|
COCCIDIOIDES ANTIBODY
|
Professional
|
Both
|
$227.29
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
3008663501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$213.65 |
| Rate for Payer: Aetna of VT Commercial |
$213.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$70.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$14.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$70.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$20.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$24.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$24.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$24.61
|
| Rate for Payer: Cash Price |
$113.64
|
| Rate for Payer: Cash Price |
$113.64
|
| Rate for Payer: Cigna Commercial |
$17.45
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$14.39
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$14.39
|
| Rate for Payer: Martins Point Health Care Commercial |
$14.19
|
| Rate for Payer: Multiplan Commercial |
$211.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$14.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$14.39
|
| Rate for Payer: United Healthcare Commercial |
$22.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.39
|
| Rate for Payer: United Healthcare VA CCN |
$14.39
|
|
|
COCCIDIOIDES ANTIBODY
|
Facility
|
OP
|
$227.29
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
3008663501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.47 |
| Max. Negotiated Rate |
$215.93 |
| Rate for Payer: Aetna of VT Commercial |
$215.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$56.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$100.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$56.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$136.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$193.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$184.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$102.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$180.70
|
| Rate for Payer: Cash Price |
$113.64
|
| Rate for Payer: Cash Price |
$113.64
|
| Rate for Payer: Cigna Commercial |
$181.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$181.83
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$181.83
|
| Rate for Payer: Martins Point Health Care Commercial |
$102.28
|
| Rate for Payer: Multiplan Commercial |
$211.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$193.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$102.28
|
| Rate for Payer: United Healthcare Commercial |
$215.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.47
|
| Rate for Payer: United Healthcare VA CCN |
$102.28
|
|
|
COCCIDIOIDES ANTIBODY
|
Facility
|
IP
|
$227.29
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
3008663501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.22 |
| Max. Negotiated Rate |
$215.93 |
| Rate for Payer: Aetna of VT Commercial |
$215.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$168.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$168.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$193.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$190.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$181.83
|
| Rate for Payer: Cash Price |
$113.64
|
| Rate for Payer: Cigna Commercial |
$181.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$181.83
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$181.83
|
| Rate for Payer: Multiplan Commercial |
$211.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$193.20
|
| Rate for Payer: United Healthcare Commercial |
$215.93
|
|
|
COL CHROMOTOGRAPHY QUAL/QUAN
|
Professional
|
Both
|
$180.17
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
3008254201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.75 |
| Max. Negotiated Rate |
$169.36 |
| Rate for Payer: Aetna of VT Commercial |
$169.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$118.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$24.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$118.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$33.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$31.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$31.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$27.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$31.25
|
| Rate for Payer: Cash Price |
$90.08
|
| Rate for Payer: Cash Price |
$90.08
|
| Rate for Payer: Cigna Commercial |
$29.35
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$24.09
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$24.09
|
| Rate for Payer: Martins Point Health Care Commercial |
$23.75
|
| Rate for Payer: Multiplan Commercial |
$167.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.09
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$24.09
|
| Rate for Payer: United Healthcare Commercial |
$37.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.09
|
| Rate for Payer: United Healthcare VA CCN |
$24.09
|
|
|
COL CHROMOTOGRAPHY QUAL/QUAN
|
Facility
|
OP
|
$180.17
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
3008254201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$171.16 |
| Rate for Payer: Aetna of VT Commercial |
$171.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$118.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$79.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$118.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$108.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$153.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$145.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$81.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$143.24
|
| Rate for Payer: Cash Price |
$90.08
|
| Rate for Payer: Cash Price |
$90.08
|
| Rate for Payer: Cigna Commercial |
$144.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$144.14
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$144.14
|
| Rate for Payer: Martins Point Health Care Commercial |
$81.08
|
| Rate for Payer: Multiplan Commercial |
$167.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$153.14
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$81.08
|
| Rate for Payer: United Healthcare Commercial |
$171.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.09
|
| Rate for Payer: United Healthcare VA CCN |
$81.08
|
|
|
COL CHROMOTOGRAPHY QUAL/QUAN
|
Facility
|
IP
|
$180.17
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
3008254201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.34 |
| Max. Negotiated Rate |
$171.16 |
| Rate for Payer: Aetna of VT Commercial |
$171.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$133.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$133.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$153.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$151.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$144.14
|
| Rate for Payer: Cash Price |
$90.08
|
| Rate for Payer: Cigna Commercial |
$144.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$144.14
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$144.14
|
| Rate for Payer: Multiplan Commercial |
$167.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$153.14
|
| Rate for Payer: United Healthcare Commercial |
$171.16
|
|
|
COLLAGEN CROSSLINKS
|
Professional
|
Both
|
$223.34
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
3008252301
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.42 |
| Max. Negotiated Rate |
$209.94 |
| Rate for Payer: Aetna of VT Commercial |
$209.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$92.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$19.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$92.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$26.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$31.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$31.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$21.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$31.10
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cigna Commercial |
$22.61
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$18.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$18.68
|
| Rate for Payer: Martins Point Health Care Commercial |
$18.42
|
| Rate for Payer: Multiplan Commercial |
$207.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$18.68
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$18.68
|
| Rate for Payer: United Healthcare Commercial |
$28.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.68
|
| Rate for Payer: United Healthcare VA CCN |
$18.68
|
|
|
COLLAGEN CROSSLINKS
|
Facility
|
IP
|
$223.34
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
3008252301
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$165.29 |
| Max. Negotiated Rate |
$212.17 |
| Rate for Payer: Aetna of VT Commercial |
$212.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$165.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$165.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$187.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$178.67
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cigna Commercial |
$178.67
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$178.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$178.67
|
| Rate for Payer: Multiplan Commercial |
$207.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$189.84
|
| Rate for Payer: United Healthcare Commercial |
$212.17
|
|
|
COLLAGEN CROSSLINKS
|
Facility
|
OP
|
$223.34
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
3008252301
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$212.17 |
| Rate for Payer: Aetna of VT Commercial |
$212.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$92.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$98.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$92.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$134.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$189.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$180.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$100.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$177.56
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cash Price |
$111.67
|
| Rate for Payer: Cigna Commercial |
$178.67
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$178.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$178.67
|
| Rate for Payer: Martins Point Health Care Commercial |
$100.50
|
| Rate for Payer: Multiplan Commercial |
$207.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$189.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$100.50
|
| Rate for Payer: United Healthcare Commercial |
$212.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.68
|
| Rate for Payer: United Healthcare VA CCN |
$100.50
|
|
|
COLLECT BLOOD FROM PICC
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
3003659201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$115.50 |
| Max. Negotiated Rate |
$148.26 |
| Rate for Payer: Aetna of VT Commercial |
$148.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$132.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$131.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$124.85
|
| Rate for Payer: Cash Price |
$78.03
|
| Rate for Payer: Cigna Commercial |
$124.85
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$124.85
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$124.85
|
| Rate for Payer: Multiplan Commercial |
$145.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$132.65
|
| Rate for Payer: United Healthcare Commercial |
$148.26
|
|
|
COLLECT BLOOD FROM PICC
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
3003659201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$148.26 |
| Rate for Payer: Aetna of VT Commercial |
$148.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$139.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$69.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$139.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$93.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$132.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$126.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$70.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$124.07
|
| Rate for Payer: Cash Price |
$78.03
|
| Rate for Payer: Cash Price |
$78.03
|
| Rate for Payer: Cigna Commercial |
$124.85
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$124.85
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$124.85
|
| Rate for Payer: Martins Point Health Care Commercial |
$70.23
|
| Rate for Payer: Multiplan Commercial |
$145.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$132.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$70.23
|
| Rate for Payer: United Healthcare Commercial |
$148.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.43
|
| Rate for Payer: United Healthcare VA CCN |
$70.23
|
|
|
COLLECT BLOOD FROM PICC
|
Professional
|
Both
|
$156.06
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
3003659201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$146.70 |
| Rate for Payer: Aetna of VT Commercial |
$146.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$139.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$29.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$139.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$39.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$36.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$36.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$32.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$36.46
|
| Rate for Payer: Cash Price |
$78.03
|
| Rate for Payer: Cash Price |
$78.03
|
| Rate for Payer: Cigna Commercial |
$52.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.78
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.78
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.43
|
| Rate for Payer: Multiplan Commercial |
$145.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$40.37
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$28.43
|
| Rate for Payer: United Healthcare Commercial |
$43.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.43
|
| Rate for Payer: United Healthcare VA CCN |
$28.43
|
|
|
COLON CA SCRN NOT HI RSK IND
|
Facility
|
IP
|
$994.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
982G012101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$735.66 |
| Max. Negotiated Rate |
$944.30 |
| Rate for Payer: Aetna of VT Commercial |
$944.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$735.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$735.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$844.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$834.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$795.20
|
| Rate for Payer: Cash Price |
$497.00
|
| Rate for Payer: Cigna Commercial |
$795.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$795.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$795.20
|
| Rate for Payer: Multiplan Commercial |
$924.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$844.90
|
| Rate for Payer: United Healthcare Commercial |
$944.30
|
|
|
COLON CA SCRN NOT HI RSK IND
|
Facility
|
OP
|
$994.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
982G012101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$440.24 |
| Max. Negotiated Rate |
$944.30 |
| Rate for Payer: Aetna of VT Commercial |
$944.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$890.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$440.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$890.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$598.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$844.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$805.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$447.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$790.23
|
| Rate for Payer: Cash Price |
$497.00
|
| Rate for Payer: Cigna Commercial |
$795.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$795.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$795.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$447.30
|
| Rate for Payer: Multiplan Commercial |
$924.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$844.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$447.30
|
| Rate for Payer: United Healthcare Commercial |
$944.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$447.30
|
| Rate for Payer: United Healthcare VA CCN |
$447.30
|
|
|
COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$994.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
982G012101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$170.32 |
| Max. Negotiated Rate |
$1,453.17 |
| Rate for Payer: Aetna of VT Commercial |
$934.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,453.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$175.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,453.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$238.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$578.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$578.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$195.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$578.55
|
| Rate for Payer: Cash Price |
$497.00
|
| Rate for Payer: Cash Price |
$497.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$521.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$521.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$319.67
|
| Rate for Payer: Multiplan Commercial |
$924.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$241.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$170.32
|
| Rate for Payer: United Healthcare Commercial |
$262.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$170.32
|
| Rate for Payer: United Healthcare VA CCN |
$170.32
|
|
|
COLONOSCOPY AND BIOPSY
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
9824538001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$185.02 |
| Max. Negotiated Rate |
$900.52 |
| Rate for Payer: Aetna of VT Commercial |
$900.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$858.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$190.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$858.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$259.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$766.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$766.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$212.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$766.20
|
| Rate for Payer: Cash Price |
$479.00
|
| Rate for Payer: Cash Price |
$479.00
|
| Rate for Payer: Cigna Commercial |
$485.35
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$659.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$659.33
|
| Rate for Payer: Martins Point Health Care Commercial |
$405.36
|
| Rate for Payer: Multiplan Commercial |
$890.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$262.73
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$185.02
|
| Rate for Payer: United Healthcare Commercial |
$284.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$185.02
|
| Rate for Payer: United Healthcare VA CCN |
$185.02
|
|
|
COLONOSCOPY AND BIOPSY
|
Facility
|
OP
|
$958.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
9824538001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$424.30 |
| Max. Negotiated Rate |
$910.10 |
| Rate for Payer: Aetna of VT Commercial |
$910.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$858.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$424.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$858.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$576.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$814.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$775.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$431.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$761.61
|
| Rate for Payer: Cash Price |
$479.00
|
| Rate for Payer: Cigna Commercial |
$766.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$766.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$766.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$431.10
|
| Rate for Payer: Multiplan Commercial |
$890.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$814.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$431.10
|
| Rate for Payer: United Healthcare Commercial |
$910.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$431.10
|
| Rate for Payer: United Healthcare VA CCN |
$431.10
|
|
|
COLONOSCOPY AND BIOPSY
|
Facility
|
IP
|
$958.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
9824538001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$709.02 |
| Max. Negotiated Rate |
$910.10 |
| Rate for Payer: Aetna of VT Commercial |
$910.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$709.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$709.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$814.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$804.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$766.40
|
| Rate for Payer: Cash Price |
$479.00
|
| Rate for Payer: Cigna Commercial |
$766.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$766.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$766.40
|
| Rate for Payer: Multiplan Commercial |
$890.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$814.30
|
| Rate for Payer: United Healthcare Commercial |
$910.10
|
|
|
COLONOSCOPY SUBMUCOUS NJX
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
9824538101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$185.02 |
| Max. Negotiated Rate |
$950.34 |
| Rate for Payer: Aetna of VT Commercial |
$950.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$905.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$190.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$905.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$259.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$770.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$770.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$212.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$770.57
|
| Rate for Payer: Cash Price |
$505.50
|
| Rate for Payer: Cash Price |
$505.50
|
| Rate for Payer: Cigna Commercial |
$338.52
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$672.19
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$672.19
|
| Rate for Payer: Martins Point Health Care Commercial |
$413.40
|
| Rate for Payer: Multiplan Commercial |
$940.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$262.73
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$185.02
|
| Rate for Payer: United Healthcare Commercial |
$284.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$185.02
|
| Rate for Payer: United Healthcare VA CCN |
$185.02
|
|
|
COLONOSCOPY SUBMUCOUS NJX
|
Facility
|
IP
|
$1,011.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
9824538101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$748.24 |
| Max. Negotiated Rate |
$960.45 |
| Rate for Payer: Aetna of VT Commercial |
$960.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$748.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$748.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$859.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$849.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$808.80
|
| Rate for Payer: Cash Price |
$505.50
|
| Rate for Payer: Cigna Commercial |
$808.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$808.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$808.80
|
| Rate for Payer: Multiplan Commercial |
$940.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$859.35
|
| Rate for Payer: United Healthcare Commercial |
$960.45
|
|
|
COLONOSCOPY SUBMUCOUS NJX
|
Facility
|
OP
|
$1,011.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
9824538101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$447.77 |
| Max. Negotiated Rate |
$960.45 |
| Rate for Payer: Aetna of VT Commercial |
$960.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$905.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$447.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$905.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$608.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$859.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$818.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$454.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$803.75
|
| Rate for Payer: Cash Price |
$505.50
|
| Rate for Payer: Cigna Commercial |
$808.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$808.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$808.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$454.95
|
| Rate for Payer: Multiplan Commercial |
$940.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$859.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$454.95
|
| Rate for Payer: United Healthcare Commercial |
$960.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$454.95
|
| Rate for Payer: United Healthcare VA CCN |
$454.95
|
|
|
COLONOSCOPY W/BAND LIGATION
|
Professional
|
Both
|
$1,391.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
9824539801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$215.15 |
| Max. Negotiated Rate |
$1,307.54 |
| Rate for Payer: Aetna of VT Commercial |
$1,307.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,246.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$221.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,246.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$301.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$247.42
|
| Rate for Payer: Cash Price |
$695.50
|
| Rate for Payer: Cash Price |
$695.50
|
| Rate for Payer: Cigna Commercial |
$394.91
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,220.95
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,220.95
|
| Rate for Payer: Martins Point Health Care Commercial |
$753.81
|
| Rate for Payer: Multiplan Commercial |
$1,293.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$305.51
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$215.15
|
| Rate for Payer: United Healthcare Commercial |
$330.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$215.15
|
| Rate for Payer: United Healthcare VA CCN |
$215.15
|
|
|
COLONOSCOPY W/BAND LIGATION
|
Facility
|
OP
|
$1,391.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
9824539801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$616.07 |
| Max. Negotiated Rate |
$1,321.45 |
| Rate for Payer: Aetna of VT Commercial |
$1,321.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,246.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$616.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,246.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$837.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,182.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,126.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$625.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,105.85
|
| Rate for Payer: Cash Price |
$695.50
|
| Rate for Payer: Cigna Commercial |
$1,112.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,112.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,112.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$625.95
|
| Rate for Payer: Multiplan Commercial |
$1,293.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,182.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$625.95
|
| Rate for Payer: United Healthcare Commercial |
$1,321.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$625.95
|
| Rate for Payer: United Healthcare VA CCN |
$625.95
|
|
|
COLONOSCOPY W/BAND LIGATION
|
Facility
|
IP
|
$1,391.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
9824539801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,029.48 |
| Max. Negotiated Rate |
$1,321.45 |
| Rate for Payer: Aetna of VT Commercial |
$1,321.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,029.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,029.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,182.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,168.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,112.80
|
| Rate for Payer: Cash Price |
$695.50
|
| Rate for Payer: Cigna Commercial |
$1,112.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,112.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,112.80
|
| Rate for Payer: Multiplan Commercial |
$1,293.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,182.35
|
| Rate for Payer: United Healthcare Commercial |
$1,321.45
|
|
|
COLONOSCOPY W/DECOMPRESSION
|
Professional
|
Both
|
$821.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
9824539301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$230.17 |
| Max. Negotiated Rate |
$771.74 |
| Rate for Payer: Aetna of VT Commercial |
$771.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$735.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$237.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$735.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$322.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$264.70
|
| Rate for Payer: Cash Price |
$410.50
|
| Rate for Payer: Cash Price |
$410.50
|
| Rate for Payer: Cigna Commercial |
$422.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$381.61
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$381.61
|
| Rate for Payer: Martins Point Health Care Commercial |
$230.17
|
| Rate for Payer: Multiplan Commercial |
$763.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$326.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$230.17
|
| Rate for Payer: United Healthcare Commercial |
$354.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$230.17
|
| Rate for Payer: United Healthcare VA CCN |
$230.17
|
|
