|
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
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
5102450501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$498.09 |
| Max. Negotiated Rate |
$639.35 |
| Rate for Payer: Aetna of VT Commercial |
$639.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$498.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$498.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$572.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$565.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$538.40
|
| Rate for Payer: Cash Price |
$336.50
|
| Rate for Payer: Cigna Commercial |
$538.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$538.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$538.40
|
| Rate for Payer: Multiplan Commercial |
$625.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$572.05
|
| Rate for Payer: United Healthcare Commercial |
$639.35
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$721.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$533.61 |
| 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 |
$533.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$533.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$612.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$605.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$576.80
|
| 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: Multiplan Commercial |
$670.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$612.85
|
| Rate for Payer: United Healthcare Commercial |
$684.95
|
|
|
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
|
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
|
|
|
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
|
$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
|
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
|
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
|
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
|
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
|
Facility
|
OP
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9812360002
|
|
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
|
IP
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9812453002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$360.43 |
| 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 |
$360.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$360.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$409.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$389.60
|
| 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: Multiplan Commercial |
$452.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.95
|
| Rate for Payer: United Healthcare Commercial |
$462.65
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9812456001
|
|
Hospital Revenue Code
|
981
|
| 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
|
IP
|
$2,741.00
|
|
|
Service Code
|
CPT 24582
|
| Hospital Charge Code |
9822458201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,028.61 |
| Max. Negotiated Rate |
$2,603.95 |
| Rate for Payer: Aetna of VT Commercial |
$2,603.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,028.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,028.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,329.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,302.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,192.80
|
| Rate for Payer: Cash Price |
$1,370.50
|
| Rate for Payer: Cigna Commercial |
$2,192.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,192.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,192.80
|
| Rate for Payer: Multiplan Commercial |
$2,549.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,329.85
|
| Rate for Payer: United Healthcare Commercial |
$2,603.95
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602456001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$285.79 |
| Max. Negotiated Rate |
$654.46 |
| Rate for Payer: Aetna of VT Commercial |
$299.86
|
| 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 |
$356.03
|
| 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 |
$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 |
$159.50
|
| Rate for Payer: Cash Price |
$159.50
|
| 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 |
$296.67
|
| 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
|
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
|
$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
|
Facility
|
OP
|
$647.28
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
4502456001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$286.68 |
| Max. Negotiated Rate |
$614.92 |
| Rate for Payer: Aetna of VT Commercial |
$614.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$579.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$286.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$579.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$389.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$550.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$524.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$291.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$514.59
|
| Rate for Payer: Cash Price |
$323.64
|
| Rate for Payer: Cigna Commercial |
$517.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$517.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$517.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$291.28
|
| Rate for Payer: Multiplan Commercial |
$601.97
|
| Rate for Payer: MVP Health Care of NY Commercial |
$550.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$291.28
|
| Rate for Payer: United Healthcare Commercial |
$614.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$291.28
|
| Rate for Payer: United Healthcare VA CCN |
$291.28
|
|
|
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
|
Professional
|
Both
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450002
|
|
Hospital Revenue Code
|
960
|
| 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
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9812453002
|
|
Hospital Revenue Code
|
981
|
| 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
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$360.43 |
| 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 |
$360.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$360.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$409.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$389.60
|
| 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: Multiplan Commercial |
$452.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.95
|
| Rate for Payer: United Healthcare Commercial |
$462.65
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360502
|
|
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
|
Facility
|
IP
|
$3,493.00
|
|
|
Service Code
|
CPT 24546
|
| Hospital Charge Code |
9822454601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,585.17 |
| Max. Negotiated Rate |
$3,318.35 |
| Rate for Payer: Aetna of VT Commercial |
$3,318.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,585.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,585.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,969.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,934.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,794.40
|
| Rate for Payer: Cash Price |
$1,746.50
|
| Rate for Payer: Cigna Commercial |
$2,794.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,794.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,794.40
|
| Rate for Payer: Multiplan Commercial |
$3,248.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,969.05
|
| Rate for Payer: United Healthcare Commercial |
$3,318.35
|
|
