|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9812360001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$313.95 |
| Max. Negotiated Rate |
$592.27 |
| Rate for Payer: Aetna of VT Commercial |
$589.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$561.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$323.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$561.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$439.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$475.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$475.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$361.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$475.54
|
| Rate for Payer: Cash Price |
$313.50
|
| Rate for Payer: Cash Price |
$313.50
|
| Rate for Payer: Cigna Commercial |
$592.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$544.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$544.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$331.61
|
| Rate for Payer: Multiplan Commercial |
$583.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$445.81
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$313.95
|
| Rate for Payer: United Healthcare Commercial |
$482.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$313.95
|
| Rate for Payer: United Healthcare VA CCN |
$313.95
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9812450002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$329.99 |
| Max. Negotiated Rate |
$856.34 |
| Rate for Payer: Aetna of VT Commercial |
$856.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$816.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$339.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$816.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$461.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$491.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$491.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$379.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$491.35
|
| Rate for Payer: Cash Price |
$455.50
|
| Rate for Payer: Cash Price |
$455.50
|
| Rate for Payer: Cigna Commercial |
$624.50
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$590.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$590.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$359.22
|
| Rate for Payer: Multiplan Commercial |
$847.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$468.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare Commercial |
$507.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare VA CCN |
$329.99
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$648.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
5102456001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$479.58 |
| Max. Negotiated Rate |
$615.60 |
| Rate for Payer: Aetna of VT Commercial |
$615.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$479.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$479.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$550.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$544.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$518.40
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cigna Commercial |
$518.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$518.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$518.40
|
| Rate for Payer: Multiplan Commercial |
$602.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$550.80
|
| Rate for Payer: United Healthcare Commercial |
$615.60
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9812360002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$464.04 |
| Max. Negotiated Rate |
$595.65 |
| Rate for Payer: Aetna of VT Commercial |
$595.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$464.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$464.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$532.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$526.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$501.60
|
| Rate for Payer: Cash Price |
$313.50
|
| Rate for Payer: Cigna Commercial |
$501.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$501.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$501.60
|
| Rate for Payer: Multiplan Commercial |
$583.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$532.95
|
| Rate for Payer: United Healthcare Commercial |
$595.65
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$257.89 |
| Max. Negotiated Rate |
$659.88 |
| Rate for Payer: Aetna of VT Commercial |
$659.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$628.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$265.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$628.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$361.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$433.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$433.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$433.93
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cigna Commercial |
$486.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$443.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$443.33
|
| Rate for Payer: Martins Point Health Care Commercial |
$269.77
|
| Rate for Payer: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$366.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$257.89
|
| Rate for Payer: United Healthcare Commercial |
$396.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$257.89
|
| Rate for Payer: United Healthcare VA CCN |
$257.89
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$15,357.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$6,801.62 |
| Max. Negotiated Rate |
$14,589.15 |
| Rate for Payer: Aetna of VT Commercial |
$14,589.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$13,758.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$6,801.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$13,758.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$9,244.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$13,053.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$12,439.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$6,910.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$12,208.82
|
| Rate for Payer: Cash Price |
$7,678.50
|
| Rate for Payer: Cigna Commercial |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$12,285.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$6,910.65
|
| Rate for Payer: Multiplan Commercial |
$14,282.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$13,053.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$6,910.65
|
| Rate for Payer: United Healthcare Commercial |
$14,589.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,910.65
|
| Rate for Payer: United Healthcare VA CCN |
$6,910.65
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$15,357.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$11,365.72 |
| Max. Negotiated Rate |
$14,589.15 |
| Rate for Payer: Aetna of VT Commercial |
$14,589.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$11,365.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$11,365.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$13,053.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$12,899.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$12,285.60
|
| Rate for Payer: Cash Price |
$7,678.50
|
| Rate for Payer: Cigna Commercial |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$12,285.60
|
| Rate for Payer: Multiplan Commercial |
$14,282.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$13,053.45
|
| Rate for Payer: United Healthcare Commercial |
$14,589.15
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,141.64
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
4502360501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$505.63 |
| Max. Negotiated Rate |
$1,084.56 |
| Rate for Payer: Aetna of VT Commercial |
$1,084.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,022.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$505.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,022.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$687.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$970.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$924.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$513.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$907.60
|
| Rate for Payer: Cash Price |
$570.82
|
| Rate for Payer: Cigna Commercial |
$913.31
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$913.31
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$913.31
|
| Rate for Payer: Martins Point Health Care Commercial |
$513.74
|
| Rate for Payer: Multiplan Commercial |
$1,061.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$970.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$513.74
|
| Rate for Payer: United Healthcare Commercial |
$1,084.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$513.74
|
| Rate for Payer: United Healthcare VA CCN |
$513.74
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$2,303.00
|
|
|
Service Code
|
CPT 24575
|
| Hospital Charge Code |
9822457501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$698.12 |
| Max. Negotiated Rate |
$2,164.82 |
| Rate for Payer: Aetna of VT Commercial |
$2,164.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,063.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$719.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,063.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$977.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,162.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,162.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$802.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,162.80
|
| Rate for Payer: Cash Price |
$1,151.50
|
| Rate for Payer: Cash Price |
$1,151.50
|
| Rate for Payer: Cigna Commercial |
$1,318.81
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,161.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,161.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$698.12
|
| Rate for Payer: Multiplan Commercial |
$2,141.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$991.33
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$698.12
|
| Rate for Payer: United Healthcare Commercial |
$1,073.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$698.12
|
| Rate for Payer: United Healthcare VA CCN |
$698.12
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$2,768.00
|
|
|
Service Code
|
CPT 24579
|
| Hospital Charge Code |
9822457901
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,048.60 |
| Max. Negotiated Rate |
$2,629.60 |
| Rate for Payer: Aetna of VT Commercial |
$2,629.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,048.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,048.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,352.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,325.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,214.40
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cigna Commercial |
$2,214.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,214.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,214.40
|
| Rate for Payer: Multiplan Commercial |
$2,574.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,352.80
|
| Rate for Payer: United Healthcare Commercial |
$2,629.60
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$634.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
5102457601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$469.22 |
| Max. Negotiated Rate |
$602.30 |
| Rate for Payer: Aetna of VT Commercial |
$602.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$469.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$469.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$538.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$532.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$507.20
|
| Rate for Payer: Cash Price |
$317.00
|
| Rate for Payer: Cigna Commercial |
$507.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.20
|
| Rate for Payer: Multiplan Commercial |
$589.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$538.90
|
| Rate for Payer: United Healthcare Commercial |
$602.30
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$648.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
5102456001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$287.00 |
| Max. Negotiated Rate |
$615.60 |
| Rate for Payer: Aetna of VT Commercial |
$615.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$580.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$287.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$580.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$390.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$550.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$524.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$291.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$515.16
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cigna Commercial |
$518.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$518.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$518.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$291.60
|
| Rate for Payer: Multiplan Commercial |
$602.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$550.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$291.60
|
| Rate for Payer: United Healthcare Commercial |
$615.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$291.60
|
| Rate for Payer: United Healthcare VA CCN |
$291.60
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$378.24 |
| Max. Negotiated Rate |
$811.30 |
| Rate for Payer: Aetna of VT Commercial |
$811.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$378.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$514.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$725.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$691.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$384.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$678.93
|
| Rate for Payer: Cash Price |
$427.00
|
| Rate for Payer: Cigna Commercial |
$683.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$683.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$683.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$384.30
|
| Rate for Payer: Multiplan Commercial |
$794.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$725.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$384.30
|
| Rate for Payer: United Healthcare Commercial |
$811.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$384.30
|
| Rate for Payer: United Healthcare VA CCN |
$384.30
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$2,741.00
|
|
|
Service Code
|
CPT 24582
|
| Hospital Charge Code |
9822458201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$778.64 |
| Max. Negotiated Rate |
$2,576.54 |
| Rate for Payer: Aetna of VT Commercial |
$2,576.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,455.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$802.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,455.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,090.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,307.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,307.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$895.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,307.54
|
| Rate for Payer: Cash Price |
$1,370.50
|
| Rate for Payer: Cash Price |
$1,370.50
|
| Rate for Payer: Cigna Commercial |
$1,473.28
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,294.51
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,294.51
|
| Rate for Payer: Martins Point Health Care Commercial |
$778.64
|
| Rate for Payer: Multiplan Commercial |
$2,549.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,105.68
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$778.65
|
| Rate for Payer: United Healthcare Commercial |
$1,197.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$778.65
|
| Rate for Payer: United Healthcare VA CCN |
$778.65
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9812453002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$215.69 |
| Max. Negotiated Rate |
$462.65 |
| Rate for Payer: Aetna of VT Commercial |
$462.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$215.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$293.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$394.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$219.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.17
|
| Rate for Payer: Cash Price |
$243.50
|
| Rate for Payer: Cigna Commercial |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$389.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$219.15
|
| Rate for Payer: Multiplan Commercial |
$452.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare Commercial |
$462.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare VA CCN |
$219.15
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$437.85 |
| Max. Negotiated Rate |
$1,264.30 |
| Rate for Payer: Aetna of VT Commercial |
$1,264.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,204.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$450.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,204.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$612.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$865.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$865.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$503.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$865.54
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cigna Commercial |
$830.35
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$812.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$812.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$491.49
|
| Rate for Payer: Multiplan Commercial |
$1,250.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$437.85
|
| Rate for Payer: United Healthcare Commercial |
$673.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$437.85
|
| Rate for Payer: United Healthcare VA CCN |
$437.85
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$2,322.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,028.41 |
| Max. Negotiated Rate |
$2,205.90 |
| Rate for Payer: Aetna of VT Commercial |
$2,205.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,080.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,028.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,080.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,397.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,973.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,880.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,044.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,845.99
|
| Rate for Payer: Cash Price |
$1,161.00
|
| Rate for Payer: Cigna Commercial |
$1,857.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,857.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,857.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,044.90
|
| Rate for Payer: Multiplan Commercial |
$2,159.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,973.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,044.90
|
| Rate for Payer: United Healthcare Commercial |
$2,205.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,044.90
|
| Rate for Payer: United Healthcare VA CCN |
$1,044.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$2,018.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9602450501
|
|
Hospital Revenue Code
|
960
|
| 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 HUMERUS FRACTURE
|
Facility
|
IP
|
$2,582.00
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
9822453801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,910.94 |
| Max. Negotiated Rate |
$2,452.90 |
| Rate for Payer: Aetna of VT Commercial |
$2,452.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,910.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,910.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,194.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,168.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,065.60
|
| Rate for Payer: Cash Price |
$1,291.00
|
| Rate for Payer: Cigna Commercial |
$2,065.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,065.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,065.60
|
| Rate for Payer: Multiplan Commercial |
$2,401.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,194.70
|
| Rate for Payer: United Healthcare Commercial |
$2,452.90
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$2,582.00
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
9822453801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$747.66 |
| Max. Negotiated Rate |
$2,427.08 |
| Rate for Payer: Aetna of VT Commercial |
$2,427.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,313.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$770.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,313.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,046.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,135.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,135.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$859.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,135.99
|
| Rate for Payer: Cash Price |
$1,291.00
|
| Rate for Payer: Cash Price |
$1,291.00
|
| Rate for Payer: Cigna Commercial |
$1,421.16
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,242.55
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,242.55
|
| Rate for Payer: Martins Point Health Care Commercial |
$747.66
|
| Rate for Payer: Multiplan Commercial |
$2,401.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,061.68
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$747.66
|
| Rate for Payer: United Healthcare Commercial |
$1,150.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$747.66
|
| Rate for Payer: United Healthcare VA CCN |
$747.66
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$310.92 |
| Max. Negotiated Rate |
$666.90 |
| Rate for Payer: Aetna of VT Commercial |
$666.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$628.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$310.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$628.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$422.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$596.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$568.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$315.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$558.09
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cigna Commercial |
$561.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$561.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$561.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$315.90
|
| Rate for Payer: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$596.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$315.90
|
| Rate for Payer: United Healthcare Commercial |
$666.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$315.90
|
| Rate for Payer: United Healthcare VA CCN |
$315.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$721.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$319.33 |
| Max. Negotiated Rate |
$684.95 |
| Rate for Payer: Aetna of VT Commercial |
$684.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$645.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$319.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$645.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$434.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$612.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$584.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$573.20
|
| Rate for Payer: Cash Price |
$360.50
|
| Rate for Payer: Cigna Commercial |
$576.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$576.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$576.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$324.45
|
| Rate for Payer: Multiplan Commercial |
$670.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$612.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$324.45
|
| Rate for Payer: United Healthcare Commercial |
$684.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$324.45
|
| Rate for Payer: United Healthcare VA CCN |
$324.45
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$472.57 |
| Max. Negotiated Rate |
$1,013.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,013.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$955.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$472.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$955.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$642.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$906.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$864.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$480.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$848.26
|
| Rate for Payer: Cash Price |
$533.50
|
| Rate for Payer: Cigna Commercial |
$853.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$853.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$853.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$480.15
|
| Rate for Payer: Multiplan Commercial |
$992.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$906.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$480.15
|
| Rate for Payer: United Healthcare Commercial |
$1,013.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$480.15
|
| Rate for Payer: United Healthcare VA CCN |
$480.15
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9602450501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$437.85 |
| 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 |
$450.99
|
| 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 |
$612.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$865.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$865.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$503.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$865.54
|
| Rate for Payer: Cash Price |
$1,009.00
|
| Rate for Payer: Cash Price |
$1,009.00
|
| Rate for Payer: Cigna Commercial |
$830.35
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$812.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$812.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$491.49
|
| Rate for Payer: Multiplan Commercial |
$1,876.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$437.85
|
| Rate for Payer: United Healthcare Commercial |
$673.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$437.85
|
| Rate for Payer: United Healthcare VA CCN |
$437.85
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
5102453001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$218.60 |
| Max. Negotiated Rate |
$654.46 |
| Rate for Payer: Aetna of VT Commercial |
$229.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$218.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$356.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$218.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$483.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$535.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$535.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$397.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$535.42
|
| Rate for Payer: Cash Price |
$122.00
|
| Rate for Payer: Cash Price |
$122.00
|
| Rate for Payer: Cigna Commercial |
$654.46
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$622.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$622.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$378.75
|
| Rate for Payer: Multiplan Commercial |
$226.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.84
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$345.66
|
| Rate for Payer: United Healthcare Commercial |
$531.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$345.66
|
| Rate for Payer: United Healthcare VA CCN |
$345.66
|
|
