,185.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,681.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,681.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$973.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,681.94
|
| Rate for Payer: Cash Price |
$509.50
|
| Rate for Payer: Cash Price |
$509.50
|
| Rate for Payer: Cigna Commercial |
$1,551.51
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,424.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,424.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$846.89
|
| Rate for Payer: Multiplan Commercial |
$947.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,202.57
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$846.88
|
| Rate for Payer: United Healthcare Commercial |
$1,302.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$846.88
|
| Rate for Payer: United Healthcare VA CCN |
$846.88
|
|
|
REMOVAL OF THYROID
|
Facility
|
IP
|
$1,019.00
|
|
|
Service Code
|
CPT 60240
|
| Hospital Charge Code |
9826024001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$754.16 |
| Max. Negotiated Rate |
$968.05 |
| Rate for Payer: Aetna of VT Commercial |
$968.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$754.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$754.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$866.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$855.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$815.20
|
| Rate for Payer: Cash Price |
$509.50
|
| Rate for Payer: Cigna Commercial |
$815.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$815.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$815.20
|
| Rate for Payer: Multiplan Commercial |
$947.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$866.15
|
| Rate for Payer: United Healthcare Commercial |
$968.05
|
|
|
REMOVAL OF TOE LESIONS
|
Professional
|
Both
|
$1,924.00
|
|
|
Service Code
|
CPT 28092
|
| Hospital Charge Code |
9822809201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$263.07 |
| Max. Negotiated Rate |
$1,808.56 |
| Rate for Payer: Aetna of VT Commercial |
$1,808.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,723.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$270.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,723.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$368.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$570.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$570.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$302.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$570.19
|
| Rate for Payer: Cash Price |
$962.00
|
| Rate for Payer: Cash Price |
$962.00
|
| Rate for Payer: Cigna Commercial |
$498.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$649.05
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$649.05
|
| Rate for Payer: Martins Point Health Care Commercial |
$400.22
|
| Rate for Payer: Multiplan Commercial |
$1,789.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$373.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$263.07
|
| Rate for Payer: United Healthcare Commercial |
$404.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$263.07
|
| Rate for Payer: United Healthcare VA CCN |
$263.07
|
|
|
REMOVAL OF TOE LESIONS
|
Facility
|
OP
|
$1,924.00
|
|
|
Service Code
|
CPT 28092
|
| Hospital Charge Code |
9822809201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$852.14 |
| Max. Negotiated Rate |
$1,827.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,827.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,723.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$852.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,723.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,158.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,635.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,558.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$865.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,529.58
|
| Rate for Payer: Cash Price |
$962.00
|
| Rate for Payer: Cigna Commercial |
$1,539.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,539.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,539.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$865.80
|
| Rate for Payer: Multiplan Commercial |
$1,789.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,635.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$865.80
|
| Rate for Payer: United Healthcare Commercial |
$1,827.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.80
|
| Rate for Payer: United Healthcare VA CCN |
$865.80
|
|
|
REMOVAL OF TOE LESIONS
|
Facility
|
IP
|
$1,924.00
|
|
|
Service Code
|
CPT 28092
|
| Hospital Charge Code |
9822809201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,423.95 |
| Max. Negotiated Rate |
$1,827.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,827.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,423.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,423.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,635.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,616.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,539.20
|
| Rate for Payer: Cash Price |
$962.00
|
| Rate for Payer: Cigna Commercial |
$1,539.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,539.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,539.20
|
| Rate for Payer: Multiplan Commercial |
$1,789.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,635.40
|
| Rate for Payer: United Healthcare Commercial |
$1,827.80
|
|
|
REMOVAL OF URETHRA GLAND
|
Professional
|
Both
|
$636.00
|
|
|
Service Code
|
CPT 53270
|
| Hospital Charge Code |
9825327001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$174.91 |
| Max. Negotiated Rate |
$597.84 |
| Rate for Payer: Aetna of VT Commercial |
$597.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$569.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$180.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$569.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$244.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$523.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$523.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$201.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$523.30
|
| Rate for Payer: Cash Price |
$318.00
|
| Rate for Payer: Cash Price |
$318.00
|
| Rate for Payer: Cigna Commercial |
$303.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.57
|
| Rate for Payer: Multiplan Commercial |
$591.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$248.37
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$174.91
|
| Rate for Payer: United Healthcare Commercial |
$269.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$174.91
|
| Rate for Payer: United Healthcare VA CCN |
$174.91
|
|
|
REMOVAL OF URETHRA GLAND
|
Facility
|
IP
|
$636.00
|
|
|
Service Code
|
CPT 53270
|
| Hospital Charge Code |
9825327001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$470.70 |
| Max. Negotiated Rate |
$604.20 |
| Rate for Payer: Aetna of VT Commercial |
$604.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$470.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$470.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$540.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$534.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$508.80
|
| Rate for Payer: Cash Price |
$318.00
|
| Rate for Payer: Cigna Commercial |
$508.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$508.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$508.80
|
| Rate for Payer: Multiplan Commercial |
$591.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$540.60
|
| Rate for Payer: United Healthcare Commercial |
$604.20
|
|
|
REMOVAL OF URETHRA GLAND
|
Facility
|
OP
|
$636.00
|
|
|
Service Code
|
CPT 53270
|
| Hospital Charge Code |
9825327001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$281.68 |
| Max. Negotiated Rate |
$604.20 |
| Rate for Payer: Aetna of VT Commercial |
$604.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$569.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$281.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$569.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$382.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$540.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$515.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$286.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$505.62
|
| Rate for Payer: Cash Price |
$318.00
|
| Rate for Payer: Cigna Commercial |
$508.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$508.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$508.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$286.20
|
| Rate for Payer: Multiplan Commercial |
$591.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$540.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$286.20
|
| Rate for Payer: United Healthcare Commercial |
$604.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.20
|
| Rate for Payer: United Healthcare VA CCN |
$286.20
|
|
|
REMOVAL/REVISION OF CAST
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
9812970501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$116.62 |
| 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 |
$43.12
|
| 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 |
$58.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$116.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$116.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$48.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$116.62
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$78.44
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$101.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$101.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$61.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$59.44
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$41.86
|
| Rate for Payer: United Healthcare Commercial |
$64.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.86
|
| Rate for Payer: United Healthcare VA CCN |
$41.86
|
|
