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Service Code CPT 26720
Hospital Charge Code 9602672002
Hospital Revenue Code 960
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 26725
Hospital Charge Code 9602672501
Hospital Revenue Code 960
Min. Negotiated Rate $299.81
Max. Negotiated Rate $1,183.46
Rate for Payer: Aetna of VT Commercial $1,183.46
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 $308.80
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 $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 $629.50
Rate for Payer: Cash Price $629.50
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 $1,170.87
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 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 26750
Hospital Charge Code 9812675002
Hospital Revenue Code 981
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 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 5102672001
Hospital Revenue Code 510
Min. Negotiated Rate $89.47
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 $180.97
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $89.47
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $180.97
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $121.60
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $171.70
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $163.62
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $90.90
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $160.59
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: Martins Point Health Care Commercial $90.90
Rate for Payer: Multiplan Commercial $187.86
Rate for Payer: MVP Health Care of NY Commercial $171.70
Rate for Payer: MVP Health Care of NY Medicare Advantage $90.90
Rate for Payer: United Healthcare Commercial $191.90
Rate for Payer: United Healthcare Medicare Advantage $90.90
Rate for Payer: United Healthcare VA CCN $90.90
Service Code CPT 26746
Hospital Charge Code 9822674601
Hospital Revenue Code 982
Min. Negotiated Rate $896.43
Max. Negotiated Rate $1,922.80
Rate for Payer: Aetna of VT Commercial $1,922.80
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 $896.43
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 $1,218.45
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,720.40
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,639.44
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $910.80
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $1,609.08
Rate for Payer: Cash Price $1,012.00
Rate for Payer: Cigna Commercial $1,619.20
Rate for Payer: Harvard Pilgrim Health Care HMO $1,619.20
Rate for Payer: Harvard Pilgrim Health Care PPO $1,619.20
Rate for Payer: Martins Point Health Care Commercial $910.80
Rate for Payer: Multiplan Commercial $1,882.32
Rate for Payer: MVP Health Care of NY Commercial $1,720.40
Rate for Payer: MVP Health Care of NY Medicare Advantage $910.80
Rate for Payer: United Healthcare Commercial $1,922.80
Rate for Payer: United Healthcare Medicare Advantage $910.80
Rate for Payer: United Healthcare VA CCN $910.80
Service Code CPT 26725
Hospital Charge Code 5102672501
Hospital Revenue Code 510
Min. Negotiated Rate $296.04
Max. Negotiated Rate $380.00
Rate for Payer: Aetna of VT Commercial $380.00
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $296.04
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $296.04
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $340.00
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $336.00
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $320.00
Rate for Payer: Cash Price $200.00
Rate for Payer: Cigna Commercial $320.00
Rate for Payer: Harvard Pilgrim Health Care HMO $320.00
Rate for Payer: Harvard Pilgrim Health Care PPO $320.00
Rate for Payer: Multiplan Commercial $372.00
Rate for Payer: MVP Health Care of NY Commercial $340.00
Rate for Payer: United Healthcare Commercial $380.00
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 26720
Hospital Charge Code 9602672002
Hospital Revenue Code 960
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
Service Code CPT 26725
Hospital Charge Code 4502672501
Hospital Revenue Code 450
Min. Negotiated Rate $295.39
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 $295.39
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $295.39
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $339.25
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $335.26
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $319.30
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: Multiplan Commercial $371.18
Rate for Payer: MVP Health Care of NY Commercial $339.25
Rate for Payer: United Healthcare Commercial $379.16
Service Code CPT 26727
Hospital Charge Code 9822672701
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 26765
Hospital Charge Code 5102676501
Hospital Revenue Code 510
Min. Negotiated Rate $485.99
Max. Negotiated Rate $956.92
Rate for Payer: Aetna of VT Commercial $956.92
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 $500.57
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 $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 $509.00
Rate for Payer: Cash Price $509.00
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 $946.74
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 9822676501
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 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
Service Code CPT 26742
Hospital Charge Code 9812674202
Hospital Revenue Code 981
Min. Negotiated Rate $480.55
Max. Negotiated Rate $1,030.75
Rate for Payer: Aetna of VT Commercial $1,030.75
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 $480.55
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 $653.17
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $922.25
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $878.85
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $488.25
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $862.58
Rate for Payer: Cash Price $542.50
Rate for Payer: Cigna Commercial $868.00
Rate for Payer: Harvard Pilgrim Health Care HMO $868.00
Rate for Payer: Harvard Pilgrim Health Care PPO $868.00
Rate for Payer: Martins Point Health Care Commercial $488.25
Rate for Payer: Multiplan Commercial $1,009.05
Rate for Payer: MVP Health Care of NY Commercial $922.25
Rate for Payer: MVP Health Care of NY Medicare Advantage $488.25
Rate for Payer: United Healthcare Commercial $1,030.75
Rate for Payer: United Healthcare Medicare Advantage $488.25
Rate for Payer: United Healthcare VA CCN $488.25
Service Code CPT 26755
Hospital Charge Code 9812675501
Hospital Revenue Code 981
Min. Negotiated Rate $271.31
Max. Negotiated Rate $1,111.08
Rate for Payer: Aetna of VT Commercial $1,111.08
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 $279.45
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 $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 $591.00
Rate for Payer: Cash Price $591.00
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 $1,099.26
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 26725
Hospital Charge Code 9812672502
Hospital Revenue Code 981
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 26755
Hospital Charge Code 9602675501
Hospital Revenue Code 960
Min. Negotiated Rate $271.31
Max. Negotiated Rate $1,169.36
Rate for Payer: Aetna of VT Commercial $1,169.36
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 $279.45
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 $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 $622.00
Rate for Payer: Cash Price $622.00
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 $1,156.92
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 26735
Hospital Charge Code 9822673501
Hospital Revenue Code 982
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 26735
Hospital Charge Code 9602673502
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 26755
Hospital Charge Code 9602675502
Hospital Revenue Code 960
Min. Negotiated Rate $332.62
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 $672.82
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $332.62
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 $452.10
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $638.35
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $608.31
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $337.95
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $597.04
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: Martins Point Health Care Commercial $337.95
Rate for Payer: Multiplan Commercial $698.43
Rate for Payer: MVP Health Care of NY Commercial $638.35
Rate for Payer: MVP Health Care of NY Medicare Advantage $337.95
Rate for Payer: United Healthcare Commercial $713.45
Rate for Payer: United Healthcare Medicare Advantage $337.95
Rate for Payer: United Healthcare VA CCN $337.95
Service Code CPT 26750
Hospital Charge Code 9812675001
Hospital Revenue Code 981
Min. Negotiated Rate $0.44
Max. Negotiated Rate $0.95
Rate for Payer: Aetna of VT Commercial $0.95
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $0.90
Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan $0.44
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $0.90
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange $0.60
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $0.85
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $0.81
Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage $0.45
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $0.80
Rate for Payer: Cash Price $0.50
Rate for Payer: Cigna Commercial $0.80
Rate for Payer: Harvard Pilgrim Health Care HMO $0.80
Rate for Payer: Harvard Pilgrim Health Care PPO $0.80
Rate for Payer: Martins Point Health Care Commercial $0.45
Rate for Payer: Multiplan Commercial $0.93
Rate for Payer: MVP Health Care of NY Commercial $0.85
Rate for Payer: MVP Health Care of NY Medicare Advantage $0.45
Rate for Payer: United Healthcare Commercial $0.95
Rate for Payer: United Healthcare Medicare Advantage $0.45
Rate for Payer: United Healthcare VA CCN $0.45
Service Code CPT 26725
Hospital Charge Code 9812672501
Hospital Revenue Code 981
Min. Negotiated Rate $894.78
Max. Negotiated Rate $1,148.55
Rate for Payer: Aetna of VT Commercial $1,148.55
Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial $894.78
Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange $894.78
Rate for Payer: Blue Cross Blue Shield of Vermont Commercial $1,027.65
Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care $1,015.56
Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan $967.20
Rate for Payer: Cash Price $604.50
Rate for Payer: Cigna Commercial $967.20
Rate for Payer: Harvard Pilgrim Health Care HMO $967.20
Rate for Payer: Harvard Pilgrim Health Care PPO $967.20
Rate for Payer: Multiplan Commercial $1,124.37
Rate for Payer: MVP Health Care of NY Commercial $1,027.65
Rate for Payer: United Healthcare Commercial $1,148.55
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