|
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 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
|
$1,418.00
|
|
|
Service Code
|
CPT 26727
|
| Hospital Charge Code |
9822672701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$628.03 |
| Max. Negotiated Rate |
$1,347.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,347.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,270.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$628.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,270.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$853.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,205.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,148.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$638.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,127.31
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,134.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$638.10
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,205.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$638.10
|
| Rate for Payer: United Healthcare Commercial |
$1,347.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$638.10
|
| Rate for Payer: United Healthcare VA CCN |
$638.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$636.49 |
| Max. Negotiated Rate |
$817.00 |
| Rate for Payer: Aetna of VT Commercial |
$817.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$722.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$688.00
|
| Rate for Payer: Cash Price |
$430.00
|
| Rate for Payer: Cigna Commercial |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$688.00
|
| Rate for Payer: Multiplan Commercial |
$799.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$817.00
|
|
|
TREAT FINGER FRACTURE EACH
|
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
|
Facility
|
IP
|
$493.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
5102675501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$468.35 |
| Rate for Payer: Aetna of VT Commercial |
$468.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$364.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$364.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$419.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$414.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$394.40
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cigna Commercial |
$394.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$394.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$394.40
|
| Rate for Payer: Multiplan Commercial |
$458.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$419.05
|
| Rate for Payer: United Healthcare Commercial |
$468.35
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$555.82 |
| Max. Negotiated Rate |
$713.45 |
| Rate for Payer: Aetna of VT Commercial |
$713.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$555.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$555.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$638.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$630.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$600.80
|
| Rate for Payer: Cash Price |
$375.50
|
| Rate for Payer: Cigna Commercial |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$600.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$600.80
|
| Rate for Payer: Multiplan Commercial |
$698.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$638.35
|
| Rate for Payer: United Healthcare Commercial |
$713.45
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
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
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9812675502
|
|
Hospital Revenue Code
|
981
|
| 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
|
$860.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9812672502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$636.49 |
| Max. Negotiated Rate |
$817.00 |
| Rate for Payer: Aetna of VT Commercial |
$817.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$722.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$688.00
|
| Rate for Payer: Cash Price |
$430.00
|
| Rate for Payer: Cigna Commercial |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$688.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$688.00
|
| Rate for Payer: Multiplan Commercial |
$799.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$817.00
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$201.63
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
4502672001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.30 |
| Max. Negotiated Rate |
$191.55 |
| Rate for Payer: Aetna of VT Commercial |
$191.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$180.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$89.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$180.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$121.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$171.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$163.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$90.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$160.30
|
| Rate for Payer: Cash Price |
$100.82
|
| Rate for Payer: Cigna Commercial |
$161.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$161.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$161.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$90.73
|
| Rate for Payer: Multiplan Commercial |
$187.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$171.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$90.73
|
| Rate for Payer: United Healthcare Commercial |
$191.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$90.73
|
| Rate for Payer: United Healthcare VA CCN |
$90.73
|
|
|
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
|
$1,418.00
|
|
|
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
|
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
|
|
|
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
|
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
|
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 FRACTURE OF RADIUS
|
Facility
|
OP
|
$1,265.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
9812550502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$560.27 |
| Max. Negotiated Rate |
$1,201.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,201.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,133.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$560.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,133.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$761.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,075.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,024.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$569.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,005.67
|
| Rate for Payer: Cash Price |
$632.50
|
| Rate for Payer: Cigna Commercial |
$1,012.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,012.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,012.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$569.25
|
| Rate for Payer: Multiplan Commercial |
$1,176.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,075.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$569.25
|
| Rate for Payer: United Healthcare Commercial |
$1,201.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$569.25
|
| Rate for Payer: United Healthcare VA CCN |
$569.25
|
|
|
TREAT FRACTURE OF RADIUS
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
9602550002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$237.41 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna of VT Commercial |
$249.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$264.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$359.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$388.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$388.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$295.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$388.26
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$484.25
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$466.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$466.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.23
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$364.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$256.93
|
| Rate for Payer: United Healthcare Commercial |
$395.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$256.93
|
| Rate for Payer: United Healthcare VA CCN |
$256.93
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$1,549.00
|
|
|
Service Code
|
CPT 25520
|
| Hospital Charge Code |
9602552002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$686.05 |
| Max. Negotiated Rate |
$1,471.55 |
| Rate for Payer: Aetna of VT Commercial |
$1,471.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,387.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$686.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,387.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$932.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,316.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,254.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$697.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,231.45
|
| Rate for Payer: Cash Price |
$774.50
|
| Rate for Payer: Cigna Commercial |
$1,239.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,239.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,239.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$697.05
|
| Rate for Payer: Multiplan Commercial |
$1,440.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,316.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$697.05
|
| Rate for Payer: United Healthcare Commercial |
$1,471.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$697.05
|
| Rate for Payer: United Healthcare VA CCN |
$697.05
|
|
|
TREAT FRACTURE OF RADIUS
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
9812550002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$237.41 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna of VT Commercial |
$249.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$264.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$359.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$388.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$388.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$295.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$388.26
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$484.25
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$466.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$466.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$284.23
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$364.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$256.93
|
| Rate for Payer: United Healthcare Commercial |
$395.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$256.93
|
| Rate for Payer: United Healthcare VA CCN |
$256.93
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
IP
|
$2,096.00
|
|
|
Service Code
|
CPT 25515
|
| Hospital Charge Code |
9822551501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,551.25 |
| Max. Negotiated Rate |
$1,991.20 |
| Rate for Payer: Aetna of VT Commercial |
$1,991.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,551.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,551.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,781.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,760.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,676.80
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cigna Commercial |
$1,676.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,676.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,676.80
|
| Rate for Payer: Multiplan Commercial |
$1,949.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,781.60
|
| Rate for Payer: United Healthcare Commercial |
$1,991.20
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
IP
|
$1,265.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
9812550502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$936.23 |
| Max. Negotiated Rate |
$1,201.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,201.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$936.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$936.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,075.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,062.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,012.00
|
| Rate for Payer: Cash Price |
$632.50
|
| Rate for Payer: Cigna Commercial |
$1,012.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,012.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,012.00
|
| Rate for Payer: Multiplan Commercial |
$1,176.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,075.25
|
| Rate for Payer: United Healthcare Commercial |
$1,201.75
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$265.00
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
9602550002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$117.37 |
| Max. Negotiated Rate |
$251.75 |
| Rate for Payer: Aetna of VT Commercial |
$251.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$117.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$237.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$159.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$214.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$119.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$210.68
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$212.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$212.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$119.25
|
| Rate for Payer: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119.25
|
| Rate for Payer: United Healthcare VA CCN |
$119.25
|
|
|
TREAT FRACTURE OF RADIUS
|
Professional
|
Both
|
$953.00
|
|
|
Service Code
|
CPT 25520
|
| Hospital Charge Code |
5102552001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$527.57 |
| Max. Negotiated Rate |
$997.14 |
| Rate for Payer: Aetna of VT Commercial |
$895.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$853.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$543.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$853.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$738.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$968.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$968.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$606.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$968.40
|
| Rate for Payer: Cash Price |
$476.50
|
| Rate for Payer: Cash Price |
$476.50
|
| Rate for Payer: Cigna Commercial |
$997.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$928.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$928.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$560.65
|
| Rate for Payer: Multiplan Commercial |
$886.29
|
| Rate for Payer: MVP Health Care of NY Commercial |
$749.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$527.57
|
| Rate for Payer: United Healthcare Commercial |
$811.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$527.57
|
| Rate for Payer: United Healthcare VA CCN |
$527.57
|
|
