Nicotine 21 Mg Patch at Springfield Hospital

Springfield, VT

Pricing by billing methodology

Price type

Payers reporting CPT 53658 at Springfield Hospital

Negotiated rates from the hospital’s own file: 7 payers, 11 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Anthem anthem exchange fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
2	Anthem medicare advantage fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
3	UnitedHealthcare medicare advantage fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
4	WellCare medicare advantage fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
5	Anthem commercial percent of total billed charges · outpatientfrom % of charges	$4	$4	—	—	—	$4 – $4
6	Cigna commercial percent of total billed charges · outpatientfrom % of charges	$4	$4	—	—	—	$4 – $4
7	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$5	$5	—	—	—	$5 – $5
8	UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges	$5	$5	—	—	—	$5 – $5
9	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$6	$6	—	—	—	$6 – $6
10	Blue Cross Blue Shield medicare advantage percent of total billed charges · outpatientfrom % of charges	$6	$6	—	—	—	$6 – $6
11	Cigna medicare advantage percent of total billed charges · outpatientfrom % of charges	$6	$6	—	—	—	$6 – $6

Last updated: Aug 27, 2026

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