|
SHAVE SKIN LESION 0.5 CM/<
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
9601130502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$79.72 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna of VT Commercial |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$161.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$79.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$161.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$108.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$145.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$81.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$143.10
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cigna Commercial |
$144.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$144.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$144.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$167.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$153.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$81.00
|
| Rate for Payer: United Healthcare Commercial |
$171.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.00
|
| Rate for Payer: United Healthcare VA CCN |
$81.00
|
|
|
SHAVE SKIN LESION 0.5 CM/<
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
CPT 11300
|
| Hospital Charge Code |
5101130001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.66 |
| Max. Negotiated Rate |
$151.72 |
| Rate for Payer: Aetna of VT Commercial |
$133.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$127.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$32.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$127.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$44.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$127.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$127.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$36.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$127.47
|
| Rate for Payer: Cash Price |
$71.00
|
| Rate for Payer: Cash Price |
$71.00
|
| Rate for Payer: Cigna Commercial |
$35.66
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$151.72
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$151.72
|
| Rate for Payer: Martins Point Health Care Commercial |
$93.97
|
| Rate for Payer: Multiplan Commercial |
$132.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$44.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$31.66
|
| Rate for Payer: United Healthcare Commercial |
$48.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.66
|
| Rate for Payer: United Healthcare VA CCN |
$31.66
|
|
|
SHAVE SKIN LESION 0.5 CM/<
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
9811130501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$133.22 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna of VT Commercial |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$133.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$133.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$151.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$144.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cigna Commercial |
$144.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$144.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$144.00
|
| Rate for Payer: Multiplan Commercial |
$167.40
|
| Rate for Payer: MVP Health Care of NY Commercial |
$153.00
|
| Rate for Payer: United Healthcare Commercial |
$171.00
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9601130101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$143.06 |
| Max. Negotiated Rate |
$306.85 |
| Rate for Payer: Aetna of VT Commercial |
$306.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$289.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$143.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$289.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$194.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$274.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$261.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$256.79
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cigna Commercial |
$258.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$258.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$258.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$145.35
|
| Rate for Payer: Multiplan Commercial |
$300.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$274.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$145.35
|
| Rate for Payer: United Healthcare Commercial |
$306.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$145.35
|
| Rate for Payer: United Healthcare VA CCN |
$145.35
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
9601130602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$45.56 |
| Max. Negotiated Rate |
$185.67 |
| Rate for Payer: Aetna of VT Commercial |
$183.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$174.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$46.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$174.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$63.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$156.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$156.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$52.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$156.64
|
| Rate for Payer: Cash Price |
$97.50
|
| Rate for Payer: Cash Price |
$97.50
|
| Rate for Payer: Cigna Commercial |
$51.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$185.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$185.67
|
| Rate for Payer: Martins Point Health Care Commercial |
$114.94
|
| Rate for Payer: Multiplan Commercial |
$181.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$64.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare Commercial |
$70.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare VA CCN |
$45.56
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
9601130601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$45.56 |
| Max. Negotiated Rate |
$291.40 |
| Rate for Payer: Aetna of VT Commercial |
$291.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$277.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$46.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$277.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$63.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$156.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$156.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$52.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$156.64
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$51.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$185.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$185.67
|
| Rate for Payer: Martins Point Health Care Commercial |
$114.94
|
| Rate for Payer: Multiplan Commercial |
$288.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$64.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare Commercial |
$70.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare VA CCN |
$45.56
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
5101130101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.13 |
| Max. Negotiated Rate |
$184.64 |
| Rate for Payer: Aetna of VT Commercial |
$105.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$100.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$49.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$100.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$67.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$154.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$154.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$55.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$154.40
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cigna Commercial |
$53.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$184.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$184.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$113.97
|
| Rate for Payer: Multiplan Commercial |
$104.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$68.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$48.13
|
| Rate for Payer: United Healthcare Commercial |
$74.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.13
|
| Rate for Payer: United Healthcare VA CCN |
$48.13
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
9601130601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$137.30 |
| Max. Negotiated Rate |
$294.50 |
| Rate for Payer: Aetna of VT Commercial |
$294.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$277.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$137.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$277.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$186.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$263.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$139.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$246.45
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$248.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$248.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$248.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$139.50
|
| Rate for Payer: Multiplan Commercial |
$288.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$263.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$139.50
|
| Rate for Payer: United Healthcare Commercial |
$294.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$139.50
|
| Rate for Payer: United Healthcare VA CCN |
$139.50
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
5101130601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.56 |
| Max. Negotiated Rate |
$185.67 |
| Rate for Payer: Aetna of VT Commercial |
$109.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$103.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$46.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$103.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$63.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$156.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$156.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$52.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$156.64
|
| Rate for Payer: Cash Price |
$58.00
|
| Rate for Payer: Cash Price |
$58.00
|
| Rate for Payer: Cigna Commercial |
$51.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$185.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$185.67
|
| Rate for Payer: Martins Point Health Care Commercial |
$114.94
|
| Rate for Payer: Multiplan Commercial |
$107.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$64.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare Commercial |
$70.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare VA CCN |
$45.56
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$116.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
5101130601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.38 |
| Max. Negotiated Rate |
$110.20 |
| Rate for Payer: Aetna of VT Commercial |
$110.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$103.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$51.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$103.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$69.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$98.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$93.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$92.22
|
| Rate for Payer: Cash Price |
$58.00
|
| Rate for Payer: Cigna Commercial |
$92.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$92.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$92.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$107.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$98.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$52.20
|
| Rate for Payer: United Healthcare Commercial |
$110.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52.20
|
| Rate for Payer: United Healthcare VA CCN |
$52.20
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
5101130601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$85.85 |
| Max. Negotiated Rate |
$110.20 |
| Rate for Payer: Aetna of VT Commercial |
$110.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$85.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$85.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$98.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$97.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$92.80
|
| Rate for Payer: Cash Price |
$58.00
|
| Rate for Payer: Cigna Commercial |
$92.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$92.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$92.80
|
| Rate for Payer: Multiplan Commercial |
$107.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$98.60
|
| Rate for Payer: United Healthcare Commercial |
$110.20
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9601130102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$48.13 |
| Max. Negotiated Rate |
$198.34 |
| Rate for Payer: Aetna of VT Commercial |
$198.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$189.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$49.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$189.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$67.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$154.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$154.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$55.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$154.40
|
| Rate for Payer: Cash Price |
$105.50
|
| Rate for Payer: Cash Price |
$105.50
|
| Rate for Payer: Cigna Commercial |
$53.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$184.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$184.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$113.97
|
| Rate for Payer: Multiplan Commercial |
$196.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$68.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$48.13
|
| Rate for Payer: United Healthcare Commercial |
$74.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.13
|
| Rate for Payer: United Healthcare VA CCN |
$48.13
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9601130102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$156.16 |
| Max. Negotiated Rate |
$200.45 |
| Rate for Payer: Aetna of VT Commercial |
$200.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$156.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$156.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$177.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$168.80
|
| Rate for Payer: Cash Price |
$105.50
|
| Rate for Payer: Cigna Commercial |
$168.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.80
|
| Rate for Payer: Multiplan Commercial |
$196.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.35
|
| Rate for Payer: United Healthcare Commercial |
$200.45
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9601130102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$93.45 |
| Max. Negotiated Rate |
$200.45 |
| Rate for Payer: Aetna of VT Commercial |
$200.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$189.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$93.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$189.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$127.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$179.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$170.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$94.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$167.75
|
| Rate for Payer: Cash Price |
$105.50
|
| Rate for Payer: Cigna Commercial |
$168.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$168.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$168.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$94.95
|
| Rate for Payer: Multiplan Commercial |
$196.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$94.95
|
| Rate for Payer: United Healthcare Commercial |
$200.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$94.95
|
| Rate for Payer: United Healthcare VA CCN |
$94.95
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$323.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9601130101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$48.13 |
| Max. Negotiated Rate |
$303.62 |
| Rate for Payer: Aetna of VT Commercial |
$303.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$289.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$49.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$289.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$67.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$154.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$154.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$55.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$154.40
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cigna Commercial |
$53.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$184.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$184.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$113.97
|
| Rate for Payer: Multiplan Commercial |
$300.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$68.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$48.13
|
| Rate for Payer: United Healthcare Commercial |
$74.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.13
|
| Rate for Payer: United Healthcare VA CCN |
$48.13
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
9601130601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$229.43 |
| Max. Negotiated Rate |
$294.50 |
| Rate for Payer: Aetna of VT Commercial |
$294.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$229.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$229.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$263.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$260.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$248.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$248.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$248.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$248.00
|
| Rate for Payer: Multiplan Commercial |
$288.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$263.50
|
| Rate for Payer: United Healthcare Commercial |
$294.50
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$195.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
9601130602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$86.37 |
| Max. Negotiated Rate |
$185.25 |
| Rate for Payer: Aetna of VT Commercial |
$185.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$174.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$86.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$174.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$117.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$157.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$87.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$155.03
|
| Rate for Payer: Cash Price |
$97.50
|
| Rate for Payer: Cigna Commercial |
$156.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$156.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$156.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$87.75
|
| Rate for Payer: Multiplan Commercial |
$181.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$165.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$87.75
|
| Rate for Payer: United Healthcare Commercial |
$185.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$87.75
|
| Rate for Payer: United Healthcare VA CCN |
$87.75
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
5101130101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$82.89 |
| Max. Negotiated Rate |
$106.40 |
| Rate for Payer: Aetna of VT Commercial |
$106.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$82.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$82.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$95.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$94.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$89.60
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cigna Commercial |
$89.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$89.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$89.60
|
| Rate for Payer: Multiplan Commercial |
$104.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$95.20
|
| Rate for Payer: United Healthcare Commercial |
$106.40
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$112.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
5101130101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$106.40 |
| Rate for Payer: Aetna of VT Commercial |
$106.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$100.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$49.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$100.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$95.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$90.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$50.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$89.04
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cigna Commercial |
$89.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$89.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$89.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$104.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$95.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$50.40
|
| Rate for Payer: United Healthcare Commercial |
$106.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50.40
|
| Rate for Payer: United Healthcare VA CCN |
$50.40
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$195.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
9601130602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$144.32 |
| Max. Negotiated Rate |
$185.25 |
| Rate for Payer: Aetna of VT Commercial |
$185.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$144.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$144.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$163.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$156.00
|
| Rate for Payer: Cash Price |
$97.50
|
| Rate for Payer: Cigna Commercial |
$156.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$156.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$156.00
|
| Rate for Payer: Multiplan Commercial |
$181.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$165.75
|
| Rate for Payer: United Healthcare Commercial |
$185.25
|
|
|
SHAVE SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9601130101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$239.05 |
| Max. Negotiated Rate |
$306.85 |
| Rate for Payer: Aetna of VT Commercial |
$306.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$239.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$239.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$274.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$271.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$258.40
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cigna Commercial |
$258.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$258.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$258.40
|
| Rate for Payer: Multiplan Commercial |
$300.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$274.55
|
| Rate for Payer: United Healthcare Commercial |
$306.85
|
|
|
SHAVE SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
9601130201
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$130.66 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Aetna of VT Commercial |
$280.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$130.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$177.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$250.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$238.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$132.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$234.53
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$236.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$132.75
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$250.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$132.75
|
| Rate for Payer: United Healthcare Commercial |
$280.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$132.75
|
| Rate for Payer: United Healthcare VA CCN |
$132.75
|
|
|
SHAVE SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
9601130202
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$152.46 |
| Max. Negotiated Rate |
$195.70 |
| Rate for Payer: Aetna of VT Commercial |
$195.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$152.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$152.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$175.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$173.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$164.80
|
| Rate for Payer: Cash Price |
$103.00
|
| Rate for Payer: Cigna Commercial |
$164.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$164.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$164.80
|
| Rate for Payer: Multiplan Commercial |
$191.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$175.10
|
| Rate for Payer: United Healthcare Commercial |
$195.70
|
|
|
SHAVE SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
9601130201
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Aetna of VT Commercial |
$280.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$250.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$247.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$236.00
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$236.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$236.00
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$250.75
|
| Rate for Payer: United Healthcare Commercial |
$280.25
|
|
|
SHAVE SKIN LESION 1.1-2.0 CM
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
9601130201
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$55.89 |
| Max. Negotiated Rate |
$277.30 |
| Rate for Payer: Aetna of VT Commercial |
$277.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$57.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$264.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$78.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$178.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$178.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$64.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$178.44
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$62.71
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$209.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$209.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$129.12
|
| Rate for Payer: Multiplan Commercial |
$274.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$79.36
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$55.89
|
| Rate for Payer: United Healthcare Commercial |
$85.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$55.89
|
| Rate for Payer: United Healthcare VA CCN |
$55.89
|
|
