|
REPAIR BLOOD VESSEL, DIRECT: N
|
Professional
|
Both
|
$4,337.00
|
|
|
Service Code
|
CPT 35201
|
| Hospital Charge Code |
9823520101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$824.03 |
| Max. Negotiated Rate |
$4,076.78 |
| Rate for Payer: Aetna of VT Commercial |
$4,076.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,885.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$848.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,885.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,153.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,635.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,635.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$947.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,635.58
|
| Rate for Payer: Cash Price |
$2,168.50
|
| Rate for Payer: Cash Price |
$2,168.50
|
| Rate for Payer: Cigna Commercial |
$1,506.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,410.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,410.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$824.03
|
| Rate for Payer: Multiplan Commercial |
$4,033.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,170.12
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$824.03
|
| Rate for Payer: United Healthcare Commercial |
$1,267.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$824.03
|
| Rate for Payer: United Healthcare VA CCN |
$824.03
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
CPT 44620
|
| Hospital Charge Code |
9824462001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$646.85 |
| Max. Negotiated Rate |
$830.30 |
| Rate for Payer: Aetna of VT Commercial |
$830.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$646.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$646.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$742.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$734.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$699.20
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$699.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$699.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$699.20
|
| Rate for Payer: Multiplan Commercial |
$812.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$742.90
|
| Rate for Payer: United Healthcare Commercial |
$830.30
|
|
|
REPAIR BOWEL OPENING
|
Professional
|
Both
|
$874.00
|
|
|
Service Code
|
CPT 44620
|
| Hospital Charge Code |
9824462001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$783.02 |
| Max. Negotiated Rate |
$1,448.39 |
| Rate for Payer: Aetna of VT Commercial |
$821.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$783.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$815.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$783.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,107.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,220.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,220.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$910.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,220.11
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$1,448.39
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,336.16
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,336.16
|
| Rate for Payer: Martins Point Health Care Commercial |
$791.34
|
| Rate for Payer: Multiplan Commercial |
$812.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,123.72
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$791.35
|
| Rate for Payer: United Healthcare Commercial |
$1,217.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$791.35
|
| Rate for Payer: United Healthcare VA CCN |
$791.35
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
IP
|
$4,107.00
|
|
|
Service Code
|
CPT 44626
|
| Hospital Charge Code |
9824462601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$3,039.59 |
| Max. Negotiated Rate |
$3,901.65 |
| Rate for Payer: Aetna of VT Commercial |
$3,901.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,039.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,039.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,490.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,449.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,285.60
|
| Rate for Payer: Cash Price |
$2,053.50
|
| Rate for Payer: Cigna Commercial |
$3,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,285.60
|
| Rate for Payer: Multiplan Commercial |
$3,819.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,490.95
|
| Rate for Payer: United Healthcare Commercial |
$3,901.65
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
OP
|
$4,107.00
|
|
|
Service Code
|
CPT 44626
|
| Hospital Charge Code |
9824462601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,818.99 |
| Max. Negotiated Rate |
$3,901.65 |
| Rate for Payer: Aetna of VT Commercial |
$3,901.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,679.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,818.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,679.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,472.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,490.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,326.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,848.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,265.07
|
| Rate for Payer: Cash Price |
$2,053.50
|
| Rate for Payer: Cigna Commercial |
$3,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,285.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,848.15
|
| Rate for Payer: Multiplan Commercial |
$3,819.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,490.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,848.15
|
| Rate for Payer: United Healthcare Commercial |
$3,901.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,848.15
|
| Rate for Payer: United Healthcare VA CCN |
$1,848.15
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
CPT 44620
|
| Hospital Charge Code |
9824462001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$387.09 |
| Max. Negotiated Rate |
$830.30 |
| Rate for Payer: Aetna of VT Commercial |
$830.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$783.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$387.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$783.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$526.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$742.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$707.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$393.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$694.83
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$699.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$699.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$699.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$393.30
|
| Rate for Payer: Multiplan Commercial |
$812.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$742.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$393.30
|
| Rate for Payer: United Healthcare Commercial |
$830.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$393.30
|
| Rate for Payer: United Healthcare VA CCN |
$393.30
|
|
|
REPAIR BOWEL OPENING
|
Professional
|
Both
|
$4,107.00
|
|
|
Service Code
|
CPT 44626
|
| Hospital Charge Code |
9824462601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,440.71 |
| Max. Negotiated Rate |
$3,860.58 |
| Rate for Payer: Aetna of VT Commercial |
$3,860.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,679.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,483.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,679.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,016.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,457.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,457.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,656.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,457.16
|
| Rate for Payer: Cash Price |
$2,053.50
|
| Rate for Payer: Cash Price |
$2,053.50
|
| Rate for Payer: Cigna Commercial |
$2,638.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,447.06
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,447.06
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,440.72
|
| Rate for Payer: Multiplan Commercial |
$3,819.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,045.81
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,440.71
|
| Rate for Payer: United Healthcare Commercial |
$2,216.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,440.71
|
| Rate for Payer: United Healthcare VA CCN |
$1,440.71
|
|
|
REPAIR DEFORMITY OF TOE
|
Facility
|
IP
|
$1,333.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
9822831301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$986.55 |
| Max. Negotiated Rate |
$1,266.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,266.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$986.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$986.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,133.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,119.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,066.40
|
| Rate for Payer: Cash Price |
$666.50
|
| Rate for Payer: Cigna Commercial |
$1,066.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,066.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,066.40
|
| Rate for Payer: Multiplan Commercial |
$1,239.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,133.05
|
| Rate for Payer: United Healthcare Commercial |
$1,266.35
|
|
|
REPAIR DEFORMITY OF TOE
|
Professional
|
Both
|
$1,333.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
9822831301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$348.70 |
| Max. Negotiated Rate |
$1,253.02 |
| Rate for Payer: Aetna of VT Commercial |
$1,253.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,194.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$359.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,194.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$488.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$800.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$800.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$401.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$800.03
|
| Rate for Payer: Cash Price |
$666.50
|
| Rate for Payer: Cash Price |
$666.50
|
| Rate for Payer: Cigna Commercial |
$655.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$821.34
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$821.34
|
| Rate for Payer: Martins Point Health Care Commercial |
$503.52
|
| Rate for Payer: Multiplan Commercial |
$1,239.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$495.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$348.70
|
| Rate for Payer: United Healthcare Commercial |
$536.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$348.70
|
| Rate for Payer: United Healthcare VA CCN |
$348.70
|
|
|
REPAIR DEFORMITY OF TOE
|
Facility
|
OP
|
$1,333.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
9822831301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$590.39 |
| Max. Negotiated Rate |
$1,266.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,266.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,194.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$590.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,194.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$802.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,133.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,079.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$599.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,059.73
|
| Rate for Payer: Cash Price |
$666.50
|
| Rate for Payer: Cigna Commercial |
$1,066.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,066.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,066.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$599.85
|
| Rate for Payer: Multiplan Commercial |
$1,239.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,133.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$599.85
|
| Rate for Payer: United Healthcare Commercial |
$1,266.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$599.85
|
| Rate for Payer: United Healthcare VA CCN |
$599.85
|
|
|
REPAIR ELBOW W/DEB OPEN
|
Facility
|
IP
|
$1,683.00
|
|
|
Service Code
|
CPT 24358
|
| Hospital Charge Code |
9822435801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,245.59 |
| Max. Negotiated Rate |
$1,598.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,598.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,245.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,245.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,430.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,413.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,346.40
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cigna Commercial |
$1,346.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,346.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,346.40
|
| Rate for Payer: Multiplan Commercial |
$1,565.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,430.55
|
| Rate for Payer: United Healthcare Commercial |
$1,598.85
|
|
|
REPAIR ELBOW W/DEB OPEN
|
Professional
|
Both
|
$1,683.00
|
|
|
Service Code
|
CPT 24358
|
| Hospital Charge Code |
9822435801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$509.25 |
| Max. Negotiated Rate |
$1,582.02 |
| Rate for Payer: Aetna of VT Commercial |
$1,582.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,507.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$524.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,507.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$712.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$660.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$660.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$585.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$660.44
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cigna Commercial |
$961.24
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$844.48
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$844.48
|
| Rate for Payer: Martins Point Health Care Commercial |
$509.25
|
| Rate for Payer: Multiplan Commercial |
$1,565.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$723.13
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$509.25
|
| Rate for Payer: United Healthcare Commercial |
$783.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$509.25
|
| Rate for Payer: United Healthcare VA CCN |
$509.25
|
|
|
REPAIR ELBOW W/DEB OPEN
|
Facility
|
OP
|
$1,683.00
|
|
|
Service Code
|
CPT 24358
|
| Hospital Charge Code |
9822435801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$745.40 |
| Max. Negotiated Rate |
$1,598.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,598.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,507.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$745.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,507.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,013.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,430.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,363.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$757.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,337.98
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cigna Commercial |
$1,346.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,346.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,346.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$757.35
|
| Rate for Payer: Multiplan Commercial |
$1,565.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,430.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$757.35
|
| Rate for Payer: United Healthcare Commercial |
$1,598.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$757.35
|
| Rate for Payer: United Healthcare VA CCN |
$757.35
|
|
|
REPAIR FINGER TENDON
|
Facility
|
OP
|
$1,758.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9812641801
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$778.62 |
| Max. Negotiated Rate |
$1,670.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,670.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,574.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,574.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,058.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,494.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,423.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$791.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,397.61
|
| Rate for Payer: Cash Price |
$879.00
|
| Rate for Payer: Cigna Commercial |
$1,406.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,406.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,406.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$791.10
|
| Rate for Payer: Multiplan Commercial |
$1,634.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,494.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$791.10
|
| Rate for Payer: United Healthcare Commercial |
$1,670.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$791.10
|
| Rate for Payer: United Healthcare VA CCN |
$791.10
|
|
|
REPAIR FINGER TENDON
|
Professional
|
Both
|
$1,758.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9812641801
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$594.85 |
| Max. Negotiated Rate |
$1,652.52 |
| Rate for Payer: Aetna of VT Commercial |
$1,652.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,574.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$612.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,574.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$832.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$990.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$990.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$684.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$990.30
|
| Rate for Payer: Cash Price |
$879.00
|
| Rate for Payer: Cash Price |
$879.00
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$971.52
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$971.52
|
| Rate for Payer: Martins Point Health Care Commercial |
$594.86
|
| Rate for Payer: Multiplan Commercial |
$1,634.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$844.69
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$594.85
|
| Rate for Payer: United Healthcare Commercial |
$915.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$594.85
|
| Rate for Payer: United Healthcare VA CCN |
$594.85
|
|
|
REPAIR FINGER TENDON
|
Facility
|
IP
|
$1,690.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9812641802
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,250.77 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,605.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,250.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,250.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,436.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,419.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,352.00
|
| Rate for Payer: Cash Price |
$845.00
|
| Rate for Payer: Cigna Commercial |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,352.00
|
| Rate for Payer: Multiplan Commercial |
$1,571.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,436.50
|
| Rate for Payer: United Healthcare Commercial |
$1,605.50
|
|
|
REPAIR FINGER TENDON
|
Facility
|
OP
|
$1,690.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9602641802
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$748.50 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,605.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,514.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$748.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,514.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,017.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,436.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,368.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$760.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,343.55
|
| Rate for Payer: Cash Price |
$845.00
|
| Rate for Payer: Cigna Commercial |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,352.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$760.50
|
| Rate for Payer: Multiplan Commercial |
$1,571.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,436.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$760.50
|
| Rate for Payer: United Healthcare Commercial |
$1,605.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$760.50
|
| Rate for Payer: United Healthcare VA CCN |
$760.50
|
|
|
REPAIR FINGER TENDON
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9812641802
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$594.85 |
| Max. Negotiated Rate |
$1,588.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,588.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,514.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$612.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,514.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$832.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$990.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$990.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$684.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$990.30
|
| Rate for Payer: Cash Price |
$845.00
|
| Rate for Payer: Cash Price |
$845.00
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$971.52
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$971.52
|
| Rate for Payer: Martins Point Health Care Commercial |
$594.86
|
| Rate for Payer: Multiplan Commercial |
$1,571.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$844.69
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$594.85
|
| Rate for Payer: United Healthcare Commercial |
$915.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$594.85
|
| Rate for Payer: United Healthcare VA CCN |
$594.85
|
|
|
REPAIR FINGER TENDON
|
Facility
|
IP
|
$1,690.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9822641801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,250.77 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,605.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,250.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,250.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,436.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,419.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,352.00
|
| Rate for Payer: Cash Price |
$845.00
|
| Rate for Payer: Cigna Commercial |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,352.00
|
| Rate for Payer: Multiplan Commercial |
$1,571.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,436.50
|
| Rate for Payer: United Healthcare Commercial |
$1,605.50
|
|
|
REPAIR FINGER TENDON
|
Facility
|
IP
|
$1,690.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9602641802
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,250.77 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,605.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,250.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,250.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,436.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,419.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,352.00
|
| Rate for Payer: Cash Price |
$845.00
|
| Rate for Payer: Cigna Commercial |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,352.00
|
| Rate for Payer: Multiplan Commercial |
$1,571.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,436.50
|
| Rate for Payer: United Healthcare Commercial |
$1,605.50
|
|
|
REPAIR FINGER TENDON
|
Facility
|
IP
|
$5,327.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9602641801
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$3,942.51 |
| Max. Negotiated Rate |
$5,060.65 |
| Rate for Payer: Aetna of VT Commercial |
$5,060.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,942.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,942.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,527.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,474.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,261.60
|
| Rate for Payer: Cash Price |
$2,663.50
|
| Rate for Payer: Cigna Commercial |
$4,261.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,261.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,261.60
|
| Rate for Payer: Multiplan Commercial |
$4,954.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,527.95
|
| Rate for Payer: United Healthcare Commercial |
$5,060.65
|
|
|
REPAIR FINGER TENDON
|
Professional
|
Both
|
$5,327.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9602641801
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$594.85 |
| Max. Negotiated Rate |
$5,007.38 |
| Rate for Payer: Aetna of VT Commercial |
$5,007.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,772.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$612.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,772.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$832.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$990.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$990.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$684.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$990.30
|
| Rate for Payer: Cash Price |
$2,663.50
|
| Rate for Payer: Cash Price |
$2,663.50
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$971.52
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$971.52
|
| Rate for Payer: Martins Point Health Care Commercial |
$594.86
|
| Rate for Payer: Multiplan Commercial |
$4,954.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$844.69
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$594.85
|
| Rate for Payer: United Healthcare Commercial |
$915.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$594.85
|
| Rate for Payer: United Healthcare VA CCN |
$594.85
|
|
|
REPAIR FINGER TENDON
|
Facility
|
OP
|
$1,690.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
9812641802
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$748.50 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,605.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,514.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$748.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,514.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,017.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,436.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,368.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$760.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,343.55
|
| Rate for Payer: Cash Price |
$845.00
|
| Rate for Payer: Cigna Commercial |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,352.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,352.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$760.50
|
| Rate for Payer: Multiplan Commercial |
$1,571.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,436.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$760.50
|
| Rate for Payer: United Healthcare Commercial |
$1,605.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$760.50
|
| Rate for Payer: United Healthcare VA CCN |
$760.50
|
|
|
REPAIR FINGER TENDON
|
Facility
|
OP
|
$3,637.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
5102641801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,610.83 |
| Max. Negotiated Rate |
$3,455.15 |
| Rate for Payer: Aetna of VT Commercial |
$3,455.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,258.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,610.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,258.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,189.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,091.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,945.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,636.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,891.41
|
| Rate for Payer: Cash Price |
$1,818.50
|
| Rate for Payer: Cigna Commercial |
$2,909.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,909.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,909.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,636.65
|
| Rate for Payer: Multiplan Commercial |
$3,382.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,091.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,636.65
|
| Rate for Payer: United Healthcare Commercial |
$3,455.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,636.65
|
| Rate for Payer: United Healthcare VA CCN |
$1,636.65
|
|
|
REPAIR FINGER TENDON
|
Facility
|
IP
|
$3,637.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
5102641801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,691.74 |
| Max. Negotiated Rate |
$3,455.15 |
| Rate for Payer: Aetna of VT Commercial |
$3,455.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,691.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,691.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,091.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,055.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,909.60
|
| Rate for Payer: Cash Price |
$1,818.50
|
| Rate for Payer: Cigna Commercial |
$2,909.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,909.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,909.60
|
| Rate for Payer: Multiplan Commercial |
$3,382.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,091.45
|
| Rate for Payer: United Healthcare Commercial |
$3,455.15
|
|
