|
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
|
IP
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9812672002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$364.13 |
| Max. Negotiated Rate |
$467.40 |
| Rate for Payer: Aetna of VT Commercial |
$467.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$364.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$364.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$418.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$413.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$393.60
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$393.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$393.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$393.60
|
| Rate for Payer: Multiplan Commercial |
$457.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$418.20
|
| Rate for Payer: United Healthcare Commercial |
$467.40
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672502
|
|
Hospital Revenue Code
|
960
|
| 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
|
OP
|
$654.01
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
4502674201
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.66 |
| Max. Negotiated Rate |
$621.31 |
| Rate for Payer: Aetna of VT Commercial |
$621.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$585.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$289.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$585.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$393.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$555.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$529.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$294.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$519.94
|
| Rate for Payer: Cash Price |
$327.00
|
| Rate for Payer: Cigna Commercial |
$523.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$523.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$523.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$294.30
|
| Rate for Payer: Multiplan Commercial |
$608.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$555.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$294.30
|
| Rate for Payer: United Healthcare Commercial |
$621.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$294.30
|
| Rate for Payer: United Healthcare VA CCN |
$294.30
|
|
|
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
|
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
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,418.00
|
|
|
Service Code
|
CPT 26727
|
| Hospital Charge Code |
9822672701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$628.03 |
| 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 |
$1,270.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$628.03
|
| 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 |
$853.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,205.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,148.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$638.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,127.31
|
| 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: Martins Point Health Care Commercial |
$638.10
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,205.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$638.10
|
| Rate for Payer: United Healthcare Commercial |
$1,347.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$638.10
|
| Rate for Payer: United Healthcare VA CCN |
$638.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$299.81 |
| Max. Negotiated Rate |
$808.40 |
| Rate for Payer: Aetna of VT Commercial |
$808.40
|
| 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 |
$308.80
|
| 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 |
$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 |
$430.00
|
| Rate for Payer: Cash Price |
$430.00
|
| 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 |
$799.80
|
| 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
|
$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
|
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
|
$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
|
Facility
|
IP
|
$202.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
5102672001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$149.50 |
| Max. Negotiated Rate |
$191.90 |
| Rate for Payer: Aetna of VT Commercial |
$191.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$149.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$149.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$169.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$161.60
|
| Rate for Payer: Cash Price |
$101.00
|
| Rate for Payer: Cigna Commercial |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$161.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$161.60
|
| Rate for Payer: Multiplan Commercial |
$187.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.70
|
| Rate for Payer: United Healthcare Commercial |
$191.90
|
|
|
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
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
5102672501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$177.16 |
| Max. Negotiated Rate |
$380.00 |
| Rate for Payer: Aetna of VT Commercial |
$380.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$358.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$177.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$358.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$240.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$340.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$324.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$318.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cigna Commercial |
$320.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$320.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$320.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$180.00
|
| Rate for Payer: Multiplan Commercial |
$372.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$340.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$180.00
|
| Rate for Payer: United Healthcare Commercial |
$380.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$180.00
|
| Rate for Payer: United Healthcare VA CCN |
$180.00
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673502
|
|
Hospital Revenue Code
|
960
|
| 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
|
Facility
|
IP
|
$493.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
5102675501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$364.87 |
| 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 |
$364.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$364.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$419.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$414.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$394.40
|
| 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: Multiplan Commercial |
$458.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$419.05
|
| Rate for Payer: United Healthcare Commercial |
$468.35
|
|
|
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
|
Facility
|
IP
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$636.49 |
| Max. Negotiated Rate |
$817.00 |
| Rate for Payer: Aetna of VT Commercial |
$817.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$722.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$688.00
|
| Rate for Payer: Cash Price |
$430.00
|
| Rate for Payer: Cigna Commercial |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$688.00
|
| Rate for Payer: Multiplan Commercial |
$799.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$817.00
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$2,436.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9602676501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,078.90 |
| 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 |
$2,182.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,078.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,182.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,466.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,070.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,973.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,096.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,936.62
|
| 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: Martins Point Health Care Commercial |
$1,096.20
|
| Rate for Payer: Multiplan Commercial |
$2,265.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,070.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,096.20
|
| Rate for Payer: United Healthcare Commercial |
$2,314.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,096.20
|
| Rate for Payer: United Healthcare VA CCN |
$1,096.20
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,182.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9812675501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$874.80 |
| Max. Negotiated Rate |
$1,122.90 |
| Rate for Payer: Aetna of VT Commercial |
$1,122.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$874.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$874.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,004.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$992.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$945.60
|
| Rate for Payer: Cash Price |
$591.00
|
| Rate for Payer: Cigna Commercial |
$945.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$945.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$945.60
|
| Rate for Payer: Multiplan Commercial |
$1,099.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,004.70
|
| Rate for Payer: United Healthcare Commercial |
$1,122.90
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,259.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$557.61 |
| 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 |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$557.61
|
| 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 |
$757.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,070.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,019.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$566.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,000.90
|
| 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: Martins Point Health Care Commercial |
$566.55
|
| Rate for Payer: Multiplan Commercial |
$1,170.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,070.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$566.55
|
| Rate for Payer: United Healthcare Commercial |
$1,196.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$566.55
|
| Rate for Payer: United Healthcare VA CCN |
$566.55
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9812675502
|
|
Hospital Revenue Code
|
981
|
| 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
|
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
|
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
|
$201.63
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
4502672001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.30 |
| Max. Negotiated Rate |
$191.55 |
| Rate for Payer: Aetna of VT Commercial |
$191.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$180.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$180.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$121.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$163.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$90.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$160.30
|
| Rate for Payer: Cash Price |
$100.82
|
| Rate for Payer: Cigna Commercial |
$161.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$161.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$161.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$90.73
|
| Rate for Payer: Multiplan Commercial |
$187.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$90.73
|
| Rate for Payer: United Healthcare Commercial |
$191.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$90.73
|
| Rate for Payer: United Healthcare VA CCN |
$90.73
|
|
