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Service Code CPT 26765
Hospital Charge Code 9602676501
Hospital Revenue Code 960
Min. Negotiated Rate $485.99
Max. Negotiated Rate $2,289.84
Rate for Payer: Aetna of VT Commercial $2,289.84
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 $500.57
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 $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 $1,218.00
Rate for Payer: Cash Price $1,218.00
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 $2,265.48
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 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 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 26755
Hospital Charge Code 9602675501
Hospital Revenue Code 960
Min. Negotiated Rate $550.97
Max. Negotiated Rate $1,181.80
Rate for Payer: Aetna of VT Commercial $1,181.80
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,114.50
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $550.97
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,114.50
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $748.89
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,057.40
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,007.64
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $559.80
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $988.98
Rate for Payer: Cash Price $622.00
Rate for Payer: Cigna Commercial $995.20
Rate for Payer: Harvard Pilgrim Health Care HMO $995.20
Rate for Payer: Harvard Pilgrim Health Care PPO $995.20
Rate for Payer: Martins Point Health Care Commercial $559.80
Rate for Payer: Multiplan Commercial $1,156.92
Rate for Payer: MVP Health Care of NY Commercial $1,057.40
Rate for Payer: MVP Health Care of NY Medicare Advantage $559.80
Rate for Payer: United Healthcare Commercial $1,181.80
Rate for Payer: United Healthcare Medicare Advantage $559.80
Rate for Payer: United Healthcare VA CCN $559.80
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 26750
Hospital Charge Code 9812675001
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
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 26750
Hospital Charge Code 9812675001
Hospital Revenue Code 981
Min. Negotiated Rate $0.90
Max. Negotiated Rate $358.80
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 $196.53
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 $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 $0.50
Rate for Payer: Cash Price $0.50
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 $0.93
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 26765
Hospital Charge Code 5102676501
Hospital Revenue Code 510
Min. Negotiated Rate $753.42
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 $753.42
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $753.42
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $865.30
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $855.12
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $814.40
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: Multiplan Commercial $946.74
Rate for Payer: MVP Health Care of NY Commercial $865.30
Rate for Payer: United Healthcare Commercial $967.10
Service Code CPT 26765
Hospital Charge Code 9822676501
Hospital Revenue Code 982
Min. Negotiated Rate $1,049.46
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 $1,049.46
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,049.46
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,205.30
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,191.12
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $1,134.40
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: Multiplan Commercial $1,318.74
Rate for Payer: MVP Health Care of NY Commercial $1,205.30
Rate for Payer: United Healthcare Commercial $1,347.10
Service Code CPT 26750
Hospital Charge Code 9602675001
Hospital Revenue Code 960
Min. Negotiated Rate $206.83
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 $418.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $206.83
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 $281.13
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $396.95
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $378.27
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $210.15
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $371.26
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: Martins Point Health Care Commercial $210.15
Rate for Payer: Multiplan Commercial $434.31
Rate for Payer: MVP Health Care of NY Commercial $396.95
Rate for Payer: MVP Health Care of NY Medicare Advantage $210.15
Rate for Payer: United Healthcare Commercial $443.65
Rate for Payer: United Healthcare Medicare Advantage $210.15
Rate for Payer: United Healthcare VA CCN $210.15
Service Code CPT 26725
Hospital Charge Code 9812672501
Hospital Revenue Code 981
Min. Negotiated Rate $299.81
Max. Negotiated Rate $1,136.46
Rate for Payer: Aetna of VT Commercial $1,136.46
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $1,083.14
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 $1,083.14
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 $604.50
Rate for Payer: Cash Price $604.50
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 $1,124.37
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 9812675002
Hospital Revenue Code 981
Min. Negotiated Rate $195.39
Max. Negotiated Rate $250.80
Rate for Payer: Aetna of VT Commercial $250.80
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $195.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $195.39
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $224.40
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $221.76
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $211.20
Rate for Payer: Cash Price $132.00
Rate for Payer: Cigna Commercial $211.20
Rate for Payer: Harvard Pilgrim Health Care HMO $211.20
Rate for Payer: Harvard Pilgrim Health Care PPO $211.20
Rate for Payer: Multiplan Commercial $245.52
Rate for Payer: MVP Health Care of NY Commercial $224.40
Rate for Payer: United Healthcare Commercial $250.80
Service Code CPT 26735
Hospital Charge Code 9822673501
Hospital Revenue Code 982
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 26735
Hospital Charge Code 9822673501
Hospital Revenue Code 982
Min. Negotiated Rate $1,049.46
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 $1,049.46
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $1,049.46
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,205.30
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,191.12
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $1,134.40
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: Multiplan Commercial $1,318.74
Rate for Payer: MVP Health Care of NY Commercial $1,205.30
Rate for Payer: United Healthcare Commercial $1,347.10
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 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 26742
Hospital Charge Code 9822674201
Hospital Revenue Code 982
Min. Negotiated Rate $328.09
Max. Negotiated Rate $1,019.90
Rate for Payer: Aetna of VT Commercial $1,019.90
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $972.05
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $337.93
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $972.05
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $459.33
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $625.65
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $625.65
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $377.30
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $625.65
Rate for Payer: Cash Price $542.50
Rate for Payer: Cash Price $542.50
Rate for Payer: Cigna Commercial $619.65
Rate for Payer: Harvard Pilgrim Health Care HMO $604.82
Rate for Payer: Harvard Pilgrim Health Care PPO $604.82
Rate for Payer: Martins Point Health Care Commercial $366.95
Rate for Payer: Multiplan Commercial $1,009.05
Rate for Payer: MVP Health Care of NY Commercial $465.89
Rate for Payer: MVP Health Care of NY Medicare Advantage $328.09
Rate for Payer: United Healthcare Commercial $504.70
Rate for Payer: United Healthcare Medicare Advantage $328.09
Rate for Payer: United Healthcare VA CCN $328.09
Service Code CPT 26720
Hospital Charge Code 5102672001
Hospital Revenue Code 510
Min. Negotiated Rate $149.50
Max. Negotiated Rate $191.90
Rate for Payer: Aetna of VT Commercial $191.90
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $149.50
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $149.50
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $171.70
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $169.68
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $161.60
Rate for Payer: Cash Price $101.00
Rate for Payer: Cigna Commercial $161.60
Rate for Payer: Harvard Pilgrim Health Care HMO $161.60
Rate for Payer: Harvard Pilgrim Health Care PPO $161.60
Rate for Payer: Multiplan Commercial $187.86
Rate for Payer: MVP Health Care of NY Commercial $171.70
Rate for Payer: United Healthcare Commercial $191.90
Service Code CPT 26755
Hospital Charge Code 9602675502
Hospital Revenue Code 960
Min. Negotiated Rate $271.31
Max. Negotiated Rate $705.94
Rate for Payer: Aetna of VT Commercial $705.94
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $672.82
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 $672.82
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 $375.50
Rate for Payer: Cash Price $375.50
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 $698.43
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 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 26735
Hospital Charge Code 9602673501
Hospital Revenue Code 960
Min. Negotiated Rate $571.03
Max. Negotiated Rate $2,942.20
Rate for Payer: Aetna of VT Commercial $2,942.20
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $2,804.17
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 $2,804.17
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 $1,565.00
Rate for Payer: Cash Price $1,565.00
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 $2,910.90
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 26750
Hospital Charge Code 9602675002
Hospital Revenue Code 960
Min. Negotiated Rate $116.93
Max. Negotiated Rate $250.80
Rate for Payer: Aetna of VT Commercial $250.80
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 $116.93
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 $158.93
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $224.40
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $213.84
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $118.80
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $209.88
Rate for Payer: Cash Price $132.00
Rate for Payer: Cigna Commercial $211.20
Rate for Payer: Harvard Pilgrim Health Care HMO $211.20
Rate for Payer: Harvard Pilgrim Health Care PPO $211.20
Rate for Payer: Martins Point Health Care Commercial $118.80
Rate for Payer: Multiplan Commercial $245.52
Rate for Payer: MVP Health Care of NY Commercial $224.40
Rate for Payer: MVP Health Care of NY Medicare Advantage $118.80
Rate for Payer: United Healthcare Commercial $250.80
Rate for Payer: United Healthcare Medicare Advantage $118.80
Rate for Payer: United Healthcare VA CCN $118.80
Service Code CPT 26720
Hospital Charge Code 9812672002
Hospital Revenue Code 981
Min. Negotiated Rate $189.35
Max. Negotiated Rate $462.48
Rate for Payer: Aetna of VT Commercial $462.48
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $440.78
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $195.03
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $440.78
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $265.09
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $277.64
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $277.64
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $217.75
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $277.64
Rate for Payer: Cash Price $246.00
Rate for Payer: Cash Price $246.00
Rate for Payer: Cigna Commercial $356.94
Rate for Payer: Harvard Pilgrim Health Care HMO $331.21
Rate for Payer: Harvard Pilgrim Health Care PPO $331.21
Rate for Payer: Martins Point Health Care Commercial $201.87
Rate for Payer: Multiplan Commercial $457.56
Rate for Payer: MVP Health Care of NY Commercial $268.88
Rate for Payer: MVP Health Care of NY Medicare Advantage $189.35
Rate for Payer: United Healthcare Commercial $291.28
Rate for Payer: United Healthcare Medicare Advantage $189.35
Rate for Payer: United Healthcare VA CCN $189.35