|
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
|
$1,515.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,121.25 |
| 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 |
$1,121.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,121.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,287.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,272.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,212.00
|
| 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: Multiplan Commercial |
$1,408.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,287.75
|
| Rate for Payer: United Healthcare Commercial |
$1,439.25
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$283.57
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
4502677501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.59 |
| 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 |
$254.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$125.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$254.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$170.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$241.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$229.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$127.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$225.44
|
| 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: Martins Point Health Care Commercial |
$127.61
|
| Rate for Payer: Multiplan Commercial |
$263.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$241.03
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$127.61
|
| Rate for Payer: United Healthcare Commercial |
$269.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$127.61
|
| Rate for Payer: United Healthcare VA CCN |
$127.61
|
|
|
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
|
Facility
|
OP
|
$1,242.00
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
9812667002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$550.08 |
| 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 |
$1,112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$550.08
|
| 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 |
$747.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,055.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,006.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$558.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$987.39
|
| 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: Martins Point Health Care Commercial |
$558.90
|
| Rate for Payer: Multiplan Commercial |
$1,155.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,055.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$558.90
|
| Rate for Payer: United Healthcare Commercial |
$1,179.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$558.90
|
| Rate for Payer: United Healthcare VA CCN |
$558.90
|
|
|
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
|
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
|
$1.00
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
9812667001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$580.59 |
| 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 |
$318.57
|
| 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 |
$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 |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| 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 |
$0.93
|
| 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
|
$1,084.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$802.27 |
| 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 |
$802.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$802.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$921.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$910.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$867.20
|
| 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: Multiplan Commercial |
$1,008.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$921.40
|
| Rate for Payer: United Healthcare Commercial |
$1,029.80
|
|
|
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
|
$1.00
|
|
|
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 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
|
$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
|
Facility
|
IP
|
$2,436.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9602676501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,802.88 |
| Max. Negotiated Rate |
$2,314.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,314.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,802.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,802.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,070.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,046.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,948.80
|
| Rate for Payer: Cash Price |
$1,218.00
|
| Rate for Payer: Cigna Commercial |
$1,948.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,948.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,948.80
|
| Rate for Payer: Multiplan Commercial |
$2,265.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,070.60
|
| Rate for Payer: United Healthcare Commercial |
$2,314.20
|
|
|
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
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9812672002
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9602675001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$188.56 |
| Max. Negotiated Rate |
$438.98 |
| Rate for Payer: Aetna of VT Commercial |
$438.98
|
| 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 |
$196.53
|
| 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 |
$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 |
$233.50
|
| Rate for Payer: Cash Price |
$233.50
|
| 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 |
$434.31
|
| 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
|
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
|
|
|
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
|
Facility
|
OP
|
$3,130.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,386.28 |
| Max. Negotiated Rate |
$2,973.50 |
| Rate for Payer: Aetna of VT Commercial |
$2,973.50
|
| 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 |
$1,386.28
|
| 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 |
$1,884.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,660.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,535.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,408.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,488.35
|
| Rate for Payer: Cash Price |
$1,565.00
|
| Rate for Payer: Cigna Commercial |
$2,504.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,504.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,504.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,408.50
|
| Rate for Payer: Multiplan Commercial |
$2,910.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,660.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,408.50
|
| Rate for Payer: United Healthcare Commercial |
$2,973.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,408.50
|
| Rate for Payer: United Healthcare VA CCN |
$1,408.50
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$3,130.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,316.51 |
| Max. Negotiated Rate |
$2,973.50 |
| Rate for Payer: Aetna of VT Commercial |
$2,973.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,316.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,316.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,660.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,629.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,504.00
|
| Rate for Payer: Cash Price |
$1,565.00
|
| Rate for Payer: Cigna Commercial |
$2,504.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,504.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,504.00
|
| Rate for Payer: Multiplan Commercial |
$2,910.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,660.50
|
| Rate for Payer: United Healthcare Commercial |
$2,973.50
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$332.62 |
| Max. Negotiated Rate |
$713.45 |
| Rate for Payer: Aetna of VT Commercial |
$713.45
|
| 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 |
$332.62
|
| 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 |
$452.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$638.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$608.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$337.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$597.04
|
| Rate for Payer: Cash Price |
$375.50
|
| Rate for Payer: Cigna Commercial |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$600.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.95
|
| Rate for Payer: Multiplan Commercial |
$698.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$638.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$337.95
|
| Rate for Payer: United Healthcare Commercial |
$713.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.95
|
| Rate for Payer: United Healthcare VA CCN |
$337.95
|
|
|
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
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$555.82 |
| Max. Negotiated Rate |
$713.45 |
| Rate for Payer: Aetna of VT Commercial |
$713.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$555.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$555.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$638.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$630.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$600.80
|
| Rate for Payer: Cash Price |
$375.50
|
| Rate for Payer: Cigna Commercial |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$600.80
|
| Rate for Payer: Multiplan Commercial |
$698.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$638.35
|
| Rate for Payer: United Healthcare Commercial |
$713.45
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$271.31 |
| Max. Negotiated Rate |
$1,169.36 |
| Rate for Payer: Aetna of VT Commercial |
$1,169.36
|
| 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 |
$279.45
|
| 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 |
$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 |
$622.00
|
| Rate for Payer: Cash Price |
$622.00
|
| 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 |
$1,156.92
|
| 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
|
|
