|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
5102675001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$150.24 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Aetna of VT Commercial |
$192.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$150.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$150.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$170.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$162.40
|
| Rate for Payer: Cash Price |
$101.50
|
| Rate for Payer: Cigna Commercial |
$162.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$162.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$162.40
|
| Rate for Payer: Multiplan Commercial |
$188.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$172.55
|
| Rate for Payer: United Healthcare Commercial |
$192.85
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$299.81 |
| Max. Negotiated Rate |
$1,136.46 |
| Rate for Payer: Aetna of VT Commercial |
$1,136.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,083.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$308.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,083.14
|
| 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 |
$604.50
|
| Rate for Payer: Cash Price |
$604.50
|
| Rate for Payer: Cigna Commercial |
$566.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$555.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$555.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.72
|
| Rate for Payer: Multiplan Commercial |
$1,124.37
|
| 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
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675001
|
|
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
|
$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
|
$3,130.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$571.03 |
| Max. Negotiated Rate |
$2,942.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,942.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,804.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$588.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,804.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$799.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$712.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$712.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$656.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$712.16
|
| Rate for Payer: Cash Price |
$1,565.00
|
| Rate for Payer: Cash Price |
$1,565.00
|
| Rate for Payer: Cigna Commercial |
$1,079.61
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$946.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$946.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$571.03
|
| Rate for Payer: Multiplan Commercial |
$2,910.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare Commercial |
$878.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare VA CCN |
$571.03
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,018.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
5102676501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$450.87 |
| 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 |
$912.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$450.87
|
| 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 |
$612.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$865.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$824.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$458.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$809.31
|
| 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: Martins Point Health Care Commercial |
$458.10
|
| Rate for Payer: Multiplan Commercial |
$946.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$865.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$458.10
|
| Rate for Payer: United Healthcare Commercial |
$967.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$458.10
|
| Rate for Payer: United Healthcare VA CCN |
$458.10
|
|
|
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
|
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
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9822674201
|
|
Hospital Revenue Code
|
982
|
| 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
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$299.81 |
| Max. Negotiated Rate |
$1,183.46 |
| Rate for Payer: Aetna of VT Commercial |
$1,183.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$308.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$419.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$344.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.45
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cigna Commercial |
$566.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$555.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$555.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.72
|
| Rate for Payer: Multiplan Commercial |
$1,170.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$425.73
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$299.81
|
| Rate for Payer: United Healthcare Commercial |
$461.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$299.81
|
| Rate for Payer: United Healthcare VA CCN |
$299.81
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,712.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
5102673501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$758.24 |
| 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 |
$1,533.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$758.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,533.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,030.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,455.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,386.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$770.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,361.04
|
| 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: Martins Point Health Care Commercial |
$770.40
|
| Rate for Payer: Multiplan Commercial |
$1,592.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,455.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$770.40
|
| Rate for Payer: United Healthcare Commercial |
$1,626.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$770.40
|
| Rate for Payer: United Healthcare VA CCN |
$770.40
|
|
|
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
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$2,436.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9602676501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,802.88 |
| Max. Negotiated Rate |
$2,314.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,314.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,802.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,802.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,070.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,046.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,948.80
|
| Rate for Payer: Cash Price |
$1,218.00
|
| Rate for Payer: Cigna Commercial |
$1,948.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,948.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,948.80
|
| Rate for Payer: Multiplan Commercial |
$2,265.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,070.60
|
| Rate for Payer: United Healthcare Commercial |
$2,314.20
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$189.35 |
| Max. Negotiated Rate |
$652.36 |
| Rate for Payer: Aetna of VT Commercial |
$652.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$621.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$195.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$621.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$265.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$217.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.64
|
| Rate for Payer: Cash Price |
$347.00
|
| Rate for Payer: Cash Price |
$347.00
|
| Rate for Payer: Cigna Commercial |
$356.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.87
|
| Rate for Payer: Multiplan Commercial |
$645.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$268.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare Commercial |
$291.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare VA CCN |
$189.35
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9602676502
|
|
Hospital Revenue Code
|
960
|
| 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
|
OP
|
$399.12
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
4502672501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.77 |
| 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 |
$357.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$176.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$357.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$240.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$339.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$323.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$179.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$317.30
|
| 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: Martins Point Health Care Commercial |
$179.60
|
| Rate for Payer: Multiplan Commercial |
$371.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$339.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$179.60
|
| Rate for Payer: United Healthcare Commercial |
$379.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$179.60
|
| Rate for Payer: United Healthcare VA CCN |
$179.60
|
|
|
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
|
$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
|
Facility
|
OP
|
$202.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
5102672001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$89.47 |
| 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 |
$180.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.47
|
| 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 |
$121.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$163.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$90.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$160.59
|
| 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: Martins Point Health Care Commercial |
$90.90
|
| Rate for Payer: Multiplan Commercial |
$187.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$90.90
|
| Rate for Payer: United Healthcare Commercial |
$191.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$90.90
|
| Rate for Payer: United Healthcare VA CCN |
$90.90
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,049.46 |
| Max. Negotiated Rate |
$1,347.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,347.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,205.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,191.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,134.40
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,134.40
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,205.30
|
| Rate for Payer: United Healthcare Commercial |
$1,347.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672502
|
|
Hospital Revenue Code
|
960
|
| 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
|
Facility
|
IP
|
$694.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$513.63 |
| Max. Negotiated Rate |
$659.30 |
| Rate for Payer: Aetna of VT Commercial |
$659.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$513.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$513.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$589.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$582.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$555.20
|
| Rate for Payer: Cash Price |
$347.00
|
| Rate for Payer: Cigna Commercial |
$555.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$555.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$555.20
|
| Rate for Payer: Multiplan Commercial |
$645.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$589.90
|
| Rate for Payer: United Healthcare Commercial |
$659.30
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9602675002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$188.56 |
| Max. Negotiated Rate |
$358.80 |
| Rate for Payer: Aetna of VT Commercial |
$248.16
|
| 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 |
$196.53
|
| 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 |
$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 |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| 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 |
$245.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$270.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare Commercial |
$293.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$190.81
|
| Rate for Payer: United Healthcare VA CCN |
$190.81
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$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
|
|
