|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$789.69 |
| 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 |
$789.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$789.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$906.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$896.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$853.60
|
| 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: Multiplan Commercial |
$992.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$906.95
|
| Rate for Payer: United Healthcare Commercial |
$1,013.65
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,670.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$739.64 |
| Max. Negotiated Rate |
$1,586.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,586.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,496.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$739.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,496.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,005.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,419.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,352.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$751.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,327.65
|
| Rate for Payer: Cash Price |
$835.00
|
| Rate for Payer: Cigna Commercial |
$1,336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,336.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$751.50
|
| Rate for Payer: Multiplan Commercial |
$1,553.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,419.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$751.50
|
| Rate for Payer: United Healthcare Commercial |
$1,586.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$751.50
|
| Rate for Payer: United Healthcare VA CCN |
$751.50
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$2,768.00
|
|
|
Service Code
|
CPT 24579
|
| Hospital Charge Code |
9822457901
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,225.95 |
| 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 |
$2,479.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,225.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,479.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,666.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,352.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,242.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,245.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,200.56
|
| 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: Martins Point Health Care Commercial |
$1,245.60
|
| Rate for Payer: Multiplan Commercial |
$2,574.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,352.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,245.60
|
| Rate for Payer: United Healthcare Commercial |
$2,629.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,245.60
|
| Rate for Payer: United Healthcare VA CCN |
$1,245.60
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$414.12 |
| Max. Negotiated Rate |
$1,002.98 |
| Rate for Payer: Aetna of VT Commercial |
$1,002.98
|
| 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 |
$426.54
|
| 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 |
$579.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$730.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$730.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$476.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$730.66
|
| Rate for Payer: Cash Price |
$533.50
|
| Rate for Payer: Cash Price |
$533.50
|
| Rate for Payer: Cigna Commercial |
$785.29
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$757.05
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$757.05
|
| Rate for Payer: Martins Point Health Care Commercial |
$458.13
|
| Rate for Payer: Multiplan Commercial |
$992.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$588.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$414.12
|
| Rate for Payer: United Healthcare Commercial |
$637.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$414.12
|
| Rate for Payer: United Healthcare VA CCN |
$414.12
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$674.23 |
| Max. Negotiated Rate |
$865.45 |
| Rate for Payer: Aetna of VT Commercial |
$865.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$674.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$674.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$774.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$765.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$728.80
|
| Rate for Payer: Cash Price |
$455.50
|
| Rate for Payer: Cigna Commercial |
$728.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$728.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$728.80
|
| Rate for Payer: Multiplan Commercial |
$847.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$774.35
|
| Rate for Payer: United Healthcare Commercial |
$865.45
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$13,035.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
5102451601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$5,773.20 |
| Max. Negotiated Rate |
$12,383.25 |
| Rate for Payer: Aetna of VT Commercial |
$12,383.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$11,678.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$5,773.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$11,678.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$7,847.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$11,079.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$10,558.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$5,865.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$10,362.83
|
| Rate for Payer: Cash Price |
$6,517.50
|
| Rate for Payer: Cigna Commercial |
$10,428.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$10,428.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$10,428.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$5,865.75
|
| Rate for Payer: Multiplan Commercial |
$12,122.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$11,079.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$5,865.75
|
| Rate for Payer: United Healthcare Commercial |
$12,383.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,865.75
|
| Rate for Payer: United Healthcare VA CCN |
$5,865.75
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$633.84
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
4502457601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$280.73 |
| Max. Negotiated Rate |
$602.15 |
| Rate for Payer: Aetna of VT Commercial |
$602.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$567.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$280.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$567.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$381.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$538.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$513.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$285.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$503.90
|
| Rate for Payer: Cash Price |
$316.92
|
| Rate for Payer: Cigna Commercial |
$507.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$285.23
|
| Rate for Payer: Multiplan Commercial |
$589.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$538.76
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$285.23
|
| Rate for Payer: United Healthcare Commercial |
$602.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$285.23
|
| Rate for Payer: United Healthcare VA CCN |
$285.23
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$672.10
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
4502450501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.67 |
| Max. Negotiated Rate |
$638.50 |
| Rate for Payer: Aetna of VT Commercial |
$638.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$602.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$297.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$602.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$404.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$571.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$544.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$302.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$534.32
|
| Rate for Payer: Cash Price |
$336.05
|
| Rate for Payer: Cigna Commercial |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$537.68
|
| Rate for Payer: Martins Point Health Care Commercial |
$302.44
|
| Rate for Payer: Multiplan Commercial |
$625.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$571.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$302.44
|
| Rate for Payer: United Healthcare Commercial |
$638.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$302.44
|
| Rate for Payer: United Healthcare VA CCN |
$302.44
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9812450001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$674.23 |
| Max. Negotiated Rate |
$865.45 |
| Rate for Payer: Aetna of VT Commercial |
$865.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$674.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$674.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$774.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$765.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$728.80
|
| Rate for Payer: Cash Price |
$455.50
|
| Rate for Payer: Cigna Commercial |
$728.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$728.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$728.80
|
| Rate for Payer: Multiplan Commercial |
$847.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$774.35
|
| Rate for Payer: United Healthcare Commercial |
$865.45
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$672.10
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
4502450501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$497.42 |
| Max. Negotiated Rate |
$638.50 |
| Rate for Payer: Aetna of VT Commercial |
$638.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$497.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$497.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$571.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$564.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$537.68
|
| Rate for Payer: Cash Price |
$336.05
|
| Rate for Payer: Cigna Commercial |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$537.68
|
| Rate for Payer: Multiplan Commercial |
$625.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$571.28
|
| Rate for Payer: United Healthcare Commercial |
$638.50
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$15,357.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$807.78 |
| Max. Negotiated Rate |
$14,435.58 |
| Rate for Payer: Aetna of VT Commercial |
$14,435.58
|
| 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 |
$832.01
|
| 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 |
$1,130.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$928.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,548.78
|
| Rate for Payer: Cash Price |
$7,678.50
|
| Rate for Payer: Cash Price |
$7,678.50
|
| Rate for Payer: Cigna Commercial |
$1,530.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,349.02
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,349.02
|
| Rate for Payer: Martins Point Health Care Commercial |
$807.78
|
| Rate for Payer: Multiplan Commercial |
$14,282.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,147.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare Commercial |
$1,242.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare VA CCN |
$807.78
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
5102453001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$231.80 |
| Rate for Payer: Aetna of VT Commercial |
$231.80
|
| 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 |
$108.07
|
| 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 |
$146.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$207.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$197.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$109.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$193.98
|
| Rate for Payer: Cash Price |
$122.00
|
| Rate for Payer: Cigna Commercial |
$195.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$195.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$195.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$109.80
|
| Rate for Payer: Multiplan Commercial |
$226.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$207.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$109.80
|
| Rate for Payer: United Healthcare Commercial |
$231.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109.80
|
| Rate for Payer: United Healthcare VA CCN |
$109.80
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$1,670.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,235.97 |
| Max. Negotiated Rate |
$1,586.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,586.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,235.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,235.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,419.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,402.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,336.00
|
| Rate for Payer: Cash Price |
$835.00
|
| Rate for Payer: Cigna Commercial |
$1,336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,336.00
|
| Rate for Payer: Multiplan Commercial |
$1,553.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,419.50
|
| Rate for Payer: United Healthcare Commercial |
$1,586.50
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362001
|
|
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
|
Professional
|
Both
|
$731.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$345.66 |
| Max. Negotiated Rate |
$687.14 |
| Rate for Payer: Aetna of VT Commercial |
$687.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$654.90
|
| 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 |
$654.90
|
| 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 |
$365.50
|
| Rate for Payer: Cash Price |
$365.50
|
| 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 |
$679.83
|
| 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
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$1,141.64
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
4502360501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$844.93 |
| 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 |
$844.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$844.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$970.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$958.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$913.31
|
| 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: Multiplan Commercial |
$1,061.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$970.39
|
| Rate for Payer: United Healthcare Commercial |
$1,084.56
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9602360002
|
|
Hospital Revenue Code
|
960
|
| 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
|
$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
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$345.66 |
| Max. Negotiated Rate |
$654.46 |
| Rate for Payer: Aetna of VT Commercial |
$457.78
|
| 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 |
$356.03
|
| 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 |
$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 |
$243.50
|
| Rate for Payer: Cash Price |
$243.50
|
| 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 |
$452.91
|
| 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
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$2,322.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,718.51 |
| 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 |
$1,718.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,718.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,973.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,950.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,857.60
|
| 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: Multiplan Commercial |
$2,159.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,973.70
|
| Rate for Payer: United Healthcare Commercial |
$2,205.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$141.29 |
| Max. Negotiated Rate |
$303.05 |
| Rate for Payer: Aetna of VT Commercial |
$303.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$141.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$192.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$271.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$258.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$143.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$253.60
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cigna Commercial |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$255.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$143.55
|
| Rate for Payer: Multiplan Commercial |
$296.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$271.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$143.55
|
| Rate for Payer: United Healthcare Commercial |
$303.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.55
|
| Rate for Payer: United Healthcare VA CCN |
$143.55
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$995.43 |
| Max. Negotiated Rate |
$1,277.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,277.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$995.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$995.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,143.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,129.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,076.00
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cigna Commercial |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,076.00
|
| Rate for Payer: Multiplan Commercial |
$1,250.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,143.25
|
| Rate for Payer: United Healthcare Commercial |
$1,277.75
|
|
|
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
|
Professional
|
Both
|
$13,035.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
5102451601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$807.78 |
| Max. Negotiated Rate |
$12,252.90 |
| Rate for Payer: Aetna of VT Commercial |
$12,252.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$11,678.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$832.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$11,678.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,130.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$928.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,548.78
|
| Rate for Payer: Cash Price |
$6,517.50
|
| Rate for Payer: Cash Price |
$6,517.50
|
| Rate for Payer: Cigna Commercial |
$1,530.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,349.02
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,349.02
|
| Rate for Payer: Martins Point Health Care Commercial |
$807.78
|
| Rate for Payer: Multiplan Commercial |
$12,122.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,147.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare Commercial |
$1,242.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare VA CCN |
$807.78
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457601
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$632.05 |
| 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 |
$632.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$632.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$725.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$717.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$683.20
|
| 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: Multiplan Commercial |
$794.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$725.90
|
| Rate for Payer: United Healthcare Commercial |
$811.30
|
|
