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Service Code CPT 26727
Hospital Charge Code 9822672701
Hospital Revenue Code 982
Min. Negotiated Rate $459.17
Max. Negotiated Rate $1,332.92
Rate for Payer: Aetna of VT Commercial $1,332.92
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $472.95
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $642.84
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $689.68
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $689.68
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $528.05
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $689.68
Rate for Payer: Cash Price $709.00
Rate for Payer: Cash Price $709.00
Rate for Payer: Cigna Commercial $869.54
Rate for Payer: Harvard Pilgrim Health Care HMO $758.59
Rate for Payer: Harvard Pilgrim Health Care PPO $758.59
Rate for Payer: Martins Point Health Care Commercial $459.17
Rate for Payer: Multiplan Commercial $1,318.74
Rate for Payer: MVP Health Care of NY Commercial $652.02
Rate for Payer: MVP Health Care of NY Medicare Advantage $459.17
Rate for Payer: United Healthcare Commercial $706.34
Rate for Payer: United Healthcare Medicare Advantage $459.17
Rate for Payer: United Healthcare VA CCN $459.17
Service Code CPT 26750
Hospital Charge Code 9602675001
Hospital Revenue Code 960
Min. Negotiated Rate $345.63
Max. Negotiated Rate $443.65
Rate for Payer: Aetna of VT Commercial $443.65
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $345.63
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $345.63
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $396.95
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $392.28
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $373.60
Rate for Payer: Cash Price $233.50
Rate for Payer: Cigna Commercial $373.60
Rate for Payer: Harvard Pilgrim Health Care HMO $373.60
Rate for Payer: Harvard Pilgrim Health Care PPO $373.60
Rate for Payer: Multiplan Commercial $434.31
Rate for Payer: MVP Health Care of NY Commercial $396.95
Rate for Payer: United Healthcare Commercial $443.65
Service Code CPT 26755
Hospital Charge Code 4502675501
Hospital Revenue Code 450
Min. Negotiated Rate $364.84
Max. Negotiated Rate $468.31
Rate for Payer: Aetna of VT Commercial $468.31
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $364.84
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $364.84
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $419.02
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $414.09
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $394.37
Rate for Payer: Cash Price $246.48
Rate for Payer: Cigna Commercial $394.37
Rate for Payer: Harvard Pilgrim Health Care HMO $394.37
Rate for Payer: Harvard Pilgrim Health Care PPO $394.37
Rate for Payer: Multiplan Commercial $458.45
Rate for Payer: MVP Health Care of NY Commercial $419.02
Rate for Payer: United Healthcare Commercial $468.31
Service Code CPT 26765
Hospital Charge Code 9602676502
Hospital Revenue Code 960
Min. Negotiated Rate $485.99
Max. Negotiated Rate $1,332.92
Rate for Payer: Aetna of VT Commercial $1,332.92
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $500.57
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $680.39
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $603.75
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $603.75
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $558.89
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $603.75
Rate for Payer: Cash Price $709.00
Rate for Payer: Cash Price $709.00
Rate for Payer: Cigna Commercial $919.55
Rate for Payer: Harvard Pilgrim Health Care HMO $803.34
Rate for Payer: Harvard Pilgrim Health Care PPO $803.34
Rate for Payer: Martins Point Health Care Commercial $485.99
Rate for Payer: Multiplan Commercial $1,318.74
Rate for Payer: MVP Health Care of NY Commercial $690.11
Rate for Payer: MVP Health Care of NY Medicare Advantage $485.99
Rate for Payer: United Healthcare Commercial $747.60
Rate for Payer: United Healthcare Medicare Advantage $485.99
Rate for Payer: United Healthcare VA CCN $485.99
Service Code CPT 26765
Hospital Charge Code 9602676502
Hospital Revenue Code 960
Min. Negotiated Rate $628.03
Max. Negotiated Rate $1,347.10
Rate for Payer: Aetna of VT Commercial $1,347.10
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $628.03
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $853.64
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,205.30
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,148.58
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $638.10
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $1,127.31
Rate for Payer: Cash Price $709.00
Rate for Payer: Cigna Commercial $1,134.40
Rate for Payer: Harvard Pilgrim Health Care HMO $1,134.40
Rate for Payer: Harvard Pilgrim Health Care PPO $1,134.40
Rate for Payer: Martins Point Health Care Commercial $638.10
Rate for Payer: Multiplan Commercial $1,318.74
Rate for Payer: MVP Health Care of NY Commercial $1,205.30
Rate for Payer: MVP Health Care of NY Medicare Advantage $638.10
Rate for Payer: United Healthcare Commercial $1,347.10
Rate for Payer: United Healthcare Medicare Advantage $638.10
Rate for Payer: United Healthcare VA CCN $638.10
Service Code CPT 26725
Hospital Charge Code 4502672501
Hospital Revenue Code 450
Min. Negotiated Rate $176.77
Max. Negotiated Rate $379.16
Rate for Payer: Aetna of VT Commercial $379.16
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $357.57
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $176.77
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $357.57
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $240.27
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $339.25
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $323.29
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $179.60
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $317.30
Rate for Payer: Cash Price $199.56
Rate for Payer: Cigna Commercial $319.30
Rate for Payer: Harvard Pilgrim Health Care HMO $319.30
Rate for Payer: Harvard Pilgrim Health Care PPO $319.30
Rate for Payer: Martins Point Health Care Commercial $179.60
Rate for Payer: Multiplan Commercial $371.18
Rate for Payer: MVP Health Care of NY Commercial $339.25
Rate for Payer: MVP Health Care of NY Medicare Advantage $179.60
Rate for Payer: United Healthcare Commercial $379.16
Rate for Payer: United Healthcare Medicare Advantage $179.60
Rate for Payer: United Healthcare VA CCN $179.60
Service Code CPT 26725
Hospital Charge Code 9602672501
Hospital Revenue Code 960
Min. Negotiated Rate $557.61
Max. Negotiated Rate $1,196.05
Rate for Payer: Aetna of VT Commercial $1,196.05
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,127.94
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $557.61
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,127.94
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $757.92
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,070.15
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,019.79
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $566.55
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $1,000.90
Rate for Payer: Cash Price $629.50
Rate for Payer: Cigna Commercial $1,007.20
Rate for Payer: Harvard Pilgrim Health Care HMO $1,007.20
Rate for Payer: Harvard Pilgrim Health Care PPO $1,007.20
Rate for Payer: Martins Point Health Care Commercial $566.55
Rate for Payer: Multiplan Commercial $1,170.87
Rate for Payer: MVP Health Care of NY Commercial $1,070.15
Rate for Payer: MVP Health Care of NY Medicare Advantage $566.55
Rate for Payer: United Healthcare Commercial $1,196.05
Rate for Payer: United Healthcare Medicare Advantage $566.55
Rate for Payer: United Healthcare VA CCN $566.55
Service Code CPT 26755
Hospital Charge Code 9812675502
Hospital Revenue Code 981
Min. Negotiated Rate $555.82
Max. Negotiated Rate $713.45
Rate for Payer: Aetna of VT Commercial $713.45
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $555.82
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $555.82
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $638.35
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $630.84
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $600.80
Rate for Payer: Cash Price $375.50
Rate for Payer: Cigna Commercial $600.80
Rate for Payer: Harvard Pilgrim Health Care HMO $600.80
Rate for Payer: Harvard Pilgrim Health Care PPO $600.80
Rate for Payer: Multiplan Commercial $698.43
Rate for Payer: MVP Health Care of NY Commercial $638.35
Rate for Payer: United Healthcare Commercial $713.45
Service Code CPT 26735
Hospital Charge Code 9602673501
Hospital Revenue Code 960
Min. Negotiated Rate $2,316.51
Max. Negotiated Rate $2,973.50
Rate for Payer: Aetna of VT Commercial $2,973.50
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $2,316.51
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $2,316.51
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $2,660.50
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $2,629.20
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $2,504.00
Rate for Payer: Cash Price $1,565.00
Rate for Payer: Cigna Commercial $2,504.00
Rate for Payer: Harvard Pilgrim Health Care HMO $2,504.00
Rate for Payer: Harvard Pilgrim Health Care PPO $2,504.00
Rate for Payer: Multiplan Commercial $2,910.90
Rate for Payer: MVP Health Care of NY Commercial $2,660.50
Rate for Payer: United Healthcare Commercial $2,973.50
Service Code CPT 26765
Hospital Charge Code 9602676501
Hospital Revenue Code 960
Min. Negotiated Rate $1,078.90
Max. Negotiated Rate $2,314.20
Rate for Payer: Aetna of VT Commercial $2,314.20
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $2,182.41
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $1,078.90
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $2,182.41
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $1,466.47
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $2,070.60
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,973.16
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $1,096.20
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $1,936.62
Rate for Payer: Cash Price $1,218.00
Rate for Payer: Cigna Commercial $1,948.80
Rate for Payer: Harvard Pilgrim Health Care HMO $1,948.80
Rate for Payer: Harvard Pilgrim Health Care PPO $1,948.80
Rate for Payer: Martins Point Health Care Commercial $1,096.20
Rate for Payer: Multiplan Commercial $2,265.48
Rate for Payer: MVP Health Care of NY Commercial $2,070.60
Rate for Payer: MVP Health Care of NY Medicare Advantage $1,096.20
Rate for Payer: United Healthcare Commercial $2,314.20
Rate for Payer: United Healthcare Medicare Advantage $1,096.20
Rate for Payer: United Healthcare VA CCN $1,096.20
Service Code CPT 26750
Hospital Charge Code 9812675002
Hospital Revenue Code 981
Min. Negotiated Rate $188.56
Max. Negotiated Rate $358.80
Rate for Payer: Aetna of VT Commercial $248.16
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $236.52
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $196.53
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $236.52
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $267.13
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $264.91
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $264.91
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $219.43
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $264.91
Rate for Payer: Cash Price $132.00
Rate for Payer: Cash Price $132.00
Rate for Payer: Cigna Commercial $358.80
Rate for Payer: Harvard Pilgrim Health Care HMO $310.12
Rate for Payer: Harvard Pilgrim Health Care PPO $310.12
Rate for Payer: Martins Point Health Care Commercial $188.56
Rate for Payer: Multiplan Commercial $245.52
Rate for Payer: MVP Health Care of NY Commercial $270.95
Rate for Payer: MVP Health Care of NY Medicare Advantage $190.81
Rate for Payer: United Healthcare Commercial $293.52
Rate for Payer: United Healthcare Medicare Advantage $190.81
Rate for Payer: United Healthcare VA CCN $190.81
Service Code CPT 26735
Hospital Charge Code 9602673502
Hospital Revenue Code 960
Min. Negotiated Rate $571.03
Max. Negotiated Rate $1,332.92
Rate for Payer: Aetna of VT Commercial $1,332.92
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $588.16
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,270.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $799.44
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $712.16
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $712.16
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $656.68
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $712.16
Rate for Payer: Cash Price $709.00
Rate for Payer: Cash Price $709.00
Rate for Payer: Cigna Commercial $1,079.61
Rate for Payer: Harvard Pilgrim Health Care HMO $946.32
Rate for Payer: Harvard Pilgrim Health Care PPO $946.32
Rate for Payer: Martins Point Health Care Commercial $571.03
Rate for Payer: Multiplan Commercial $1,318.74
Rate for Payer: MVP Health Care of NY Commercial $810.86
Rate for Payer: MVP Health Care of NY Medicare Advantage $571.03
Rate for Payer: United Healthcare Commercial $878.42
Rate for Payer: United Healthcare Medicare Advantage $571.03
Rate for Payer: United Healthcare VA CCN $571.03
Service Code CPT 26720
Hospital Charge Code 9602672001
Hospital Revenue Code 960
Min. Negotiated Rate $513.63
Max. Negotiated Rate $659.30
Rate for Payer: Aetna of VT Commercial $659.30
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $513.63
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $513.63
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $589.90
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $582.96
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $555.20
Rate for Payer: Cash Price $347.00
Rate for Payer: Cigna Commercial $555.20
Rate for Payer: Harvard Pilgrim Health Care HMO $555.20
Rate for Payer: Harvard Pilgrim Health Care PPO $555.20
Rate for Payer: Multiplan Commercial $645.42
Rate for Payer: MVP Health Care of NY Commercial $589.90
Rate for Payer: United Healthcare Commercial $659.30
Service Code CPT 26746
Hospital Charge Code 9822674601
Hospital Revenue Code 982
Min. Negotiated Rate $707.25
Max. Negotiated Rate $1,902.56
Rate for Payer: Aetna of VT Commercial $1,902.56
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,813.30
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $728.47
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,813.30
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $990.15
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $886.43
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $886.43
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $813.34
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $886.43
Rate for Payer: Cash Price $1,012.00
Rate for Payer: Cash Price $1,012.00
Rate for Payer: Cigna Commercial $1,336.84
Rate for Payer: Harvard Pilgrim Health Care HMO $1,174.15
Rate for Payer: Harvard Pilgrim Health Care PPO $1,174.15
Rate for Payer: Martins Point Health Care Commercial $707.25
Rate for Payer: Multiplan Commercial $1,882.32
Rate for Payer: MVP Health Care of NY Commercial $1,004.29
Rate for Payer: MVP Health Care of NY Medicare Advantage $707.25
Rate for Payer: United Healthcare Commercial $1,087.96
Rate for Payer: United Healthcare Medicare Advantage $707.25
Rate for Payer: United Healthcare VA CCN $707.25
Service Code CPT 26725
Hospital Charge Code 9602672502
Hospital Revenue Code 960
Min. Negotiated Rate $380.89
Max. Negotiated Rate $817.00
Rate for Payer: Aetna of VT Commercial $817.00
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $770.47
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $380.89
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $770.47
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $517.72
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $731.00
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $696.60
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $387.00
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $683.70
Rate for Payer: Cash Price $430.00
Rate for Payer: Cigna Commercial $688.00
Rate for Payer: Harvard Pilgrim Health Care HMO $688.00
Rate for Payer: Harvard Pilgrim Health Care PPO $688.00
Rate for Payer: Martins Point Health Care Commercial $387.00
Rate for Payer: Multiplan Commercial $799.80
Rate for Payer: MVP Health Care of NY Commercial $731.00
Rate for Payer: MVP Health Care of NY Medicare Advantage $387.00
Rate for Payer: United Healthcare Commercial $817.00
Rate for Payer: United Healthcare Medicare Advantage $387.00
Rate for Payer: United Healthcare VA CCN $387.00
Service Code CPT 26725
Hospital Charge Code 9602672502
Hospital Revenue Code 960
Min. Negotiated Rate $299.81
Max. Negotiated Rate $808.40
Rate for Payer: Aetna of VT Commercial $808.40
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $770.47
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $308.80
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $770.47
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $419.73
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $454.45
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $454.45
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $344.78
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $454.45
Rate for Payer: Cash Price $430.00
Rate for Payer: Cash Price $430.00
Rate for Payer: Cigna Commercial $566.22
Rate for Payer: Harvard Pilgrim Health Care HMO $555.96
Rate for Payer: Harvard Pilgrim Health Care PPO $555.96
Rate for Payer: Martins Point Health Care Commercial $337.72
Rate for Payer: Multiplan Commercial $799.80
Rate for Payer: MVP Health Care of NY Commercial $425.73
Rate for Payer: MVP Health Care of NY Medicare Advantage $299.81
Rate for Payer: United Healthcare Commercial $461.20
Rate for Payer: United Healthcare Medicare Advantage $299.81
Rate for Payer: United Healthcare VA CCN $299.81
Service Code CPT 26720
Hospital Charge Code 9812672002
Hospital Revenue Code 981
Min. Negotiated Rate $364.13
Max. Negotiated Rate $467.40
Rate for Payer: Aetna of VT Commercial $467.40
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $364.13
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $364.13
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $418.20
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $413.28
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $393.60
Rate for Payer: Cash Price $246.00
Rate for Payer: Cigna Commercial $393.60
Rate for Payer: Harvard Pilgrim Health Care HMO $393.60
Rate for Payer: Harvard Pilgrim Health Care PPO $393.60
Rate for Payer: Multiplan Commercial $457.56
Rate for Payer: MVP Health Care of NY Commercial $418.20
Rate for Payer: United Healthcare Commercial $467.40
Service Code CPT 26765
Hospital Charge Code 5102676501
Hospital Revenue Code 510
Min. Negotiated Rate $450.87
Max. Negotiated Rate $967.10
Rate for Payer: Aetna of VT Commercial $967.10
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $912.03
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $450.87
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $912.03
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $612.84
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $865.30
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $824.58
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $458.10
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $809.31
Rate for Payer: Cash Price $509.00
Rate for Payer: Cigna Commercial $814.40
Rate for Payer: Harvard Pilgrim Health Care HMO $814.40
Rate for Payer: Harvard Pilgrim Health Care PPO $814.40
Rate for Payer: Martins Point Health Care Commercial $458.10
Rate for Payer: Multiplan Commercial $946.74
Rate for Payer: MVP Health Care of NY Commercial $865.30
Rate for Payer: MVP Health Care of NY Medicare Advantage $458.10
Rate for Payer: United Healthcare Commercial $967.10
Rate for Payer: United Healthcare Medicare Advantage $458.10
Rate for Payer: United Healthcare VA CCN $458.10
Service Code CPT 26725
Hospital Charge Code 5102672501
Hospital Revenue Code 510
Min. Negotiated Rate $299.81
Max. Negotiated Rate $566.22
Rate for Payer: Aetna of VT Commercial $376.00
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $358.36
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $308.80
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $358.36
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $419.73
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $454.45
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $454.45
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $344.78
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $454.45
Rate for Payer: Cash Price $200.00
Rate for Payer: Cash Price $200.00
Rate for Payer: Cigna Commercial $566.22
Rate for Payer: Harvard Pilgrim Health Care HMO $555.96
Rate for Payer: Harvard Pilgrim Health Care PPO $555.96
Rate for Payer: Martins Point Health Care Commercial $337.72
Rate for Payer: Multiplan Commercial $372.00
Rate for Payer: MVP Health Care of NY Commercial $425.73
Rate for Payer: MVP Health Care of NY Medicare Advantage $299.81
Rate for Payer: United Healthcare Commercial $461.20
Rate for Payer: United Healthcare Medicare Advantage $299.81
Rate for Payer: United Healthcare VA CCN $299.81
Service Code CPT 26750
Hospital Charge Code 5102675001
Hospital Revenue Code 510
Min. Negotiated Rate $89.91
Max. Negotiated Rate $192.85
Rate for Payer: Aetna of VT Commercial $192.85
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $181.87
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $89.91
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $181.87
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $122.21
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $172.55
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $164.43
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $91.35
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $161.38
Rate for Payer: Cash Price $101.50
Rate for Payer: Cigna Commercial $162.40
Rate for Payer: Harvard Pilgrim Health Care HMO $162.40
Rate for Payer: Harvard Pilgrim Health Care PPO $162.40
Rate for Payer: Martins Point Health Care Commercial $91.35
Rate for Payer: Multiplan Commercial $188.79
Rate for Payer: MVP Health Care of NY Commercial $172.55
Rate for Payer: MVP Health Care of NY Medicare Advantage $91.35
Rate for Payer: United Healthcare Commercial $192.85
Rate for Payer: United Healthcare Medicare Advantage $91.35
Rate for Payer: United Healthcare VA CCN $91.35
Service Code CPT 26720
Hospital Charge Code 9602672001
Hospital Revenue Code 960
Min. Negotiated Rate $307.37
Max. Negotiated Rate $659.30
Rate for Payer: Aetna of VT Commercial $659.30
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $621.75
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $307.37
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $621.75
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $417.79
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $589.90
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $562.14
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $312.30
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $551.73
Rate for Payer: Cash Price $347.00
Rate for Payer: Cigna Commercial $555.20
Rate for Payer: Harvard Pilgrim Health Care HMO $555.20
Rate for Payer: Harvard Pilgrim Health Care PPO $555.20
Rate for Payer: Martins Point Health Care Commercial $312.30
Rate for Payer: Multiplan Commercial $645.42
Rate for Payer: MVP Health Care of NY Commercial $589.90
Rate for Payer: MVP Health Care of NY Medicare Advantage $312.30
Rate for Payer: United Healthcare Commercial $659.30
Rate for Payer: United Healthcare Medicare Advantage $312.30
Rate for Payer: United Healthcare VA CCN $312.30
Service Code CPT 26750
Hospital Charge Code 9602675001
Hospital Revenue Code 960
Min. Negotiated Rate $188.56
Max. Negotiated Rate $438.98
Rate for Payer: Aetna of VT Commercial $438.98
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $418.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $196.53
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $418.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $267.13
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $264.91
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $264.91
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $219.43
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $264.91
Rate for Payer: Cash Price $233.50
Rate for Payer: Cash Price $233.50
Rate for Payer: Cigna Commercial $358.80
Rate for Payer: Harvard Pilgrim Health Care HMO $310.12
Rate for Payer: Harvard Pilgrim Health Care PPO $310.12
Rate for Payer: Martins Point Health Care Commercial $188.56
Rate for Payer: Multiplan Commercial $434.31
Rate for Payer: MVP Health Care of NY Commercial $270.95
Rate for Payer: MVP Health Care of NY Medicare Advantage $190.81
Rate for Payer: United Healthcare Commercial $293.52
Rate for Payer: United Healthcare Medicare Advantage $190.81
Rate for Payer: United Healthcare VA CCN $190.81
Service Code CPT 26755
Hospital Charge Code 5102675501
Hospital Revenue Code 510
Min. Negotiated Rate $271.31
Max. Negotiated Rate $524.60
Rate for Payer: Aetna of VT Commercial $463.42
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $441.68
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $279.45
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $441.68
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $379.83
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $406.45
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $406.45
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $312.01
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $406.45
Rate for Payer: Cash Price $246.50
Rate for Payer: Cash Price $246.50
Rate for Payer: Cigna Commercial $508.65
Rate for Payer: Harvard Pilgrim Health Care HMO $524.60
Rate for Payer: Harvard Pilgrim Health Care PPO $524.60
Rate for Payer: Martins Point Health Care Commercial $318.52
Rate for Payer: Multiplan Commercial $458.49
Rate for Payer: MVP Health Care of NY Commercial $385.26
Rate for Payer: MVP Health Care of NY Medicare Advantage $271.31
Rate for Payer: United Healthcare Commercial $417.36
Rate for Payer: United Healthcare Medicare Advantage $271.31
Rate for Payer: United Healthcare VA CCN $271.31
Service Code CPT 26755
Hospital Charge Code 9812675501
Hospital Revenue Code 981
Min. Negotiated Rate $523.51
Max. Negotiated Rate $1,122.90
Rate for Payer: Aetna of VT Commercial $1,122.90
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,058.95
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $523.51
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,058.95
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $711.56
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,004.70
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $957.42
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $531.90
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $939.69
Rate for Payer: Cash Price $591.00
Rate for Payer: Cigna Commercial $945.60
Rate for Payer: Harvard Pilgrim Health Care HMO $945.60
Rate for Payer: Harvard Pilgrim Health Care PPO $945.60
Rate for Payer: Martins Point Health Care Commercial $531.90
Rate for Payer: Multiplan Commercial $1,099.26
Rate for Payer: MVP Health Care of NY Commercial $1,004.70
Rate for Payer: MVP Health Care of NY Medicare Advantage $531.90
Rate for Payer: United Healthcare Commercial $1,122.90
Rate for Payer: United Healthcare Medicare Advantage $531.90
Rate for Payer: United Healthcare VA CCN $531.90
Service Code CPT 26742
Hospital Charge Code 4502674201
Hospital Revenue Code 450
Min. Negotiated Rate $289.66
Max. Negotiated Rate $621.31
Rate for Payer: Aetna of VT Commercial $621.31
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $585.93
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $289.66
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $585.93
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $393.71
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $555.91
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $529.75
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $294.30
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $519.94
Rate for Payer: Cash Price $327.00
Rate for Payer: Cigna Commercial $523.21
Rate for Payer: Harvard Pilgrim Health Care HMO $523.21
Rate for Payer: Harvard Pilgrim Health Care PPO $523.21
Rate for Payer: Martins Point Health Care Commercial $294.30
Rate for Payer: Multiplan Commercial $608.23
Rate for Payer: MVP Health Care of NY Commercial $555.91
Rate for Payer: MVP Health Care of NY Medicare Advantage $294.30
Rate for Payer: United Healthcare Commercial $621.31
Rate for Payer: United Healthcare Medicare Advantage $294.30
Rate for Payer: United Healthcare VA CCN $294.30