|
STRAPPING OF SHOULDER
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
9812924001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$73.70 |
| 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 |
$17.47
|
| 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 |
$23.74
|
| 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 |
$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 |
$28.20
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| 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 THORAX
|
Facility
|
OP
|
$218.17
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
4502920001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$96.63 |
| Max. Negotiated Rate |
$207.26 |
| Rate for Payer: Aetna of VT Commercial |
$207.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$195.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$96.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$195.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$131.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$185.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$176.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$98.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$173.45
|
| Rate for Payer: Cash Price |
$109.08
|
| Rate for Payer: Cigna Commercial |
$174.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$174.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$174.54
|
| Rate for Payer: Martins Point Health Care Commercial |
$98.18
|
| Rate for Payer: Multiplan Commercial |
$202.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$185.44
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$98.18
|
| Rate for Payer: United Healthcare Commercial |
$207.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.18
|
| Rate for Payer: United Healthcare VA CCN |
$98.18
|
|
|
STRAPPING OF THORAX
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9822920001
|
|
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 THORAX
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9812920002
|
|
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 THORAX
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9812920001
|
|
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 THORAX
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9812920001
|
|
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 THORAX
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9812920002
|
|
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 |
$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 THORAX
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9812920001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$78.31 |
| 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 |
$17.47
|
| 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 |
$23.74
|
| 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 |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| 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 |
$0.93
|
| 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 THORAX
|
Facility
|
IP
|
$218.17
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
4502920001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$161.47 |
| Max. Negotiated Rate |
$207.26 |
| Rate for Payer: Aetna of VT Commercial |
$207.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$161.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$161.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$185.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$183.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$174.54
|
| Rate for Payer: Cash Price |
$109.08
|
| Rate for Payer: Cigna Commercial |
$174.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$174.54
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$174.54
|
| Rate for Payer: Multiplan Commercial |
$202.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$185.44
|
| Rate for Payer: United Healthcare Commercial |
$207.26
|
|
|
STRAPPING OF THORAX
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9812920002
|
|
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 THORAX
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9822920001
|
|
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 THORAX
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
9822920001
|
|
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 |
$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 UNNA BOOT
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9602958002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$199.09 |
| Max. Negotiated Rate |
$255.55 |
| Rate for Payer: Aetna of VT Commercial |
$255.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$199.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$199.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$228.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$225.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$215.20
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cigna Commercial |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$215.20
|
| Rate for Payer: Multiplan Commercial |
$250.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$228.65
|
| Rate for Payer: United Healthcare Commercial |
$255.55
|
|
|
STRAPPING OF UNNA BOOT
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9822958001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$252.86 |
| Rate for Payer: Aetna of VT Commercial |
$252.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$24.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$33.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$27.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$81.01
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cigna Commercial |
$46.06
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$97.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$97.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$59.90
|
| Rate for Payer: Multiplan Commercial |
$250.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$34.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare Commercial |
$37.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare VA CCN |
$24.26
|
|
|
STRAPPING OF UNNA BOOT
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9822958001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$255.55 |
| Rate for Payer: Aetna of VT Commercial |
$255.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$119.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$161.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$228.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$217.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$121.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$213.85
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cigna Commercial |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$215.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$121.05
|
| Rate for Payer: Multiplan Commercial |
$250.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$228.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$121.05
|
| Rate for Payer: United Healthcare Commercial |
$255.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$121.05
|
| Rate for Payer: United Healthcare VA CCN |
$121.05
|
|
|
STRAPPING OF UNNA BOOT
|
Facility
|
IP
|
$477.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9602958001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$353.03 |
| Max. Negotiated Rate |
$453.15 |
| Rate for Payer: Aetna of VT Commercial |
$453.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$353.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$353.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$405.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$400.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$381.60
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cigna Commercial |
$381.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$381.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$381.60
|
| Rate for Payer: Multiplan Commercial |
$443.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$405.45
|
| Rate for Payer: United Healthcare Commercial |
$453.15
|
|
|
STRAPPING OF UNNA BOOT
|
Facility
|
OP
|
$477.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9602958001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$211.26 |
| Max. Negotiated Rate |
$453.15 |
| Rate for Payer: Aetna of VT Commercial |
$453.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$427.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$211.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$427.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$287.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$405.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$386.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$214.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$379.21
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cigna Commercial |
$381.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$381.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$381.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$214.65
|
| Rate for Payer: Multiplan Commercial |
$443.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$405.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$214.65
|
| Rate for Payer: United Healthcare Commercial |
$453.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$214.65
|
| Rate for Payer: United Healthcare VA CCN |
$214.65
|
|
|
STRAPPING OF UNNA BOOT
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9602958001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$448.38 |
| Rate for Payer: Aetna of VT Commercial |
$448.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$427.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$24.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$427.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$33.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$27.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$81.01
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cigna Commercial |
$46.06
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$97.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$97.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$59.90
|
| Rate for Payer: Multiplan Commercial |
$443.61
|
| Rate for Payer: MVP Health Care of NY Commercial |
$34.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare Commercial |
$37.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare VA CCN |
$24.26
|
|
|
STRAPPING OF UNNA BOOT
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9602958002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$252.86 |
| Rate for Payer: Aetna of VT Commercial |
$252.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$24.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$33.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$27.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$81.01
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cigna Commercial |
$46.06
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$97.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$97.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$59.90
|
| Rate for Payer: Multiplan Commercial |
$250.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$34.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare Commercial |
$37.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare VA CCN |
$24.26
|
|
|
STRAPPING OF UNNA BOOT
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
5102958001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$195.52 |
| Rate for Payer: Aetna of VT Commercial |
$195.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$186.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$24.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$186.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$33.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$81.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$27.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$81.01
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cigna Commercial |
$46.06
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$97.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$97.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$59.90
|
| Rate for Payer: Multiplan Commercial |
$193.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$34.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare Commercial |
$37.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.26
|
| Rate for Payer: United Healthcare VA CCN |
$24.26
|
|
|
STRAPPING OF UNNA BOOT
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9822958001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$199.09 |
| Max. Negotiated Rate |
$255.55 |
| Rate for Payer: Aetna of VT Commercial |
$255.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$199.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$199.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$228.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$225.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$215.20
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cigna Commercial |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$215.20
|
| Rate for Payer: Multiplan Commercial |
$250.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$228.65
|
| Rate for Payer: United Healthcare Commercial |
$255.55
|
|
|
STRAPPING OF UNNA BOOT
|
Facility
|
IP
|
$208.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
5102958001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$153.94 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna of VT Commercial |
$197.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$153.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$153.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$176.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$174.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$166.40
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cigna Commercial |
$166.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$166.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$166.40
|
| Rate for Payer: Multiplan Commercial |
$193.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$176.80
|
| Rate for Payer: United Healthcare Commercial |
$197.60
|
|
|
STRAPPING OF UNNA BOOT
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9602958002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$255.55 |
| Rate for Payer: Aetna of VT Commercial |
$255.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$119.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$241.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$161.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$228.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$217.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$121.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$213.85
|
| Rate for Payer: Cash Price |
$134.50
|
| Rate for Payer: Cigna Commercial |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$215.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$215.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$121.05
|
| Rate for Payer: Multiplan Commercial |
$250.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$228.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$121.05
|
| Rate for Payer: United Healthcare Commercial |
$255.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$121.05
|
| Rate for Payer: United Healthcare VA CCN |
$121.05
|
|
|
STRAPPING OF UNNA BOOT
|
Facility
|
OP
|
$208.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
5102958001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$92.12 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna of VT Commercial |
$197.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$186.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$92.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$186.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$125.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$176.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$168.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$93.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$165.36
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cigna Commercial |
$166.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$166.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$166.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$193.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$176.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$93.60
|
| Rate for Payer: United Healthcare Commercial |
$197.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$93.60
|
| Rate for Payer: United Healthcare VA CCN |
$93.60
|
|
|
STRAPPING TOES
|
Facility
|
IP
|
$57.90
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
4502955001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$42.85 |
| Max. Negotiated Rate |
$55.01 |
| Rate for Payer: Aetna of VT Commercial |
$55.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$42.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$42.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$49.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$48.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$46.32
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cigna Commercial |
$46.32
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$46.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$46.32
|
| Rate for Payer: Multiplan Commercial |
$53.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$49.22
|
| Rate for Payer: United Healthcare Commercial |
$55.01
|
|
