|
TREAT FINGER FRACTURE EACH
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$299.81 |
| Max. Negotiated Rate |
$1,183.46 |
| Rate for Payer: Aetna of VT Commercial |
$1,183.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$308.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$419.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$344.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.45
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cigna Commercial |
$566.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$555.96
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$555.96
|
| Rate for Payer: Martins Point Health Care Commercial |
$337.72
|
| Rate for Payer: Multiplan Commercial |
$1,170.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$425.73
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$299.81
|
| Rate for Payer: United Healthcare Commercial |
$461.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$299.81
|
| Rate for Payer: United Healthcare VA CCN |
$299.81
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
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
|
$492.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
9812672002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$364.13 |
| 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 |
$364.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$364.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$418.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$413.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$393.60
|
| 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: Multiplan Commercial |
$457.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$418.20
|
| Rate for Payer: United Healthcare Commercial |
$467.40
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
OP
|
$1,259.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$557.61 |
| Max. Negotiated Rate |
$1,196.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,196.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$557.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,127.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$757.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,070.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,019.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$566.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,000.90
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cigna Commercial |
$1,007.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,007.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,007.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$566.55
|
| Rate for Payer: Multiplan Commercial |
$1,170.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,070.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$566.55
|
| Rate for Payer: United Healthcare Commercial |
$1,196.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$566.55
|
| Rate for Payer: United Healthcare VA CCN |
$566.55
|
|
|
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
|
Professional
|
Both
|
$2,024.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
9822674601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$707.25 |
| Max. Negotiated Rate |
$1,902.56 |
| Rate for Payer: Aetna of VT Commercial |
$1,902.56
|
| 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 |
$728.47
|
| 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 |
$990.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$886.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$886.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$813.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$886.43
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cigna Commercial |
$1,336.84
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,174.15
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,174.15
|
| Rate for Payer: Martins Point Health Care Commercial |
$707.25
|
| Rate for Payer: Multiplan Commercial |
$1,882.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,004.29
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$707.25
|
| Rate for Payer: United Healthcare Commercial |
$1,087.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$707.25
|
| Rate for Payer: United Healthcare VA CCN |
$707.25
|
|
|
TREAT FINGER FRACTURE EACH
|
Facility
|
IP
|
$1,259.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
9602672501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$931.79 |
| Max. Negotiated Rate |
$1,196.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,196.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$931.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$931.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,070.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,057.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,007.20
|
| Rate for Payer: Cash Price |
$629.50
|
| Rate for Payer: Cigna Commercial |
$1,007.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,007.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,007.20
|
| Rate for Payer: Multiplan Commercial |
$1,170.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,070.15
|
| Rate for Payer: United Healthcare Commercial |
$1,196.05
|
|
|
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
|
$400.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
5102672501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$177.16 |
| 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 |
$358.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$177.16
|
| 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 |
$240.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$340.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$324.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$318.00
|
| 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: Martins Point Health Care Commercial |
$180.00
|
| Rate for Payer: Multiplan Commercial |
$372.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$340.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$180.00
|
| Rate for Payer: United Healthcare Commercial |
$380.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$180.00
|
| Rate for Payer: United Healthcare VA CCN |
$180.00
|
|
|
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
|
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
|
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 26735
|
| Hospital Charge Code |
9822673501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$571.03 |
| 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 |
$588.16
|
| 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 |
$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 |
$709.00
|
| Rate for Payer: Cash Price |
$709.00
|
| 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 |
$1,318.74
|
| 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
|
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
|
$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
|
OP
|
$492.96
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
4502675501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$468.31 |
| Rate for Payer: Aetna of VT Commercial |
$468.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$441.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$218.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$441.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$296.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$419.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$399.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$221.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$391.90
|
| Rate for Payer: Cash Price |
$246.48
|
| Rate for Payer: Cigna Commercial |
$394.37
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$394.37
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$394.37
|
| Rate for Payer: Martins Point Health Care Commercial |
$221.83
|
| Rate for Payer: Multiplan Commercial |
$458.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$419.02
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$221.83
|
| Rate for Payer: United Healthcare Commercial |
$468.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$221.83
|
| Rate for Payer: United Healthcare VA CCN |
$221.83
|
|
|
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 FRACTURE OF RADIUS
|
Professional
|
Both
|
$2,096.00
|
|
|
Service Code
|
CPT 25515
|
| Hospital Charge Code |
9822551501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$639.48 |
| Max. Negotiated Rate |
$1,970.24 |
| Rate for Payer: Aetna of VT Commercial |
$1,970.24
|
| 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 |
$658.67
|
| 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 |
$895.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,075.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,075.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$735.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,075.32
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cigna Commercial |
$1,210.44
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,063.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,063.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$639.48
|
| Rate for Payer: Multiplan Commercial |
$1,949.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$908.08
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$639.49
|
| Rate for Payer: United Healthcare Commercial |
$983.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$639.49
|
| Rate for Payer: United Healthcare VA CCN |
$639.49
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
IP
|
$1,265.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
9602550502
|
|
Hospital Revenue Code
|
960
|
| 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
|
$2,504.00
|
|
|
Service Code
|
CPT 25525
|
| Hospital Charge Code |
9822552501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,109.02 |
| Max. Negotiated Rate |
$2,378.80 |
| Rate for Payer: Aetna of VT Commercial |
$2,378.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,243.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,109.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,243.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,507.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,128.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,028.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,126.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,990.68
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cigna Commercial |
$2,003.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,003.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,003.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,126.80
|
| Rate for Payer: Multiplan Commercial |
$2,328.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,128.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,126.80
|
| Rate for Payer: United Healthcare Commercial |
$2,378.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,126.80
|
| Rate for Payer: United Healthcare VA CCN |
$1,126.80
|
|
|
TREAT FRACTURE OF RADIUS
|
Professional
|
Both
|
$1,292.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
9812550501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$447.35 |
| Max. Negotiated Rate |
$1,214.48 |
| Rate for Payer: Aetna of VT Commercial |
$1,214.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$460.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$626.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$739.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$739.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$514.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$739.10
|
| Rate for Payer: Cash Price |
$646.00
|
| Rate for Payer: Cash Price |
$646.00
|
| Rate for Payer: Cigna Commercial |
$848.79
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$819.29
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$819.29
|
| Rate for Payer: Martins Point Health Care Commercial |
$495.85
|
| Rate for Payer: Multiplan Commercial |
$1,201.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$635.24
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$447.35
|
| Rate for Payer: United Healthcare Commercial |
$688.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$447.35
|
| Rate for Payer: United Healthcare VA CCN |
$447.35
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$604.00
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
5102550001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$267.51 |
| Max. Negotiated Rate |
$573.80 |
| Rate for Payer: Aetna of VT Commercial |
$573.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$541.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$267.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$541.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$363.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$513.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$489.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$271.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$480.18
|
| Rate for Payer: Cash Price |
$302.00
|
| Rate for Payer: Cigna Commercial |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$483.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$483.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$271.80
|
| Rate for Payer: Multiplan Commercial |
$561.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$513.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$271.80
|
| Rate for Payer: United Healthcare Commercial |
$573.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$271.80
|
| Rate for Payer: United Healthcare VA CCN |
$271.80
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
IP
|
$265.00
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
9602550002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$196.13 |
| 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 |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$196.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$225.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$222.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$212.00
|
| 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: Multiplan Commercial |
$246.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$225.25
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$265.00
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
9812550002
|
|
Hospital Revenue Code
|
981
|
| 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
|
$3,056.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
9602550501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$447.35 |
| Max. Negotiated Rate |
$2,872.64 |
| Rate for Payer: Aetna of VT Commercial |
$2,872.64
|
| 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 |
$460.77
|
| 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 |
$626.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$739.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$739.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$514.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$739.10
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cigna Commercial |
$848.79
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$819.29
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$819.29
|
| Rate for Payer: Martins Point Health Care Commercial |
$495.85
|
| Rate for Payer: Multiplan Commercial |
$2,842.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$635.24
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$447.35
|
| Rate for Payer: United Healthcare Commercial |
$688.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$447.35
|
| Rate for Payer: United Healthcare VA CCN |
$447.35
|
|
