|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$279.91 |
| Max. Negotiated Rate |
$600.40 |
| Rate for Payer: Aetna of VT Commercial |
$600.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$380.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$511.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$502.44
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$505.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.40
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$537.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare Commercial |
$600.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare VA CCN |
$284.40
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
9812667001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$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
|
OP
|
$632.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$279.91 |
| Max. Negotiated Rate |
$600.40 |
| Rate for Payer: Aetna of VT Commercial |
$600.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$566.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$380.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$511.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$502.44
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$505.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$505.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.40
|
| Rate for Payer: Multiplan Commercial |
$587.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$537.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare Commercial |
$600.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$284.40
|
| Rate for Payer: United Healthcare VA CCN |
$284.40
|
|
|
TREAT FINGER DISLOCATION
|
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
|
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
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$259.56 |
| Max. Negotiated Rate |
$1,424.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,424.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$298.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$382.95
|
| Rate for Payer: Cash Price |
$757.50
|
| Rate for Payer: Cash Price |
$757.50
|
| Rate for Payer: Cigna Commercial |
$489.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$472.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$472.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$286.21
|
| Rate for Payer: Multiplan Commercial |
$1,408.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$368.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare Commercial |
$399.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.56
|
| Rate for Payer: United Healthcare VA CCN |
$259.56
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
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
|
$1,515.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9812677001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$670.99 |
| Max. Negotiated Rate |
$1,439.25 |
| Rate for Payer: Aetna of VT Commercial |
$1,439.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$670.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,357.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$912.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,287.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,227.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$681.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,204.42
|
| Rate for Payer: Cash Price |
$757.50
|
| Rate for Payer: Cigna Commercial |
$1,212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,212.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$1,408.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,287.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$681.75
|
| Rate for Payer: United Healthcare Commercial |
$1,439.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.75
|
| Rate for Payer: United Healthcare VA CCN |
$681.75
|
|
|
TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
9602677001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$480.10 |
| Max. Negotiated Rate |
$1,029.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,029.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$971.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$480.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$971.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$652.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$921.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$878.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$487.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$861.78
|
| Rate for Payer: Cash Price |
$542.00
|
| Rate for Payer: Cigna Commercial |
$867.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$867.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$867.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$487.80
|
| Rate for Payer: Multiplan Commercial |
$1,008.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$921.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$487.80
|
| Rate for Payer: United Healthcare Commercial |
$1,029.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$487.80
|
| Rate for Payer: United Healthcare VA CCN |
$487.80
|
|
|
TREAT FINGER DISLOCATION
|
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 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
|
Facility
|
OP
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$380.89 |
| 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 |
$770.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$380.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$770.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$517.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$696.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$387.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$683.70
|
| 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: Martins Point Health Care Commercial |
$387.00
|
| Rate for Payer: Multiplan Commercial |
$799.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$387.00
|
| Rate for Payer: United Healthcare Commercial |
$817.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.00
|
| Rate for Payer: United Healthcare VA CCN |
$387.00
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$894.78 |
| Max. Negotiated Rate |
$1,148.55 |
| Rate for Payer: Aetna of VT Commercial |
$1,148.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$894.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$894.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,027.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,015.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$967.20
|
| Rate for Payer: Cash Price |
$604.50
|
| Rate for Payer: Cigna Commercial |
$967.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$967.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$967.20
|
| Rate for Payer: Multiplan Commercial |
$1,124.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,027.65
|
| Rate for Payer: United Healthcare Commercial |
$1,148.55
|
|
|
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
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9822676501
|
|
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
|
Professional
|
Both
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$189.35 |
| Max. Negotiated Rate |
$462.48 |
| Rate for Payer: Aetna of VT Commercial |
$462.48
|
| 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 |
$195.03
|
| 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 |
$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 |
$246.00
|
| Rate for Payer: Cash Price |
$246.00
|
| 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 |
$457.56
|
| 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
|
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
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
5102672001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$180.97 |
| Max. Negotiated Rate |
$356.94 |
| Rate for Payer: Aetna of VT Commercial |
$189.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$180.97
|
| 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 |
$180.97
|
| 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 |
$101.00
|
| Rate for Payer: Cash Price |
$101.00
|
| 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 |
$187.86
|
| 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
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674202
|
|
Hospital Revenue Code
|
981
|
| 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
|
$1,259.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$931.79 |
| Max. Negotiated Rate |
$1,196.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,196.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$931.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$931.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,070.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,057.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,007.20
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cigna Commercial |
$1,007.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,007.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,007.20
|
| Rate for Payer: Multiplan Commercial |
$1,170.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,070.15
|
| Rate for Payer: United Healthcare Commercial |
$1,196.05
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$493.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
5102675501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$218.35 |
| Max. Negotiated Rate |
$468.35 |
| Rate for Payer: Aetna of VT Commercial |
$468.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$441.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$218.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$441.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$296.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$419.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$399.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$221.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$391.94
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cigna Commercial |
$394.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$394.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$394.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$221.85
|
| Rate for Payer: Multiplan Commercial |
$458.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$419.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$221.85
|
| Rate for Payer: United Healthcare Commercial |
$468.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$221.85
|
| Rate for Payer: United Healthcare VA CCN |
$221.85
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$803.01 |
| 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 |
$803.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$803.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$922.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$911.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$868.00
|
| 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: Multiplan Commercial |
$1,009.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$922.25
|
| Rate for Payer: United Healthcare Commercial |
$1,030.75
|
|
|
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
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674201
|
|
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
|
|
