|
TREAT FRACTURE RADIUS/ULNA
|
Facility
|
IP
|
$366.04
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
4502560001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.91 |
| Max. Negotiated Rate |
$347.74 |
| Rate for Payer: Aetna of VT Commercial |
$347.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$270.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$270.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$311.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$307.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$292.83
|
| Rate for Payer: Cash Price |
$183.02
|
| Rate for Payer: Cigna Commercial |
$292.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$292.83
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$292.83
|
| Rate for Payer: Multiplan Commercial |
$340.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$311.13
|
| Rate for Payer: United Healthcare Commercial |
$347.74
|
|
|
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
|
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
|
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
|
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
|
OP
|
$1,255.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9602560001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$555.84 |
| 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 |
$1,124.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$555.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,124.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$755.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,066.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,016.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$564.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$997.73
|
| 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: Martins Point Health Care Commercial |
$564.75
|
| Rate for Payer: Multiplan Commercial |
$1,167.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,066.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$564.75
|
| Rate for Payer: United Healthcare Commercial |
$1,192.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$564.75
|
| Rate for Payer: United Healthcare VA CCN |
$564.75
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
9602560001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$324.13 |
| Max. Negotiated Rate |
$1,179.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,179.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,124.35
|
| 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 |
$1,124.35
|
| 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 |
$627.50
|
| Rate for Payer: Cash Price |
$627.50
|
| 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 |
$1,167.15
|
| 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
|
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
|
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
|
|
|
TREAT FRACTURE RADIUS/ULNA
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9602560502
|
|
Hospital Revenue Code
|
960
|
| 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
|
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
|
$1,772.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
9812560501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$784.82 |
| 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 |
$1,587.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$784.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,587.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,066.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,506.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,435.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$797.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,408.74
|
| 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: Martins Point Health Care Commercial |
$797.40
|
| Rate for Payer: Multiplan Commercial |
$1,647.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,506.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$797.40
|
| Rate for Payer: United Healthcare Commercial |
$1,683.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$797.40
|
| Rate for Payer: United Healthcare VA CCN |
$797.40
|
|
|
TREAT FX DISTAL RADIAL
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
9822560601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$641.09 |
| Max. Negotiated Rate |
$1,586.72 |
| Rate for Payer: Aetna of VT Commercial |
$1,586.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,512.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$660.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,512.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$897.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,081.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,081.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$737.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,081.36
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Cigna Commercial |
$1,211.37
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,064.09
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,064.09
|
| Rate for Payer: Martins Point Health Care Commercial |
$641.10
|
| Rate for Payer: Multiplan Commercial |
$1,569.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$910.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$641.09
|
| Rate for Payer: United Healthcare Commercial |
$986.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$641.09
|
| Rate for Payer: United Healthcare VA CCN |
$641.09
|
|
|
TREAT FX DISTAL RADIAL
|
Facility
|
OP
|
$1,688.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
9822560601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$747.62 |
| Max. Negotiated Rate |
$1,603.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,603.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,512.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$747.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,512.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,016.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,434.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,367.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$759.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,341.96
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Cigna Commercial |
$1,350.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,350.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,350.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$759.60
|
| Rate for Payer: Multiplan Commercial |
$1,569.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,434.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$759.60
|
| Rate for Payer: United Healthcare Commercial |
$1,603.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$759.60
|
| Rate for Payer: United Healthcare VA CCN |
$759.60
|
|
|
TREAT FX DISTAL RADIAL
|
Facility
|
IP
|
$1,688.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
9822560601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,249.29 |
| Max. Negotiated Rate |
$1,603.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,603.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,249.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,249.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,434.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,417.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,350.40
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Cigna Commercial |
$1,350.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,350.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,350.40
|
| Rate for Payer: Multiplan Commercial |
$1,569.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,434.80
|
| Rate for Payer: United Healthcare Commercial |
$1,603.60
|
|
|
TREAT FX RAD EXTRA-ARTICUL
|
Facility
|
OP
|
$2,018.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
9822560701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$893.77 |
| Max. Negotiated Rate |
$1,917.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,917.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,807.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$893.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,807.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,214.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,715.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,634.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$908.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,604.31
|
| Rate for Payer: Cash Price |
$1,009.00
|
| Rate for Payer: Cigna Commercial |
$1,614.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,614.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,614.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$908.10
|
| Rate for Payer: Multiplan Commercial |
$1,876.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,715.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$908.10
|
| Rate for Payer: United Healthcare Commercial |
$1,917.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$908.10
|
| Rate for Payer: United Healthcare VA CCN |
$908.10
|
|
|
TREAT FX RAD EXTRA-ARTICUL
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
9822560701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$707.71 |
| Max. Negotiated Rate |
$1,896.92 |
| Rate for Payer: Aetna of VT Commercial |
$1,896.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,807.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$728.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,807.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$990.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,097.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,097.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$813.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,097.12
|
| Rate for Payer: Cash Price |
$1,009.00
|
| Rate for Payer: Cash Price |
$1,009.00
|
| Rate for Payer: Cigna Commercial |
$1,336.47
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,176.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,176.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$707.71
|
| Rate for Payer: Multiplan Commercial |
$1,876.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,004.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$707.71
|
| Rate for Payer: United Healthcare Commercial |
$1,088.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$707.71
|
| Rate for Payer: United Healthcare VA CCN |
$707.71
|
|
|
TREAT FX RAD EXTRA-ARTICUL
|
Facility
|
IP
|
$2,018.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
9822560701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,493.52 |
| Max. Negotiated Rate |
$1,917.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,917.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,493.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,493.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,715.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,695.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,614.40
|
| Rate for Payer: Cash Price |
$1,009.00
|
| Rate for Payer: Cigna Commercial |
$1,614.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,614.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,614.40
|
| Rate for Payer: Multiplan Commercial |
$1,876.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,715.30
|
| Rate for Payer: United Healthcare Commercial |
$1,917.10
|
|
|
TREAT FX RADIAL 3+ FRAG
|
Facility
|
IP
|
$3,058.00
|
|
|
Service Code
|
CPT 25609
|
| Hospital Charge Code |
9822560901
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,263.23 |
| Max. Negotiated Rate |
$2,905.10 |
| Rate for Payer: Aetna of VT Commercial |
$2,905.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,263.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,263.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,599.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,568.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,446.40
|
| Rate for Payer: Cash Price |
$1,529.00
|
| Rate for Payer: Cigna Commercial |
$2,446.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,446.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,446.40
|
| Rate for Payer: Multiplan Commercial |
$2,843.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,599.30
|
| Rate for Payer: United Healthcare Commercial |
$2,905.10
|
|
|
TREAT FX RADIAL 3+ FRAG
|
Facility
|
OP
|
$3,058.00
|
|
|
Service Code
|
CPT 25609
|
| Hospital Charge Code |
9822560901
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,354.39 |
| Max. Negotiated Rate |
$2,905.10 |
| Rate for Payer: Aetna of VT Commercial |
$2,905.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,739.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,354.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,739.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,840.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,599.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,476.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,376.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,431.11
|
| Rate for Payer: Cash Price |
$1,529.00
|
| Rate for Payer: Cigna Commercial |
$2,446.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,446.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,446.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,376.10
|
| Rate for Payer: Multiplan Commercial |
$2,843.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,599.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,376.10
|
| Rate for Payer: United Healthcare Commercial |
$2,905.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,376.10
|
| Rate for Payer: United Healthcare VA CCN |
$1,376.10
|
|
|
TREAT FX RADIAL 3+ FRAG
|
Professional
|
Both
|
$3,058.00
|
|
|
Service Code
|
CPT 25609
|
| Hospital Charge Code |
9822560901
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$997.69 |
| Max. Negotiated Rate |
$2,874.52 |
| Rate for Payer: Aetna of VT Commercial |
$2,874.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,739.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,027.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,739.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,396.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,312.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,312.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,147.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,312.77
|
| Rate for Payer: Cash Price |
$1,529.00
|
| Rate for Payer: Cash Price |
$1,529.00
|
| Rate for Payer: Cigna Commercial |
$1,885.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,660.18
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,660.18
|
| Rate for Payer: Martins Point Health Care Commercial |
$997.69
|
| Rate for Payer: Multiplan Commercial |
$2,843.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,416.72
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$997.69
|
| Rate for Payer: United Healthcare Commercial |
$1,534.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$997.69
|
| Rate for Payer: United Healthcare VA CCN |
$997.69
|
|
|
TREAT FX RAD INTRA-ARTICUL
|
Facility
|
OP
|
$2,059.00
|
|
|
Service Code
|
CPT 25608
|
| Hospital Charge Code |
9822560801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$911.93 |
| Max. Negotiated Rate |
$1,956.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,956.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,844.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$911.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,844.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,239.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,750.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,667.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$926.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,636.90
|
| Rate for Payer: Cash Price |
$1,029.50
|
| Rate for Payer: Cigna Commercial |
$1,647.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,647.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,647.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$926.55
|
| Rate for Payer: Multiplan Commercial |
$1,914.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,750.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$926.55
|
| Rate for Payer: United Healthcare Commercial |
$1,956.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$926.55
|
| Rate for Payer: United Healthcare VA CCN |
$926.55
|
|
|
TREAT FX RAD INTRA-ARTICUL
|
Professional
|
Both
|
$2,059.00
|
|
|
Service Code
|
CPT 25608
|
| Hospital Charge Code |
9822560801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$787.72 |
| Max. Negotiated Rate |
$1,935.46 |
| Rate for Payer: Aetna of VT Commercial |
$1,935.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,844.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$811.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,844.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,102.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,119.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,119.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$905.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,119.06
|
| Rate for Payer: Cash Price |
$1,029.50
|
| Rate for Payer: Cash Price |
$1,029.50
|
| Rate for Payer: Cigna Commercial |
$1,489.45
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,309.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,309.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$787.73
|
| Rate for Payer: Multiplan Commercial |
$1,914.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,118.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$787.72
|
| Rate for Payer: United Healthcare Commercial |
$1,211.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$787.72
|
| Rate for Payer: United Healthcare VA CCN |
$787.72
|
|
|
TREAT FX RAD INTRA-ARTICUL
|
Facility
|
IP
|
$2,059.00
|
|
|
Service Code
|
CPT 25608
|
| Hospital Charge Code |
9822560801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,523.87 |
| Max. Negotiated Rate |
$1,956.05 |
| Rate for Payer: Aetna of VT Commercial |
$1,956.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,523.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,523.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,750.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,729.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,647.20
|
| Rate for Payer: Cash Price |
$1,029.50
|
| Rate for Payer: Cigna Commercial |
$1,647.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,647.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,647.20
|
| Rate for Payer: Multiplan Commercial |
$1,914.87
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,750.15
|
| Rate for Payer: United Healthcare Commercial |
$1,956.05
|
|
