|
CARDIOVERSION ELECTRIC EXT
|
Professional
|
Both
|
$2,267.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
9609296001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$101.10 |
| Max. Negotiated Rate |
$2,130.98 |
| Rate for Payer: Aetna of VT Commercial |
$2,130.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,031.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$104.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,031.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$141.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$116.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$284.40
|
| Rate for Payer: Cash Price |
$1,133.50
|
| Rate for Payer: Cash Price |
$1,133.50
|
| Rate for Payer: Cigna Commercial |
$232.01
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$235.55
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$235.55
|
| Rate for Payer: Martins Point Health Care Commercial |
$145.11
|
| Rate for Payer: Multiplan Commercial |
$2,108.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$143.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$101.10
|
| Rate for Payer: United Healthcare Commercial |
$155.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$101.10
|
| Rate for Payer: United Healthcare VA CCN |
$101.10
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
OP
|
$2,267.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
9609296001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,004.05 |
| Max. Negotiated Rate |
$2,153.65 |
| Rate for Payer: Aetna of VT Commercial |
$2,153.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,031.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,004.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,031.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,364.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,926.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,836.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,020.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,802.27
|
| Rate for Payer: Cash Price |
$1,133.50
|
| Rate for Payer: Cigna Commercial |
$1,813.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,813.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,813.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,020.15
|
| Rate for Payer: Multiplan Commercial |
$2,108.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,926.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,020.15
|
| Rate for Payer: United Healthcare Commercial |
$2,153.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,020.15
|
| Rate for Payer: United Healthcare VA CCN |
$1,020.15
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
OP
|
$1,662.67
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
4509296001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$736.40 |
| Max. Negotiated Rate |
$1,579.54 |
| Rate for Payer: Aetna of VT Commercial |
$1,579.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,489.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$736.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,489.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,000.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,413.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,346.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$748.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,321.82
|
| Rate for Payer: Cash Price |
$831.34
|
| Rate for Payer: Cigna Commercial |
$1,330.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,330.14
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,330.14
|
| Rate for Payer: Martins Point Health Care Commercial |
$748.20
|
| Rate for Payer: Multiplan Commercial |
$1,546.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,413.27
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$748.20
|
| Rate for Payer: United Healthcare Commercial |
$1,579.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$748.20
|
| Rate for Payer: United Healthcare VA CCN |
$748.20
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
IP
|
$604.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
9609296002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$447.02 |
| Max. Negotiated Rate |
$573.80 |
| Rate for Payer: Aetna of VT Commercial |
$573.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$447.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$447.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$513.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$507.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$483.20
|
| Rate for Payer: Cash Price |
$302.00
|
| Rate for Payer: Cigna Commercial |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$483.20
|
| Rate for Payer: Multiplan Commercial |
$561.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$513.40
|
| Rate for Payer: United Healthcare Commercial |
$573.80
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
OP
|
$604.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
9609296002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$267.51 |
| Max. Negotiated Rate |
$573.80 |
| Rate for Payer: Aetna of VT Commercial |
$573.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$541.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$541.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$513.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$489.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$271.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$480.18
|
| Rate for Payer: Cash Price |
$302.00
|
| Rate for Payer: Cigna Commercial |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$483.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$271.80
|
| Rate for Payer: Multiplan Commercial |
$561.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$513.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$271.80
|
| Rate for Payer: United Healthcare Commercial |
$573.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$271.80
|
| Rate for Payer: United Healthcare VA CCN |
$271.80
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Professional
|
Both
|
$604.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
9609296002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$101.10 |
| Max. Negotiated Rate |
$567.76 |
| Rate for Payer: Aetna of VT Commercial |
$567.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$541.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$104.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$541.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$141.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$116.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$284.40
|
| Rate for Payer: Cash Price |
$302.00
|
| Rate for Payer: Cash Price |
$302.00
|
| Rate for Payer: Cigna Commercial |
$232.01
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$235.55
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$235.55
|
| Rate for Payer: Martins Point Health Care Commercial |
$145.11
|
| Rate for Payer: Multiplan Commercial |
$561.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$143.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$101.10
|
| Rate for Payer: United Healthcare Commercial |
$155.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$101.10
|
| Rate for Payer: United Healthcare VA CCN |
$101.10
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
IP
|
$604.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
9819296002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$447.02 |
| Max. Negotiated Rate |
$573.80 |
| Rate for Payer: Aetna of VT Commercial |
$573.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$447.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$447.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$513.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$507.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$483.20
|
| Rate for Payer: Cash Price |
$302.00
|
| Rate for Payer: Cigna Commercial |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$483.20
|
| Rate for Payer: Multiplan Commercial |
$561.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$513.40
|
| Rate for Payer: United Healthcare Commercial |
$573.80
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
9829296001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$514.37 |
| Max. Negotiated Rate |
$660.25 |
| Rate for Payer: Aetna of VT Commercial |
$660.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$514.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$514.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$590.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$583.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$556.00
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cigna Commercial |
$556.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$556.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$556.00
|
| Rate for Payer: Multiplan Commercial |
$646.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$590.75
|
| Rate for Payer: United Healthcare Commercial |
$660.25
|
|
|
CAREGIVER TRAING 1ST 30 MIN
|
Facility
|
IP
|
$136.43
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
9429755001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$100.97 |
| Max. Negotiated Rate |
$129.61 |
| Rate for Payer: Aetna of VT Commercial |
$129.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$100.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$100.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$115.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$114.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$109.14
|
| Rate for Payer: Cash Price |
$68.22
|
| Rate for Payer: Cigna Commercial |
$109.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$109.14
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$109.14
|
| Rate for Payer: Multiplan Commercial |
$126.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$115.97
|
| Rate for Payer: United Healthcare Commercial |
$129.61
|
|
|
CAREGIVER TRAING 1ST 30 MIN
|
Facility
|
OP
|
$136.43
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
9429755001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$60.42 |
| Max. Negotiated Rate |
$129.61 |
| Rate for Payer: Aetna of VT Commercial |
$129.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$122.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$60.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$122.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$82.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$115.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$110.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$61.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$108.46
|
| Rate for Payer: Cash Price |
$68.22
|
| Rate for Payer: Cigna Commercial |
$109.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$109.14
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$109.14
|
| Rate for Payer: Martins Point Health Care Commercial |
$61.39
|
| Rate for Payer: Multiplan Commercial |
$126.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$115.97
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$61.39
|
| Rate for Payer: United Healthcare Commercial |
$129.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$61.39
|
| Rate for Payer: United Healthcare VA CCN |
$61.39
|
|
|
CAREGIVER TRAING EA ADDL 15
|
Facility
|
IP
|
$73.52
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
9429755101
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$54.41 |
| Max. Negotiated Rate |
$69.84 |
| Rate for Payer: Aetna of VT Commercial |
$69.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$54.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$54.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$62.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$61.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$58.82
|
| Rate for Payer: Cash Price |
$36.76
|
| Rate for Payer: Cigna Commercial |
$58.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$58.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$58.82
|
| Rate for Payer: Multiplan Commercial |
$68.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$62.49
|
| Rate for Payer: United Healthcare Commercial |
$69.84
|
|
|
CAREGIVER TRAING EA ADDL 15
|
Facility
|
OP
|
$73.52
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
9429755101
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$32.56 |
| Max. Negotiated Rate |
$69.84 |
| Rate for Payer: Aetna of VT Commercial |
$69.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$65.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$65.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$44.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$62.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$59.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$33.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$58.45
|
| Rate for Payer: Cash Price |
$36.76
|
| Rate for Payer: Cigna Commercial |
$58.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$58.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$58.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$33.08
|
| Rate for Payer: Multiplan Commercial |
$68.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$62.49
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$33.08
|
| Rate for Payer: United Healthcare Commercial |
$69.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.08
|
| Rate for Payer: United Healthcare VA CCN |
$33.08
|
|
|
CARE OF MISCARRIAGE
|
Facility
|
IP
|
$858.00
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
9695982001
|
|
Hospital Revenue Code
|
969
|
| Min. Negotiated Rate |
$635.01 |
| Max. Negotiated Rate |
$815.10 |
| Rate for Payer: Aetna of VT Commercial |
$815.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$635.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$635.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$729.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$720.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$686.40
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$686.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$686.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$686.40
|
| Rate for Payer: Multiplan Commercial |
$797.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$729.30
|
| Rate for Payer: United Healthcare Commercial |
$815.10
|
|
|
CARE OF MISCARRIAGE
|
Facility
|
OP
|
$858.00
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
9695982001
|
|
Hospital Revenue Code
|
969
|
| Min. Negotiated Rate |
$380.01 |
| Max. Negotiated Rate |
$815.10 |
| Rate for Payer: Aetna of VT Commercial |
$815.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$768.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$380.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$768.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$516.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$729.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$694.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$386.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$682.11
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$686.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$686.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$686.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$386.10
|
| Rate for Payer: Multiplan Commercial |
$797.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$729.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$386.10
|
| Rate for Payer: United Healthcare Commercial |
$815.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$386.10
|
| Rate for Payer: United Healthcare VA CCN |
$386.10
|
|
|
CARE OF MISCARRIAGE
|
Professional
|
Both
|
$858.00
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
9695982001
|
|
Hospital Revenue Code
|
969
|
| Min. Negotiated Rate |
$355.28 |
| Max. Negotiated Rate |
$806.52 |
| Rate for Payer: Aetna of VT Commercial |
$806.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$768.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$365.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$768.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$497.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$557.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$557.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$408.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$557.06
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$391.15
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$681.46
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$681.46
|
| Rate for Payer: Martins Point Health Care Commercial |
$404.10
|
| Rate for Payer: Multiplan Commercial |
$797.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$504.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare Commercial |
$546.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare VA CCN |
$355.28
|
|
|
CARPAL TUNNEL SURGERY
|
Facility
|
OP
|
$3,399.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
5106472101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,505.42 |
| Max. Negotiated Rate |
$3,229.05 |
| Rate for Payer: Aetna of VT Commercial |
$3,229.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,505.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,046.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,889.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,753.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,529.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,702.20
|
| Rate for Payer: Cash Price |
$1,699.50
|
| Rate for Payer: Cigna Commercial |
$2,719.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,719.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,719.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,529.55
|
| Rate for Payer: Multiplan Commercial |
$3,161.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,889.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,529.55
|
| Rate for Payer: United Healthcare Commercial |
$3,229.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,529.55
|
| Rate for Payer: United Healthcare VA CCN |
$1,529.55
|
|
|
CARPAL TUNNEL SURGERY
|
Professional
|
Both
|
$1,487.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9606472102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$419.21 |
| Max. Negotiated Rate |
$1,397.78 |
| Rate for Payer: Aetna of VT Commercial |
$1,397.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$431.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$586.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$482.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,079.24
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$582.17
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$705.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$705.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$426.60
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$595.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare Commercial |
$644.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare VA CCN |
$419.21
|
|
|
CARPAL TUNNEL SURGERY
|
Facility
|
OP
|
$1,487.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9826472101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$658.59 |
| Max. Negotiated Rate |
$1,412.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,412.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$658.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$895.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,263.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,204.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$669.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,182.16
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,189.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$669.15
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,263.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$669.15
|
| Rate for Payer: United Healthcare Commercial |
$1,412.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$669.15
|
| Rate for Payer: United Healthcare VA CCN |
$669.15
|
|
|
CARPAL TUNNEL SURGERY
|
Facility
|
OP
|
$1,487.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9606472102
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$658.59 |
| Max. Negotiated Rate |
$1,412.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,412.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$658.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$895.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,263.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,204.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$669.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,182.16
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,189.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$669.15
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,263.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$669.15
|
| Rate for Payer: United Healthcare Commercial |
$1,412.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$669.15
|
| Rate for Payer: United Healthcare VA CCN |
$669.15
|
|
|
CARPAL TUNNEL SURGERY
|
Professional
|
Both
|
$1,487.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9826472101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$419.21 |
| Max. Negotiated Rate |
$1,397.78 |
| Rate for Payer: Aetna of VT Commercial |
$1,397.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$431.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$586.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$482.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,079.24
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$582.17
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$705.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$705.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$426.60
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$595.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare Commercial |
$644.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare VA CCN |
$419.21
|
|
|
CARPAL TUNNEL SURGERY
|
Professional
|
Both
|
$3,399.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
5106472101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$419.21 |
| Max. Negotiated Rate |
$3,195.06 |
| Rate for Payer: Aetna of VT Commercial |
$3,195.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$431.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,045.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$586.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$482.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,079.24
|
| Rate for Payer: Cash Price |
$1,699.50
|
| Rate for Payer: Cash Price |
$1,699.50
|
| Rate for Payer: Cigna Commercial |
$582.17
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$705.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$705.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$426.60
|
| Rate for Payer: Multiplan Commercial |
$3,161.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$595.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare Commercial |
$644.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare VA CCN |
$419.21
|
|
|
CARPAL TUNNEL SURGERY
|
Facility
|
IP
|
$1,487.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9826472101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,100.53 |
| Max. Negotiated Rate |
$1,412.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,412.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,100.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,100.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,263.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,249.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,189.60
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,189.60
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,263.95
|
| Rate for Payer: United Healthcare Commercial |
$1,412.65
|
|
|
CARPAL TUNNEL SURGERY
|
Facility
|
OP
|
$4,886.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9606472101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,164.01 |
| Max. Negotiated Rate |
$4,641.70 |
| Rate for Payer: Aetna of VT Commercial |
$4,641.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,377.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,164.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,377.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,941.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,153.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,957.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,198.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,884.37
|
| Rate for Payer: Cash Price |
$2,443.00
|
| Rate for Payer: Cigna Commercial |
$3,908.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,908.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,908.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$2,198.70
|
| Rate for Payer: Multiplan Commercial |
$4,543.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,153.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,198.70
|
| Rate for Payer: United Healthcare Commercial |
$4,641.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,198.70
|
| Rate for Payer: United Healthcare VA CCN |
$2,198.70
|
|
|
CARPAL TUNNEL SURGERY
|
Facility
|
IP
|
$4,886.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9606472101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,616.13 |
| Max. Negotiated Rate |
$4,641.70 |
| Rate for Payer: Aetna of VT Commercial |
$4,641.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,616.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,616.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,153.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,104.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,908.80
|
| Rate for Payer: Cash Price |
$2,443.00
|
| Rate for Payer: Cigna Commercial |
$3,908.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,908.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,908.80
|
| Rate for Payer: Multiplan Commercial |
$4,543.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,153.10
|
| Rate for Payer: United Healthcare Commercial |
$4,641.70
|
|
|
CARPAL TUNNEL SURGERY
|
Professional
|
Both
|
$4,886.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
9606472101
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$419.21 |
| Max. Negotiated Rate |
$4,592.84 |
| Rate for Payer: Aetna of VT Commercial |
$4,592.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,377.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$431.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,377.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$586.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,079.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$482.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,079.24
|
| Rate for Payer: Cash Price |
$2,443.00
|
| Rate for Payer: Cash Price |
$2,443.00
|
| Rate for Payer: Cigna Commercial |
$582.17
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$705.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$705.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$426.60
|
| Rate for Payer: Multiplan Commercial |
$4,543.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$595.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare Commercial |
$644.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$419.21
|
| Rate for Payer: United Healthcare VA CCN |
$419.21
|
|
