|
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
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9602675002
|
|
Hospital Revenue Code
|
960
|
| 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
|
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
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
5102676501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$485.99 |
| Max. Negotiated Rate |
$956.92 |
| Rate for Payer: Aetna of VT Commercial |
$956.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$912.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$500.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$912.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$680.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$558.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$603.75
|
| Rate for Payer: Cash Price |
$509.00
|
| Rate for Payer: Cash Price |
$509.00
|
| Rate for Payer: Cigna Commercial |
$919.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$803.34
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$803.34
|
| Rate for Payer: Martins Point Health Care Commercial |
$485.99
|
| Rate for Payer: Multiplan Commercial |
$946.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$690.11
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare Commercial |
$747.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare VA CCN |
$485.99
|
|
|
TREAT FINGER FRACTURE EACH
|
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
|
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
|
$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
|
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
|
Professional
|
Both
|
$2,436.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9602676501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$485.99 |
| Max. Negotiated Rate |
$2,289.84 |
| Rate for Payer: Aetna of VT Commercial |
$2,289.84
|
| 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 |
$500.57
|
| 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 |
$680.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$558.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$603.75
|
| Rate for Payer: Cash Price |
$1,218.00
|
| Rate for Payer: Cash Price |
$1,218.00
|
| Rate for Payer: Cigna Commercial |
$919.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$803.34
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$803.34
|
| Rate for Payer: Martins Point Health Care Commercial |
$485.99
|
| Rate for Payer: Multiplan Commercial |
$2,265.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$690.11
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare Commercial |
$747.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare VA CCN |
$485.99
|
|
|
TREAT FINGER FRACTURE EACH
|
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
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$328.09 |
| Max. Negotiated Rate |
$1,019.90 |
| Rate for Payer: Aetna of VT Commercial |
$1,019.90
|
| 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 |
$337.93
|
| 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 |
$459.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$377.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$625.65
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Cigna Commercial |
$619.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$604.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$604.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$366.95
|
| Rate for Payer: Multiplan Commercial |
$1,009.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$465.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare Commercial |
$504.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare VA CCN |
$328.09
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9812675501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$271.31 |
| Max. Negotiated Rate |
$1,111.08 |
| Rate for Payer: Aetna of VT Commercial |
$1,111.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,058.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,058.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$379.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$406.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$406.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$312.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$406.45
|
| Rate for Payer: Cash Price |
$591.00
|
| Rate for Payer: Cash Price |
$591.00
|
| Rate for Payer: Cigna Commercial |
$508.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$524.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$524.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$318.52
|
| Rate for Payer: Multiplan Commercial |
$1,099.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$385.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$271.31
|
| Rate for Payer: United Healthcare Commercial |
$417.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$271.31
|
| Rate for Payer: United Healthcare VA CCN |
$271.31
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674201
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$625.65 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$337.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$459.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$377.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$625.65
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$619.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$604.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$604.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$366.95
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$465.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare Commercial |
$504.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare VA CCN |
$328.09
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9812672002
|
|
Hospital Revenue Code
|
981
|
| 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
|
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
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9822674201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$328.09 |
| Max. Negotiated Rate |
$1,019.90 |
| Rate for Payer: Aetna of VT Commercial |
$1,019.90
|
| 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 |
$337.93
|
| 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 |
$459.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$625.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$377.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$625.65
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Cigna Commercial |
$619.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$604.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$604.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$366.95
|
| Rate for Payer: Multiplan Commercial |
$1,009.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$465.89
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare Commercial |
$504.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$328.09
|
| Rate for Payer: United Healthcare VA CCN |
$328.09
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$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
|
Facility
|
IP
|
$1,018.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
5102676501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$753.42 |
| Max. Negotiated Rate |
$967.10 |
| Rate for Payer: Aetna of VT Commercial |
$967.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$753.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$753.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$865.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$855.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$814.40
|
| Rate for Payer: Cash Price |
$509.00
|
| Rate for Payer: Cigna Commercial |
$814.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$814.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$814.40
|
| Rate for Payer: Multiplan Commercial |
$946.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$865.30
|
| Rate for Payer: United Healthcare Commercial |
$967.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9822676501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$485.99 |
| Max. Negotiated Rate |
$1,332.92 |
| Rate for Payer: Aetna of VT Commercial |
$1,332.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,270.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$500.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,270.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$680.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$603.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$558.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$603.75
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$919.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$803.34
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$803.34
|
| Rate for Payer: Martins Point Health Care Commercial |
$485.99
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$690.11
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare Commercial |
$747.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$485.99
|
| Rate for Payer: United Healthcare VA CCN |
$485.99
|
|
|
TREAT FINGER FRACTURE EACH
|
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
|
IP
|
$654.01
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
4502674201
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$484.03 |
| 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 |
$484.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$484.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$555.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$549.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$523.21
|
| 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: Multiplan Commercial |
$608.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$555.91
|
| Rate for Payer: United Healthcare Commercial |
$621.31
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$399.12
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
4502672501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$295.39 |
| Max. Negotiated Rate |
$379.16 |
| Rate for Payer: Aetna of VT Commercial |
$379.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$295.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$295.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$339.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$335.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$319.30
|
| Rate for Payer: Cash Price |
$199.56
|
| Rate for Payer: Cigna Commercial |
$319.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$319.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$319.30
|
| Rate for Payer: Multiplan Commercial |
$371.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$339.25
|
| Rate for Payer: United Healthcare Commercial |
$379.16
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,712.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
5102673501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,267.05 |
| Max. Negotiated Rate |
$1,626.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,626.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,267.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,267.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,455.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,438.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,369.60
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cigna Commercial |
$1,369.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,369.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,369.60
|
| Rate for Payer: Multiplan Commercial |
$1,592.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,455.20
|
| Rate for Payer: United Healthcare Commercial |
$1,626.40
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9602675002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$116.93 |
| 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 |
$236.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$116.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$236.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$158.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$224.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$213.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$118.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$209.88
|
| 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: Martins Point Health Care Commercial |
$118.80
|
| Rate for Payer: Multiplan Commercial |
$245.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$224.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$118.80
|
| Rate for Payer: United Healthcare Commercial |
$250.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$118.80
|
| Rate for Payer: United Healthcare VA CCN |
$118.80
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9822676501
|
|
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
|
|
