|
CHEMO ADM SUBQ/IM ANTINEOPL
|
Professional
|
Both
|
$241.08
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
3319640201
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$34.42 |
| Max. Negotiated Rate |
$226.62 |
| Rate for Payer: Aetna of VT Commercial |
$226.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$215.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$35.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$215.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$48.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$56.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$56.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$39.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$56.50
|
| Rate for Payer: Cash Price |
$120.54
|
| Rate for Payer: Cash Price |
$120.54
|
| Rate for Payer: Cigna Commercial |
$53.85
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$55.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$55.54
|
| Rate for Payer: Martins Point Health Care Commercial |
$34.42
|
| Rate for Payer: Multiplan Commercial |
$224.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$48.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$34.43
|
| Rate for Payer: United Healthcare Commercial |
$52.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.43
|
| Rate for Payer: United Healthcare VA CCN |
$34.43
|
|
|
CHEMODENERVATION ANAL MUSC
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
9824650501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$234.61 |
| Max. Negotiated Rate |
$675.86 |
| Rate for Payer: Aetna of VT Commercial |
$675.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$644.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$241.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$644.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$328.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$385.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$385.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$269.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$385.27
|
| Rate for Payer: Cash Price |
$359.50
|
| Rate for Payer: Cash Price |
$359.50
|
| Rate for Payer: Cigna Commercial |
$432.52
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$483.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$483.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$294.67
|
| Rate for Payer: Multiplan Commercial |
$668.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$333.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$234.61
|
| Rate for Payer: United Healthcare Commercial |
$360.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$234.61
|
| Rate for Payer: United Healthcare VA CCN |
$234.61
|
|
|
CHEMODENERVATION ANAL MUSC
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
9824650501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$318.45 |
| Max. Negotiated Rate |
$683.05 |
| Rate for Payer: Aetna of VT Commercial |
$683.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$644.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$318.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$644.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$432.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$611.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$582.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$323.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$571.61
|
| Rate for Payer: Cash Price |
$359.50
|
| Rate for Payer: Cigna Commercial |
$575.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$575.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$575.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$323.55
|
| Rate for Payer: Multiplan Commercial |
$668.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$611.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$323.55
|
| Rate for Payer: United Healthcare Commercial |
$683.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$323.55
|
| Rate for Payer: United Healthcare VA CCN |
$323.55
|
|
|
CHEMODENERVATION ANAL MUSC
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
9824650501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$532.13 |
| Max. Negotiated Rate |
$683.05 |
| Rate for Payer: Aetna of VT Commercial |
$683.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$532.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$532.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$611.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$603.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$575.20
|
| Rate for Payer: Cash Price |
$359.50
|
| Rate for Payer: Cigna Commercial |
$575.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$575.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$575.20
|
| Rate for Payer: Multiplan Commercial |
$668.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$611.15
|
| Rate for Payer: United Healthcare Commercial |
$683.05
|
|
|
CHEST WALL MANIPULATION
|
Facility
|
OP
|
$117.62
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
4109466801
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$52.09 |
| Max. Negotiated Rate |
$111.74 |
| Rate for Payer: Aetna of VT Commercial |
$111.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$105.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$52.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$105.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$99.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$95.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$52.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$93.51
|
| Rate for Payer: Cash Price |
$58.81
|
| Rate for Payer: Cigna Commercial |
$94.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$94.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$94.10
|
| Rate for Payer: Martins Point Health Care Commercial |
$52.93
|
| Rate for Payer: Multiplan Commercial |
$109.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$99.98
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$52.93
|
| Rate for Payer: United Healthcare Commercial |
$111.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52.93
|
| Rate for Payer: United Healthcare VA CCN |
$52.93
|
|
|
CHEST WALL MANIPULATION
|
Facility
|
OP
|
$300.38
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
4109466701
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$133.04 |
| Max. Negotiated Rate |
$285.36 |
| Rate for Payer: Aetna of VT Commercial |
$285.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$269.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$133.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$269.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$180.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$255.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$243.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$135.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$238.80
|
| Rate for Payer: Cash Price |
$150.19
|
| Rate for Payer: Cigna Commercial |
$240.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$240.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$240.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$135.17
|
| Rate for Payer: Multiplan Commercial |
$279.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$255.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$135.17
|
| Rate for Payer: United Healthcare Commercial |
$285.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$135.17
|
| Rate for Payer: United Healthcare VA CCN |
$135.17
|
|
|
CHEST WALL MANIPULATION
|
Facility
|
IP
|
$300.38
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
4109466701
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$222.31 |
| Max. Negotiated Rate |
$285.36 |
| Rate for Payer: Aetna of VT Commercial |
$285.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$222.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$222.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$255.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$252.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$240.30
|
| Rate for Payer: Cash Price |
$150.19
|
| Rate for Payer: Cigna Commercial |
$240.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$240.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$240.30
|
| Rate for Payer: Multiplan Commercial |
$279.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$255.32
|
| Rate for Payer: United Healthcare Commercial |
$285.36
|
|
|
CHEST WALL MANIPULATION
|
Facility
|
IP
|
$117.62
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
4109466801
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$87.05 |
| Max. Negotiated Rate |
$111.74 |
| Rate for Payer: Aetna of VT Commercial |
$111.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$87.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$87.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$99.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$98.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$94.10
|
| Rate for Payer: Cash Price |
$58.81
|
| Rate for Payer: Cigna Commercial |
$94.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$94.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$94.10
|
| Rate for Payer: Multiplan Commercial |
$109.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$99.98
|
| Rate for Payer: United Healthcare Commercial |
$111.74
|
|
|
CHIROPRACTIC MANJ 5 REGIONS
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 98942
|
| Hospital Charge Code |
9839894201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$25.25 |
| Max. Negotiated Rate |
$54.15 |
| Rate for Payer: Aetna of VT Commercial |
$54.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$25.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$34.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$46.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$45.31
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$25.65
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$48.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$25.65
|
| Rate for Payer: United Healthcare Commercial |
$54.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.65
|
| Rate for Payer: United Healthcare VA CCN |
$25.65
|
|
|
CHIROPRACTIC MANJ 5 REGIONS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
CPT 98942
|
| Hospital Charge Code |
9839894201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$79.21 |
| Rate for Payer: Aetna of VT Commercial |
$53.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$49.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$45.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$49.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$61.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$53.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$53.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$50.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$53.19
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$52.96
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$49.53
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$62.12
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$43.75
|
| Rate for Payer: United Healthcare Commercial |
$67.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43.75
|
| Rate for Payer: United Healthcare VA CCN |
$43.75
|
|
|
CHIROPRACTIC MANJ 5 REGIONS
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 98942
|
| Hospital Charge Code |
9839894201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$42.19 |
| Max. Negotiated Rate |
$54.15 |
| Rate for Payer: Aetna of VT Commercial |
$54.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$42.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$42.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$47.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$45.60
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$48.45
|
| Rate for Payer: United Healthcare Commercial |
$54.15
|
|
|
CHIROPRACT MANJ 1-2 REGIONS
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 98940
|
| Hospital Charge Code |
9839894001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$42.19 |
| Max. Negotiated Rate |
$54.15 |
| Rate for Payer: Aetna of VT Commercial |
$54.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$42.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$42.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$47.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$45.60
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$48.45
|
| Rate for Payer: United Healthcare Commercial |
$54.15
|
|
|
CHIROPRACT MANJ 1-2 REGIONS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
CPT 98940
|
| Hospital Charge Code |
9839894001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$21.15 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna of VT Commercial |
$53.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$26.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$21.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$26.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$29.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$28.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$28.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$24.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$28.43
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$25.59
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$42.17
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$42.17
|
| Rate for Payer: Martins Point Health Care Commercial |
$26.28
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$30.03
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$21.15
|
| Rate for Payer: United Healthcare Commercial |
$32.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.15
|
| Rate for Payer: United Healthcare VA CCN |
$21.15
|
|
|
CHIROPRACT MANJ 1-2 REGIONS
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 98940
|
| Hospital Charge Code |
9839894001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$25.25 |
| Max. Negotiated Rate |
$54.15 |
| Rate for Payer: Aetna of VT Commercial |
$54.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$25.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$34.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$46.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$45.31
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$25.65
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$48.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$25.65
|
| Rate for Payer: United Healthcare Commercial |
$54.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.65
|
| Rate for Payer: United Healthcare VA CCN |
$25.65
|
|
|
CHIROPRACT MANJ 3-4 REGIONS
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 98941
|
| Hospital Charge Code |
9839894101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$25.25 |
| Max. Negotiated Rate |
$54.15 |
| Rate for Payer: Aetna of VT Commercial |
$54.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$51.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$25.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$51.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$34.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$46.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$45.31
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$25.65
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$48.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$25.65
|
| Rate for Payer: United Healthcare Commercial |
$54.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.65
|
| Rate for Payer: United Healthcare VA CCN |
$25.65
|
|
|
CHIROPRACT MANJ 3-4 REGIONS
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 98941
|
| Hospital Charge Code |
9839894101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$42.19 |
| Max. Negotiated Rate |
$54.15 |
| Rate for Payer: Aetna of VT Commercial |
$54.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$42.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$42.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$47.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$45.60
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$48.45
|
| Rate for Payer: United Healthcare Commercial |
$54.15
|
|
|
CHIROPRACT MANJ 3-4 REGIONS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
CPT 98941
|
| Hospital Charge Code |
9839894101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$32.45 |
| Max. Negotiated Rate |
$61.21 |
| Rate for Payer: Aetna of VT Commercial |
$53.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$38.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$33.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$38.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$45.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$40.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$40.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$37.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$40.98
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cash Price |
$28.50
|
| Rate for Payer: Cigna Commercial |
$39.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$61.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$61.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$38.23
|
| Rate for Payer: Multiplan Commercial |
$53.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$46.08
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$32.45
|
| Rate for Payer: United Healthcare Commercial |
$49.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32.45
|
| Rate for Payer: United Healthcare VA CCN |
$32.45
|
|
|
CHIROPRACT MANJ XTRSPINL 1/>
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 98943
|
| Hospital Charge Code |
9839894301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$18.60 |
| Max. Negotiated Rate |
$39.90 |
| Rate for Payer: Aetna of VT Commercial |
$39.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$18.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$25.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$34.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$18.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$33.39
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$33.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$33.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$33.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.90
|
| Rate for Payer: Multiplan Commercial |
$39.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$35.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$18.90
|
| Rate for Payer: United Healthcare Commercial |
$39.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.90
|
| Rate for Payer: United Healthcare VA CCN |
$18.90
|
|
|
CHIROPRACT MANJ XTRSPINL 1/>
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
CPT 98943
|
| Hospital Charge Code |
9839894301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$21.97 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna of VT Commercial |
$39.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$24.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$24.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$30.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$30.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$30.51
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$39.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$39.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$24.38
|
| Rate for Payer: Multiplan Commercial |
$39.06
|
| Rate for Payer: United Healthcare Commercial |
$35.70
|
| Rate for Payer: United Healthcare VA CCN |
$21.97
|
|
|
CHIROPRACT MANJ XTRSPINL 1/>
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 98943
|
| Hospital Charge Code |
9839894301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$31.08 |
| Max. Negotiated Rate |
$39.90 |
| Rate for Payer: Aetna of VT Commercial |
$39.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$31.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$31.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$35.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$33.60
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$33.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$33.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$33.60
|
| Rate for Payer: Multiplan Commercial |
$39.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$35.70
|
| Rate for Payer: United Healthcare Commercial |
$39.90
|
|
|
CHLAMYDIA ANTIBODY
|
Professional
|
Both
|
$125.51
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
3008663101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$117.98 |
| Rate for Payer: Aetna of VT Commercial |
$117.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$58.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$12.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$58.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$13.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$17.21
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cigna Commercial |
$14.28
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$11.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$11.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$11.65
|
| Rate for Payer: Multiplan Commercial |
$116.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$11.82
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$11.82
|
| Rate for Payer: United Healthcare Commercial |
$18.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.82
|
| Rate for Payer: United Healthcare VA CCN |
$11.82
|
|
|
CHLAMYDIA ANTIBODY
|
Facility
|
OP
|
$125.51
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
3008663101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$119.23 |
| Rate for Payer: Aetna of VT Commercial |
$119.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$58.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$55.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$58.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$75.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$106.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$101.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$56.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$99.78
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cigna Commercial |
$100.41
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$100.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$100.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$56.48
|
| Rate for Payer: Multiplan Commercial |
$116.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$106.68
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$56.48
|
| Rate for Payer: United Healthcare Commercial |
$119.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.82
|
| Rate for Payer: United Healthcare VA CCN |
$56.48
|
|
|
CHLAMYDIA ANTIBODY
|
Facility
|
IP
|
$125.51
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
3008663101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$92.89 |
| Max. Negotiated Rate |
$119.23 |
| Rate for Payer: Aetna of VT Commercial |
$119.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$92.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$92.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$106.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$105.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$100.41
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cigna Commercial |
$100.41
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$100.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$100.41
|
| Rate for Payer: Multiplan Commercial |
$116.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$106.68
|
| Rate for Payer: United Healthcare Commercial |
$119.23
|
|
|
CHLAMYDIA IGM ANTIBODY
|
Professional
|
Both
|
$134.10
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
3008663201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.50 |
| Max. Negotiated Rate |
$126.05 |
| Rate for Payer: Aetna of VT Commercial |
$126.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$13.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$17.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$18.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$18.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$14.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$18.45
|
| Rate for Payer: Cash Price |
$67.05
|
| Rate for Payer: Cash Price |
$67.05
|
| Rate for Payer: Cigna Commercial |
$15.47
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$12.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$12.68
|
| Rate for Payer: Martins Point Health Care Commercial |
$12.50
|
| Rate for Payer: Multiplan Commercial |
$124.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$12.68
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$12.68
|
| Rate for Payer: United Healthcare Commercial |
$19.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.68
|
| Rate for Payer: United Healthcare VA CCN |
$12.68
|
|
|
CHLAMYDIA IGM ANTIBODY
|
Facility
|
IP
|
$134.10
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
3008663201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$99.25 |
| Max. Negotiated Rate |
$127.39 |
| Rate for Payer: Aetna of VT Commercial |
$127.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$99.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$99.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$113.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$112.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$107.28
|
| Rate for Payer: Cash Price |
$67.05
|
| Rate for Payer: Cigna Commercial |
$107.28
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$107.28
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$107.28
|
| Rate for Payer: Multiplan Commercial |
$124.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$113.98
|
| Rate for Payer: United Healthcare Commercial |
$127.39
|
|
