|
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
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9812360001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$313.95 |
| Max. Negotiated Rate |
$592.27 |
| Rate for Payer: Aetna of VT Commercial |
$589.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$561.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$323.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$561.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$439.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$475.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$475.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$361.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$475.54
|
| Rate for Payer: Cash Price |
$313.50
|
| Rate for Payer: Cash Price |
$313.50
|
| Rate for Payer: Cigna Commercial |
$592.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$544.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$544.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$331.61
|
| Rate for Payer: Multiplan Commercial |
$583.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$445.81
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$313.95
|
| Rate for Payer: United Healthcare Commercial |
$482.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$313.95
|
| Rate for Payer: United Healthcare VA CCN |
$313.95
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$2,322.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,028.41 |
| Max. Negotiated Rate |
$2,205.90 |
| Rate for Payer: Aetna of VT Commercial |
$2,205.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,080.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,028.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,080.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,397.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,973.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,880.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,044.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,845.99
|
| Rate for Payer: Cash Price |
$1,161.00
|
| Rate for Payer: Cigna Commercial |
$1,857.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,857.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,857.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,044.90
|
| Rate for Payer: Multiplan Commercial |
$2,159.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,973.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,044.90
|
| Rate for Payer: United Healthcare Commercial |
$2,205.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,044.90
|
| Rate for Payer: United Healthcare VA CCN |
$1,044.90
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450502
|
|
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
|
$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
|
$634.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
5102457601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$280.80 |
| Max. Negotiated Rate |
$602.30 |
| Rate for Payer: Aetna of VT Commercial |
$602.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$568.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$280.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$568.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$381.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$538.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$513.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$285.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$504.03
|
| Rate for Payer: Cash Price |
$317.00
|
| Rate for Payer: Cigna Commercial |
$507.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$285.30
|
| Rate for Payer: Multiplan Commercial |
$589.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$538.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$285.30
|
| Rate for Payer: United Healthcare Commercial |
$602.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$285.30
|
| Rate for Payer: United Healthcare VA CCN |
$285.30
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9812450001
|
|
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
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$995.43 |
| Max. Negotiated Rate |
$1,277.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,277.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$995.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$995.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,143.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,129.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,076.00
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cigna Commercial |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,076.00
|
| Rate for Payer: Multiplan Commercial |
$1,250.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,143.25
|
| Rate for Payer: United Healthcare Commercial |
$1,277.75
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457602
|
|
Hospital Revenue Code
|
981
|
| 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
|
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
|
$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
|
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
|
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
|
$2,582.00
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
9822453801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,910.94 |
| Max. Negotiated Rate |
$2,452.90 |
| Rate for Payer: Aetna of VT Commercial |
$2,452.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,910.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,910.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,194.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,168.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,065.60
|
| Rate for Payer: Cash Price |
$1,291.00
|
| Rate for Payer: Cigna Commercial |
$2,065.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,065.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,065.60
|
| Rate for Payer: Multiplan Commercial |
$2,401.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,194.70
|
| Rate for Payer: United Healthcare Commercial |
$2,452.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$648.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
5102456001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$479.58 |
| Max. Negotiated Rate |
$615.60 |
| Rate for Payer: Aetna of VT Commercial |
$615.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$479.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$479.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$550.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$544.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$518.40
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cigna Commercial |
$518.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$518.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$518.40
|
| Rate for Payer: Multiplan Commercial |
$602.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$550.80
|
| Rate for Payer: United Healthcare Commercial |
$615.60
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$930.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9602360001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$688.29 |
| Max. Negotiated Rate |
$883.50 |
| Rate for Payer: Aetna of VT Commercial |
$883.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$688.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$688.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$790.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$781.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$744.00
|
| Rate for Payer: Cash Price |
$465.00
|
| Rate for Payer: Cigna Commercial |
$744.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$744.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$744.00
|
| Rate for Payer: Multiplan Commercial |
$864.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$790.50
|
| Rate for Payer: United Healthcare Commercial |
$883.50
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$279.18
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
4502362001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.65 |
| Max. Negotiated Rate |
$265.22 |
| Rate for Payer: Aetna of VT Commercial |
$265.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$250.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$250.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$168.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$237.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$226.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$125.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$221.95
|
| Rate for Payer: Cash Price |
$139.59
|
| Rate for Payer: Cigna Commercial |
$223.34
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$223.34
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$223.34
|
| Rate for Payer: Martins Point Health Care Commercial |
$125.63
|
| Rate for Payer: Multiplan Commercial |
$259.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$237.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$125.63
|
| Rate for Payer: United Healthcare Commercial |
$265.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$125.63
|
| Rate for Payer: United Healthcare VA CCN |
$125.63
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9812453001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$215.69 |
| Max. Negotiated Rate |
$462.65 |
| Rate for Payer: Aetna of VT Commercial |
$462.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$215.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$293.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$394.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$219.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.17
|
| Rate for Payer: Cash Price |
$243.50
|
| Rate for Payer: Cigna Commercial |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$389.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$219.15
|
| Rate for Payer: Multiplan Commercial |
$452.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare Commercial |
$462.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare VA CCN |
$219.15
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$15,357.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$11,365.72 |
| Max. Negotiated Rate |
$14,589.15 |
| Rate for Payer: Aetna of VT Commercial |
$14,589.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$11,365.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$11,365.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$13,053.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$12,899.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$12,285.60
|
| Rate for Payer: Cash Price |
$7,678.50
|
| Rate for Payer: Cigna Commercial |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$12,285.60
|
| Rate for Payer: Multiplan Commercial |
$14,282.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$13,053.45
|
| Rate for Payer: United Healthcare Commercial |
$14,589.15
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
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 |
9602456002
|
|
Hospital Revenue Code
|
960
|
| 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
|
Facility
|
OP
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9812453002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$215.69 |
| Max. Negotiated Rate |
$462.65 |
| Rate for Payer: Aetna of VT Commercial |
$462.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$215.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$293.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$394.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$219.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.17
|
| Rate for Payer: Cash Price |
$243.50
|
| Rate for Payer: Cigna Commercial |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$389.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$219.15
|
| Rate for Payer: Multiplan Commercial |
$452.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare Commercial |
$462.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare VA CCN |
$219.15
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$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
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9602450502
|
|
Hospital Revenue Code
|
960
|
| 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
|
|
