|
REMOVE PILONIDAL CYST EXTEN
|
Facility
|
OP
|
$1,535.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
9821177101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$679.85 |
| Max. Negotiated Rate |
$1,458.25 |
| Rate for Payer: Aetna of VT Commercial |
$1,458.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,375.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$679.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,375.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$924.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,304.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,243.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$690.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,220.33
|
| Rate for Payer: Cash Price |
$767.50
|
| Rate for Payer: Cigna Commercial |
$1,228.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,228.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,228.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$690.75
|
| Rate for Payer: Multiplan Commercial |
$1,427.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,304.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$690.75
|
| Rate for Payer: United Healthcare Commercial |
$1,458.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$690.75
|
| Rate for Payer: United Healthcare VA CCN |
$690.75
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
9811177002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$171.26 |
| Max. Negotiated Rate |
$774.56 |
| Rate for Payer: Aetna of VT Commercial |
$774.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$176.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$239.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$443.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$443.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$196.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$443.68
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cigna Commercial |
$315.29
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$536.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$536.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$326.39
|
| Rate for Payer: Multiplan Commercial |
$766.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$243.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$171.26
|
| Rate for Payer: United Healthcare Commercial |
$263.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$171.26
|
| Rate for Payer: United Healthcare VA CCN |
$171.26
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$824.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
9811177002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$364.95 |
| Max. Negotiated Rate |
$782.80 |
| Rate for Payer: Aetna of VT Commercial |
$782.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$364.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$496.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$700.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$667.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$370.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$655.08
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cigna Commercial |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$659.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$370.80
|
| Rate for Payer: Multiplan Commercial |
$766.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$700.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$370.80
|
| Rate for Payer: United Healthcare Commercial |
$782.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$370.80
|
| Rate for Payer: United Healthcare VA CCN |
$370.80
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
9811177001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$171.26 |
| Max. Negotiated Rate |
$774.56 |
| Rate for Payer: Aetna of VT Commercial |
$774.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$176.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$239.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$443.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$443.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$196.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$443.68
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cigna Commercial |
$315.29
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$536.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$536.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$326.39
|
| Rate for Payer: Multiplan Commercial |
$766.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$243.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$171.26
|
| Rate for Payer: United Healthcare Commercial |
$263.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$171.26
|
| Rate for Payer: United Healthcare VA CCN |
$171.26
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$824.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
9811177002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$609.84 |
| Max. Negotiated Rate |
$782.80 |
| Rate for Payer: Aetna of VT Commercial |
$782.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$609.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$609.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$700.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$692.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$659.20
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cigna Commercial |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$659.20
|
| Rate for Payer: Multiplan Commercial |
$766.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$700.40
|
| Rate for Payer: United Healthcare Commercial |
$782.80
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$5,439.67
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
4501177001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,409.23 |
| Max. Negotiated Rate |
$5,167.69 |
| Rate for Payer: Aetna of VT Commercial |
$5,167.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,873.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,409.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,873.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$3,274.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,623.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,406.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,447.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,324.54
|
| Rate for Payer: Cash Price |
$2,719.84
|
| Rate for Payer: Cigna Commercial |
$4,351.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,351.74
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,351.74
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,447.85
|
| Rate for Payer: Multiplan Commercial |
$5,058.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,623.72
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,447.85
|
| Rate for Payer: United Healthcare Commercial |
$5,167.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,447.85
|
| Rate for Payer: United Healthcare VA CCN |
$2,447.85
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$824.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
9811177001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$364.95 |
| Max. Negotiated Rate |
$782.80 |
| Rate for Payer: Aetna of VT Commercial |
$782.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$364.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$738.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$496.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$700.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$667.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$370.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$655.08
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cigna Commercial |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$659.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$370.80
|
| Rate for Payer: Multiplan Commercial |
$766.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$700.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$370.80
|
| Rate for Payer: United Healthcare Commercial |
$782.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$370.80
|
| Rate for Payer: United Healthcare VA CCN |
$370.80
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$824.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
9811177001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$609.84 |
| Max. Negotiated Rate |
$782.80 |
| Rate for Payer: Aetna of VT Commercial |
$782.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$609.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$609.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$700.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$692.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$659.20
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cigna Commercial |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$659.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$659.20
|
| Rate for Payer: Multiplan Commercial |
$766.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$700.40
|
| Rate for Payer: United Healthcare Commercial |
$782.80
|
|
|
REMOVE PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$5,439.67
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
4501177001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,025.90 |
| Max. Negotiated Rate |
$5,167.69 |
| Rate for Payer: Aetna of VT Commercial |
$5,167.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,025.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,025.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,623.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,569.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,351.74
|
| Rate for Payer: Cash Price |
$2,719.84
|
| Rate for Payer: Cigna Commercial |
$4,351.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,351.74
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,351.74
|
| Rate for Payer: Multiplan Commercial |
$5,058.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,623.72
|
| Rate for Payer: United Healthcare Commercial |
$5,167.69
|
|
|
REMOVE PROSTATE REGROWTH
|
Facility
|
OP
|
$3,016.00
|
|
|
Service Code
|
CPT 52630
|
| Hospital Charge Code |
9825263001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,335.79 |
| Max. Negotiated Rate |
$2,865.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,865.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,702.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,335.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,702.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,815.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,563.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,442.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,357.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,397.72
|
| Rate for Payer: Cash Price |
$1,508.00
|
| Rate for Payer: Cigna Commercial |
$2,412.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,412.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,412.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,357.20
|
| Rate for Payer: Multiplan Commercial |
$2,804.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,563.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,357.20
|
| Rate for Payer: United Healthcare Commercial |
$2,865.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,357.20
|
| Rate for Payer: United Healthcare VA CCN |
$1,357.20
|
|
|
REMOVE PROSTATE REGROWTH
|
Professional
|
Both
|
$3,016.00
|
|
|
Service Code
|
CPT 52630
|
| Hospital Charge Code |
9825263001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$384.59 |
| Max. Negotiated Rate |
$2,835.04 |
| Rate for Payer: Aetna of VT Commercial |
$2,835.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,702.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$396.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,702.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$538.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$980.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$980.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$442.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$980.75
|
| Rate for Payer: Cash Price |
$1,508.00
|
| Rate for Payer: Cash Price |
$1,508.00
|
| Rate for Payer: Cigna Commercial |
$668.09
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$633.11
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$633.11
|
| Rate for Payer: Martins Point Health Care Commercial |
$384.59
|
| Rate for Payer: Multiplan Commercial |
$2,804.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$546.12
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$384.59
|
| Rate for Payer: United Healthcare Commercial |
$591.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$384.59
|
| Rate for Payer: United Healthcare VA CCN |
$384.59
|
|
|
REMOVE PROSTATE REGROWTH
|
Facility
|
IP
|
$3,016.00
|
|
|
Service Code
|
CPT 52630
|
| Hospital Charge Code |
9825263001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,232.14 |
| Max. Negotiated Rate |
$2,865.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,865.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,232.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,232.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,563.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,533.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,412.80
|
| Rate for Payer: Cash Price |
$1,508.00
|
| Rate for Payer: Cigna Commercial |
$2,412.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,412.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,412.80
|
| Rate for Payer: Multiplan Commercial |
$2,804.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,563.60
|
| Rate for Payer: United Healthcare Commercial |
$2,865.20
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
IP
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9814591501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$706.06 |
| Max. Negotiated Rate |
$906.30 |
| Rate for Payer: Aetna of VT Commercial |
$906.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$706.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$706.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$810.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$801.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$763.20
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$763.20
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.90
|
| Rate for Payer: United Healthcare Commercial |
$906.30
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
IP
|
$10,098.30
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
4504591501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$7,473.75 |
| Max. Negotiated Rate |
$9,593.39 |
| Rate for Payer: Aetna of VT Commercial |
$9,593.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$7,473.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$7,473.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$8,583.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$8,482.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$8,078.64
|
| Rate for Payer: Cash Price |
$5,049.15
|
| Rate for Payer: Cigna Commercial |
$8,078.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$8,078.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$8,078.64
|
| Rate for Payer: Multiplan Commercial |
$9,391.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$8,583.56
|
| Rate for Payer: United Healthcare Commercial |
$9,593.39
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
OP
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9824591501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$422.53 |
| Max. Negotiated Rate |
$906.30 |
| Rate for Payer: Aetna of VT Commercial |
$906.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$422.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$574.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$810.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$772.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$429.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$758.43
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$763.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$429.30
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$429.30
|
| Rate for Payer: United Healthcare Commercial |
$906.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$429.30
|
| Rate for Payer: United Healthcare VA CCN |
$429.30
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
IP
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9824591501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$706.06 |
| Max. Negotiated Rate |
$906.30 |
| Rate for Payer: Aetna of VT Commercial |
$906.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$706.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$706.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$810.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$801.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$763.20
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$763.20
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.90
|
| Rate for Payer: United Healthcare Commercial |
$906.30
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9814591502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$215.38 |
| Max. Negotiated Rate |
$896.76 |
| Rate for Payer: Aetna of VT Commercial |
$896.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$221.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$301.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$505.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$505.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$247.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$505.07
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$391.79
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$549.79
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$549.79
|
| Rate for Payer: Martins Point Health Care Commercial |
$334.86
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$305.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$215.38
|
| Rate for Payer: United Healthcare Commercial |
$331.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$215.38
|
| Rate for Payer: United Healthcare VA CCN |
$215.38
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9814591501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$215.38 |
| Max. Negotiated Rate |
$896.76 |
| Rate for Payer: Aetna of VT Commercial |
$896.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$221.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$301.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$505.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$505.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$247.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$505.07
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$391.79
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$549.79
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$549.79
|
| Rate for Payer: Martins Point Health Care Commercial |
$334.86
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$305.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$215.38
|
| Rate for Payer: United Healthcare Commercial |
$331.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$215.38
|
| Rate for Payer: United Healthcare VA CCN |
$215.38
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
IP
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9814591502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$706.06 |
| Max. Negotiated Rate |
$906.30 |
| Rate for Payer: Aetna of VT Commercial |
$906.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$706.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$706.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$810.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$801.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$763.20
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$763.20
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.90
|
| Rate for Payer: United Healthcare Commercial |
$906.30
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
OP
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9814591501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$422.53 |
| Max. Negotiated Rate |
$906.30 |
| Rate for Payer: Aetna of VT Commercial |
$906.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$422.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$574.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$810.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$772.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$429.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$758.43
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$763.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$429.30
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$429.30
|
| Rate for Payer: United Healthcare Commercial |
$906.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$429.30
|
| Rate for Payer: United Healthcare VA CCN |
$429.30
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
OP
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9814591502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$422.53 |
| Max. Negotiated Rate |
$906.30 |
| Rate for Payer: Aetna of VT Commercial |
$906.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$422.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$574.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$810.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$772.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$429.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$758.43
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$763.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$763.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$429.30
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$429.30
|
| Rate for Payer: United Healthcare Commercial |
$906.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$429.30
|
| Rate for Payer: United Healthcare VA CCN |
$429.30
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
9824591501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$215.38 |
| Max. Negotiated Rate |
$896.76 |
| Rate for Payer: Aetna of VT Commercial |
$896.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$221.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$854.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$301.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$505.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$505.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$247.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$505.07
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cash Price |
$477.00
|
| Rate for Payer: Cigna Commercial |
$391.79
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$549.79
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$549.79
|
| Rate for Payer: Martins Point Health Care Commercial |
$334.86
|
| Rate for Payer: Multiplan Commercial |
$887.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$305.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$215.38
|
| Rate for Payer: United Healthcare Commercial |
$331.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$215.38
|
| Rate for Payer: United Healthcare VA CCN |
$215.38
|
|
|
REMOVE RECTAL OBSTRUCTION
|
Facility
|
OP
|
$10,098.30
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
4504591501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,472.54 |
| Max. Negotiated Rate |
$9,593.39 |
| Rate for Payer: Aetna of VT Commercial |
$9,593.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$9,047.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$4,472.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$9,047.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$6,079.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$8,583.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$8,179.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$4,544.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$8,028.15
|
| Rate for Payer: Cash Price |
$5,049.15
|
| Rate for Payer: Cigna Commercial |
$8,078.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$8,078.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$8,078.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$4,544.23
|
| Rate for Payer: Multiplan Commercial |
$9,391.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$8,583.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$4,544.23
|
| Rate for Payer: United Healthcare Commercial |
$9,593.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,544.23
|
| Rate for Payer: United Healthcare VA CCN |
$4,544.23
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
OP
|
$455.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
9601585101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$201.52 |
| Max. Negotiated Rate |
$432.25 |
| Rate for Payer: Aetna of VT Commercial |
$432.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$407.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$201.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$407.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$273.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$386.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$368.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$204.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$361.73
|
| Rate for Payer: Cash Price |
$227.50
|
| Rate for Payer: Cigna Commercial |
$364.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$364.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$364.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$204.75
|
| Rate for Payer: Multiplan Commercial |
$423.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$386.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$204.75
|
| Rate for Payer: United Healthcare Commercial |
$432.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$204.75
|
| Rate for Payer: United Healthcare VA CCN |
$204.75
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
9601585101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$53.17 |
| Max. Negotiated Rate |
$427.70 |
| Rate for Payer: Aetna of VT Commercial |
$427.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$407.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$63.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$407.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$86.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$139.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$139.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$70.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$139.67
|
| Rate for Payer: Cash Price |
$227.50
|
| Rate for Payer: Cash Price |
$227.50
|
| Rate for Payer: Cigna Commercial |
$69.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$87.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$87.94
|
| Rate for Payer: Martins Point Health Care Commercial |
$53.17
|
| Rate for Payer: Multiplan Commercial |
$423.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$87.37
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$61.53
|
| Rate for Payer: United Healthcare Commercial |
$94.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$61.53
|
| Rate for Payer: United Healthcare VA CCN |
$61.53
|
|
