|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,244.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$920.68 |
| Max. Negotiated Rate |
$1,181.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,181.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$920.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$920.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,057.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,044.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$995.20
|
| Rate for Payer: Cash Price |
$622.00
|
| Rate for Payer: Cigna Commercial |
$995.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$995.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$995.20
|
| Rate for Payer: Multiplan Commercial |
$1,156.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,057.40
|
| Rate for Payer: United Healthcare Commercial |
$1,181.80
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9822676501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,049.46 |
| Max. Negotiated Rate |
$1,347.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,347.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,205.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,191.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,134.40
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,134.40
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,205.30
|
| Rate for Payer: United Healthcare Commercial |
$1,347.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$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
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9602676502
|
|
Hospital Revenue Code
|
960
|
| 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
|
Facility
|
IP
|
$3,130.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,316.51 |
| Max. Negotiated Rate |
$2,973.50 |
| Rate for Payer: Aetna of VT Commercial |
$2,973.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,316.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,316.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,660.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,629.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,504.00
|
| Rate for Payer: Cash Price |
$1,565.00
|
| Rate for Payer: Cigna Commercial |
$2,504.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,504.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,504.00
|
| Rate for Payer: Multiplan Commercial |
$2,910.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,660.50
|
| Rate for Payer: United Healthcare Commercial |
$2,973.50
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$332.62 |
| Max. Negotiated Rate |
$713.45 |
| Rate for Payer: Aetna of VT Commercial |
$713.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$672.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$332.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$672.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$452.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$638.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$608.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$337.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$597.04
|
| Rate for Payer: Cash Price |
$375.50
|
| Rate for Payer: Cigna Commercial |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$600.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.95
|
| Rate for Payer: Multiplan Commercial |
$698.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$638.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$337.95
|
| Rate for Payer: United Healthcare Commercial |
$713.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.95
|
| Rate for Payer: United Healthcare VA CCN |
$337.95
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
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
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
5102672001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$180.97 |
| Max. Negotiated Rate |
$356.94 |
| Rate for Payer: Aetna of VT Commercial |
$189.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$180.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$195.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$180.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$265.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$217.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.64
|
| Rate for Payer: Cash Price |
$101.00
|
| Rate for Payer: Cash Price |
$101.00
|
| Rate for Payer: Cigna Commercial |
$356.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.87
|
| Rate for Payer: Multiplan Commercial |
$187.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$268.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare Commercial |
$291.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare VA CCN |
$189.35
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9602673502
|
|
Hospital Revenue Code
|
960
|
| 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
|
Facility
|
OP
|
$1,182.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9812675501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$523.51 |
| 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 |
$1,058.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$523.51
|
| 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 |
$711.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,004.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$957.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$531.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$939.69
|
| 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: Martins Point Health Care Commercial |
$531.90
|
| Rate for Payer: Multiplan Commercial |
$1,099.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,004.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$531.90
|
| Rate for Payer: United Healthcare Commercial |
$1,122.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$531.90
|
| Rate for Payer: United Healthcare VA CCN |
$531.90
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9822673501
|
|
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
|
$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
|
$1,085.00
|
|
|
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
|
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
|
OP
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$480.55 |
| Max. Negotiated Rate |
$1,030.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,030.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$972.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$480.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$972.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$653.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$922.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$878.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$488.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$862.58
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Cigna Commercial |
$868.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$868.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$868.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$488.25
|
| Rate for Payer: Multiplan Commercial |
$1,009.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$922.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$488.25
|
| Rate for Payer: United Healthcare Commercial |
$1,030.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$488.25
|
| Rate for Payer: United Healthcare VA CCN |
$488.25
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$201.63
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
4502672001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$149.23 |
| 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 |
$149.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$149.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$169.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$161.30
|
| 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: Multiplan Commercial |
$187.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.39
|
| Rate for Payer: United Healthcare Commercial |
$191.55
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
CPT 26727
|
| Hospital Charge Code |
9822672701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$459.17 |
| 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 |
$472.95
|
| 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 |
$642.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$689.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$689.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$528.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$689.68
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$869.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$758.59
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$758.59
|
| Rate for Payer: Martins Point Health Care Commercial |
$459.17
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$652.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$459.17
|
| Rate for Payer: United Healthcare Commercial |
$706.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$459.17
|
| Rate for Payer: United Healthcare VA CCN |
$459.17
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$358.80 |
| 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 |
$196.53
|
| 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 |
$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 |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| 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 |
$0.93
|
| 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
|
$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
|
$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
|
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
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
5102672501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$296.04 |
| 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 |
$296.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$296.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$340.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$320.00
|
| 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: Multiplan Commercial |
$372.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$340.00
|
| Rate for Payer: United Healthcare Commercial |
$380.00
|
|
|
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
|
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
|
$1,209.00
|
|
|
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
|
|
