|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$399.12
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
4502672501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$295.39 |
| Max. Negotiated Rate |
$379.16 |
| Rate for Payer: Aetna of VT Commercial |
$379.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$295.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$295.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$339.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$335.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$319.30
|
| Rate for Payer: Cash Price |
$199.56
|
| Rate for Payer: Cigna Commercial |
$319.30
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$319.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$319.30
|
| Rate for Payer: Multiplan Commercial |
$371.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$339.25
|
| Rate for Payer: United Healthcare Commercial |
$379.16
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$189.35 |
| Max. Negotiated Rate |
$462.48 |
| Rate for Payer: Aetna of VT Commercial |
$462.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$195.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$265.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$217.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.64
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$356.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.87
|
| Rate for Payer: Multiplan Commercial |
$457.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$268.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare Commercial |
$291.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare VA CCN |
$189.35
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 26727
|
| Hospital Charge Code |
9822672701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,049.46 |
| Max. Negotiated Rate |
$1,347.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,347.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,049.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,205.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,191.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,134.40
|
| Rate for Payer: Cash Price |
$709.00
|
| Rate for Payer: Cigna Commercial |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,134.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,134.40
|
| Rate for Payer: Multiplan Commercial |
$1,318.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,205.30
|
| Rate for Payer: United Healthcare Commercial |
$1,347.10
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,712.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
5102673501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,267.05 |
| Max. Negotiated Rate |
$1,626.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,626.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,267.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,267.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,455.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,438.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,369.60
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cigna Commercial |
$1,369.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,369.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,369.60
|
| Rate for Payer: Multiplan Commercial |
$1,592.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,455.20
|
| Rate for Payer: United Healthcare Commercial |
$1,626.40
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
9822673501
|
|
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
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9812672002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$189.35 |
| Max. Negotiated Rate |
$462.48 |
| Rate for Payer: Aetna of VT Commercial |
$462.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$195.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$265.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$277.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$217.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$277.64
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$356.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$331.21
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$331.21
|
| Rate for Payer: Martins Point Health Care Commercial |
$201.87
|
| Rate for Payer: Multiplan Commercial |
$457.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$268.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare Commercial |
$291.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$189.35
|
| Rate for Payer: United Healthcare VA CCN |
$189.35
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,244.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
9602675501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$550.97 |
| 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 |
$1,114.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$550.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,114.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$748.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,057.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,007.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$559.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$988.98
|
| 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: Martins Point Health Care Commercial |
$559.80
|
| Rate for Payer: Multiplan Commercial |
$1,156.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,057.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$559.80
|
| Rate for Payer: United Healthcare Commercial |
$1,181.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$559.80
|
| Rate for Payer: United Healthcare VA CCN |
$559.80
|
|
|
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
|
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
|
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
|
$1,418.00
|
|
|
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
|
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
|
OP
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9812672002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$217.91 |
| Max. Negotiated Rate |
$467.40 |
| Rate for Payer: Aetna of VT Commercial |
$467.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$217.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$440.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$296.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$418.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$398.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$221.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$391.14
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$393.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$393.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$393.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$221.40
|
| Rate for Payer: Multiplan Commercial |
$457.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$418.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$221.40
|
| Rate for Payer: United Healthcare Commercial |
$467.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$221.40
|
| Rate for Payer: United Healthcare VA CCN |
$221.40
|
|
|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$493.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
5102675501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$271.31 |
| Max. Negotiated Rate |
$524.60 |
| Rate for Payer: Aetna of VT Commercial |
$463.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$441.68
|
| 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 |
$441.68
|
| 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 |
$246.50
|
| Rate for Payer: Cash Price |
$246.50
|
| 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 |
$458.49
|
| 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
|
OP
|
$694.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9602672001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$307.37 |
| Max. Negotiated Rate |
$659.30 |
| Rate for Payer: Aetna of VT Commercial |
$659.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$621.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$307.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$621.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$417.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$589.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$562.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$312.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$551.73
|
| Rate for Payer: Cash Price |
$347.00
|
| Rate for Payer: Cigna Commercial |
$555.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$555.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$555.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$312.30
|
| Rate for Payer: Multiplan Commercial |
$645.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$589.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$312.30
|
| Rate for Payer: United Healthcare Commercial |
$659.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$312.30
|
| Rate for Payer: United Healthcare VA CCN |
$312.30
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,085.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
9812674202
|
|
Hospital Revenue Code
|
981
|
| 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
|
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 FRACTURE OF RADIUS
|
Facility
|
IP
|
$1,791.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
5102550501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,325.52 |
| Max. Negotiated Rate |
$1,701.45 |
| Rate for Payer: Aetna of VT Commercial |
$1,701.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,325.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,325.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,522.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,504.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,432.80
|
| Rate for Payer: Cash Price |
$895.50
|
| Rate for Payer: Cigna Commercial |
$1,432.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,432.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,432.80
|
| Rate for Payer: Multiplan Commercial |
$1,665.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,522.35
|
| Rate for Payer: United Healthcare Commercial |
$1,701.45
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$2,096.00
|
|
|
Service Code
|
CPT 25515
|
| Hospital Charge Code |
9822551501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$928.32 |
| 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 |
$1,877.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$928.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,877.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,261.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,781.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,697.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$943.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,666.32
|
| 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: Martins Point Health Care Commercial |
$943.20
|
| Rate for Payer: Multiplan Commercial |
$1,949.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,781.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$943.20
|
| Rate for Payer: United Healthcare Commercial |
$1,991.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$943.20
|
| Rate for Payer: United Healthcare VA CCN |
$943.20
|
|
|
TREAT FRACTURE OF RADIUS
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
CPT 25520
|
| Hospital Charge Code |
9812552002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$527.57 |
| Max. Negotiated Rate |
$1,456.06 |
| Rate for Payer: Aetna of VT Commercial |
$1,456.06
|
| 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 |
$543.40
|
| 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 |
$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 |
$774.50
|
| Rate for Payer: Cash Price |
$774.50
|
| 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 |
$1,440.57
|
| 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
|
|
|
TREAT FRACTURE OF RADIUS
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
9602550001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$256.93 |
| Max. Negotiated Rate |
$816.86 |
| Rate for Payer: Aetna of VT Commercial |
$816.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$778.54
|
| 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 |
$778.54
|
| 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 |
$434.50
|
| Rate for Payer: Cash Price |
$434.50
|
| 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 |
$808.17
|
| 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
|
Professional
|
Both
|
$2,502.00
|
|
|
Service Code
|
CPT 25520
|
| Hospital Charge Code |
9602552001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$527.57 |
| Max. Negotiated Rate |
$2,351.88 |
| Rate for Payer: Aetna of VT Commercial |
$2,351.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,241.54
|
| 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 |
$2,241.54
|
| 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 |
$1,251.00
|
| Rate for Payer: Cash Price |
$1,251.00
|
| 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 |
$2,326.86
|
| 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
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$3,056.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
9602550501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,353.50 |
| Max. Negotiated Rate |
$2,903.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,903.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,737.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,353.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,737.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,839.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,597.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,475.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,375.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,429.52
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cigna Commercial |
$2,444.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,444.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,444.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,375.20
|
| Rate for Payer: Multiplan Commercial |
$2,842.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,597.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,375.20
|
| Rate for Payer: United Healthcare Commercial |
$2,903.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,375.20
|
| Rate for Payer: United Healthcare VA CCN |
$1,375.20
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$952.83
|
|
|
Service Code
|
CPT 25520
|
| Hospital Charge Code |
4502552001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$422.01 |
| Max. Negotiated Rate |
$905.19 |
| Rate for Payer: Aetna of VT Commercial |
$905.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$853.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$422.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$853.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$573.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$809.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$771.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$428.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$757.50
|
| Rate for Payer: Cash Price |
$476.42
|
| Rate for Payer: Cigna Commercial |
$762.26
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$762.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$762.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$428.77
|
| Rate for Payer: Multiplan Commercial |
$886.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$809.91
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$428.77
|
| Rate for Payer: United Healthcare Commercial |
$905.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$428.77
|
| Rate for Payer: United Healthcare VA CCN |
$428.77
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
IP
|
$1,549.00
|
|
|
Service Code
|
CPT 25520
|
| Hospital Charge Code |
9812552001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,146.41 |
| 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 |
$1,146.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,146.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,316.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,301.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,239.20
|
| 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: Multiplan Commercial |
$1,440.57
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,316.65
|
| Rate for Payer: United Healthcare Commercial |
$1,471.55
|
|
