|
STRAPPING OF HAND OR FINGER
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9832928001
|
|
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 HAND OR FINGER
|
Facility
|
IP
|
$229.55
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
4302928001
|
|
Hospital Revenue Code
|
430
|
| 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 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
|
IP
|
$139.59
|
|
|
Service Code
|
CPT 29280 GP
|
| Hospital Charge Code |
4202928001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$103.31 |
| Max. Negotiated Rate |
$132.61 |
| Rate for Payer: Aetna of VT Commercial |
$132.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$103.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$103.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$118.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$117.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$111.67
|
| Rate for Payer: Cash Price |
$69.80
|
| Rate for Payer: Cigna Commercial |
$111.67
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$111.67
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$111.67
|
| Rate for Payer: Multiplan Commercial |
$129.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$118.65
|
| Rate for Payer: United Healthcare Commercial |
$132.61
|
|
|
STRAPPING OF HAND OR FINGER
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9832928001
|
|
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 HAND OR FINGER
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9822928001
|
|
Hospital Revenue Code
|
982
|
| 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 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
|
|
|
STRAPPING OF HAND OR FINGER
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
9822928001
|
|
Hospital Revenue Code
|
982
|
| 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 OF HIP
|
Facility
|
OP
|
$127.18
|
|
|
Service Code
|
CPT 29520 GP
|
| Hospital Charge Code |
4202952001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$56.33 |
| Max. Negotiated Rate |
$120.82 |
| Rate for Payer: Aetna of VT Commercial |
$120.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$113.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$56.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$113.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$76.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$108.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$103.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$57.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$101.11
|
| Rate for Payer: Cash Price |
$63.59
|
| Rate for Payer: Cigna Commercial |
$101.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$101.74
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$101.74
|
| Rate for Payer: Martins Point Health Care Commercial |
$57.23
|
| Rate for Payer: Multiplan Commercial |
$118.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$71.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$57.23
|
| Rate for Payer: United Healthcare Commercial |
$120.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57.23
|
| Rate for Payer: United Healthcare VA CCN |
$57.23
|
|
|
STRAPPING OF HIP
|
Facility
|
IP
|
$127.18
|
|
|
Service Code
|
CPT 29520 GP
|
| Hospital Charge Code |
4202952001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$94.13 |
| Max. Negotiated Rate |
$120.82 |
| Rate for Payer: Aetna of VT Commercial |
$120.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$94.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$94.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$108.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$106.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$101.74
|
| Rate for Payer: Cash Price |
$63.59
|
| Rate for Payer: Cigna Commercial |
$101.74
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$101.74
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$101.74
|
| Rate for Payer: Multiplan Commercial |
$118.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$108.10
|
| Rate for Payer: United Healthcare Commercial |
$120.82
|
|
|
STRAPPING OF SHOULDER
|
Facility
|
OP
|
$116.01
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
4502924001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$51.38 |
| Max. Negotiated Rate |
$110.21 |
| Rate for Payer: Aetna of VT Commercial |
$110.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$103.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$51.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$103.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$69.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$98.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$93.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$92.23
|
| Rate for Payer: Cash Price |
$58.01
|
| Rate for Payer: Cigna Commercial |
$92.81
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$92.81
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$92.81
|
| Rate for Payer: Martins Point Health Care Commercial |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$107.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$98.61
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$52.20
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52.20
|
| Rate for Payer: United Healthcare VA CCN |
$52.20
|
|
|
STRAPPING OF SHOULDER
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9812924002
|
|
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 OF SHOULDER
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9812924002
|
|
Hospital Revenue Code
|
981
|
| 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 |
$73.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$73.70
|
| 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 |
$73.70
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cash Price |
$49.00
|
| 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 |
$28.20
|
| 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 SHOULDER
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9822924001
|
|
Hospital Revenue Code
|
982
|
| 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 SHOULDER
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9812924002
|
|
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 OF SHOULDER
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9822924001
|
|
Hospital Revenue Code
|
982
|
| 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 |
$73.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$73.70
|
| 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 |
$73.70
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cash Price |
$49.00
|
| 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 |
$28.20
|
| 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 SHOULDER
|
Facility
|
IP
|
$116.01
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
4502924001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$85.86 |
| Max. Negotiated Rate |
$110.21 |
| Rate for Payer: Aetna of VT Commercial |
$110.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$98.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$97.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$92.81
|
| Rate for Payer: Cash Price |
$58.01
|
| Rate for Payer: Cigna Commercial |
$92.81
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$92.81
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$92.81
|
| Rate for Payer: Multiplan Commercial |
$107.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$98.61
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
|
|
STRAPPING OF SHOULDER
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9832924001
|
|
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 |
$73.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$73.70
|
| 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 |
$73.70
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: Cash Price |
$49.00
|
| 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 |
$28.20
|
| 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 SHOULDER
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9812924001
|
|
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 OF SHOULDER
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9812924001
|
|
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 OF SHOULDER
|
Facility
|
OP
|
$179.93
|
|
|
Service Code
|
CPT 29240 GP
|
| Hospital Charge Code |
4202924001
|
|
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 SHOULDER
|
Facility
|
IP
|
$179.93
|
|
|
Service Code
|
CPT 29240 GP
|
| Hospital Charge Code |
4202924001
|
|
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 SHOULDER
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9832924001
|
|
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 SHOULDER
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9822924001
|
|
Hospital Revenue Code
|
982
|
| 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 SHOULDER
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9832924001
|
|
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
|
|
