|
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
|
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
|
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
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9812677501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$660.69 |
| 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 |
$359.23
|
| 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 |
$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 |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| 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 |
$0.93
|
| 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
|
Facility
|
IP
|
$1,242.00
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
9812667002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$919.20 |
| Max. Negotiated Rate |
$1,179.90 |
| Rate for Payer: Aetna of VT Commercial |
$1,179.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$919.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$919.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,055.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,043.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$993.60
|
| Rate for Payer: Cash Price |
$621.00
|
| Rate for Payer: Cigna Commercial |
$993.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$993.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$993.60
|
| Rate for Payer: Multiplan Commercial |
$1,155.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,055.70
|
| Rate for Payer: United Healthcare Commercial |
$1,179.90
|
|
|
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
|
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
|
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
|
Facility
|
IP
|
$883.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
9812677502
|
|
Hospital Revenue Code
|
981
|
| 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
|
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
|
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 FRACTURE EACH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9822673501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$571.03 |
| 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 |
$588.16
|
| 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 |
$799.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$712.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$712.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$656.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$712.16
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$1,079.61
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$946.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$946.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$571.03
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare Commercial |
$878.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare VA CCN |
$571.03
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$299.81 |
| Max. Negotiated Rate |
$1,183.46 |
| Rate for Payer: Aetna of VT Commercial |
$1,183.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$308.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$419.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$344.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.45
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cigna Commercial |
$566.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$555.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$555.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.72
|
| Rate for Payer: Multiplan Commercial |
$1,170.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$425.73
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$299.81
|
| Rate for Payer: United Healthcare Commercial |
$461.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$299.81
|
| Rate for Payer: United Healthcare VA CCN |
$299.81
|
|
|
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
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9822673501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,049.46 |
| Max. Negotiated Rate |
$1,347.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,347.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,205.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,191.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,134.40
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,134.40
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,205.30
|
| Rate for Payer: United Healthcare Commercial |
$1,347.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674201
|
|
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 FRACTURE EACH
|
Facility
|
OP
|
$492.96
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
4502675501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$218.33 |
| 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 |
$441.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$441.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$296.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$419.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$399.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$221.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$391.90
|
| 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: Martins Point Health Care Commercial |
$221.83
|
| Rate for Payer: Multiplan Commercial |
$458.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$419.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$221.83
|
| Rate for Payer: United Healthcare Commercial |
$468.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$221.83
|
| Rate for Payer: United Healthcare VA CCN |
$221.83
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$3,130.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$571.03 |
| Max. Negotiated Rate |
$2,942.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,942.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,804.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$588.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,804.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$799.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$712.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$712.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$656.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$712.16
|
| Rate for Payer: Cash Price |
$1,565.00
|
| Rate for Payer: Cash Price |
$1,565.00
|
| Rate for Payer: Cigna Commercial |
$1,079.61
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$946.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$946.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$571.03
|
| Rate for Payer: Multiplan Commercial |
$2,910.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare Commercial |
$878.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare VA CCN |
$571.03
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,049.46 |
| Max. Negotiated Rate |
$1,347.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,347.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,205.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,191.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,134.40
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,134.40
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,205.30
|
| Rate for Payer: United Healthcare Commercial |
$1,347.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675001
|
|
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 FRACTURE EACH
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$271.31 |
| Max. Negotiated Rate |
$705.94 |
| Rate for Payer: Aetna of VT Commercial |
$705.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$672.82
|
| 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 |
$672.82
|
| 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 |
$375.50
|
| Rate for Payer: Cash Price |
$375.50
|
| 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 |
$698.43
|
| 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
|
Facility
|
OP
|
$1,244.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$550.97 |
| Max. Negotiated Rate |
$1,181.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,181.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,114.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$550.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,114.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$748.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,057.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,007.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$559.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$988.98
|
| Rate for Payer: Cash Price |
$622.00
|
| Rate for Payer: Cigna Commercial |
$995.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$995.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$995.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$559.80
|
| Rate for Payer: Multiplan Commercial |
$1,156.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,057.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$559.80
|
| Rate for Payer: United Healthcare Commercial |
$1,181.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$559.80
|
| Rate for Payer: United Healthcare VA CCN |
$559.80
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$189.35 |
| Max. Negotiated Rate |
$652.36 |
| Rate for Payer: Aetna of VT Commercial |
$652.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$621.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$195.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$621.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$265.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$217.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.64
|
| Rate for Payer: Cash Price |
$347.00
|
| Rate for Payer: Cash Price |
$347.00
|
| Rate for Payer: Cigna Commercial |
$356.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.87
|
| Rate for Payer: Multiplan Commercial |
$645.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$268.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare Commercial |
$291.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare VA CCN |
$189.35
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$202.66
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
4502675001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$192.53 |
| Rate for Payer: Aetna of VT Commercial |
$192.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$181.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$181.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$122.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$164.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$91.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$161.11
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cigna Commercial |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$162.13
|
| Rate for Payer: Martins Point Health Care Commercial |
$91.20
|
| Rate for Payer: Multiplan Commercial |
$188.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$172.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.20
|
| Rate for Payer: United Healthcare Commercial |
$192.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.20
|
| Rate for Payer: United Healthcare VA CCN |
$91.20
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$217.91 |
| 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 |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$217.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$296.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$418.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$398.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$221.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$391.14
|
| 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: Martins Point Health Care Commercial |
$221.40
|
| Rate for Payer: Multiplan Commercial |
$457.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$418.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$221.40
|
| Rate for Payer: United Healthcare Commercial |
$467.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$221.40
|
| Rate for Payer: United Healthcare VA CCN |
$221.40
|
|
