|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$883.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9822677501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$391.08 |
| Max. Negotiated Rate |
$838.85 |
| Rate for Payer: Aetna of VT Commercial |
$838.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$391.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$531.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$750.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$715.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$397.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$701.99
|
| Rate for Payer: Cash Price |
$441.50
|
| Rate for Payer: Cigna Commercial |
$706.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$706.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$706.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$397.35
|
| Rate for Payer: Multiplan Commercial |
$821.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$750.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$397.35
|
| Rate for Payer: United Healthcare Commercial |
$838.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$397.35
|
| Rate for Payer: United Healthcare VA CCN |
$397.35
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$452.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
5102677001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$200.19 |
| Max. Negotiated Rate |
$429.40 |
| Rate for Payer: Aetna of VT Commercial |
$429.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$200.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$272.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$384.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$366.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$203.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$359.34
|
| Rate for Payer: Cash Price |
$226.00
|
| Rate for Payer: Cigna Commercial |
$361.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$361.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$361.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$203.40
|
| Rate for Payer: Multiplan Commercial |
$420.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$384.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$203.40
|
| Rate for Payer: United Healthcare Commercial |
$429.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$203.40
|
| Rate for Payer: United Healthcare VA CCN |
$203.40
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$259.56 |
| Max. Negotiated Rate |
$1,424.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$298.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$382.95
|
| Rate for Payer: Cash Price |
$757.50
|
| Rate for Payer: Cash Price |
$757.50
|
| Rate for Payer: Cigna Commercial |
$489.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$472.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$472.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$286.21
|
| Rate for Payer: Multiplan Commercial |
$1,408.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$368.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare Commercial |
$399.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare VA CCN |
$259.56
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
9812667001
|
|
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
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$480.10 |
| Max. Negotiated Rate |
$1,029.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,029.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$971.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$480.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$971.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$652.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$921.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$878.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$487.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$861.78
|
| Rate for Payer: Cash Price |
$542.00
|
| Rate for Payer: Cigna Commercial |
$867.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$867.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$867.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$487.80
|
| Rate for Payer: Multiplan Commercial |
$1,008.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$921.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$487.80
|
| Rate for Payer: United Healthcare Commercial |
$1,029.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$487.80
|
| Rate for Payer: United Healthcare VA CCN |
$487.80
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$283.57
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
4502677501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$209.87 |
| Max. Negotiated Rate |
$269.39 |
| Rate for Payer: Aetna of VT Commercial |
$269.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$209.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$209.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$241.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$238.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$226.86
|
| Rate for Payer: Cash Price |
$141.78
|
| Rate for Payer: Cigna Commercial |
$226.86
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$226.86
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$226.86
|
| Rate for Payer: Multiplan Commercial |
$263.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$241.03
|
| Rate for Payer: United Healthcare Commercial |
$269.39
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9822677501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$348.77 |
| Max. Negotiated Rate |
$830.02 |
| Rate for Payer: Aetna of VT Commercial |
$830.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$359.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$488.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$559.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$559.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$401.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$559.82
|
| Rate for Payer: Cash Price |
$441.50
|
| Rate for Payer: Cash Price |
$441.50
|
| Rate for Payer: Cigna Commercial |
$660.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$640.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$640.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$389.89
|
| Rate for Payer: Multiplan Commercial |
$821.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$495.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$348.77
|
| Rate for Payer: United Healthcare Commercial |
$536.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$348.77
|
| Rate for Payer: United Healthcare VA CCN |
$348.77
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$259.56 |
| Max. Negotiated Rate |
$594.08 |
| Rate for Payer: Aetna of VT Commercial |
$594.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$298.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$382.95
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$489.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$472.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$472.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$286.21
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$368.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare Commercial |
$399.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare VA CCN |
$259.56
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$279.91 |
| Max. Negotiated Rate |
$600.40 |
| Rate for Payer: Aetna of VT Commercial |
$600.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$380.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$511.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$502.44
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$505.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.40
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$537.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare Commercial |
$600.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare VA CCN |
$284.40
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$883.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9822677501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$653.51 |
| Max. Negotiated Rate |
$838.85 |
| Rate for Payer: Aetna of VT Commercial |
$838.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$653.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$653.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$750.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$741.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$706.40
|
| Rate for Payer: Cash Price |
$441.50
|
| Rate for Payer: Cigna Commercial |
$706.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$706.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$706.40
|
| Rate for Payer: Multiplan Commercial |
$821.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$750.55
|
| Rate for Payer: United Healthcare Commercial |
$838.85
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$421.98
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
4502667001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$312.31 |
| Max. Negotiated Rate |
$400.88 |
| Rate for Payer: Aetna of VT Commercial |
$400.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$312.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$312.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$358.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$354.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$337.58
|
| Rate for Payer: Cash Price |
$210.99
|
| Rate for Payer: Cigna Commercial |
$337.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$337.58
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$337.58
|
| Rate for Payer: Multiplan Commercial |
$392.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$358.68
|
| Rate for Payer: United Healthcare Commercial |
$400.88
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$1,242.00
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
9812667002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$309.29 |
| Max. Negotiated Rate |
$1,167.48 |
| Rate for Payer: Aetna of VT Commercial |
$1,167.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$433.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$565.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$565.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$355.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$565.20
|
| Rate for Payer: Cash Price |
$621.00
|
| Rate for Payer: Cash Price |
$621.00
|
| Rate for Payer: Cigna Commercial |
$580.59
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$574.48
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$574.48
|
| Rate for Payer: Martins Point Health Care Commercial |
$347.51
|
| Rate for Payer: Multiplan Commercial |
$1,155.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$439.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$309.29
|
| Rate for Payer: United Healthcare Commercial |
$475.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$309.29
|
| Rate for Payer: United Healthcare VA CCN |
$309.29
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
5102677001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$259.56 |
| Max. Negotiated Rate |
$489.56 |
| Rate for Payer: Aetna of VT Commercial |
$424.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$404.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$298.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$382.95
|
| Rate for Payer: Cash Price |
$226.00
|
| Rate for Payer: Cash Price |
$226.00
|
| Rate for Payer: Cigna Commercial |
$489.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$472.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$472.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$286.21
|
| Rate for Payer: Multiplan Commercial |
$420.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$368.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare Commercial |
$399.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare VA CCN |
$259.56
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$467.74 |
| Max. Negotiated Rate |
$600.40 |
| Rate for Payer: Aetna of VT Commercial |
$600.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$467.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$467.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$530.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$505.60
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$505.60
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$537.20
|
| Rate for Payer: United Healthcare Commercial |
$600.40
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$1,515.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$670.99 |
| Max. Negotiated Rate |
$1,439.25 |
| Rate for Payer: Aetna of VT Commercial |
$1,439.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$670.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$912.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,287.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,227.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$681.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,204.42
|
| Rate for Payer: Cash Price |
$757.50
|
| Rate for Payer: Cigna Commercial |
$1,212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,212.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$1,408.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,287.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$681.75
|
| Rate for Payer: United Healthcare Commercial |
$1,439.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.75
|
| Rate for Payer: United Healthcare VA CCN |
$681.75
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$467.74 |
| Max. Negotiated Rate |
$600.40 |
| Rate for Payer: Aetna of VT Commercial |
$600.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$467.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$467.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$530.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$505.60
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$505.60
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$537.20
|
| Rate for Payer: United Healthcare Commercial |
$600.40
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
9812667001
|
|
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
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$421.98
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
4502667001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$186.89 |
| Max. Negotiated Rate |
$400.88 |
| Rate for Payer: Aetna of VT Commercial |
$400.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$378.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$186.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$378.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$254.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$358.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$341.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$189.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$335.47
|
| Rate for Payer: Cash Price |
$210.99
|
| Rate for Payer: Cigna Commercial |
$337.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$337.58
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$337.58
|
| Rate for Payer: Martins Point Health Care Commercial |
$189.89
|
| Rate for Payer: Multiplan Commercial |
$392.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$358.68
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.89
|
| Rate for Payer: United Healthcare Commercial |
$400.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.89
|
| Rate for Payer: United Healthcare VA CCN |
$189.89
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$451.86
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
4502677001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$200.13 |
| Max. Negotiated Rate |
$429.27 |
| Rate for Payer: Aetna of VT Commercial |
$429.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$404.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$200.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$404.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$272.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$384.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$366.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$203.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$359.23
|
| Rate for Payer: Cash Price |
$225.93
|
| Rate for Payer: Cigna Commercial |
$361.49
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$361.49
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$361.49
|
| Rate for Payer: Martins Point Health Care Commercial |
$203.34
|
| Rate for Payer: Multiplan Commercial |
$420.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$384.08
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$203.34
|
| Rate for Payer: United Healthcare Commercial |
$429.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$203.34
|
| Rate for Payer: United Healthcare VA CCN |
$203.34
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$259.56 |
| Max. Negotiated Rate |
$1,018.96 |
| Rate for Payer: Aetna of VT Commercial |
$1,018.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$971.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$971.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$298.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$382.95
|
| Rate for Payer: Cash Price |
$542.00
|
| Rate for Payer: Cash Price |
$542.00
|
| Rate for Payer: Cigna Commercial |
$489.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$472.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$472.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$286.21
|
| Rate for Payer: Multiplan Commercial |
$1,008.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$368.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare Commercial |
$399.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare VA CCN |
$259.56
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$279.91 |
| Max. Negotiated Rate |
$600.40 |
| Rate for Payer: Aetna of VT Commercial |
$600.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$380.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$511.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$502.44
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$505.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.40
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$537.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare Commercial |
$600.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare VA CCN |
$284.40
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$259.56 |
| Max. Negotiated Rate |
$594.08 |
| Rate for Payer: Aetna of VT Commercial |
$594.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$298.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$382.95
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$489.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$472.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$472.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$286.21
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$368.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare Commercial |
$399.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare VA CCN |
$259.56
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9812677501
|
|
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
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$451.86
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
4502677001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$334.42 |
| Max. Negotiated Rate |
$429.27 |
| Rate for Payer: Aetna of VT Commercial |
$429.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$334.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$334.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$384.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$379.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$361.49
|
| Rate for Payer: Cash Price |
$225.93
|
| Rate for Payer: Cigna Commercial |
$361.49
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$361.49
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$361.49
|
| Rate for Payer: Multiplan Commercial |
$420.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$384.08
|
| Rate for Payer: United Healthcare Commercial |
$429.27
|
|
|
TREAT FINGER DISLOCATION
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9812677502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$348.77 |
| Max. Negotiated Rate |
$830.02 |
| Rate for Payer: Aetna of VT Commercial |
$830.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$359.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$488.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$559.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$559.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$401.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$559.82
|
| Rate for Payer: Cash Price |
$441.50
|
| Rate for Payer: Cash Price |
$441.50
|
| Rate for Payer: Cigna Commercial |
$660.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$640.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$640.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$389.89
|
| Rate for Payer: Multiplan Commercial |
$821.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$495.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$348.77
|
| Rate for Payer: United Healthcare Commercial |
$536.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$348.77
|
| Rate for Payer: United Healthcare VA CCN |
$348.77
|
|
