|
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
|
$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
|
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
|
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
|
$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
|
$883.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9812677502
|
|
Hospital Revenue Code
|
981
|
| 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
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9812677501
|
|
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
|
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
|
IP
|
$452.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
5102677001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$334.53 |
| 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 |
$334.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$334.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$384.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$379.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$361.60
|
| 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: Multiplan Commercial |
$420.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$384.20
|
| Rate for Payer: United Healthcare Commercial |
$429.40
|
|
|
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
|
$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 FRACTURE EACH
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9812675501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$271.31 |
| Max. Negotiated Rate |
$1,111.08 |
| Rate for Payer: Aetna of VT Commercial |
$1,111.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,058.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,058.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$379.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$406.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$406.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$312.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$406.45
|
| Rate for Payer: Cash Price |
$591.00
|
| Rate for Payer: Cash Price |
$591.00
|
| Rate for Payer: Cigna Commercial |
$508.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$524.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$524.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$318.52
|
| Rate for Payer: Multiplan Commercial |
$1,099.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$385.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$271.31
|
| Rate for Payer: United Healthcare Commercial |
$417.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$271.31
|
| Rate for Payer: United Healthcare VA CCN |
$271.31
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$2,024.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
9822674601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$707.25 |
| Max. Negotiated Rate |
$1,902.56 |
| Rate for Payer: Aetna of VT Commercial |
$1,902.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,813.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$728.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,813.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$990.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$886.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$886.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$813.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$886.43
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cigna Commercial |
$1,336.84
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,174.15
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,174.15
|
| Rate for Payer: Martins Point Health Care Commercial |
$707.25
|
| Rate for Payer: Multiplan Commercial |
$1,882.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,004.29
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$707.25
|
| Rate for Payer: United Healthcare Commercial |
$1,087.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$707.25
|
| Rate for Payer: United Healthcare VA CCN |
$707.25
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$364.13 |
| Max. Negotiated Rate |
$467.40 |
| Rate for Payer: Aetna of VT Commercial |
$467.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$364.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$364.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$418.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$413.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$393.60
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$393.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$393.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$393.60
|
| Rate for Payer: Multiplan Commercial |
$457.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$418.20
|
| Rate for Payer: United Healthcare Commercial |
$467.40
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$492.96
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
4502675501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$364.84 |
| Max. Negotiated Rate |
$468.31 |
| Rate for Payer: Aetna of VT Commercial |
$468.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$364.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$364.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$419.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$414.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$394.37
|
| Rate for Payer: Cash Price |
$246.48
|
| Rate for Payer: Cigna Commercial |
$394.37
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$394.37
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$394.37
|
| Rate for Payer: Multiplan Commercial |
$458.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$419.02
|
| Rate for Payer: United Healthcare Commercial |
$468.31
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
5102675001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$181.87 |
| Max. Negotiated Rate |
$358.80 |
| Rate for Payer: Aetna of VT Commercial |
$190.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$181.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$196.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$181.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$267.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$264.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$264.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$219.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$264.91
|
| Rate for Payer: Cash Price |
$101.50
|
| Rate for Payer: Cash Price |
$101.50
|
| Rate for Payer: Cigna Commercial |
$358.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$310.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$310.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$188.56
|
| Rate for Payer: Multiplan Commercial |
$188.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$270.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare Commercial |
$293.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare VA CCN |
$190.81
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$250.80 |
| Rate for Payer: Aetna of VT Commercial |
$250.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$195.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$195.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$224.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$221.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$211.20
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cigna Commercial |
$211.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$211.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$211.20
|
| Rate for Payer: Multiplan Commercial |
$245.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$224.40
|
| Rate for Payer: United Healthcare Commercial |
$250.80
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9602675001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$345.63 |
| Max. Negotiated Rate |
$443.65 |
| Rate for Payer: Aetna of VT Commercial |
$443.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$345.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$345.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$396.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$392.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$373.60
|
| Rate for Payer: Cash Price |
$233.50
|
| Rate for Payer: Cigna Commercial |
$373.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$373.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$373.60
|
| Rate for Payer: Multiplan Commercial |
$434.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$396.95
|
| Rate for Payer: United Healthcare Commercial |
$443.65
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$358.80 |
| 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 |
$196.53
|
| 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 |
$267.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$264.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$264.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$219.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$264.91
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$358.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$310.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$310.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$188.56
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$270.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare Commercial |
$293.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare VA CCN |
$190.81
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9822676501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$485.99 |
| Max. Negotiated Rate |
$1,332.92 |
| Rate for Payer: Aetna of VT Commercial |
$1,332.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,270.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$500.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,270.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$680.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$558.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$603.75
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$919.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$803.34
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$803.34
|
| Rate for Payer: Martins Point Health Care Commercial |
$485.99
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$690.11
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare Commercial |
$747.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare VA CCN |
$485.99
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$188.56 |
| Max. Negotiated Rate |
$358.80 |
| Rate for Payer: Aetna of VT Commercial |
$248.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$236.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$196.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$236.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$267.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$264.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$264.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$219.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$264.91
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cigna Commercial |
$358.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$310.12
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$310.12
|
| Rate for Payer: Martins Point Health Care Commercial |
$188.56
|
| Rate for Payer: Multiplan Commercial |
$245.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$270.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare Commercial |
$293.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare VA CCN |
$190.81
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$636.49 |
| Max. Negotiated Rate |
$817.00 |
| Rate for Payer: Aetna of VT Commercial |
$817.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$722.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$688.00
|
| Rate for Payer: Cash Price |
$430.00
|
| Rate for Payer: Cigna Commercial |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$688.00
|
| Rate for Payer: Multiplan Commercial |
$799.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$817.00
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9822674201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$480.55 |
| Max. Negotiated Rate |
$1,030.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,030.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$972.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$480.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$972.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$653.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$922.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$878.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$488.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$862.58
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Cigna Commercial |
$868.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$868.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$868.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$488.25
|
| Rate for Payer: Multiplan Commercial |
$1,009.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$922.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$488.25
|
| Rate for Payer: United Healthcare Commercial |
$1,030.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$488.25
|
| Rate for Payer: United Healthcare VA CCN |
$488.25
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674201
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$625.65 |
| 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 |
$337.93
|
| 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 |
$459.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$377.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$625.65
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$619.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$604.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$604.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$366.95
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$465.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare Commercial |
$504.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare VA CCN |
$328.09
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$467.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9602675001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$206.83 |
| Max. Negotiated Rate |
$443.65 |
| Rate for Payer: Aetna of VT Commercial |
$443.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$418.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$206.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$418.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$281.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$396.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$378.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$210.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$371.26
|
| Rate for Payer: Cash Price |
$233.50
|
| Rate for Payer: Cigna Commercial |
$373.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$373.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$373.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$210.15
|
| Rate for Payer: Multiplan Commercial |
$434.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$396.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$210.15
|
| Rate for Payer: United Healthcare Commercial |
$443.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$210.15
|
| Rate for Payer: United Healthcare VA CCN |
$210.15
|
|
