|
XR WRIST COMPL MIN 3 VIEWS
|
Facility
|
IP
|
$521.55
|
|
|
Service Code
|
CPT 73110 RT
|
| Hospital Charge Code |
32073110RT
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$386.00 |
| Max. Negotiated Rate |
$495.47 |
| Rate for Payer: Aetna of VT Commercial |
$495.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$386.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$438.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$417.24
|
| Rate for Payer: Cash Price |
$260.78
|
| Rate for Payer: Cigna Commercial |
$417.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$417.24
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$417.24
|
| Rate for Payer: Multiplan Commercial |
$485.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$443.32
|
| Rate for Payer: United Healthcare Commercial |
$495.47
|
|
|
XR WRIST COMPL MIN 3 VIEWS
|
Facility
|
OP
|
$521.55
|
|
|
Service Code
|
CPT 73110 RT
|
| Hospital Charge Code |
32073110RT
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$142.83 |
| Max. Negotiated Rate |
$495.47 |
| Rate for Payer: Aetna of VT Commercial |
$495.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$230.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$313.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$422.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$234.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$414.63
|
| Rate for Payer: Cash Price |
$260.78
|
| Rate for Payer: Cash Price |
$260.78
|
| Rate for Payer: Cigna Commercial |
$417.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$417.24
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$417.24
|
| Rate for Payer: Martins Point Health Care Commercial |
$234.70
|
| Rate for Payer: Multiplan Commercial |
$485.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$443.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$234.70
|
| Rate for Payer: United Healthcare Commercial |
$495.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$234.70
|
| Rate for Payer: United Healthcare VA CCN |
$234.70
|
|
|
XR WRIST COMPL MIN 3 VIEWS
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
CPT 73110 26
|
| Hospital Charge Code |
9727311001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$7.91 |
| Max. Negotiated Rate |
$142.83 |
| Rate for Payer: Aetna of VT Commercial |
$77.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$8.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$11.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$13.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$13.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$9.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$13.33
|
| Rate for Payer: Cash Price |
$41.00
|
| Rate for Payer: Cash Price |
$41.00
|
| Rate for Payer: Cigna Commercial |
$12.02
|
| Rate for Payer: Martins Point Health Care Commercial |
$7.92
|
| Rate for Payer: Multiplan Commercial |
$76.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$7.91
|
| Rate for Payer: United Healthcare Commercial |
$12.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.91
|
| Rate for Payer: United Healthcare VA CCN |
$7.91
|
|
|
XR WRIST COMPL MIN 3 VIEWS
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 73110 26
|
| Hospital Charge Code |
9727311001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$36.32 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Aetna of VT Commercial |
$77.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$73.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$73.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$49.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$69.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$36.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$65.19
|
| Rate for Payer: Cash Price |
$41.00
|
| Rate for Payer: Cigna Commercial |
$65.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$65.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$65.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$36.90
|
| Rate for Payer: Multiplan Commercial |
$76.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$69.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$36.90
|
| Rate for Payer: United Healthcare Commercial |
$77.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.90
|
| Rate for Payer: United Healthcare VA CCN |
$36.90
|
|
|
XR WRIST COMPL MIN 3 VIEWS
|
Facility
|
OP
|
$557.33
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
3207311001
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$142.83 |
| Max. Negotiated Rate |
$529.46 |
| Rate for Payer: Aetna of VT Commercial |
$529.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$142.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$246.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$142.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$335.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$473.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$451.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$250.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$443.08
|
| Rate for Payer: Cash Price |
$278.66
|
| Rate for Payer: Cash Price |
$278.66
|
| Rate for Payer: Cigna Commercial |
$445.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$445.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$445.86
|
| Rate for Payer: Martins Point Health Care Commercial |
$250.80
|
| Rate for Payer: Multiplan Commercial |
$518.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$473.73
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$250.80
|
| Rate for Payer: United Healthcare Commercial |
$529.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$250.80
|
| Rate for Payer: United Healthcare VA CCN |
$250.80
|
|
|
XR WRIST COMPL MIN 3 VIEWS
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 73110 26
|
| Hospital Charge Code |
9727311001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$60.69 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Aetna of VT Commercial |
$77.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$60.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$60.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$69.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$68.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$65.60
|
| Rate for Payer: Cash Price |
$41.00
|
| Rate for Payer: Cigna Commercial |
$65.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$65.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$65.60
|
| Rate for Payer: Multiplan Commercial |
$76.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$69.70
|
| Rate for Payer: United Healthcare Commercial |
$77.90
|
|
|
XT ECG>7D<15D REC SCAN A/R
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
CPT 93245
|
| Hospital Charge Code |
9859324501
|
|
Hospital Revenue Code
|
985
|
| Min. Negotiated Rate |
$223.08 |
| Max. Negotiated Rate |
$604.46 |
| Rate for Payer: Aetna of VT Commercial |
$234.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$223.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$276.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$223.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$375.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$378.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$378.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$308.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$378.93
|
| Rate for Payer: Cash Price |
$124.50
|
| Rate for Payer: Cash Price |
$124.50
|
| Rate for Payer: Cigna Commercial |
$604.46
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$429.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$429.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$268.04
|
| Rate for Payer: Multiplan Commercial |
$231.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$380.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$268.03
|
| Rate for Payer: United Healthcare Commercial |
$412.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$268.03
|
| Rate for Payer: United Healthcare VA CCN |
$268.03
|
|
|
XT ECG>7D<15D REC SCAN A/R
|
Facility
|
IP
|
$249.00
|
|
|
Service Code
|
CPT 93245
|
| Hospital Charge Code |
9859324501
|
|
Hospital Revenue Code
|
985
|
| Min. Negotiated Rate |
$184.28 |
| Max. Negotiated Rate |
$236.55 |
| Rate for Payer: Aetna of VT Commercial |
$236.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$184.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$184.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$211.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$209.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$199.20
|
| Rate for Payer: Cash Price |
$124.50
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$199.20
|
| Rate for Payer: Multiplan Commercial |
$231.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$211.65
|
| Rate for Payer: United Healthcare Commercial |
$236.55
|
|
|
XT ECG>7D<15D REC SCAN A/R
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 93245
|
| Hospital Charge Code |
9859324501
|
|
Hospital Revenue Code
|
985
|
| Min. Negotiated Rate |
$110.28 |
| Max. Negotiated Rate |
$236.55 |
| Rate for Payer: Aetna of VT Commercial |
$236.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$223.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$110.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$223.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$149.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$211.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$201.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$112.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$197.96
|
| Rate for Payer: Cash Price |
$124.50
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$199.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$112.05
|
| Rate for Payer: Multiplan Commercial |
$231.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$211.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$112.05
|
| Rate for Payer: United Healthcare Commercial |
$236.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$112.05
|
| Rate for Payer: United Healthcare VA CCN |
$112.05
|
|
|
XTRNL ECG & 48 HR RECORDING
|
Facility
|
OP
|
$588.35
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
7319322501
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$260.58 |
| Max. Negotiated Rate |
$558.93 |
| Rate for Payer: Aetna of VT Commercial |
$558.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$527.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$260.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$527.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$354.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$500.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$476.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$264.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$467.74
|
| Rate for Payer: Cash Price |
$294.18
|
| Rate for Payer: Cigna Commercial |
$470.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$470.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$470.68
|
| Rate for Payer: Martins Point Health Care Commercial |
$264.76
|
| Rate for Payer: Multiplan Commercial |
$547.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$500.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$264.76
|
| Rate for Payer: United Healthcare Commercial |
$558.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$264.76
|
| Rate for Payer: United Healthcare VA CCN |
$264.76
|
|
|
XTRNL ECG & 48 HR RECORDING
|
Facility
|
IP
|
$588.35
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
7319322501
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$435.44 |
| Max. Negotiated Rate |
$558.93 |
| Rate for Payer: Aetna of VT Commercial |
$558.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$435.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$435.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$500.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$494.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$470.68
|
| Rate for Payer: Cash Price |
$294.18
|
| Rate for Payer: Cigna Commercial |
$470.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$470.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$470.68
|
| Rate for Payer: Multiplan Commercial |
$547.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$500.10
|
| Rate for Payer: United Healthcare Commercial |
$558.93
|
|
|
XTRNL ECG & 48 HR RECORDING
|
Professional
|
Both
|
$588.35
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
7319322501
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$553.05 |
| Rate for Payer: Aetna of VT Commercial |
$553.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$527.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$17.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$527.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$24.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$51.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$51.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$51.47
|
| Rate for Payer: Cash Price |
$294.18
|
| Rate for Payer: Cash Price |
$294.18
|
| Rate for Payer: Cigna Commercial |
$40.51
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$27.78
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$27.78
|
| Rate for Payer: Martins Point Health Care Commercial |
$17.19
|
| Rate for Payer: Multiplan Commercial |
$547.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.41
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$17.19
|
| Rate for Payer: United Healthcare Commercial |
$26.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.19
|
| Rate for Payer: United Healthcare VA CCN |
$17.19
|
|
|
XTRNL ECG REC>48HR<7D
|
Facility
|
OP
|
$342.00
|
|
|
Service Code
|
CPT 93241
|
| Hospital Charge Code |
7319324101
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$151.47 |
| Max. Negotiated Rate |
$324.90 |
| Rate for Payer: Aetna of VT Commercial |
$324.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$306.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$151.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$306.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$205.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$290.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$153.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$271.89
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cigna Commercial |
$273.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$273.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$273.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$153.90
|
| Rate for Payer: Multiplan Commercial |
$318.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$290.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$153.90
|
| Rate for Payer: United Healthcare Commercial |
$324.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$153.90
|
| Rate for Payer: United Healthcare VA CCN |
$153.90
|
|
|
XTRNL ECG REC>48HR<7D
|
Facility
|
IP
|
$342.00
|
|
|
Service Code
|
CPT 93241
|
| Hospital Charge Code |
7319324101
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$253.11 |
| Max. Negotiated Rate |
$324.90 |
| Rate for Payer: Aetna of VT Commercial |
$324.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$253.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$253.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$290.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$287.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$273.60
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cigna Commercial |
$273.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$273.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$273.60
|
| Rate for Payer: Multiplan Commercial |
$318.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$290.70
|
| Rate for Payer: United Healthcare Commercial |
$324.90
|
|
|
XTRNL ECG REC>48HR<7D
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 93241
|
| Hospital Charge Code |
9729324101
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$47.50 |
| Rate for Payer: Aetna of VT Commercial |
$47.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$37.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$37.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$42.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$42.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$40.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna Commercial |
$40.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$40.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: MVP Health Care of NY Commercial |
$42.50
|
| Rate for Payer: United Healthcare Commercial |
$47.50
|
|
|
XTRNL ECG REC>48HR<7D
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 93241
|
| Hospital Charge Code |
9729324101
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.14 |
| Max. Negotiated Rate |
$47.50 |
| Rate for Payer: Aetna of VT Commercial |
$47.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$22.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$30.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$42.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$22.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$39.75
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna Commercial |
$40.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$40.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$40.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$22.50
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: MVP Health Care of NY Commercial |
$42.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$22.50
|
| Rate for Payer: United Healthcare Commercial |
$47.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.50
|
| Rate for Payer: United Healthcare VA CCN |
$22.50
|
|
|
XTRNL ECG REC>48HR<7D
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
CPT 93241
|
| Hospital Charge Code |
9729324101
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$574.72 |
| Rate for Payer: Aetna of VT Commercial |
$47.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$265.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$360.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$359.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$359.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$359.72
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna Commercial |
$574.72
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$412.98
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$412.98
|
| Rate for Payer: Martins Point Health Care Commercial |
$257.42
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: MVP Health Care of NY Commercial |
$365.54
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$257.42
|
| Rate for Payer: United Healthcare Commercial |
$395.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$257.42
|
| Rate for Payer: United Healthcare VA CCN |
$257.42
|
|
|
XTRNL ECG REC>48HR<7D
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
CPT 93241
|
| Hospital Charge Code |
7319324101
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$257.42 |
| Max. Negotiated Rate |
$574.72 |
| Rate for Payer: Aetna of VT Commercial |
$321.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$306.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$265.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$306.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$360.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$359.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$359.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$359.72
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cigna Commercial |
$574.72
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$412.98
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$412.98
|
| Rate for Payer: Martins Point Health Care Commercial |
$257.42
|
| Rate for Payer: Multiplan Commercial |
$318.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$365.54
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$257.42
|
| Rate for Payer: United Healthcare Commercial |
$395.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$257.42
|
| Rate for Payer: United Healthcare VA CCN |
$257.42
|
|
