|
STRAPPING ANKLE &/FOOT
|
Facility
|
OP
|
$42.39
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
4502954001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna of VT Commercial |
$40.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$37.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$18.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$37.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$25.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$36.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$34.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$33.70
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cigna Commercial |
$33.91
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$33.91
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$33.91
|
| Rate for Payer: Martins Point Health Care Commercial |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$36.03
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$19.08
|
| Rate for Payer: United Healthcare Commercial |
$40.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.08
|
| Rate for Payer: United Healthcare VA CCN |
$19.08
|
|
|
STRAPPING ELBOW/WRIST
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9812926002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$92.12 |
| Rate for Payer: Aetna of VT Commercial |
$92.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$87.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$87.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$24.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$73.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$73.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$73.22
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cigna Commercial |
$33.66
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$44.75
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$44.75
|
| Rate for Payer: Martins Point Health Care Commercial |
$27.57
|
| Rate for Payer: Multiplan Commercial |
$91.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.01
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$17.61
|
| Rate for Payer: United Healthcare Commercial |
$27.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.61
|
| Rate for Payer: United Healthcare VA CCN |
$17.61
|
|
|
STRAPPING ELBOW/WRIST
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9812926002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$72.53 |
| Max. Negotiated Rate |
$93.10 |
| Rate for Payer: Aetna of VT Commercial |
$93.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$72.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$72.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$82.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$78.40
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cigna Commercial |
$78.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$78.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$91.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$83.30
|
| Rate for Payer: United Healthcare Commercial |
$93.10
|
|
|
STRAPPING ELBOW/WRIST
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9812926002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$93.10 |
| Rate for Payer: Aetna of VT Commercial |
$93.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$87.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$43.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$87.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$59.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$79.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$44.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$77.91
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cigna Commercial |
$78.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$78.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$78.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$44.10
|
| Rate for Payer: Multiplan Commercial |
$91.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$83.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$44.10
|
| Rate for Payer: United Healthcare Commercial |
$93.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44.10
|
| Rate for Payer: United Healthcare VA CCN |
$44.10
|
|
|
STRAPPING ELBOW/WRIST
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9812926001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
STRAPPING ELBOW/WRIST
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9812926001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$73.22 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$24.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$73.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$73.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$73.22
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$33.66
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$44.75
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$44.75
|
| Rate for Payer: Martins Point Health Care Commercial |
$27.57
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.01
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$17.61
|
| Rate for Payer: United Healthcare Commercial |
$27.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.61
|
| Rate for Payer: United Healthcare VA CCN |
$17.61
|
|
|
STRAPPING ELBOW/WRIST
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9812926001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
STRAPPING ELBOW/WRIST
|
Facility
|
OP
|
$42.39
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
4502926001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna of VT Commercial |
$40.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$37.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$18.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$37.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$25.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$36.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$34.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$33.70
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cigna Commercial |
$33.91
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$33.91
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$33.91
|
| Rate for Payer: Martins Point Health Care Commercial |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$36.03
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$19.08
|
| Rate for Payer: United Healthcare Commercial |
$40.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.08
|
| Rate for Payer: United Healthcare VA CCN |
$19.08
|
|
|
STRAPPING ELBOW/WRIST
|
Facility
|
IP
|
$42.39
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
4502926001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.37 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna of VT Commercial |
$40.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$31.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$31.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$36.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$35.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$33.91
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cigna Commercial |
$33.91
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$33.91
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$33.91
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$36.03
|
| Rate for Payer: United Healthcare Commercial |
$40.27
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9812928001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
STRAPPING HAND/FINGER
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9812928001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$54.81 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$18.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$25.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$54.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$21.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$54.81
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$35.53
|
| 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 |
$28.06
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$26.16
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$18.42
|
| Rate for Payer: United Healthcare Commercial |
$28.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.42
|
| Rate for Payer: United Healthcare VA CCN |
$18.42
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9812928002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna of VT Commercial |
$94.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$73.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$73.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$83.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$79.20
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna Commercial |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.20
|
| Rate for Payer: Multiplan Commercial |
$92.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.15
|
| Rate for Payer: United Healthcare Commercial |
$94.05
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9812928002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna of VT Commercial |
$94.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$88.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$43.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$88.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$59.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$80.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$44.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$78.70
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna Commercial |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$79.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$79.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$44.55
|
| Rate for Payer: Multiplan Commercial |
$92.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$84.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$44.55
|
| Rate for Payer: United Healthcare Commercial |
$94.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44.55
|
| Rate for Payer: United Healthcare VA CCN |
$44.55
|
|
|
STRAPPING HAND/FINGER
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9812928002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$18.42 |
| Max. Negotiated Rate |
$93.06 |
| Rate for Payer: Aetna of VT Commercial |
$93.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$88.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$18.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$88.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$25.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$54.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$54.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$21.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$54.81
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna Commercial |
$35.53
|
| 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 |
$28.06
|
| Rate for Payer: Multiplan Commercial |
$92.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$26.16
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$18.42
|
| Rate for Payer: United Healthcare Commercial |
$28.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.42
|
| Rate for Payer: United Healthcare VA CCN |
$18.42
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9812928001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
IP
|
$229.55
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
4502928001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.89 |
| Max. Negotiated Rate |
$218.07 |
| Rate for Payer: Aetna of VT Commercial |
$218.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$169.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$169.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$195.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$192.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$183.64
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cigna Commercial |
$183.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$183.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$183.64
|
| Rate for Payer: Multiplan Commercial |
$213.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$195.12
|
| Rate for Payer: United Healthcare Commercial |
$218.07
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
OP
|
$229.55
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
4502928001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$101.67 |
| Max. Negotiated Rate |
$218.07 |
| Rate for Payer: Aetna of VT Commercial |
$218.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$205.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$101.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$205.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$138.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$195.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$185.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$103.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$182.49
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cigna Commercial |
$183.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$183.64
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$183.64
|
| Rate for Payer: Martins Point Health Care Commercial |
$103.30
|
| Rate for Payer: Multiplan Commercial |
$213.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$195.12
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$103.30
|
| Rate for Payer: United Healthcare Commercial |
$218.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.30
|
| Rate for Payer: United Healthcare VA CCN |
$103.30
|
|
|
STRAPPING KNEE
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9812953002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$82.15 |
| Max. Negotiated Rate |
$105.45 |
| Rate for Payer: Aetna of VT Commercial |
$105.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$82.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$82.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$93.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$88.80
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cigna Commercial |
$88.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$88.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$88.80
|
| Rate for Payer: Multiplan Commercial |
$103.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$94.35
|
| Rate for Payer: United Healthcare Commercial |
$105.45
|
|
|
STRAPPING KNEE
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
5102953001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$213.15 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Aetna of VT Commercial |
$273.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$241.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$230.40
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$230.40
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.80
|
| Rate for Payer: United Healthcare Commercial |
$273.60
|
|
|
STRAPPING KNEE
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9602953002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$82.15 |
| Max. Negotiated Rate |
$105.45 |
| Rate for Payer: Aetna of VT Commercial |
$105.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$82.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$82.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$93.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$88.80
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cigna Commercial |
$88.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$88.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$88.80
|
| Rate for Payer: Multiplan Commercial |
$103.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$94.35
|
| Rate for Payer: United Healthcare Commercial |
$105.45
|
|
|
STRAPPING KNEE
|
Facility
|
IP
|
$287.71
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
4502953001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$212.93 |
| Max. Negotiated Rate |
$273.32 |
| Rate for Payer: Aetna of VT Commercial |
$273.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$212.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$212.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$241.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$230.17
|
| Rate for Payer: Cash Price |
$143.85
|
| Rate for Payer: Cigna Commercial |
$230.17
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$230.17
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$230.17
|
| Rate for Payer: Multiplan Commercial |
$267.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.55
|
| Rate for Payer: United Healthcare Commercial |
$273.32
|
|
|
STRAPPING KNEE
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9602953002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$17.13 |
| Max. Negotiated Rate |
$104.34 |
| Rate for Payer: Aetna of VT Commercial |
$104.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$99.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$17.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$99.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$23.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$71.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$71.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$71.93
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cigna Commercial |
$32.11
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.04
|
| Rate for Payer: Multiplan Commercial |
$103.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$17.13
|
| Rate for Payer: United Healthcare Commercial |
$26.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.13
|
| Rate for Payer: United Healthcare VA CCN |
$17.13
|
|
|
STRAPPING KNEE
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
5102953001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$127.56 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Aetna of VT Commercial |
$273.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$127.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$173.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$233.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$129.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$228.96
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$230.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$129.60
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.60
|
| Rate for Payer: United Healthcare Commercial |
$273.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.60
|
| Rate for Payer: United Healthcare VA CCN |
$129.60
|
|
|
STRAPPING KNEE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9812953001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
STRAPPING KNEE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9812953001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$71.93 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$17.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$23.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$71.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$71.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$71.93
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$32.11
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$45.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$45.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$28.04
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$17.13
|
| Rate for Payer: United Healthcare Commercial |
$26.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.13
|
| Rate for Payer: United Healthcare VA CCN |
$17.13
|
|
