|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$759.47
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
4502450001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$562.08 |
| Max. Negotiated Rate |
$721.50 |
| Rate for Payer: Aetna of VT Commercial |
$721.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$562.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$562.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$645.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$637.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$607.58
|
| Rate for Payer: Cash Price |
$379.74
|
| Rate for Payer: Cigna Commercial |
$607.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$607.58
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$607.58
|
| Rate for Payer: Multiplan Commercial |
$706.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$645.55
|
| Rate for Payer: United Healthcare Commercial |
$721.50
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$303.04
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
4502360001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$134.22 |
| Max. Negotiated Rate |
$287.89 |
| Rate for Payer: Aetna of VT Commercial |
$287.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$271.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$134.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$271.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$182.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$245.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$136.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$240.92
|
| Rate for Payer: Cash Price |
$151.52
|
| Rate for Payer: Cigna Commercial |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$242.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.37
|
| Rate for Payer: Multiplan Commercial |
$281.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$257.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$136.37
|
| Rate for Payer: United Healthcare Commercial |
$287.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$136.37
|
| Rate for Payer: United Healthcare VA CCN |
$136.37
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
5102450001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$336.60 |
| Max. Negotiated Rate |
$722.00 |
| Rate for Payer: Aetna of VT Commercial |
$722.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$680.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$336.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$680.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$457.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$646.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$615.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$604.20
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cigna Commercial |
$608.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$608.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$608.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$342.00
|
| Rate for Payer: Multiplan Commercial |
$706.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$646.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$342.00
|
| Rate for Payer: United Healthcare Commercial |
$722.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$342.00
|
| Rate for Payer: United Healthcare VA CCN |
$342.00
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$236.09 |
| 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 |
$236.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$236.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$271.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$267.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$255.20
|
| 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: Multiplan Commercial |
$296.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$271.15
|
| Rate for Payer: United Healthcare Commercial |
$303.05
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9812360001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$277.70 |
| 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 |
$561.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$277.70
|
| 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 |
$377.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$532.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$507.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$282.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$498.46
|
| 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: Martins Point Health Care Commercial |
$282.15
|
| Rate for Payer: Multiplan Commercial |
$583.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$532.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.15
|
| Rate for Payer: United Healthcare Commercial |
$595.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.15
|
| Rate for Payer: United Healthcare VA CCN |
$282.15
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$731.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$323.76 |
| Max. Negotiated Rate |
$694.45 |
| Rate for Payer: Aetna of VT Commercial |
$694.45
|
| 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 |
$323.76
|
| 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 |
$440.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$621.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$592.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$328.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$581.14
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Cigna Commercial |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$584.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$328.95
|
| Rate for Payer: Multiplan Commercial |
$679.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$328.95
|
| Rate for Payer: United Healthcare Commercial |
$694.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$328.95
|
| Rate for Payer: United Healthcare VA CCN |
$328.95
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9812360001
|
|
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
|
$1,670.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$329.99 |
| Max. Negotiated Rate |
$1,569.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,569.80
|
| 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 |
$339.89
|
| 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 |
$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 |
$835.00
|
| Rate for Payer: Cash Price |
$835.00
|
| 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 |
$1,553.10
|
| 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
|
Professional
|
Both
|
$3,493.00
|
|
|
Service Code
|
CPT 24546
|
| Hospital Charge Code |
9822454601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$975.15 |
| Max. Negotiated Rate |
$3,283.42 |
| Rate for Payer: Aetna of VT Commercial |
$3,283.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,129.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,004.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,129.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,365.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,673.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,673.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,121.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,673.62
|
| Rate for Payer: Cash Price |
$1,746.50
|
| Rate for Payer: Cash Price |
$1,746.50
|
| Rate for Payer: Cigna Commercial |
$1,844.51
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,629.31
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,629.31
|
| Rate for Payer: Martins Point Health Care Commercial |
$975.16
|
| Rate for Payer: Multiplan Commercial |
$3,248.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,384.71
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$975.15
|
| Rate for Payer: United Healthcare Commercial |
$1,500.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$975.15
|
| Rate for Payer: United Healthcare VA CCN |
$975.15
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$303.04
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
4502360001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$224.28 |
| Max. Negotiated Rate |
$287.89 |
| Rate for Payer: Aetna of VT Commercial |
$287.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$254.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$242.43
|
| Rate for Payer: Cash Price |
$151.52
|
| Rate for Payer: Cigna Commercial |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$242.43
|
| Rate for Payer: Multiplan Commercial |
$281.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$257.58
|
| Rate for Payer: United Healthcare Commercial |
$287.89
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$519.55 |
| 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 |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$596.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$589.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$561.60
|
| 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: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$596.70
|
| Rate for Payer: United Healthcare Commercial |
$666.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$519.55 |
| 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 |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$596.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$589.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$561.60
|
| 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: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$596.70
|
| Rate for Payer: United Healthcare Commercial |
$666.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9602360002
|
|
Hospital Revenue Code
|
960
|
| 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
|
Facility
|
IP
|
$731.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$541.01 |
| Max. Negotiated Rate |
$694.45 |
| Rate for Payer: Aetna of VT Commercial |
$694.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$541.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$541.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$621.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$614.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$584.80
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Cigna Commercial |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$584.80
|
| Rate for Payer: Multiplan Commercial |
$679.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.35
|
| Rate for Payer: United Healthcare Commercial |
$694.45
|
|
|
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
|
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
|
$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
|
OP
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$595.70 |
| 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 |
$1,204.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$595.70
|
| 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 |
$809.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,143.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,089.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$605.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,069.28
|
| 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: Martins Point Health Care Commercial |
$605.25
|
| Rate for Payer: Multiplan Commercial |
$1,250.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,143.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$605.25
|
| Rate for Payer: United Healthcare Commercial |
$1,277.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$605.25
|
| Rate for Payer: United Healthcare VA CCN |
$605.25
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
5102450501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$437.85 |
| Max. Negotiated Rate |
$865.54 |
| Rate for Payer: Aetna of VT Commercial |
$632.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$602.94
|
| 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 |
$602.94
|
| 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 |
$336.50
|
| Rate for Payer: Cash Price |
$336.50
|
| 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 |
$625.89
|
| 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
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9812450002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$403.48 |
| 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 |
$816.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$403.48
|
| 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 |
$548.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$774.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$737.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$409.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$724.25
|
| 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: Martins Point Health Care Commercial |
$409.95
|
| Rate for Payer: Multiplan Commercial |
$847.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$774.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$409.95
|
| Rate for Payer: United Healthcare Commercial |
$865.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$409.95
|
| Rate for Payer: United Healthcare VA CCN |
$409.95
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457602
|
|
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
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$2,018.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9602450501
|
|
Hospital Revenue Code
|
960
|
| 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 HUMERUS FRACTURE
|
Facility
|
OP
|
$243.77
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
4502453001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.97 |
| Max. Negotiated Rate |
$231.58 |
| Rate for Payer: Aetna of VT Commercial |
$231.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$218.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$107.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$218.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$146.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$207.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$197.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$109.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$193.80
|
| Rate for Payer: Cash Price |
$121.89
|
| Rate for Payer: Cigna Commercial |
$195.02
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$195.02
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$195.02
|
| Rate for Payer: Martins Point Health Care Commercial |
$109.70
|
| Rate for Payer: Multiplan Commercial |
$226.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$207.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$109.70
|
| Rate for Payer: United Healthcare Commercial |
$231.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109.70
|
| Rate for Payer: United Healthcare VA CCN |
$109.70
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$1,487.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,100.53 |
| Max. Negotiated Rate |
$1,412.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,412.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,100.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,100.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,263.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,249.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,189.60
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,189.60
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,263.95
|
| Rate for Payer: United Healthcare Commercial |
$1,412.65
|
|
|
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
|
|
