|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$6,341.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
5103850001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$4,692.97 |
| Max. Negotiated Rate |
$6,023.95 |
| Rate for Payer: Aetna of VT Commercial |
$6,023.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,692.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,692.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,389.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,326.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,072.80
|
| Rate for Payer: Cash Price |
$3,170.50
|
| Rate for Payer: Cigna Commercial |
$5,072.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,072.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,072.80
|
| Rate for Payer: Multiplan Commercial |
$5,897.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,389.85
|
| Rate for Payer: United Healthcare Commercial |
$6,023.95
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Professional
|
Both
|
$1,455.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
9823851001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$388.18 |
| Max. Negotiated Rate |
$1,367.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,367.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,303.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$399.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,303.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$543.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$657.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$657.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$446.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$657.20
|
| Rate for Payer: Cash Price |
$727.50
|
| Rate for Payer: Cash Price |
$727.50
|
| Rate for Payer: Cigna Commercial |
$710.23
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$816.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$816.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$491.61
|
| Rate for Payer: Multiplan Commercial |
$1,353.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$551.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$388.18
|
| Rate for Payer: United Healthcare Commercial |
$597.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$388.18
|
| Rate for Payer: United Healthcare VA CCN |
$388.18
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$1,455.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
9823851001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$644.42 |
| Max. Negotiated Rate |
$1,382.25 |
| Rate for Payer: Aetna of VT Commercial |
$1,382.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,303.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$644.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,303.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$875.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,236.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,178.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$654.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,156.72
|
| Rate for Payer: Cash Price |
$727.50
|
| Rate for Payer: Cigna Commercial |
$1,164.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,164.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,164.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$654.75
|
| Rate for Payer: Multiplan Commercial |
$1,353.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,236.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$654.75
|
| Rate for Payer: United Healthcare Commercial |
$1,382.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$654.75
|
| Rate for Payer: United Healthcare VA CCN |
$654.75
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$3,199.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
5103852501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,416.84 |
| Max. Negotiated Rate |
$3,039.05 |
| Rate for Payer: Aetna of VT Commercial |
$3,039.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,865.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,416.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,865.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,925.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,719.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,591.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,439.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,543.20
|
| Rate for Payer: Cash Price |
$1,599.50
|
| Rate for Payer: Cigna Commercial |
$2,559.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,559.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,559.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,439.55
|
| Rate for Payer: Multiplan Commercial |
$2,975.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,719.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,439.55
|
| Rate for Payer: United Healthcare Commercial |
$3,039.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,439.55
|
| Rate for Payer: United Healthcare VA CCN |
$1,439.55
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Professional
|
Both
|
$6,341.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
5103850001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$235.63 |
| Max. Negotiated Rate |
$5,960.54 |
| Rate for Payer: Aetna of VT Commercial |
$5,960.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$5,680.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$242.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$5,680.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$329.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$405.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$405.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$270.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$405.52
|
| Rate for Payer: Cash Price |
$3,170.50
|
| Rate for Payer: Cash Price |
$3,170.50
|
| Rate for Payer: Cigna Commercial |
$431.46
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$520.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$520.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$312.40
|
| Rate for Payer: Multiplan Commercial |
$5,897.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$235.63
|
| Rate for Payer: United Healthcare Commercial |
$362.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$235.63
|
| Rate for Payer: United Healthcare VA CCN |
$235.63
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$4,485.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
9603852501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,986.41 |
| Max. Negotiated Rate |
$4,260.75 |
| Rate for Payer: Aetna of VT Commercial |
$4,260.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,018.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,986.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,018.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,699.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,812.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,632.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,018.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,565.57
|
| Rate for Payer: Cash Price |
$2,242.50
|
| Rate for Payer: Cigna Commercial |
$3,588.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,588.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,588.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,018.25
|
| Rate for Payer: Multiplan Commercial |
$4,171.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,812.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,018.25
|
| Rate for Payer: United Healthcare Commercial |
$4,260.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,018.25
|
| Rate for Payer: United Healthcare VA CCN |
$2,018.25
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$7,135.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
9603850001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,160.09 |
| Max. Negotiated Rate |
$6,778.25 |
| Rate for Payer: Aetna of VT Commercial |
$6,778.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$6,392.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$3,160.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$6,392.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$4,295.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$6,064.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,779.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$3,210.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,672.32
|
| Rate for Payer: Cash Price |
$3,567.50
|
| Rate for Payer: Cigna Commercial |
$5,708.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,708.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,708.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$3,210.75
|
| Rate for Payer: Multiplan Commercial |
$6,635.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$6,064.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$3,210.75
|
| Rate for Payer: United Healthcare Commercial |
$6,778.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,210.75
|
| Rate for Payer: United Healthcare VA CCN |
$3,210.75
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$4,485.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
9823852501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,986.41 |
| Max. Negotiated Rate |
$4,260.75 |
| Rate for Payer: Aetna of VT Commercial |
$4,260.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,018.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,986.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,018.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,699.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,812.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,632.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,018.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,565.57
|
| Rate for Payer: Cash Price |
$2,242.50
|
| Rate for Payer: Cigna Commercial |
$3,588.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,588.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,588.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,018.25
|
| Rate for Payer: Multiplan Commercial |
$4,171.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,812.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,018.25
|
| Rate for Payer: United Healthcare Commercial |
$4,260.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,018.25
|
| Rate for Payer: United Healthcare VA CCN |
$2,018.25
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Professional
|
Both
|
$7,135.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
9603850001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$235.63 |
| Max. Negotiated Rate |
$6,706.90 |
| Rate for Payer: Aetna of VT Commercial |
$6,706.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$6,392.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$242.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$6,392.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$329.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$405.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$405.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$270.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$405.52
|
| Rate for Payer: Cash Price |
$3,567.50
|
| Rate for Payer: Cash Price |
$3,567.50
|
| Rate for Payer: Cigna Commercial |
$431.46
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$520.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$520.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$312.40
|
| Rate for Payer: Multiplan Commercial |
$6,635.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$235.63
|
| Rate for Payer: United Healthcare Commercial |
$362.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$235.63
|
| Rate for Payer: United Healthcare VA CCN |
$235.63
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$4,485.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
9823852501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$3,319.35 |
| Max. Negotiated Rate |
$4,260.75 |
| Rate for Payer: Aetna of VT Commercial |
$4,260.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,319.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,319.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,812.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,767.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,588.00
|
| Rate for Payer: Cash Price |
$2,242.50
|
| Rate for Payer: Cigna Commercial |
$3,588.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,588.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,588.00
|
| Rate for Payer: Multiplan Commercial |
$4,171.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,812.25
|
| Rate for Payer: United Healthcare Commercial |
$4,260.75
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$1,286.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
9603852502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$951.77 |
| Max. Negotiated Rate |
$1,221.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,221.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$951.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$951.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,093.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,080.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,028.80
|
| Rate for Payer: Cash Price |
$643.00
|
| Rate for Payer: Cigna Commercial |
$1,028.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,028.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,028.80
|
| Rate for Payer: Multiplan Commercial |
$1,195.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,093.10
|
| Rate for Payer: United Healthcare Commercial |
$1,221.70
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Professional
|
Both
|
$4,485.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
9603852501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$408.40 |
| Max. Negotiated Rate |
$4,215.90 |
| Rate for Payer: Aetna of VT Commercial |
$4,215.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,018.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$420.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,018.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$571.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$547.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$547.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$469.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$547.34
|
| Rate for Payer: Cash Price |
$2,242.50
|
| Rate for Payer: Cash Price |
$2,242.50
|
| Rate for Payer: Cigna Commercial |
$745.99
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$690.71
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$690.71
|
| Rate for Payer: Martins Point Health Care Commercial |
$408.40
|
| Rate for Payer: Multiplan Commercial |
$4,171.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$579.93
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$408.40
|
| Rate for Payer: United Healthcare Commercial |
$628.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$408.40
|
| Rate for Payer: United Healthcare VA CCN |
$408.40
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$1,455.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
9823851001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,076.85 |
| Max. Negotiated Rate |
$1,382.25 |
| Rate for Payer: Aetna of VT Commercial |
$1,382.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,076.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,076.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,236.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,222.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,164.00
|
| Rate for Payer: Cash Price |
$727.50
|
| Rate for Payer: Cigna Commercial |
$1,164.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,164.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,164.00
|
| Rate for Payer: Multiplan Commercial |
$1,353.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,236.75
|
| Rate for Payer: United Healthcare Commercial |
$1,382.25
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$794.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
9603850002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$587.64 |
| Max. Negotiated Rate |
$754.30 |
| Rate for Payer: Aetna of VT Commercial |
$754.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$587.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$587.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$674.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$666.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$635.20
|
| Rate for Payer: Cash Price |
$397.00
|
| Rate for Payer: Cigna Commercial |
$635.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$635.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$635.20
|
| Rate for Payer: Multiplan Commercial |
$738.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$674.90
|
| Rate for Payer: United Healthcare Commercial |
$754.30
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
9603850002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$235.63 |
| Max. Negotiated Rate |
$746.36 |
| Rate for Payer: Aetna of VT Commercial |
$746.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$711.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$242.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$711.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$329.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$405.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$405.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$270.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$405.52
|
| Rate for Payer: Cash Price |
$397.00
|
| Rate for Payer: Cash Price |
$397.00
|
| Rate for Payer: Cigna Commercial |
$431.46
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$520.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$520.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$312.40
|
| Rate for Payer: Multiplan Commercial |
$738.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$334.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$235.63
|
| Rate for Payer: United Healthcare Commercial |
$362.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$235.63
|
| Rate for Payer: United Healthcare VA CCN |
$235.63
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Professional
|
Both
|
$3,199.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
5103852501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$408.40 |
| Max. Negotiated Rate |
$3,007.06 |
| Rate for Payer: Aetna of VT Commercial |
$3,007.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,865.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$420.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,865.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$571.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$547.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$547.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$469.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$547.34
|
| Rate for Payer: Cash Price |
$1,599.50
|
| Rate for Payer: Cash Price |
$1,599.50
|
| Rate for Payer: Cigna Commercial |
$745.99
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$690.71
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$690.71
|
| Rate for Payer: Martins Point Health Care Commercial |
$408.40
|
| Rate for Payer: Multiplan Commercial |
$2,975.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$579.93
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$408.40
|
| Rate for Payer: United Healthcare Commercial |
$628.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$408.40
|
| Rate for Payer: United Healthcare VA CCN |
$408.40
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$7,135.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
9603850001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$5,280.61 |
| Max. Negotiated Rate |
$6,778.25 |
| Rate for Payer: Aetna of VT Commercial |
$6,778.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$5,280.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$5,280.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$6,064.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$5,993.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$5,708.00
|
| Rate for Payer: Cash Price |
$3,567.50
|
| Rate for Payer: Cigna Commercial |
$5,708.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$5,708.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$5,708.00
|
| Rate for Payer: Multiplan Commercial |
$6,635.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$6,064.75
|
| Rate for Payer: United Healthcare Commercial |
$6,778.25
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$794.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
9603850002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$351.66 |
| Max. Negotiated Rate |
$754.30 |
| Rate for Payer: Aetna of VT Commercial |
$754.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$711.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$351.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$711.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$477.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$674.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$643.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$357.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$631.23
|
| Rate for Payer: Cash Price |
$397.00
|
| Rate for Payer: Cigna Commercial |
$635.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$635.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$635.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$357.30
|
| Rate for Payer: Multiplan Commercial |
$738.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$674.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$357.30
|
| Rate for Payer: United Healthcare Commercial |
$754.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$357.30
|
| Rate for Payer: United Healthcare VA CCN |
$357.30
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$1,286.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
9603852502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$569.57 |
| Max. Negotiated Rate |
$1,221.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,221.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,152.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$569.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,152.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$774.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,093.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,041.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$578.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,022.37
|
| Rate for Payer: Cash Price |
$643.00
|
| Rate for Payer: Cigna Commercial |
$1,028.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,028.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,028.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$578.70
|
| Rate for Payer: Multiplan Commercial |
$1,195.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,093.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$578.70
|
| Rate for Payer: United Healthcare Commercial |
$1,221.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$578.70
|
| Rate for Payer: United Healthcare VA CCN |
$578.70
|
|
|
BIOPSY VAGINAL MUCOSA EXTENSIV
|
Facility
|
IP
|
$397.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
9825710501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$293.82 |
| Max. Negotiated Rate |
$377.15 |
| Rate for Payer: Aetna of VT Commercial |
$377.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$293.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$293.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$337.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$333.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$317.60
|
| Rate for Payer: Cash Price |
$198.50
|
| Rate for Payer: Cigna Commercial |
$317.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$317.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$317.60
|
| Rate for Payer: Multiplan Commercial |
$369.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$337.45
|
| Rate for Payer: United Healthcare Commercial |
$377.15
|
|
|
BIOPSY VAGINAL MUCOSA EXTENSIV
|
Facility
|
OP
|
$5,939.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
9605710501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,630.38 |
| Max. Negotiated Rate |
$5,642.05 |
| Rate for Payer: Aetna of VT Commercial |
$5,642.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$5,320.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,630.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$5,320.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$3,575.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,048.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,810.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,672.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,721.51
|
| Rate for Payer: Cash Price |
$2,969.50
|
| Rate for Payer: Cigna Commercial |
$4,751.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,751.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,751.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,672.55
|
| Rate for Payer: Multiplan Commercial |
$5,523.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,048.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,672.55
|
| Rate for Payer: United Healthcare Commercial |
$5,642.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,672.55
|
| Rate for Payer: United Healthcare VA CCN |
$2,672.55
|
|
|
BIOPSY VAGINAL MUCOSA EXTENSIV
|
Facility
|
IP
|
$5,543.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
5105710501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$4,102.37 |
| Max. Negotiated Rate |
$5,265.85 |
| Rate for Payer: Aetna of VT Commercial |
$5,265.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,102.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,102.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,711.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,656.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,434.40
|
| Rate for Payer: Cash Price |
$2,771.50
|
| Rate for Payer: Cigna Commercial |
$4,434.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,434.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,434.40
|
| Rate for Payer: Multiplan Commercial |
$5,154.99
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,711.55
|
| Rate for Payer: United Healthcare Commercial |
$5,265.85
|
|
|
BIOPSY VAGINAL MUCOSA EXTENSIV
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
9605710502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$138.06 |
| Max. Negotiated Rate |
$373.18 |
| Rate for Payer: Aetna of VT Commercial |
$373.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$355.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$142.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$355.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$193.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$237.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$237.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$158.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$237.24
|
| Rate for Payer: Cash Price |
$198.50
|
| Rate for Payer: Cash Price |
$198.50
|
| Rate for Payer: Cigna Commercial |
$245.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$272.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$272.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$166.00
|
| Rate for Payer: Multiplan Commercial |
$369.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$196.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$138.06
|
| Rate for Payer: United Healthcare Commercial |
$212.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$138.06
|
| Rate for Payer: United Healthcare VA CCN |
$138.06
|
|
|
BIOPSY VAGINAL MUCOSA EXTENSIV
|
Facility
|
OP
|
$5,543.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
5105710501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,454.99 |
| Max. Negotiated Rate |
$5,265.85 |
| Rate for Payer: Aetna of VT Commercial |
$5,265.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,965.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,454.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,965.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$3,336.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,711.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,489.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,494.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,406.69
|
| Rate for Payer: Cash Price |
$2,771.50
|
| Rate for Payer: Cigna Commercial |
$4,434.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,434.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,434.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,494.35
|
| Rate for Payer: Multiplan Commercial |
$5,154.99
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,711.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,494.35
|
| Rate for Payer: United Healthcare Commercial |
$5,265.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,494.35
|
| Rate for Payer: United Healthcare VA CCN |
$2,494.35
|
|
|
BIOPSY VAGINAL MUCOSA EXTENSIV
|
Facility
|
IP
|
$5,939.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
9605710501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$4,395.45 |
| Max. Negotiated Rate |
$5,642.05 |
| Rate for Payer: Aetna of VT Commercial |
$5,642.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,395.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,395.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$5,048.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,988.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,751.20
|
| Rate for Payer: Cash Price |
$2,969.50
|
| Rate for Payer: Cigna Commercial |
$4,751.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,751.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,751.20
|
| Rate for Payer: Multiplan Commercial |
$5,523.27
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,048.15
|
| Rate for Payer: United Healthcare Commercial |
$5,642.05
|
|
