|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9812453001
|
|
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
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
5102360001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$272.35 |
| Max. Negotiated Rate |
$592.27 |
| Rate for Payer: Aetna of VT Commercial |
$285.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$272.35
|
| 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 |
$272.35
|
| 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 |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| 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 |
$282.72
|
| 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
|
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
|
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
|
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
|
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
|
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
|
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
|
IP
|
$2,303.00
|
|
|
Service Code
|
CPT 24575
|
| Hospital Charge Code |
9822457501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,704.45 |
| Max. Negotiated Rate |
$2,187.85 |
| Rate for Payer: Aetna of VT Commercial |
$2,187.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,704.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,704.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,957.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,934.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,842.40
|
| Rate for Payer: Cash Price |
$1,151.50
|
| Rate for Payer: Cigna Commercial |
$1,842.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,842.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,842.40
|
| Rate for Payer: Multiplan Commercial |
$2,141.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,957.55
|
| Rate for Payer: United Healthcare Commercial |
$2,187.85
|
|
|
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
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
CPT 24579
|
| Hospital Charge Code |
9822457901
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$791.26 |
| Max. Negotiated Rate |
$2,601.92 |
| Rate for Payer: Aetna of VT Commercial |
$2,601.92
|
| 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 |
$815.00
|
| 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 |
$1,107.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,288.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,288.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$909.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,288.81
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cigna Commercial |
$1,495.56
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,318.16
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,318.16
|
| Rate for Payer: Martins Point Health Care Commercial |
$791.26
|
| Rate for Payer: Multiplan Commercial |
$2,574.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,123.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$791.26
|
| Rate for Payer: United Healthcare Commercial |
$1,217.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$791.26
|
| Rate for Payer: United Healthcare VA CCN |
$791.26
|
|
|
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
|
$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
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9812456002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$285.79 |
| Max. Negotiated Rate |
$551.14 |
| 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 |
$300.20
|
| 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 |
$408.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$530.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$530.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$335.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$530.87
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cigna Commercial |
$551.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$542.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$542.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$330.00
|
| Rate for Payer: Multiplan Commercial |
$296.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$291.46
|
| Rate for Payer: United Healthcare Commercial |
$448.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$291.46
|
| Rate for Payer: United Healthcare VA CCN |
$291.46
|
|
|
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
|
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
|
$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
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
5102453001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$180.58 |
| 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 |
$180.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$180.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$207.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$204.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$195.20
|
| 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: Multiplan Commercial |
$226.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$207.40
|
| Rate for Payer: United Healthcare Commercial |
$231.80
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
5102456001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$291.46 |
| Max. Negotiated Rate |
$609.12 |
| Rate for Payer: Aetna of VT Commercial |
$609.12
|
| 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 |
$300.20
|
| 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 |
$408.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$530.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$530.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$335.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$530.87
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cigna Commercial |
$551.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$542.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$542.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$330.00
|
| Rate for Payer: Multiplan Commercial |
$602.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$291.46
|
| Rate for Payer: United Healthcare Commercial |
$448.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$291.46
|
| Rate for Payer: United Healthcare VA CCN |
$291.46
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457601
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$378.24 |
| Max. Negotiated Rate |
$811.30 |
| Rate for Payer: Aetna of VT Commercial |
$811.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$378.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$514.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$725.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$691.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$384.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$678.93
|
| Rate for Payer: Cash Price |
$427.00
|
| Rate for Payer: Cigna Commercial |
$683.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$683.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$683.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$384.30
|
| Rate for Payer: Multiplan Commercial |
$794.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$725.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$384.30
|
| Rate for Payer: United Healthcare Commercial |
$811.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$384.30
|
| Rate for Payer: United Healthcare VA CCN |
$384.30
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$310.59 |
| Max. Negotiated Rate |
$802.76 |
| Rate for Payer: Aetna of VT Commercial |
$802.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$319.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$434.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$469.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$469.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$357.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$469.97
|
| Rate for Payer: Cash Price |
$427.00
|
| Rate for Payer: Cash Price |
$427.00
|
| Rate for Payer: Cigna Commercial |
$588.03
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$573.44
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$573.44
|
| Rate for Payer: Martins Point Health Care Commercial |
$349.46
|
| Rate for Payer: Multiplan Commercial |
$794.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$441.04
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$310.59
|
| Rate for Payer: United Healthcare Commercial |
$477.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$310.59
|
| Rate for Payer: United Healthcare VA CCN |
$310.59
|
|
|
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
|
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
|
$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
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457602
|
|
Hospital Revenue Code
|
960
|
| 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
|
|
