|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
IP
|
$191.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
5101585101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$141.36 |
| Max. Negotiated Rate |
$181.45 |
| Rate for Payer: Aetna of VT Commercial |
$181.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$141.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$141.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$162.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$160.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$152.80
|
| Rate for Payer: Cash Price |
$95.50
|
| Rate for Payer: Cigna Commercial |
$152.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$152.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$152.80
|
| Rate for Payer: Multiplan Commercial |
$177.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$162.35
|
| Rate for Payer: United Healthcare Commercial |
$181.45
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
CPT 23630
|
| Hospital Charge Code |
9821585101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$237.41 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna of VT Commercial |
$249.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$762.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,036.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,059.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,059.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$851.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,059.85
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$1,400.77
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,233.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,233.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$740.21
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,051.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$740.21
|
| Rate for Payer: United Healthcare Commercial |
$1,138.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$740.21
|
| Rate for Payer: United Healthcare VA CCN |
$740.21
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
5101585101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.17 |
| Max. Negotiated Rate |
$179.54 |
| Rate for Payer: Aetna of VT Commercial |
$179.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$171.12
|
| 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 |
$171.12
|
| 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 |
$95.50
|
| Rate for Payer: Cash Price |
$95.50
|
| 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 |
$177.63
|
| 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
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
IP
|
$265.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
9601585102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$196.13 |
| Max. Negotiated Rate |
$251.75 |
| Rate for Payer: Aetna of VT Commercial |
$251.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$222.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$212.00
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$212.00
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
IP
|
$455.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
9601585101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$336.75 |
| 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 |
$336.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$336.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$386.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$382.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$364.00
|
| 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: Multiplan Commercial |
$423.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$386.75
|
| Rate for Payer: United Healthcare Commercial |
$432.25
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
OP
|
$191.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
5101585101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$84.59 |
| Max. Negotiated Rate |
$181.45 |
| Rate for Payer: Aetna of VT Commercial |
$181.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$171.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$84.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$171.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$114.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$162.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$154.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$85.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$151.84
|
| Rate for Payer: Cash Price |
$95.50
|
| Rate for Payer: Cigna Commercial |
$152.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$152.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$152.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$85.95
|
| Rate for Payer: Multiplan Commercial |
$177.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$162.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$85.95
|
| Rate for Payer: United Healthcare Commercial |
$181.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$85.95
|
| Rate for Payer: United Healthcare VA CCN |
$85.95
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
OP
|
$265.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
9601585102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$117.37 |
| Max. Negotiated Rate |
$251.75 |
| Rate for Payer: Aetna of VT Commercial |
$251.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$117.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$159.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$214.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$210.68
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$212.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$119.25
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare VA CCN |
$119.25
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
OP
|
$265.00
|
|
|
Service Code
|
CPT 23630
|
| Hospital Charge Code |
9821585101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$117.37 |
| Max. Negotiated Rate |
$251.75 |
| Rate for Payer: Aetna of VT Commercial |
$251.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$117.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$159.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$214.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$210.68
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$212.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$119.25
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare VA CCN |
$119.25
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
9601585102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$53.17 |
| Max. Negotiated Rate |
$249.10 |
| Rate for Payer: Aetna of VT Commercial |
$249.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| 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 |
$237.41
|
| 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 |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| 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 |
$246.45
|
| 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
|
|
|
REMOVE SUTURES DIFF SURGEON
|
Facility
|
IP
|
$265.00
|
|
|
Service Code
|
CPT 23630
|
| Hospital Charge Code |
9821585101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$196.13 |
| Max. Negotiated Rate |
$251.75 |
| Rate for Payer: Aetna of VT Commercial |
$251.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$222.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$212.00
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$212.00
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
|
|
REMOVE SUTURES SAME SURGEON
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
5101585001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.94 |
| 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 SHOP Off Exchange |
$0.90
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: United Healthcare Commercial |
$0.85
|
| Rate for Payer: United Healthcare VA CCN |
$0.40
|
|
|
REMOVE SUTURES SAME SURGEON
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
9601585002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.94 |
| 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 SHOP Off Exchange |
$0.90
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: United Healthcare Commercial |
$0.85
|
| Rate for Payer: United Healthcare VA CCN |
$0.40
|
|
|
REMOVE SUTURES SAME SURGEON
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
9601585002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
REMOVE SUTURES SAME SURGEON
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
9601585001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.94 |
| 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 SHOP Off Exchange |
$0.90
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: United Healthcare Commercial |
$0.85
|
| Rate for Payer: United Healthcare VA CCN |
$0.40
|
|
|
REMOVE SUTURES SAME SURGEON
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
5101585001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
REMOVE SUTURES SAME SURGEON
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
5101585001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
REMOVE SUTURES SAME SURGEON
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
9601585001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
REMOVE SUTURES SAME SURGEON
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
9601585001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
REMOVE SUTURES SAME SURGEON
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 15850
|
| Hospital Charge Code |
9601585002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
REMOVE TENDON SHEATH LESION
|
Facility
|
IP
|
$2,883.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
5102616001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,133.71 |
| Max. Negotiated Rate |
$2,738.85 |
| Rate for Payer: Aetna of VT Commercial |
$2,738.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,133.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,133.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,450.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,421.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,306.40
|
| Rate for Payer: Cash Price |
$1,441.50
|
| Rate for Payer: Cigna Commercial |
$2,306.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,306.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,306.40
|
| Rate for Payer: Multiplan Commercial |
$2,681.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,450.55
|
| Rate for Payer: United Healthcare Commercial |
$2,738.85
|
|
|
REMOVE TENDON SHEATH LESION
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
9602616002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$306.73 |
| Max. Negotiated Rate |
$1,876.24 |
| Rate for Payer: Aetna of VT Commercial |
$1,876.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,788.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$315.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,788.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$429.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,030.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,030.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$352.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,030.05
|
| Rate for Payer: Cash Price |
$998.00
|
| Rate for Payer: Cash Price |
$998.00
|
| Rate for Payer: Cigna Commercial |
$579.44
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$946.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$946.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$581.68
|
| Rate for Payer: Multiplan Commercial |
$1,856.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$435.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$306.73
|
| Rate for Payer: United Healthcare Commercial |
$471.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$306.73
|
| Rate for Payer: United Healthcare VA CCN |
$306.73
|
|
|
REMOVE TENDON SHEATH LESION
|
Professional
|
Both
|
$4,879.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
9602616001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$306.73 |
| Max. Negotiated Rate |
$4,586.26 |
| Rate for Payer: Aetna of VT Commercial |
$4,586.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,371.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$315.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,371.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$429.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,030.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,030.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$352.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,030.05
|
| Rate for Payer: Cash Price |
$2,439.50
|
| Rate for Payer: Cash Price |
$2,439.50
|
| Rate for Payer: Cigna Commercial |
$579.44
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$946.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$946.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$581.68
|
| Rate for Payer: Multiplan Commercial |
$4,537.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$435.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$306.73
|
| Rate for Payer: United Healthcare Commercial |
$471.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$306.73
|
| Rate for Payer: United Healthcare VA CCN |
$306.73
|
|
|
REMOVE TENDON SHEATH LESION
|
Facility
|
OP
|
$1,996.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
9602616002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$884.03 |
| Max. Negotiated Rate |
$1,896.20 |
| Rate for Payer: Aetna of VT Commercial |
$1,896.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,788.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$884.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,788.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,201.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,696.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,616.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$898.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,586.82
|
| Rate for Payer: Cash Price |
$998.00
|
| Rate for Payer: Cigna Commercial |
$1,596.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,596.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,596.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$898.20
|
| Rate for Payer: Multiplan Commercial |
$1,856.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,696.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$898.20
|
| Rate for Payer: United Healthcare Commercial |
$1,896.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$898.20
|
| Rate for Payer: United Healthcare VA CCN |
$898.20
|
|
|
REMOVE TENDON SHEATH LESION
|
Facility
|
OP
|
$2,883.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
5102616001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,276.88 |
| Max. Negotiated Rate |
$2,738.85 |
| Rate for Payer: Aetna of VT Commercial |
$2,738.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,582.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,276.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,582.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,735.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,450.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,335.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,297.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,291.99
|
| Rate for Payer: Cash Price |
$1,441.50
|
| Rate for Payer: Cigna Commercial |
$2,306.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,306.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,306.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,297.35
|
| Rate for Payer: Multiplan Commercial |
$2,681.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,450.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,297.35
|
| Rate for Payer: United Healthcare Commercial |
$2,738.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,297.35
|
| Rate for Payer: United Healthcare VA CCN |
$1,297.35
|
|
|
REMOVE TENDON SHEATH LESION
|
Professional
|
Both
|
$2,883.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
5102616001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$306.73 |
| Max. Negotiated Rate |
$2,710.02 |
| Rate for Payer: Aetna of VT Commercial |
$2,710.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,582.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$315.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,582.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$429.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,030.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,030.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$352.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,030.05
|
| Rate for Payer: Cash Price |
$1,441.50
|
| Rate for Payer: Cash Price |
$1,441.50
|
| Rate for Payer: Cigna Commercial |
$579.44
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$946.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$946.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$581.68
|
| Rate for Payer: Multiplan Commercial |
$2,681.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$435.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$306.73
|
| Rate for Payer: United Healthcare Commercial |
$471.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$306.73
|
| Rate for Payer: United Healthcare VA CCN |
$306.73
|
|
