|
TIGHTROPE II ABS IMPLANT OPEN
|
Facility
|
IP
|
$330.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2780072991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.73 |
| Max. Negotiated Rate |
$314.14 |
| Rate for Payer: Aetna of VT Commercial |
$314.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$244.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$244.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$281.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$264.54
|
| Rate for Payer: Cash Price |
$165.34
|
| Rate for Payer: Cigna Commercial |
$264.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$264.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$264.54
|
| Rate for Payer: Multiplan Commercial |
$307.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$281.07
|
| Rate for Payer: United Healthcare Commercial |
$314.14
|
|
|
TISS TRNSGLTMNASE EA IG CLAS
|
Facility
|
OP
|
$218.36
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
3008636401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$207.44 |
| Rate for Payer: Aetna of VT Commercial |
$207.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$56.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$96.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$56.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$131.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$185.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$176.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$98.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$173.60
|
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Cigna Commercial |
$174.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$174.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$174.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$98.26
|
| Rate for Payer: Multiplan Commercial |
$203.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$185.61
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.26
|
| Rate for Payer: United Healthcare Commercial |
$207.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.53
|
| Rate for Payer: United Healthcare VA CCN |
$98.26
|
|
|
TISS TRNSGLTMNASE EA IG CLAS
|
Professional
|
Both
|
$218.36
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
3008636401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$205.26 |
| Rate for Payer: Aetna of VT Commercial |
$205.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$56.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$11.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$56.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$16.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$13.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$13.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$13.60
|
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Cigna Commercial |
$13.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$11.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$11.53
|
| Rate for Payer: Martins Point Health Care Commercial |
$11.37
|
| Rate for Payer: Multiplan Commercial |
$203.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$11.53
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$11.53
|
| Rate for Payer: United Healthcare Commercial |
$17.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.53
|
| Rate for Payer: United Healthcare VA CCN |
$11.53
|
|
|
TISS TRNSGLTMNASE EA IG CLAS
|
Facility
|
IP
|
$218.36
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
3008636401
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$161.61 |
| Max. Negotiated Rate |
$207.44 |
| Rate for Payer: Aetna of VT Commercial |
$207.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$161.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$161.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$185.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$183.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$174.69
|
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Cigna Commercial |
$174.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$174.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$174.69
|
| Rate for Payer: Multiplan Commercial |
$203.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$185.61
|
| Rate for Payer: United Healthcare Commercial |
$207.44
|
|
|
TISSUE CULTURE BONE MARROW
|
Facility
|
OP
|
$634.07
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
3008823701
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$143.75 |
| Max. Negotiated Rate |
$708.33 |
| Rate for Payer: Aetna of VT Commercial |
$602.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$708.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$280.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$708.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$381.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$538.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$513.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$285.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$504.09
|
| Rate for Payer: Cash Price |
$317.04
|
| Rate for Payer: Cash Price |
$317.04
|
| Rate for Payer: Cigna Commercial |
$507.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$285.33
|
| Rate for Payer: Multiplan Commercial |
$589.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$538.96
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$285.33
|
| Rate for Payer: United Healthcare Commercial |
$602.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.75
|
| Rate for Payer: United Healthcare VA CCN |
$285.33
|
|
|
TISSUE CULTURE BONE MARROW
|
Professional
|
Both
|
$634.07
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
3008823701
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$141.74 |
| Max. Negotiated Rate |
$708.33 |
| Rate for Payer: Aetna of VT Commercial |
$596.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$708.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$148.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$708.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$201.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$169.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$169.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$165.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$169.45
|
| Rate for Payer: Cash Price |
$317.04
|
| Rate for Payer: Cash Price |
$317.04
|
| Rate for Payer: Cigna Commercial |
$174.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$199.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$199.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$141.74
|
| Rate for Payer: Multiplan Commercial |
$589.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$143.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$143.75
|
| Rate for Payer: United Healthcare Commercial |
$221.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.75
|
| Rate for Payer: United Healthcare VA CCN |
$143.75
|
|
|
TISSUE CULTURE BONE MARROW
|
Facility
|
IP
|
$634.07
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
3008823701
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$469.28 |
| Max. Negotiated Rate |
$602.37 |
| Rate for Payer: Aetna of VT Commercial |
$602.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$469.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$469.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$538.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$532.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$507.26
|
| Rate for Payer: Cash Price |
$317.04
|
| Rate for Payer: Cigna Commercial |
$507.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.26
|
| Rate for Payer: Multiplan Commercial |
$589.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$538.96
|
| Rate for Payer: United Healthcare Commercial |
$602.37
|
|
|
TISSUE CULTURE LYMPHOCYTE
|
Facility
|
IP
|
$800.32
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
3008823001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$592.32 |
| Max. Negotiated Rate |
$760.30 |
| Rate for Payer: Aetna of VT Commercial |
$760.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$592.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$592.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$680.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$672.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$640.26
|
| Rate for Payer: Cash Price |
$400.16
|
| Rate for Payer: Cigna Commercial |
$640.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$640.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$640.26
|
| Rate for Payer: Multiplan Commercial |
$744.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$680.27
|
| Rate for Payer: United Healthcare Commercial |
$760.30
|
|
|
TISSUE CULTURE LYMPHOCYTE
|
Facility
|
OP
|
$800.32
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
3008823001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$116.49 |
| Max. Negotiated Rate |
$760.30 |
| Rate for Payer: Aetna of VT Commercial |
$760.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$574.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$354.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$574.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$481.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$680.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$648.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$360.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$636.25
|
| Rate for Payer: Cash Price |
$400.16
|
| Rate for Payer: Cash Price |
$400.16
|
| Rate for Payer: Cigna Commercial |
$640.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$640.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$640.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$360.14
|
| Rate for Payer: Multiplan Commercial |
$744.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$680.27
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$360.14
|
| Rate for Payer: United Healthcare Commercial |
$760.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$116.49
|
| Rate for Payer: United Healthcare VA CCN |
$360.14
|
|
|
TISSUE CULTURE LYMPHOCYTE
|
Professional
|
Both
|
$800.32
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
3008823001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$114.86 |
| Max. Negotiated Rate |
$752.30 |
| Rate for Payer: Aetna of VT Commercial |
$752.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$574.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$119.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$574.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$163.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$137.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$137.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$133.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$137.31
|
| Rate for Payer: Cash Price |
$400.16
|
| Rate for Payer: Cash Price |
$400.16
|
| Rate for Payer: Cigna Commercial |
$141.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$161.79
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$161.79
|
| Rate for Payer: Martins Point Health Care Commercial |
$114.86
|
| Rate for Payer: Multiplan Commercial |
$744.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$116.49
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$116.49
|
| Rate for Payer: United Healthcare Commercial |
$179.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$116.49
|
| Rate for Payer: United Healthcare VA CCN |
$116.49
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Professional
|
Both
|
$716.93
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
3008830701
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$275.52 |
| Max. Negotiated Rate |
$1,011.67 |
| Rate for Payer: Aetna of VT Commercial |
$673.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,011.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$283.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,011.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$385.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$375.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$375.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$316.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$375.88
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cigna Commercial |
$370.31
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$442.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$442.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$275.52
|
| Rate for Payer: Multiplan Commercial |
$666.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$275.52
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$275.52
|
| Rate for Payer: United Healthcare Commercial |
$423.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$275.52
|
| Rate for Payer: United Healthcare VA CCN |
$275.52
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
IP
|
$266.77
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
3008830401
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$197.44 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna of VT Commercial |
$253.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$197.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$197.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$226.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$224.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$213.42
|
| Rate for Payer: Cash Price |
$133.38
|
| Rate for Payer: Cigna Commercial |
$213.42
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$213.42
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$213.42
|
| Rate for Payer: Multiplan Commercial |
$248.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$226.75
|
| Rate for Payer: United Healthcare Commercial |
$253.43
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Professional
|
Both
|
$193.10
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
3008830201
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$181.51 |
| Rate for Payer: Aetna of VT Commercial |
$181.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$129.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$32.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$129.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$44.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$54.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$54.40
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cigna Commercial |
$42.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$51.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$51.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$31.85
|
| Rate for Payer: Multiplan Commercial |
$179.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$31.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$31.84
|
| Rate for Payer: United Healthcare Commercial |
$48.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.84
|
| Rate for Payer: United Healthcare VA CCN |
$31.84
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
OP
|
$262.76
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
3008830501
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.92 |
| Max. Negotiated Rate |
$249.62 |
| Rate for Payer: Aetna of VT Commercial |
$249.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$172.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$116.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$172.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$158.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$223.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$212.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$118.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$208.89
|
| Rate for Payer: Cash Price |
$131.38
|
| Rate for Payer: Cash Price |
$131.38
|
| Rate for Payer: Cigna Commercial |
$210.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$210.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$210.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$118.24
|
| Rate for Payer: Multiplan Commercial |
$244.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$223.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$118.24
|
| Rate for Payer: United Healthcare Commercial |
$249.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$68.92
|
| Rate for Payer: United Healthcare VA CCN |
$118.24
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
OP
|
$716.93
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
3008830901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$317.53 |
| Max. Negotiated Rate |
$1,419.86 |
| Rate for Payer: Aetna of VT Commercial |
$681.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,419.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$317.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,419.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$431.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$609.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$580.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$322.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$569.96
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cigna Commercial |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$573.54
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.62
|
| Rate for Payer: Multiplan Commercial |
$666.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$609.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$322.62
|
| Rate for Payer: United Healthcare Commercial |
$681.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$411.83
|
| Rate for Payer: United Healthcare VA CCN |
$322.62
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
IP
|
$716.93
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
3008830901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$530.60 |
| Max. Negotiated Rate |
$681.08 |
| Rate for Payer: Aetna of VT Commercial |
$681.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$530.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$530.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$609.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$602.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$573.54
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cigna Commercial |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$573.54
|
| Rate for Payer: Multiplan Commercial |
$666.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$609.39
|
| Rate for Payer: United Healthcare Commercial |
$681.08
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Professional
|
Both
|
$266.77
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
3008830401
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.85 |
| Max. Negotiated Rate |
$250.76 |
| Rate for Payer: Aetna of VT Commercial |
$250.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$154.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$42.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$154.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$57.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$46.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$71.70
|
| Rate for Payer: Cash Price |
$133.38
|
| Rate for Payer: Cash Price |
$133.38
|
| Rate for Payer: Cigna Commercial |
$55.09
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$65.83
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$65.83
|
| Rate for Payer: Martins Point Health Care Commercial |
$40.85
|
| Rate for Payer: Multiplan Commercial |
$248.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$40.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$40.86
|
| Rate for Payer: United Healthcare Commercial |
$62.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.86
|
| Rate for Payer: United Healthcare VA CCN |
$40.86
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
IP
|
$262.76
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
3008830501
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$194.47 |
| Max. Negotiated Rate |
$249.62 |
| Rate for Payer: Aetna of VT Commercial |
$249.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$194.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$194.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$223.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$220.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$210.21
|
| Rate for Payer: Cash Price |
$131.38
|
| Rate for Payer: Cigna Commercial |
$210.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$210.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$210.21
|
| Rate for Payer: Multiplan Commercial |
$244.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$223.35
|
| Rate for Payer: United Healthcare Commercial |
$249.62
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
OP
|
$193.10
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
3008830201
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$183.44 |
| Rate for Payer: Aetna of VT Commercial |
$183.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$129.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$85.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$129.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$116.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$164.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$156.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$86.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$153.51
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cigna Commercial |
$154.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$154.48
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$154.48
|
| Rate for Payer: Martins Point Health Care Commercial |
$86.89
|
| Rate for Payer: Multiplan Commercial |
$179.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$164.13
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$86.89
|
| Rate for Payer: United Healthcare Commercial |
$183.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.84
|
| Rate for Payer: United Healthcare VA CCN |
$86.89
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Professional
|
Both
|
$262.76
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
3008830501
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.92 |
| Max. Negotiated Rate |
$246.99 |
| Rate for Payer: Aetna of VT Commercial |
$246.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$172.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$70.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$172.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$96.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$121.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$121.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$79.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$121.82
|
| Rate for Payer: Cash Price |
$131.38
|
| Rate for Payer: Cash Price |
$131.38
|
| Rate for Payer: Cigna Commercial |
$92.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$110.57
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$110.57
|
| Rate for Payer: Martins Point Health Care Commercial |
$68.92
|
| Rate for Payer: Multiplan Commercial |
$244.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$68.92
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$68.92
|
| Rate for Payer: United Healthcare Commercial |
$106.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$68.92
|
| Rate for Payer: United Healthcare VA CCN |
$68.92
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
IP
|
$716.93
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
3008830701
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$530.60 |
| Max. Negotiated Rate |
$681.08 |
| Rate for Payer: Aetna of VT Commercial |
$681.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$530.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$530.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$609.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$602.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$573.54
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cigna Commercial |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$573.54
|
| Rate for Payer: Multiplan Commercial |
$666.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$609.39
|
| Rate for Payer: United Healthcare Commercial |
$681.08
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
OP
|
$716.93
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
3008830701
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$275.52 |
| Max. Negotiated Rate |
$1,011.67 |
| Rate for Payer: Aetna of VT Commercial |
$681.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,011.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$317.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,011.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$431.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$609.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$580.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$322.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$569.96
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cigna Commercial |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$573.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$573.54
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.62
|
| Rate for Payer: Multiplan Commercial |
$666.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$609.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$322.62
|
| Rate for Payer: United Healthcare Commercial |
$681.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$275.52
|
| Rate for Payer: United Healthcare VA CCN |
$322.62
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
OP
|
$266.77
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
3008830401
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.86 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna of VT Commercial |
$253.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$154.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$118.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$154.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$160.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$226.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$216.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$120.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$212.08
|
| Rate for Payer: Cash Price |
$133.38
|
| Rate for Payer: Cash Price |
$133.38
|
| Rate for Payer: Cigna Commercial |
$213.42
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$213.42
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$213.42
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.05
|
| Rate for Payer: Multiplan Commercial |
$248.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$226.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$120.05
|
| Rate for Payer: United Healthcare Commercial |
$253.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.86
|
| Rate for Payer: United Healthcare VA CCN |
$120.05
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Facility
|
IP
|
$193.10
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
3008830201
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$142.91 |
| Max. Negotiated Rate |
$183.44 |
| Rate for Payer: Aetna of VT Commercial |
$183.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$164.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$162.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$154.48
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cigna Commercial |
$154.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$154.48
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$154.48
|
| Rate for Payer: Multiplan Commercial |
$179.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$164.13
|
| Rate for Payer: United Healthcare Commercial |
$183.44
|
|
|
TISSUE EXAM BY PATHOLOGIST
|
Professional
|
Both
|
$716.93
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
3008830901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$411.83 |
| Max. Negotiated Rate |
$1,419.86 |
| Rate for Payer: Aetna of VT Commercial |
$673.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,419.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$424.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,419.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$576.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$548.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$548.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$473.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$548.94
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cash Price |
$358.46
|
| Rate for Payer: Cigna Commercial |
$556.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$660.37
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$660.37
|
| Rate for Payer: Martins Point Health Care Commercial |
$411.83
|
| Rate for Payer: Multiplan Commercial |
$666.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$411.83
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$411.83
|
| Rate for Payer: United Healthcare Commercial |
$633.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$411.83
|
| Rate for Payer: United Healthcare VA CCN |
$411.83
|
|
