|
TREAT FRACTURE RADIUS & ULNA
|
Professional
|
Both
|
$725.00
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
9812556001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$258.06 |
| Max. Negotiated Rate |
$681.50 |
| Rate for Payer: Aetna of VT Commercial |
$681.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$649.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$265.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$649.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$361.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$387.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$387.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.31
|
| Rate for Payer: Cash Price |
$362.50
|
| Rate for Payer: Cash Price |
$362.50
|
| Rate for Payer: Cigna Commercial |
$486.41
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$475.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$475.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$289.54
|
| Rate for Payer: Multiplan Commercial |
$674.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$366.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$258.06
|
| Rate for Payer: United Healthcare Commercial |
$396.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$258.06
|
| Rate for Payer: United Healthcare VA CCN |
$258.06
|
|
|
TREAT FRACTURE RADIUS & ULNA
|
Professional
|
Both
|
$1,364.00
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
9602556001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$258.06 |
| Max. Negotiated Rate |
$1,282.16 |
| Rate for Payer: Aetna of VT Commercial |
$1,282.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,222.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$265.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,222.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$361.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$387.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$387.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.31
|
| Rate for Payer: Cash Price |
$682.00
|
| Rate for Payer: Cash Price |
$682.00
|
| Rate for Payer: Cigna Commercial |
$486.41
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$475.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$475.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$289.54
|
| Rate for Payer: Multiplan Commercial |
$1,268.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$366.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$258.06
|
| Rate for Payer: United Healthcare Commercial |
$396.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$258.06
|
| Rate for Payer: United Healthcare VA CCN |
$258.06
|
|
|
TREAT FRACTURE RADIUS & ULNA
|
Professional
|
Both
|
$725.00
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
9812556002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$258.06 |
| Max. Negotiated Rate |
$681.50 |
| Rate for Payer: Aetna of VT Commercial |
$681.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$649.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$265.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$649.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$361.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$387.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$387.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.31
|
| Rate for Payer: Cash Price |
$362.50
|
| Rate for Payer: Cash Price |
$362.50
|
| Rate for Payer: Cigna Commercial |
$486.41
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$475.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$475.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$289.54
|
| Rate for Payer: Multiplan Commercial |
$674.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$366.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$258.06
|
| Rate for Payer: United Healthcare Commercial |
$396.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$258.06
|
| Rate for Payer: United Healthcare VA CCN |
$258.06
|
|
|
TREAT FRACTURE RADIUS & ULNA
|
Facility
|
IP
|
$725.00
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
9812556001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$536.57 |
| Max. Negotiated Rate |
$688.75 |
| Rate for Payer: Aetna of VT Commercial |
$688.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$536.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$536.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$616.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$609.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$580.00
|
| Rate for Payer: Cash Price |
$362.50
|
| Rate for Payer: Cigna Commercial |
$580.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$580.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$580.00
|
| Rate for Payer: Multiplan Commercial |
$674.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$616.25
|
| Rate for Payer: United Healthcare Commercial |
$688.75
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$1,398.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9812560502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,034.66 |
| Max. Negotiated Rate |
$1,328.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,328.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,034.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,034.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,188.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,174.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,118.40
|
| Rate for Payer: Cash Price |
$699.00
|
| Rate for Payer: Cigna Commercial |
$1,118.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,118.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,118.40
|
| Rate for Payer: Multiplan Commercial |
$1,300.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,188.30
|
| Rate for Payer: United Healthcare Commercial |
$1,328.10
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
5102560001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$324.13 |
| Max. Negotiated Rate |
$610.22 |
| Rate for Payer: Aetna of VT Commercial |
$344.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$328.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$333.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$328.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$453.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$372.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$452.90
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cigna Commercial |
$610.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$553.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$553.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$338.26
|
| Rate for Payer: Multiplan Commercial |
$341.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$460.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare Commercial |
$498.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare VA CCN |
$324.13
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9812560002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$324.13 |
| Max. Negotiated Rate |
$835.66 |
| Rate for Payer: Aetna of VT Commercial |
$835.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$796.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$333.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$796.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$453.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$372.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$452.90
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: Cigna Commercial |
$610.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$553.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$553.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$338.26
|
| Rate for Payer: Multiplan Commercial |
$826.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$460.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare Commercial |
$498.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare VA CCN |
$324.13
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$1,772.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9812560501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,311.46 |
| Max. Negotiated Rate |
$1,683.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,683.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,311.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,311.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,506.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,488.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,417.60
|
| Rate for Payer: Cash Price |
$886.00
|
| Rate for Payer: Cigna Commercial |
$1,417.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,417.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,417.60
|
| Rate for Payer: Multiplan Commercial |
$1,647.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,506.20
|
| Rate for Payer: United Healthcare Commercial |
$1,683.40
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9812560502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$493.57 |
| Max. Negotiated Rate |
$1,314.12 |
| Rate for Payer: Aetna of VT Commercial |
$1,314.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,252.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$508.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,252.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$691.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$848.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$848.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$567.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$848.62
|
| Rate for Payer: Cash Price |
$699.00
|
| Rate for Payer: Cash Price |
$699.00
|
| Rate for Payer: Cigna Commercial |
$936.19
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$868.66
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$868.66
|
| Rate for Payer: Martins Point Health Care Commercial |
$524.41
|
| Rate for Payer: Multiplan Commercial |
$1,300.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$700.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$493.57
|
| Rate for Payer: United Healthcare Commercial |
$759.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$493.57
|
| Rate for Payer: United Healthcare VA CCN |
$493.57
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$1,627.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
5102560501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,204.14 |
| Max. Negotiated Rate |
$1,545.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,545.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,204.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,204.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,366.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,301.60
|
| Rate for Payer: Cash Price |
$813.50
|
| Rate for Payer: Cigna Commercial |
$1,301.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,301.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,301.60
|
| Rate for Payer: Multiplan Commercial |
$1,513.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,382.95
|
| Rate for Payer: United Healthcare Commercial |
$1,545.65
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
OP
|
$3,025.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9602560501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,339.77 |
| Max. Negotiated Rate |
$2,873.75 |
| Rate for Payer: Aetna of VT Commercial |
$2,873.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,710.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,339.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,710.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,821.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,571.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,450.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,361.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,404.88
|
| Rate for Payer: Cash Price |
$1,512.50
|
| Rate for Payer: Cigna Commercial |
$2,420.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,420.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,420.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,361.25
|
| Rate for Payer: Multiplan Commercial |
$2,813.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,571.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,361.25
|
| Rate for Payer: United Healthcare Commercial |
$2,873.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,361.25
|
| Rate for Payer: United Healthcare VA CCN |
$1,361.25
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9812560001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| 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 |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| 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 |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| 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: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$1,398.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9602560502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,034.66 |
| Max. Negotiated Rate |
$1,328.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,328.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,034.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,034.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,188.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,174.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,118.40
|
| Rate for Payer: Cash Price |
$699.00
|
| Rate for Payer: Cigna Commercial |
$1,118.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,118.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,118.40
|
| Rate for Payer: Multiplan Commercial |
$1,300.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,188.30
|
| Rate for Payer: United Healthcare Commercial |
$1,328.10
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
OP
|
$1,626.48
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
4502560501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$720.37 |
| Max. Negotiated Rate |
$1,545.16 |
| Rate for Payer: Aetna of VT Commercial |
$1,545.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,457.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$720.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,457.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$979.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,382.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,317.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$731.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,293.05
|
| Rate for Payer: Cash Price |
$813.24
|
| Rate for Payer: Cigna Commercial |
$1,301.18
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,301.18
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,301.18
|
| Rate for Payer: Martins Point Health Care Commercial |
$731.92
|
| Rate for Payer: Multiplan Commercial |
$1,512.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,382.51
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$731.92
|
| Rate for Payer: United Healthcare Commercial |
$1,545.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$731.92
|
| Rate for Payer: United Healthcare VA CCN |
$731.92
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$1,255.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9602560001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$928.83 |
| Max. Negotiated Rate |
$1,192.25 |
| Rate for Payer: Aetna of VT Commercial |
$1,192.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$928.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$928.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,066.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,054.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,004.00
|
| Rate for Payer: Cash Price |
$627.50
|
| Rate for Payer: Cigna Commercial |
$1,004.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,004.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,004.00
|
| Rate for Payer: Multiplan Commercial |
$1,167.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,066.75
|
| Rate for Payer: United Healthcare Commercial |
$1,192.25
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$889.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9812560002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$657.95 |
| Max. Negotiated Rate |
$844.55 |
| Rate for Payer: Aetna of VT Commercial |
$844.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$657.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$657.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$755.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$746.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$711.20
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: Cigna Commercial |
$711.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$711.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$711.20
|
| Rate for Payer: Multiplan Commercial |
$826.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$755.65
|
| Rate for Payer: United Healthcare Commercial |
$844.55
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$889.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9602560002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$657.95 |
| Max. Negotiated Rate |
$844.55 |
| Rate for Payer: Aetna of VT Commercial |
$844.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$657.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$657.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$755.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$746.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$711.20
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: Cigna Commercial |
$711.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$711.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$711.20
|
| Rate for Payer: Multiplan Commercial |
$826.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$755.65
|
| Rate for Payer: United Healthcare Commercial |
$844.55
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
5102560001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$162.54 |
| Max. Negotiated Rate |
$348.65 |
| Rate for Payer: Aetna of VT Commercial |
$348.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$328.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$162.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$328.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$220.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$311.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$297.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$165.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$291.76
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cigna Commercial |
$293.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$293.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$293.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$165.15
|
| Rate for Payer: Multiplan Commercial |
$341.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$311.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$165.15
|
| Rate for Payer: United Healthcare Commercial |
$348.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$165.15
|
| Rate for Payer: United Healthcare VA CCN |
$165.15
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9812560001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$610.22 |
| 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 |
$333.85
|
| 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 |
$453.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$372.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$452.90
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$610.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$553.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$553.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$338.26
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$460.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare Commercial |
$498.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare VA CCN |
$324.13
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9602560002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$324.13 |
| Max. Negotiated Rate |
$835.66 |
| Rate for Payer: Aetna of VT Commercial |
$835.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$796.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$333.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$796.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$453.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$452.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$372.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$452.90
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: Cigna Commercial |
$610.22
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$553.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$553.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$338.26
|
| Rate for Payer: Multiplan Commercial |
$826.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$460.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare Commercial |
$498.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$324.13
|
| Rate for Payer: United Healthcare VA CCN |
$324.13
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
OP
|
$889.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9812560002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$393.74 |
| Max. Negotiated Rate |
$844.55 |
| Rate for Payer: Aetna of VT Commercial |
$844.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$796.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$393.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$796.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$535.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$755.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$720.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$400.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$706.75
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: Cigna Commercial |
$711.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$711.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$711.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$400.05
|
| Rate for Payer: Multiplan Commercial |
$826.77
|
| Rate for Payer: MVP Health Care of NY Commercial |
$755.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$400.05
|
| Rate for Payer: United Healthcare Commercial |
$844.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$400.05
|
| Rate for Payer: United Healthcare VA CCN |
$400.05
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
OP
|
$1,627.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
5102560501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$720.60 |
| Max. Negotiated Rate |
$1,545.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,545.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,457.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$720.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,457.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$979.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,382.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,317.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$732.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,293.46
|
| Rate for Payer: Cash Price |
$813.50
|
| Rate for Payer: Cigna Commercial |
$1,301.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,301.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,301.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$732.15
|
| Rate for Payer: Multiplan Commercial |
$1,513.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,382.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$732.15
|
| Rate for Payer: United Healthcare Commercial |
$1,545.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$732.15
|
| Rate for Payer: United Healthcare VA CCN |
$732.15
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$3,025.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9602560501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$493.57 |
| Max. Negotiated Rate |
$2,843.50 |
| Rate for Payer: Aetna of VT Commercial |
$2,843.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,710.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$508.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,710.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$691.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$848.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$848.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$567.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$848.62
|
| Rate for Payer: Cash Price |
$1,512.50
|
| Rate for Payer: Cash Price |
$1,512.50
|
| Rate for Payer: Cigna Commercial |
$936.19
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$868.66
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$868.66
|
| Rate for Payer: Martins Point Health Care Commercial |
$524.41
|
| Rate for Payer: Multiplan Commercial |
$2,813.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$700.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$493.57
|
| Rate for Payer: United Healthcare Commercial |
$759.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$493.57
|
| Rate for Payer: United Healthcare VA CCN |
$493.57
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$1,627.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
5102560501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$493.57 |
| Max. Negotiated Rate |
$1,529.38 |
| Rate for Payer: Aetna of VT Commercial |
$1,529.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,457.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$508.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,457.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$691.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$848.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$848.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$567.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$848.62
|
| Rate for Payer: Cash Price |
$813.50
|
| Rate for Payer: Cash Price |
$813.50
|
| Rate for Payer: Cigna Commercial |
$936.19
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$868.66
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$868.66
|
| Rate for Payer: Martins Point Health Care Commercial |
$524.41
|
| Rate for Payer: Multiplan Commercial |
$1,513.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$700.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$493.57
|
| Rate for Payer: United Healthcare Commercial |
$759.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$493.57
|
| Rate for Payer: United Healthcare VA CCN |
$493.57
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9812560001
|
|
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
|
|
