|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$271.31 |
| Max. Negotiated Rate |
$705.94 |
| Rate for Payer: Aetna of VT Commercial |
$705.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$672.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$672.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$379.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$406.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$406.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$312.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$406.45
|
| Rate for Payer: Cash Price |
$375.50
|
| Rate for Payer: Cash Price |
$375.50
|
| Rate for Payer: Cigna Commercial |
$508.65
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$524.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$524.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$318.52
|
| Rate for Payer: Multiplan Commercial |
$698.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$385.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$271.31
|
| Rate for Payer: United Healthcare Commercial |
$417.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$271.31
|
| Rate for Payer: United Healthcare VA CCN |
$271.31
|
|
|
TREAT FINGER FRACTURE EACH
|
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
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
9812675002
|
|
Hospital Revenue Code
|
981
|
| 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
|
IP
|
$202.66
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
4502675001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$149.99 |
| Max. Negotiated Rate |
$192.53 |
| Rate for Payer: Aetna of VT Commercial |
$192.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$149.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$149.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$170.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$162.13
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cigna Commercial |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$162.13
|
| Rate for Payer: Multiplan Commercial |
$188.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$172.26
|
| Rate for Payer: United Healthcare Commercial |
$192.53
|
|
|
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
|
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
|
$203.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
5102675001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$89.91 |
| 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 |
$181.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$181.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$122.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$164.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$91.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$161.38
|
| 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: Martins Point Health Care Commercial |
$91.35
|
| Rate for Payer: Multiplan Commercial |
$188.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$172.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.35
|
| Rate for Payer: United Healthcare Commercial |
$192.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.35
|
| Rate for Payer: United Healthcare VA CCN |
$91.35
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,712.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
5102673501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$571.03 |
| Max. Negotiated Rate |
$1,609.28 |
| Rate for Payer: Aetna of VT Commercial |
$1,609.28
|
| 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 |
$588.16
|
| 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 |
$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 |
$856.00
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cigna Commercial |
$1,079.61
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$946.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$946.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$571.03
|
| Rate for Payer: Multiplan Commercial |
$1,592.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$810.86
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare Commercial |
$878.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$571.03
|
| Rate for Payer: United Healthcare VA CCN |
$571.03
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$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
|
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
|
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
|
$202.66
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
4502675001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$192.53 |
| Rate for Payer: Aetna of VT Commercial |
$192.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$181.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$181.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$122.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$172.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$164.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$91.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$161.11
|
| Rate for Payer: Cash Price |
$101.33
|
| Rate for Payer: Cigna Commercial |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$162.13
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$162.13
|
| Rate for Payer: Martins Point Health Care Commercial |
$91.20
|
| Rate for Payer: Multiplan Commercial |
$188.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$172.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$91.20
|
| Rate for Payer: United Healthcare Commercial |
$192.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.20
|
| Rate for Payer: United Healthcare VA CCN |
$91.20
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$2,024.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
9822674601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,497.96 |
| Max. Negotiated Rate |
$1,922.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,922.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,497.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,497.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,720.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,700.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,619.20
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cigna Commercial |
$1,619.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,619.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,619.20
|
| Rate for Payer: Multiplan Commercial |
$1,882.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,720.40
|
| Rate for Payer: United Healthcare Commercial |
$1,922.80
|
|
|
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
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
9602676502
|
|
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
|
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
|
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
|
$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
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$2,024.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
9822674601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$896.43 |
| Max. Negotiated Rate |
$1,922.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,922.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,813.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$896.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,813.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,218.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,720.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,639.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$910.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,609.08
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cigna Commercial |
$1,619.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,619.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,619.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$910.80
|
| Rate for Payer: Multiplan Commercial |
$1,882.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,720.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$910.80
|
| Rate for Payer: United Healthcare Commercial |
$1,922.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$910.80
|
| Rate for Payer: United Healthcare VA CCN |
$910.80
|
|
|
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
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$380.89 |
| Max. Negotiated Rate |
$817.00 |
| Rate for Payer: Aetna of VT Commercial |
$817.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$770.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$380.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$770.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$517.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$696.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$387.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$683.70
|
| Rate for Payer: Cash Price |
$430.00
|
| Rate for Payer: Cigna Commercial |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$688.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$387.00
|
| Rate for Payer: Multiplan Commercial |
$799.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$387.00
|
| Rate for Payer: United Healthcare Commercial |
$817.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.00
|
| Rate for Payer: United Healthcare VA CCN |
$387.00
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9812675502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$555.82 |
| Max. Negotiated Rate |
$713.45 |
| Rate for Payer: Aetna of VT Commercial |
$713.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$555.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$555.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$638.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$630.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$600.80
|
| Rate for Payer: Cash Price |
$375.50
|
| Rate for Payer: Cigna Commercial |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$600.80
|
| Rate for Payer: Multiplan Commercial |
$698.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$638.35
|
| Rate for Payer: United Healthcare Commercial |
$713.45
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
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
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
5102672501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$299.81 |
| Max. Negotiated Rate |
$566.22 |
| Rate for Payer: Aetna of VT Commercial |
$376.00
|
| 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 |
$308.80
|
| 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 |
$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 |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| 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 |
$372.00
|
| 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
|
$1,209.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$535.47 |
| 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 |
$1,083.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$535.47
|
| 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 |
$727.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,027.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$979.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$544.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$961.15
|
| 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: Martins Point Health Care Commercial |
$544.05
|
| Rate for Payer: Multiplan Commercial |
$1,124.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,027.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$544.05
|
| Rate for Payer: United Healthcare Commercial |
$1,148.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$544.05
|
| Rate for Payer: United Healthcare VA CCN |
$544.05
|
|
