|
STRAPPING TOES
|
Facility
|
OP
|
$57.90
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
4502955001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$55.01 |
| Rate for Payer: Aetna of VT Commercial |
$55.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$25.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$34.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$49.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$46.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$26.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$46.03
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cigna Commercial |
$46.32
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$46.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$46.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$26.05
|
| Rate for Payer: Multiplan Commercial |
$53.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$49.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$26.05
|
| Rate for Payer: United Healthcare Commercial |
$55.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.05
|
| Rate for Payer: United Healthcare VA CCN |
$26.05
|
|
|
STRAPPING TOES
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9822955001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$60.16 |
| Rate for Payer: Aetna of VT Commercial |
$60.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$14.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$48.08
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$19.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$30.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$30.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.70
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare Commercial |
$15.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare VA CCN |
$10.35
|
|
|
STRAPPING TOES
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9602955002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$60.16 |
| Rate for Payer: Aetna of VT Commercial |
$60.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$14.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$48.08
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$19.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$30.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$30.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.70
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare Commercial |
$15.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare VA CCN |
$10.35
|
|
|
STRAPPING TOES
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9602955001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$54.03 |
| Max. Negotiated Rate |
$115.90 |
| Rate for Payer: Aetna of VT Commercial |
$115.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$109.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$54.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$109.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$73.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$103.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$98.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$54.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$96.99
|
| Rate for Payer: Cash Price |
$61.00
|
| Rate for Payer: Cigna Commercial |
$97.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$97.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$97.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$54.90
|
| Rate for Payer: Multiplan Commercial |
$113.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$103.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$54.90
|
| Rate for Payer: United Healthcare Commercial |
$115.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.90
|
| Rate for Payer: United Healthcare VA CCN |
$54.90
|
|
|
STRAPPING TOES
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9812955001
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
|
STRAPPING TOES
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9822955001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$47.37 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna of VT Commercial |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$53.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$51.20
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$54.40
|
| Rate for Payer: United Healthcare Commercial |
$60.80
|
|
|
STRAPPING TOES
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9812955002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna of VT Commercial |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$28.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$38.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$51.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$28.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$50.88
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$51.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.80
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$54.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$28.80
|
| Rate for Payer: United Healthcare Commercial |
$60.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.80
|
| Rate for Payer: United Healthcare VA CCN |
$28.80
|
|
|
STRAPPING TOES
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9812955001
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
|
STRAPPING TOES
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9602955002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna of VT Commercial |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$28.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$38.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$51.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$28.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$50.88
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$51.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.80
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$54.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$28.80
|
| Rate for Payer: United Healthcare Commercial |
$60.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.80
|
| Rate for Payer: United Healthcare VA CCN |
$28.80
|
|
|
STRAPPING TOES
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
5102955001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$54.52 |
| Rate for Payer: Aetna of VT Commercial |
$54.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$14.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$48.08
|
| Rate for Payer: Cash Price |
$29.00
|
| Rate for Payer: Cash Price |
$29.00
|
| Rate for Payer: Cigna Commercial |
$19.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$30.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$30.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.70
|
| Rate for Payer: Multiplan Commercial |
$53.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare Commercial |
$15.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare VA CCN |
$10.35
|
|
|
STRAPPING TOES
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
5102955001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.69 |
| Max. Negotiated Rate |
$55.10 |
| Rate for Payer: Aetna of VT Commercial |
$55.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$25.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$34.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$49.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$46.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$26.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$46.11
|
| Rate for Payer: Cash Price |
$29.00
|
| Rate for Payer: Cigna Commercial |
$46.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$46.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$46.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$26.10
|
| Rate for Payer: Multiplan Commercial |
$53.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$49.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$26.10
|
| Rate for Payer: United Healthcare Commercial |
$55.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.10
|
| Rate for Payer: United Healthcare VA CCN |
$26.10
|
|
|
STRAPPING TOES
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9602955001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$114.68 |
| Rate for Payer: Aetna of VT Commercial |
$114.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$109.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$109.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$14.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$48.08
|
| Rate for Payer: Cash Price |
$61.00
|
| Rate for Payer: Cash Price |
$61.00
|
| Rate for Payer: Cigna Commercial |
$19.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$30.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$30.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.70
|
| Rate for Payer: Multiplan Commercial |
$113.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare Commercial |
$15.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare VA CCN |
$10.35
|
|
|
STRAPPING TOES
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9812955001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$48.08 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.66
|
| 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 |
$14.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$48.08
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$19.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$30.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$30.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.70
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare Commercial |
$15.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare VA CCN |
$10.35
|
|
|
STRAPPING TOES
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9812955002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$60.16 |
| Rate for Payer: Aetna of VT Commercial |
$60.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$10.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$14.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$11.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$48.08
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$19.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$30.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$30.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.70
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare Commercial |
$15.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.35
|
| Rate for Payer: United Healthcare VA CCN |
$10.35
|
|
|
STRAPPING TOES
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9602955001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$90.29 |
| Max. Negotiated Rate |
$115.90 |
| Rate for Payer: Aetna of VT Commercial |
$115.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$90.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$90.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$103.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$102.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$97.60
|
| Rate for Payer: Cash Price |
$61.00
|
| Rate for Payer: Cigna Commercial |
$97.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$97.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$97.60
|
| Rate for Payer: Multiplan Commercial |
$113.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$103.70
|
| Rate for Payer: United Healthcare Commercial |
$115.90
|
|
|
STRAPPING TOES
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9602955002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$47.37 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna of VT Commercial |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$53.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$51.20
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$54.40
|
| Rate for Payer: United Healthcare Commercial |
$60.80
|
|
|
STRAPPING TOES
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9812955002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$47.37 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna of VT Commercial |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$53.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$51.20
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$54.40
|
| Rate for Payer: United Healthcare Commercial |
$60.80
|
|
|
STRAPPING TOES
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
5102955001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.93 |
| Max. Negotiated Rate |
$55.10 |
| Rate for Payer: Aetna of VT Commercial |
$55.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$42.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$42.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$49.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$46.40
|
| Rate for Payer: Cash Price |
$29.00
|
| Rate for Payer: Cigna Commercial |
$46.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$46.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$46.40
|
| Rate for Payer: Multiplan Commercial |
$53.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$49.30
|
| Rate for Payer: United Healthcare Commercial |
$55.10
|
|
|
STRAPPING TOES
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9822955001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna of VT Commercial |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$28.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$57.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$38.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$51.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$28.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$50.88
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cigna Commercial |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$51.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$51.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.80
|
| Rate for Payer: Multiplan Commercial |
$59.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$54.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$28.80
|
| Rate for Payer: United Healthcare Commercial |
$60.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.80
|
| Rate for Payer: United Healthcare VA CCN |
$28.80
|
|
|
STREP A ASSAY W/OPTIC
|
Facility
|
OP
|
$62.30
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
300878800
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.53 |
| Max. Negotiated Rate |
$81.45 |
| Rate for Payer: Aetna of VT Commercial |
$59.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$81.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$27.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$81.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$37.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$52.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$50.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$28.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$49.53
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cigna Commercial |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$49.84
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.04
|
| Rate for Payer: Multiplan Commercial |
$57.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$52.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$28.04
|
| Rate for Payer: United Healthcare Commercial |
$59.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.53
|
| Rate for Payer: United Healthcare VA CCN |
$28.04
|
|
|
STREP A ASSAY W/OPTIC
|
Professional
|
Both
|
$62.30
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
3008788001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$81.45 |
| Rate for Payer: Aetna of VT Commercial |
$58.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$81.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$17.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$81.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$23.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$28.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$28.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$28.26
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cigna Commercial |
$19.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$16.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$16.53
|
| Rate for Payer: Martins Point Health Care Commercial |
$16.30
|
| Rate for Payer: Multiplan Commercial |
$57.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$16.53
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$16.53
|
| Rate for Payer: United Healthcare Commercial |
$25.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.53
|
| Rate for Payer: United Healthcare VA CCN |
$16.53
|
|
|
STREP A ASSAY W/OPTIC
|
Facility
|
OP
|
$62.30
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
3008788001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.53 |
| Max. Negotiated Rate |
$81.45 |
| Rate for Payer: Aetna of VT Commercial |
$59.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$81.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$27.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$81.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$37.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$52.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$50.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$28.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$49.53
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cigna Commercial |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$49.84
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.04
|
| Rate for Payer: Multiplan Commercial |
$57.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$52.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$28.04
|
| Rate for Payer: United Healthcare Commercial |
$59.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.53
|
| Rate for Payer: United Healthcare VA CCN |
$28.04
|
|
|
STREP A ASSAY W/OPTIC
|
Facility
|
IP
|
$62.30
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
3008788001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.11 |
| Max. Negotiated Rate |
$59.19 |
| Rate for Payer: Aetna of VT Commercial |
$59.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$46.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$46.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$52.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$52.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$49.84
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cigna Commercial |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$49.84
|
| Rate for Payer: Multiplan Commercial |
$57.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$52.95
|
| Rate for Payer: United Healthcare Commercial |
$59.19
|
|
|
STREP A ASSAY W/OPTIC
|
Facility
|
IP
|
$62.30
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
300878800
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.11 |
| Max. Negotiated Rate |
$59.19 |
| Rate for Payer: Aetna of VT Commercial |
$59.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$46.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$46.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$52.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$52.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$49.84
|
| Rate for Payer: Cash Price |
$31.15
|
| Rate for Payer: Cigna Commercial |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$49.84
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$49.84
|
| Rate for Payer: Multiplan Commercial |
$57.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$52.95
|
| Rate for Payer: United Healthcare Commercial |
$59.19
|
|
|
STREP B DNA AMP PROBE
|
Facility
|
IP
|
$161.30
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
3008765301
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$119.38 |
| Max. Negotiated Rate |
$153.24 |
| Rate for Payer: Aetna of VT Commercial |
$153.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$119.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$119.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$137.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$135.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$129.04
|
| Rate for Payer: Cash Price |
$80.65
|
| Rate for Payer: Cigna Commercial |
$129.04
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$129.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$129.04
|
| Rate for Payer: Multiplan Commercial |
$150.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$137.10
|
| Rate for Payer: United Healthcare Commercial |
$153.24
|
|
