|
TREAT ELBOW DISLOCATION
|
Professional
|
Both
|
$1,543.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
9822460501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$459.30 |
| Max. Negotiated Rate |
$1,450.42 |
| Rate for Payer: Aetna of VT Commercial |
$1,450.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,382.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$473.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,382.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$643.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$652.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$652.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$528.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$652.10
|
| Rate for Payer: Cash Price |
$771.50
|
| Rate for Payer: Cash Price |
$771.50
|
| Rate for Payer: Cigna Commercial |
$873.15
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$761.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$761.68
|
| Rate for Payer: Martins Point Health Care Commercial |
$459.30
|
| Rate for Payer: Multiplan Commercial |
$1,434.99
|
| Rate for Payer: MVP Health Care of NY Commercial |
$652.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$459.31
|
| Rate for Payer: United Healthcare Commercial |
$706.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$459.31
|
| Rate for Payer: United Healthcare VA CCN |
$459.31
|
|
|
TREAT ELBOW DISLOCATION
|
Professional
|
Both
|
$1,543.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
9812460501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$459.30 |
| Max. Negotiated Rate |
$1,450.42 |
| Rate for Payer: Aetna of VT Commercial |
$1,450.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,382.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$473.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,382.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$643.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$652.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$652.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$528.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$652.10
|
| Rate for Payer: Cash Price |
$771.50
|
| Rate for Payer: Cash Price |
$771.50
|
| Rate for Payer: Cigna Commercial |
$873.15
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$761.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$761.68
|
| Rate for Payer: Martins Point Health Care Commercial |
$459.30
|
| Rate for Payer: Multiplan Commercial |
$1,434.99
|
| Rate for Payer: MVP Health Care of NY Commercial |
$652.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$459.31
|
| Rate for Payer: United Healthcare Commercial |
$706.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$459.31
|
| Rate for Payer: United Healthcare VA CCN |
$459.31
|
|
|
TREAT ELBOW DISLOCATION
|
Facility
|
OP
|
$669.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
5102460001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$296.30 |
| Max. Negotiated Rate |
$635.55 |
| Rate for Payer: Aetna of VT Commercial |
$635.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$599.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$296.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$599.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$402.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$568.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$541.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$301.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$531.86
|
| Rate for Payer: Cash Price |
$334.50
|
| Rate for Payer: Cigna Commercial |
$535.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$535.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$535.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$301.05
|
| Rate for Payer: Multiplan Commercial |
$622.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$568.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$301.05
|
| Rate for Payer: United Healthcare Commercial |
$635.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$301.05
|
| Rate for Payer: United Healthcare VA CCN |
$301.05
|
|
|
TREAT ELBOW DISLOCATION
|
Professional
|
Both
|
$1,286.00
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
9602464001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$75.82 |
| Max. Negotiated Rate |
$1,208.84 |
| Rate for Payer: Aetna of VT Commercial |
$1,208.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,152.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$78.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,152.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$106.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$220.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$220.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$87.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$220.60
|
| Rate for Payer: Cash Price |
$643.00
|
| Rate for Payer: Cash Price |
$643.00
|
| Rate for Payer: Cigna Commercial |
$146.44
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$160.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$160.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$99.59
|
| Rate for Payer: Multiplan Commercial |
$1,195.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$107.66
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$75.82
|
| Rate for Payer: United Healthcare Commercial |
$116.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$75.82
|
| Rate for Payer: United Healthcare VA CCN |
$75.82
|
|
|
TREAT ELBOW DISLOCATION
|
Facility
|
IP
|
$669.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
4502460001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$495.13 |
| Max. Negotiated Rate |
$635.55 |
| Rate for Payer: Aetna of VT Commercial |
$635.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$495.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$495.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$568.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$561.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$535.20
|
| Rate for Payer: Cash Price |
$334.50
|
| Rate for Payer: Cigna Commercial |
$535.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$535.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$535.20
|
| Rate for Payer: Multiplan Commercial |
$622.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$568.65
|
| Rate for Payer: United Healthcare Commercial |
$635.55
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
OP
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9602462002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$663.91 |
| Max. Negotiated Rate |
$1,424.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$663.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$902.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,274.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,214.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$674.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,191.70
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,199.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$674.55
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,274.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$674.55
|
| Rate for Payer: United Healthcare Commercial |
$1,424.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$674.55
|
| Rate for Payer: United Healthcare VA CCN |
$674.55
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
IP
|
$3,756.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9602462001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,779.82 |
| Max. Negotiated Rate |
$3,568.20 |
| Rate for Payer: Aetna of VT Commercial |
$3,568.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,779.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,779.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,192.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,155.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,004.80
|
| Rate for Payer: Cash Price |
$1,878.00
|
| Rate for Payer: Cigna Commercial |
$3,004.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,004.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,004.80
|
| Rate for Payer: Multiplan Commercial |
$3,493.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,192.60
|
| Rate for Payer: United Healthcare Commercial |
$3,568.20
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
OP
|
$2,921.00
|
|
|
Service Code
|
CPT 24635
|
| Hospital Charge Code |
9822463501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,293.71 |
| Max. Negotiated Rate |
$2,774.95 |
| Rate for Payer: Aetna of VT Commercial |
$2,774.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,616.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,293.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,616.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,758.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,482.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,366.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,314.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,322.20
|
| Rate for Payer: Cash Price |
$1,460.50
|
| Rate for Payer: Cigna Commercial |
$2,336.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,336.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,336.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,314.45
|
| Rate for Payer: Multiplan Commercial |
$2,716.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,482.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,314.45
|
| Rate for Payer: United Healthcare Commercial |
$2,774.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,314.45
|
| Rate for Payer: United Healthcare VA CCN |
$1,314.45
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
IP
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9812462002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,109.41 |
| Max. Negotiated Rate |
$1,424.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,109.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,109.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,274.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,259.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,199.20
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,199.20
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,274.15
|
| Rate for Payer: United Healthcare Commercial |
$1,424.05
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
OP
|
$2,256.31
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
4502462001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$999.32 |
| Max. Negotiated Rate |
$2,143.49 |
| Rate for Payer: Aetna of VT Commercial |
$2,143.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,021.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$999.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,021.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,358.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,917.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,827.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,015.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,793.77
|
| Rate for Payer: Cash Price |
$1,128.15
|
| Rate for Payer: Cigna Commercial |
$1,805.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,805.05
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,805.05
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,015.34
|
| Rate for Payer: Multiplan Commercial |
$2,098.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,917.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,015.34
|
| Rate for Payer: United Healthcare Commercial |
$2,143.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,015.34
|
| Rate for Payer: United Healthcare VA CCN |
$1,015.34
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
IP
|
$2,256.31
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
4502462001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,669.90 |
| Max. Negotiated Rate |
$2,143.49 |
| Rate for Payer: Aetna of VT Commercial |
$2,143.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,669.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,669.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,917.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,895.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,805.05
|
| Rate for Payer: Cash Price |
$1,128.15
|
| Rate for Payer: Cigna Commercial |
$1,805.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,805.05
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,805.05
|
| Rate for Payer: Multiplan Commercial |
$2,098.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,917.86
|
| Rate for Payer: United Healthcare Commercial |
$2,143.49
|
|
|
TREAT ELBOW FRACTURE
|
Professional
|
Both
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9812462001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$565.56 |
| Max. Negotiated Rate |
$1,409.06 |
| Rate for Payer: Aetna of VT Commercial |
$1,409.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$582.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$791.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$650.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$977.67
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,069.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$939.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$939.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$565.56
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$803.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare Commercial |
$870.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare VA CCN |
$565.56
|
|
|
TREAT ELBOW FRACTURE
|
Professional
|
Both
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9602462002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$565.56 |
| Max. Negotiated Rate |
$1,409.06 |
| Rate for Payer: Aetna of VT Commercial |
$1,409.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$582.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$791.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$650.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$977.67
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,069.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$939.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$939.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$565.56
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$803.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare Commercial |
$870.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare VA CCN |
$565.56
|
|
|
TREAT ELBOW FRACTURE
|
Professional
|
Both
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9812462002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$565.56 |
| Max. Negotiated Rate |
$1,409.06 |
| Rate for Payer: Aetna of VT Commercial |
$1,409.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$582.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$791.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$650.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$977.67
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,069.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$939.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$939.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$565.56
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$803.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare Commercial |
$870.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare VA CCN |
$565.56
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
IP
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9602462002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,109.41 |
| Max. Negotiated Rate |
$1,424.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,109.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,109.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,274.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,259.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,199.20
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,199.20
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,274.15
|
| Rate for Payer: United Healthcare Commercial |
$1,424.05
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
OP
|
$2,257.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
5102462001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$999.63 |
| Max. Negotiated Rate |
$2,144.15 |
| Rate for Payer: Aetna of VT Commercial |
$2,144.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,022.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$999.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,022.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,358.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,918.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,828.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,015.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,794.32
|
| Rate for Payer: Cash Price |
$1,128.50
|
| Rate for Payer: Cigna Commercial |
$1,805.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,805.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,805.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,015.65
|
| Rate for Payer: Multiplan Commercial |
$2,099.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,918.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,015.65
|
| Rate for Payer: United Healthcare Commercial |
$2,144.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,015.65
|
| Rate for Payer: United Healthcare VA CCN |
$1,015.65
|
|
|
TREAT ELBOW FRACTURE
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
5102462001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$565.56 |
| Max. Negotiated Rate |
$2,121.58 |
| Rate for Payer: Aetna of VT Commercial |
$2,121.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,022.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$582.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,022.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$791.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$650.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$977.67
|
| Rate for Payer: Cash Price |
$1,128.50
|
| Rate for Payer: Cash Price |
$1,128.50
|
| Rate for Payer: Cigna Commercial |
$1,069.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$939.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$939.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$565.56
|
| Rate for Payer: Multiplan Commercial |
$2,099.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$803.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare Commercial |
$870.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare VA CCN |
$565.56
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
IP
|
$2,257.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
5102462001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,670.41 |
| Max. Negotiated Rate |
$2,144.15 |
| Rate for Payer: Aetna of VT Commercial |
$2,144.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,670.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,670.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,918.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,895.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,128.50
|
| Rate for Payer: Cigna Commercial |
$1,805.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,805.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,805.60
|
| Rate for Payer: Multiplan Commercial |
$2,099.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,918.45
|
| Rate for Payer: United Healthcare Commercial |
$2,144.15
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
IP
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9812462001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,109.41 |
| Max. Negotiated Rate |
$1,424.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,109.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,109.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,274.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,259.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,199.20
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,199.20
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,274.15
|
| Rate for Payer: United Healthcare Commercial |
$1,424.05
|
|
|
TREAT ELBOW FRACTURE
|
Professional
|
Both
|
$2,921.00
|
|
|
Service Code
|
CPT 24635
|
| Hospital Charge Code |
9822463501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$646.09 |
| Max. Negotiated Rate |
$2,745.74 |
| Rate for Payer: Aetna of VT Commercial |
$2,745.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,616.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$665.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,616.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$904.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,495.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,495.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$743.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,495.59
|
| Rate for Payer: Cash Price |
$1,460.50
|
| Rate for Payer: Cash Price |
$1,460.50
|
| Rate for Payer: Cigna Commercial |
$1,217.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,074.39
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,074.39
|
| Rate for Payer: Martins Point Health Care Commercial |
$646.09
|
| Rate for Payer: Multiplan Commercial |
$2,716.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$917.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$646.09
|
| Rate for Payer: United Healthcare Commercial |
$993.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$646.09
|
| Rate for Payer: United Healthcare VA CCN |
$646.09
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
IP
|
$2,921.00
|
|
|
Service Code
|
CPT 24635
|
| Hospital Charge Code |
9822463501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,161.83 |
| Max. Negotiated Rate |
$2,774.95 |
| Rate for Payer: Aetna of VT Commercial |
$2,774.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,161.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,161.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,482.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,453.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,336.80
|
| Rate for Payer: Cash Price |
$1,460.50
|
| Rate for Payer: Cigna Commercial |
$2,336.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,336.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,336.80
|
| Rate for Payer: Multiplan Commercial |
$2,716.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,482.85
|
| Rate for Payer: United Healthcare Commercial |
$2,774.95
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
OP
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9812462001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$663.91 |
| Max. Negotiated Rate |
$1,424.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$663.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$902.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,274.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,214.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$674.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,191.70
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,199.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$674.55
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,274.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$674.55
|
| Rate for Payer: United Healthcare Commercial |
$1,424.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$674.55
|
| Rate for Payer: United Healthcare VA CCN |
$674.55
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
OP
|
$3,756.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9602462001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,663.53 |
| Max. Negotiated Rate |
$3,568.20 |
| Rate for Payer: Aetna of VT Commercial |
$3,568.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,365.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,663.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,365.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,261.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,192.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,042.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,690.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,986.02
|
| Rate for Payer: Cash Price |
$1,878.00
|
| Rate for Payer: Cigna Commercial |
$3,004.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,004.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,004.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,690.20
|
| Rate for Payer: Multiplan Commercial |
$3,493.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,192.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,690.20
|
| Rate for Payer: United Healthcare Commercial |
$3,568.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,690.20
|
| Rate for Payer: United Healthcare VA CCN |
$1,690.20
|
|
|
TREAT ELBOW FRACTURE
|
Facility
|
OP
|
$1,499.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9812462002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$663.91 |
| Max. Negotiated Rate |
$1,424.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$663.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,342.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$902.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,274.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,214.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$674.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,191.70
|
| Rate for Payer: Cash Price |
$749.50
|
| Rate for Payer: Cigna Commercial |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,199.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,199.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$674.55
|
| Rate for Payer: Multiplan Commercial |
$1,394.07
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,274.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$674.55
|
| Rate for Payer: United Healthcare Commercial |
$1,424.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$674.55
|
| Rate for Payer: United Healthcare VA CCN |
$674.55
|
|
|
TREAT ELBOW FRACTURE
|
Professional
|
Both
|
$3,756.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
9602462001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$565.56 |
| Max. Negotiated Rate |
$3,530.64 |
| Rate for Payer: Aetna of VT Commercial |
$3,530.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,365.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$582.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,365.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$791.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$977.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$650.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$977.67
|
| Rate for Payer: Cash Price |
$1,878.00
|
| Rate for Payer: Cash Price |
$1,878.00
|
| Rate for Payer: Cigna Commercial |
$1,069.48
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$939.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$939.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$565.56
|
| Rate for Payer: Multiplan Commercial |
$3,493.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$803.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare Commercial |
$870.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$565.56
|
| Rate for Payer: United Healthcare VA CCN |
$565.56
|
|
