|
STRAPPING KNEE
|
Facility
|
OP
|
$287.71
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
4502953001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$127.43 |
| 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 |
$257.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$127.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$257.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$173.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$233.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$129.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$228.73
|
| 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: Martins Point Health Care Commercial |
$129.47
|
| Rate for Payer: Multiplan Commercial |
$267.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.47
|
| Rate for Payer: United Healthcare Commercial |
$273.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.47
|
| Rate for Payer: United Healthcare VA CCN |
$129.47
|
|
|
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
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9602953002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$49.16 |
| 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 |
$99.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$49.16
|
| 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 |
$66.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$89.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$49.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$88.25
|
| 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: Martins Point Health Care Commercial |
$49.95
|
| Rate for Payer: Multiplan Commercial |
$103.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$94.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$49.95
|
| Rate for Payer: United Healthcare Commercial |
$105.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49.95
|
| Rate for Payer: United Healthcare VA CCN |
$49.95
|
|
|
STRAPPING KNEE
|
Professional
|
Both
|
$399.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9602953001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$17.13 |
| Max. Negotiated Rate |
$375.06 |
| Rate for Payer: Aetna of VT Commercial |
$375.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$357.46
|
| 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 |
$357.46
|
| 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 |
$199.50
|
| Rate for Payer: Cash Price |
$199.50
|
| 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 |
$371.07
|
| 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
|
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
|
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
|
$111.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9812953002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$49.16 |
| 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 |
$99.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$49.16
|
| 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 |
$66.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$89.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$49.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$88.25
|
| 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: Martins Point Health Care Commercial |
$49.95
|
| Rate for Payer: Multiplan Commercial |
$103.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$94.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$49.95
|
| Rate for Payer: United Healthcare Commercial |
$105.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49.95
|
| Rate for Payer: United Healthcare VA CCN |
$49.95
|
|
|
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
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
9812953002
|
|
Hospital Revenue Code
|
981
|
| 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 OF CHEST
|
Facility
|
OP
|
$179.93
|
|
|
Service Code
|
CPT 29200 GP
|
| Hospital Charge Code |
4202920001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$79.69 |
| Max. Negotiated Rate |
$170.93 |
| Rate for Payer: Aetna of VT Commercial |
$170.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$161.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$79.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$161.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$108.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$152.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$145.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$80.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$143.04
|
| Rate for Payer: Cash Price |
$89.97
|
| Rate for Payer: Cigna Commercial |
$143.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$143.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$143.94
|
| Rate for Payer: Martins Point Health Care Commercial |
$80.97
|
| Rate for Payer: Multiplan Commercial |
$167.33
|
| Rate for Payer: MVP Health Care of NY Commercial |
$100.76
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$80.97
|
| Rate for Payer: United Healthcare Commercial |
$170.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$80.97
|
| Rate for Payer: United Healthcare VA CCN |
$80.97
|
|
|
STRAPPING OF CHEST
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9832920001
|
|
Hospital Revenue Code
|
983
|
| 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 OF CHEST
|
Facility
|
IP
|
$179.93
|
|
|
Service Code
|
CPT 29200 GP
|
| Hospital Charge Code |
4202920001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$133.17 |
| Max. Negotiated Rate |
$170.93 |
| Rate for Payer: Aetna of VT Commercial |
$170.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$133.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$133.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$152.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$151.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$143.94
|
| Rate for Payer: Cash Price |
$89.97
|
| Rate for Payer: Cigna Commercial |
$143.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$143.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$143.94
|
| Rate for Payer: Multiplan Commercial |
$167.33
|
| Rate for Payer: MVP Health Care of NY Commercial |
$152.94
|
| Rate for Payer: United Healthcare Commercial |
$170.93
|
|
|
STRAPPING OF CHEST
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9832920001
|
|
Hospital Revenue Code
|
983
|
| 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 OF CHEST
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9832920001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$16.96 |
| 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 |
$17.47
|
| 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 |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$78.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$78.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$78.31
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cigna Commercial |
$32.73
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$48.35
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$48.35
|
| Rate for Payer: Martins Point Health Care Commercial |
$30.13
|
| Rate for Payer: Multiplan Commercial |
$91.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.08
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$16.96
|
| Rate for Payer: United Healthcare Commercial |
$26.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.96
|
| Rate for Payer: United Healthcare VA CCN |
$16.96
|
|
|
STRAPPING OF ELBOW OR WRIST
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9602926001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$103.61 |
| Max. Negotiated Rate |
$133.00 |
| Rate for Payer: Aetna of VT Commercial |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$103.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$103.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$119.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$117.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$112.00
|
| Rate for Payer: Cash Price |
$70.00
|
| Rate for Payer: Cigna Commercial |
$112.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$112.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$112.00
|
| Rate for Payer: Multiplan Commercial |
$130.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$119.00
|
| Rate for Payer: United Healthcare Commercial |
$133.00
|
|
|
STRAPPING OF ELBOW OR WRIST
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9602926001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$62.01 |
| Max. Negotiated Rate |
$133.00 |
| Rate for Payer: Aetna of VT Commercial |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$125.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$62.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$125.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$84.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$119.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$113.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$63.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$111.30
|
| Rate for Payer: Cash Price |
$70.00
|
| Rate for Payer: Cigna Commercial |
$112.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$112.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$112.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$130.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$119.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$63.00
|
| Rate for Payer: United Healthcare Commercial |
$133.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63.00
|
| Rate for Payer: United Healthcare VA CCN |
$63.00
|
|
|
STRAPPING OF ELBOW OR WRIST
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9602926002
|
|
Hospital Revenue Code
|
960
|
| 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 OF ELBOW OR WRIST
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
5102926001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.04 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Aetna of VT Commercial |
$40.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$38.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$19.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$38.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$25.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$36.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$34.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$19.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$34.19
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cigna Commercial |
$34.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$34.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$34.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$19.35
|
| Rate for Payer: Multiplan Commercial |
$39.99
|
| Rate for Payer: MVP Health Care of NY Commercial |
$36.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$19.35
|
| Rate for Payer: United Healthcare Commercial |
$40.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.35
|
| Rate for Payer: United Healthcare VA CCN |
$19.35
|
|
|
STRAPPING OF ELBOW OR WRIST
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9602926002
|
|
Hospital Revenue Code
|
960
|
| 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 OF ELBOW OR WRIST
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9602926002
|
|
Hospital Revenue Code
|
960
|
| 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 OF ELBOW OR WRIST
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
9602926001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$131.60 |
| Rate for Payer: Aetna of VT Commercial |
$131.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$125.43
|
| 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 |
$125.43
|
| 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 |
$70.00
|
| Rate for Payer: Cash Price |
$70.00
|
| 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 |
$130.20
|
| 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 OF ELBOW OR WRIST
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
5102926001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$73.22 |
| Rate for Payer: Aetna of VT Commercial |
$40.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$38.52
|
| 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 |
$38.52
|
| 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 |
$21.50
|
| Rate for Payer: Cash Price |
$21.50
|
| 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 |
$39.99
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
5102926001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Aetna of VT Commercial |
$40.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$31.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$31.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$36.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$36.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$34.40
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cigna Commercial |
$34.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$34.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$34.40
|
| Rate for Payer: Multiplan Commercial |
$39.99
|
| Rate for Payer: MVP Health Care of NY Commercial |
$36.55
|
| Rate for Payer: United Healthcare Commercial |
$40.85
|
|
|
STRAPPING OF HAND OR FINGER
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9832928001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$18.42 |
| 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 |
$18.97
|
| 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 |
$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 |
$49.00
|
| Rate for Payer: Cash Price |
$49.00
|
| 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 |
$91.14
|
| 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 OF HAND OR FINGER
|
Facility
|
OP
|
$229.55
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
4302928001
|
|
Hospital Revenue Code
|
430
|
| 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 |
$128.55
|
| 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
|
|
