PDF Save money with low-cost providers

Save money with low-cost providers

Costs for medical tests and procedures often vary widely with no significant difference in quality. So why pay more if you don't have to? When your Harvard Pilgrim plan has LP (low-cost provider) benefits, you can pay lower out-of-pocket costs for lab and outpatient surgery services when you receive them at select LP facilities.

When you use LP facilities:

The deductible will not apply.

Lab tests, excluding genetic testing, are covered at no charge to you.

You'll pay a copayment for outpatient surgery.

Read on for more details.

For the most up-to-date information on LP facilities, visit .

? Click on "Find a Provider" and choose the directory for your plan under "LP (Low-Cost Provider) Plans."

? Under "Search by Provider Type," Select "Other Care Providers."

? At the next screen, under "Specialty," choose either "General Laboratory" or "Ambulatory Surgical Center."

? LP facilities will be shown with an "LP (Low-Cost Provider)" designation.

This list may change at any time without prior notice. Refer to the online provider directory at for the latest information.

Ambulatory Surgical Centers

Your plan will cover outpatient surgery with a copayment when you have it performed at one of the following locations. HMO plans require your primary care provider's or specialist's referral. See the Schedule of Benefits for details.

New Hampshire

Name Access Ambulatory Surgery Center, LLC Barrington Surgical Care, LLC Bedford Ambulatory Surgical Center, LLC Minimally Invasive Surgery Center of New England, LLC Androscoggin Valley Hospital ASC Upper Connecticut Valley Hospital ASC Orthopaedic Surgery Center - Concord Concord Ambulatory Surgery Center Concord Endoscopy Center, LLC Concord Eye Surgery, LLC Orthopaedic Surgery Center - Derry Hillside ASC, LLC dba LRGHealthcare Ambulatory Surgical Center at Hillside Medical Park Lakes Region General Hospital Outpatient Surgery Weeks Medical Center ASC Littleton Regional Healthcare ASC Dartmouth Hitchcock Clinic Manchester Surgery Center Elliot One Day Surgery Center* Centers For Pain Solutions, LLC Dartmouth Hitchcock Clinic Nashua Nashua Ambulatory Surgical Center, LLC NovaMed Surgery Center of Nashua, LLC dba, Nashua Eye Surgery Center The Surgery Center of Greater Nashua Northeast Surgical Care Atlantic Plastic Surgery Center Portsmouth Regional Ambulatory Surgery Center Rye Surgical Center, LLC Orchard Surgical Center, LLC Wentworth Surgery Center, LLC Stratham Ambulatory Surgery Center Cottage Hospital Ambulatory Services

Address 45 Dartmouth Drive 944 Calef Highway 11 Washington Place 4 Hawthorne Drive

59 Page Hill Road 181 Corliss Lane 264 Pleasant Street 60 Commercial Street, Suite 301 1 Corporate Place, 60 Commercial Street, Suite 201 246 Pleasant Street, Suite 105B 14 Tsienneto Road, Suite 100 14 Maple Street

80 Highland Avenue

173 Middle Street 600 St. Johnsbury Road 100 Hitchcock Way

185 Queen City Avenue 280 Main Street, Suite 420 2300 Southwood Drive 15 Riverside Street 5 Coliseum Avenue

10 Prospect Street 2299 Woodbury Avenue 100 Griffin Road, Suite B 333 Borthwick Avenue, Suite 200

270 Lafayette Road 16 Keewaydin Drive 6 Works Way 4B West Road 90 Swiftwater Road

City/Town Auburn Barrington Bedford Bedford

Berlin Colebrook Concord Concord Concord Concord Derry Gilford

Laconia

Lancaster Littleton Manchester

Manchester Nashua Nashua Nashua Nashua

Nashua Newington Portsmouth Portsmouth

Rye Salem Somersworth Stratham Woodsville

Phone Number (603) 518-7190 (603) 664-0100 (603) 622-3670 (603) 218-1912

(603) 752-2200 (603) 237-4971 (603) 224-3368 (603) 415-9460 (603) 415-9450 (603) 224-6503 (603) 224-3368 (603) 524-7514

(603) 524-3211

(603) 788-4911 (800) 464-7731 (603) 695-2500

(603) 663-5900 (603) 577-3003 (603) 577-4000 (603) 622-3670 (603) 882-9800

(603) 578-9909 (603) 431-5563 (800) 633-6860 (603) 433-0941

(603) 664-0100 (603) 401-6466 (603) 285-9288 (603) 772-2076 (603) 747-9000

*Applies to procedures performed at Elliot One Day Surgery Center only, and not other Elliot Hospital departments also located at River's Edge, 185 Queen City Avenue. 1

Massachusetts

Name Middlesex Endoscopy Center, LLC dba Middlesex Digestive Health and Endoscopy Center Cataract & Laser Center Associates, PC Valley Medical Group, PC, dba Valley Medical Group Ambulatory Surgery and Procedure Center Cataract & Laser Center of the North Shore, LLC New England Surgery Center, LLC

Boston Eye Surgery & Laser Center

Richard A. Bartlett, MD, PC

Longwood Plastic Surgery, PC

New England Ambulatory SurgiCenter

Northeast Plastic Surgery, PC West Suburban Eye Surgery Center, LLC dba Surgisite North Cataract & Laser Center, Inc. Same Day SurgiCare of New England, Inc. dba Same Day SurgiClinic Charles River Endoscopy, LLC

Cataract & Laser Center Central, LLC

Cape And Islands Endoscopy Center, LLC

Hyde Park Pain Management, LLC Central MA Ambulatory Endoscopy Center, LLC Northeast Endoscopy Center, LLC Medical Affiliates of Cape Cod, Inc. dba Cape Cod Surgery Center Cataract Surgery Center of Milford, Inc.

Advanced Eye Surgery Center, LLC Candescent Eye Health Surgicenter, LLC dba Greater New Bedford Surgicenter Eastern Massachusetts Surgery Center, LLC

New England Pain Care, Inc. Orthopaedic Surgical Center of The North Shore, LLC Berskshire Cosmetic & Reconstructive Surgery Center East Pond Enterprises, Inc. Plymouth Laser Center, PC, dba Plymouth Laser & Surgical Center, PC Boston Plastic Surgery

Address 45A Discovery Way

1 Berkshire Square 31 Hall Drive

349 North Main Street

900 Cummings Center, Suite 122U 50 Staniford Street 77 Pond Avenue, Suite 104-C 235 Cypress Street, Suite 210 799 Concord Avenue 15 Village Square 321 Billerica Road, Suite 1

333 Elm Street 272 Stanley Street

571 Union Avenue, 2nd Floor 95 Mechanic Street 700 Attuck's Lane, Suite 1B 188 Providence Street 105 Erdman Way

59 Composite Way 160 Falmouth Road, Suite 1

145 West Street 500 Faunce Corner Road, Suite 180 51 State Street

100 Morse Street 10 Centennial Drive One Orthopedic Drive, Main Level

426 South Street

40 Industrial Park Road 146 Industrial Park Road

2300 Crown Colony Drive, Suite 101

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City/Town Acton

Phone Number (978) 429-2000

Adams Amherst

(413) 943-9934 (413) 772-3329

Andover

Beverly Boston Brookline Brookline Cambridge Chelmsford Chelmsford

Dedham Fall River

Framingham Gardner Hyannis Hyde Park Leominster

Lowell Mashpee

Milford N. Dartmouth N. Dartmouth

Norwood Peabody Peabody

Pittsfield

Plymouth Plymouth

Quincy

(978) 475-0959

(978) 922-4670 (617) 723-2015 (617) 735-1800 (617) 383-6250 (617) 547-7163 (978) 256-8048 (978) 614-0510

(781) 326-3800 (508) 672-2290

(508) 665-4111 (978) 632-6674 (508) 775-7751 (617) 833-6100 (978) 840-6767

(978) 349-2146 (774) 361-8700

(508) 381-6040 (508) 717-0270 (508) 997-1274

(781) 255-0362 (978) 826-7234 (978) 818-6514

(413) 496-9272

(508) 747-7246 (508) 746-6178

(617) 786-7600

Massachusetts (continued)

Name Boston University Eye Associates, Inc. dba BU Eye Associates Surgery and Laser Center Cape Cod ASC, LLC, dba Ambulatory Surgery and Laser Center of Cape Cod

Cape Cod Eye Surgery & Laser Center

Address 90 New State Highway

280 Heritage Park, Suite F 282 Rt. 130 & Cotuit Road

City/Town Raynham

Sandwich Sandwich

Phone Number (508) 822-8839

(508) 833-6050 (508) 833-8222

Greater Springfield Surgery Center, LLC MD Sine, LLC dba Surgery Center of New England Pioneer Valley Surgicenter, LLC

100 Wason Avenue, Suite 110 55 St. George Road

3550 Main Street, Suite 103

Springfield Springfield

Springfield

(413) 304-2171 (413) 736-7463

(413) 788-9700

Northeast Ambulatory Center

3 Woodland Road, Suite 321

Stoneham

(781) 665-5233

North Shore Cataract & Laser Center

91 Montvale Avenue

Stoneham

(781) 438-5995

DHA Endoscopy, LLC

91 Montvale Avenue, Suite 103

Stoneham

(781) 835-2111

East Bay Surgery Center, LLC

Boston IVF, dba The Surgery Center of Waltham West Suburban Eye Surgery Center, LLC dba Surgisite Boston Boston Eye Surgery & Laser Center (Waltham) dba Boston Eye Surgery & Laser Center

Boston Out-Patient Surgical Suites, LLC

440 Swansea Mall Drive 130 Second Avenue 1440 Main Street 52 Second Avenue, Suite 2500

840 Winter Street

Swansea Waltham Waltham Waltham

Waltham

508) 324-1171 (781) 434-6400 (781) 891-9300 (781) 768-5590

(781) 895-4901

Boston Surgery Center, LLC

85 First Avenue

Waltham

(781) 647-7246

Christopher J. Davidson, MD, LLC

332 Washington Street, Suite 100

Wellesley

(781) 237-7700

Boston Endoscopy Center West Bridgewater MA Endoscopy ASC, LLC dba Commonwealth Endoscopy Center Cataract & Laser Center West, LLC

175 Worcester Street 120 West Center Street

171 Interstate Drive

Wellesley W. Bridgewater

W. Springfield

(617) 754-0800 (508) 588-6700

(413) 737-5500

Weymouth Endoscopy, LLC

1085 Main Street

Weymouth

(781) 331-2911

New England Eye Surgical Center, Inc. ARC Worcester Surgical Center, LP dba Worcester Surgical Center Surgical Eye Experts, LLC Reliant Medical Group The Endoscopy Center, LLC dba The Endoscopy Center

696 Main Street 300 Grove Street 385 Grove Street 630A Plantation Street

Weymouth Worcester Worcester Worcester

(781) 331-3820 (508) 754-0700 (508) 453-8820 (508) 425-5446

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Lab Locations

Your plan will cover lab services at no charge when you have them done at the following locations. HMO plans require your primary care provider's or specialist's referral. See the Schedule of Benefits for details.

New Hampshire

Name Androscoggin Valley Hospital Lab Upper Connecticut Valley Hospital Lab CH Medical Offices at Horseshoe Pond Memorial Medical Office Building on the Concord Hospital Campus CH Medical Offices East Franklin Regional Hospital Independent Lab Westside Healthcare Lakes Region General Hospital Independent Lab Weeks Medical Center Lab Littleton Regional Healthcare Lab Interlakes Medical Center Penacook Family Physicians Family Physicians of Pembroke Granite State Lab, LLC Cottage Hospital Lab

Address 59 Page Hill Road 181 Corliss Lane Road One Corporate Center, 60 Commercial Street 246 Pleasant Street

City/Town Berlin Colebrook Concord Concord

1990 Dover Road 15 Aiken Avenue 125 South Main Street 80 Highland Street 173 Middle Street 600 St. Johnsbury Road 238 Daniel Webster Highway 4 Crescent Street 121 Pembroke Street 120 Washington Street, Suite 203 90 Swiftwater Road

Epsom Franklin Franklin Laconia Lancaster Littleton Meredith Penacook Pembroke Rochester Woodsville

Phone Number (603) 752-2200 (603) 237-4971 (603) 230-1200 (603) 227-7180

(603) 736-6235 (603) 524-3211 (603) 524-3211 (603) 524-3211 (603) 788-4911 (800) 464-7731 (603) 524-3211 (603) 565-1095 (603) 485-8441 (603) 330-7057 (603) 747-9000

Additional Lab Locations

Lab locations can change frequently. Before you visit, please check the LabCorp, NorDx and Quest Diagnostics web sites to confirm the locations of their patient service centers in these towns.

Labcorp ()

LP benefits apply when you receive covered services from Labcorp locations in New England only.

New Hampshire

Bedford Dover Exeter Portsmouth

Rochester Salem Somersworth Windham

Massachusetts

Methuen Newton Center N. Andover Stoughton

Waltham Webster Worcester

Connecticut

Bridgeport Danbury Fairfield Greenwich

Hamden Newington Norwich Stamford

Wallingford Waterbury W. Haven

NorDx Laboratory ()

LP benefits apply when you receive covered services from NorDx locations in New Hampshire only.

New Hampshire Conway* Exeter Somersworth *NorDx uses the following as a patient service draw site: Saco River Medical Group, 7 Greenwood Avenue, Conway, NH.

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