|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$236.09 |
| Max. Negotiated Rate |
$303.05 |
| Rate for Payer: Aetna of VT Commercial |
$303.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$236.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$236.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$271.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$267.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$255.20
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cigna Commercial |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$255.20
|
| Rate for Payer: Multiplan Commercial |
$296.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$271.15
|
| Rate for Payer: United Healthcare Commercial |
$303.05
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$759.47
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
4502450001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$562.08 |
| Max. Negotiated Rate |
$721.50 |
| Rate for Payer: Aetna of VT Commercial |
$721.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$562.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$562.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$645.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$637.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$607.58
|
| Rate for Payer: Cash Price |
$379.74
|
| Rate for Payer: Cigna Commercial |
$607.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$607.58
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$607.58
|
| Rate for Payer: Multiplan Commercial |
$706.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$645.55
|
| Rate for Payer: United Healthcare Commercial |
$721.50
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
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
|
OP
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$141.29 |
| Max. Negotiated Rate |
$303.05 |
| Rate for Payer: Aetna of VT Commercial |
$303.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$141.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$192.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$271.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$258.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$143.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$253.60
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cigna Commercial |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$255.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$143.55
|
| Rate for Payer: Multiplan Commercial |
$296.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$271.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$143.55
|
| Rate for Payer: United Healthcare Commercial |
$303.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.55
|
| Rate for Payer: United Healthcare VA CCN |
$143.55
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,487.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$658.59 |
| Max. Negotiated Rate |
$1,412.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,412.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$658.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,332.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$895.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,263.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,204.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$669.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,182.16
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,189.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$669.15
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,263.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$669.15
|
| Rate for Payer: United Healthcare Commercial |
$1,412.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$669.15
|
| Rate for Payer: United Healthcare VA CCN |
$669.15
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9602450502
|
|
Hospital Revenue Code
|
960
|
| 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
|
Facility
|
IP
|
$672.10
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
4502450501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$497.42 |
| Max. Negotiated Rate |
$638.50 |
| Rate for Payer: Aetna of VT Commercial |
$638.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$497.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$497.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$571.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$564.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$537.68
|
| Rate for Payer: Cash Price |
$336.05
|
| Rate for Payer: Cigna Commercial |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$537.68
|
| Rate for Payer: Multiplan Commercial |
$625.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$571.28
|
| Rate for Payer: United Healthcare Commercial |
$638.50
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$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
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
5102450001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$329.99 |
| Max. Negotiated Rate |
$714.40 |
| Rate for Payer: Aetna of VT Commercial |
$714.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$680.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$339.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$680.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$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 |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cigna Commercial |
$624.50
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$590.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$590.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$359.22
|
| Rate for Payer: Multiplan Commercial |
$706.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$468.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare Commercial |
$507.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare VA CCN |
$329.99
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$1,487.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,100.53 |
| Max. Negotiated Rate |
$1,412.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,412.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,100.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,100.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,263.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,249.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,189.60
|
| Rate for Payer: Cash Price |
$743.50
|
| Rate for Payer: Cigna Commercial |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,189.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,189.60
|
| Rate for Payer: Multiplan Commercial |
$1,382.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,263.95
|
| Rate for Payer: United Healthcare Commercial |
$1,412.65
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$633.84
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
4502457601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$280.73 |
| Max. Negotiated Rate |
$602.15 |
| Rate for Payer: Aetna of VT Commercial |
$602.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$567.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$280.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$567.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$381.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$538.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$513.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$285.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$503.90
|
| Rate for Payer: Cash Price |
$316.92
|
| Rate for Payer: Cigna Commercial |
$507.07
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$285.23
|
| Rate for Payer: Multiplan Commercial |
$589.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$538.76
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$285.23
|
| Rate for Payer: United Healthcare Commercial |
$602.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$285.23
|
| Rate for Payer: United Healthcare VA CCN |
$285.23
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$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
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$310.92 |
| Max. Negotiated Rate |
$666.90 |
| Rate for Payer: Aetna of VT Commercial |
$666.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$628.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$310.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$628.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$422.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$596.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$568.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$315.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$558.09
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cigna Commercial |
$561.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$561.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$561.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$315.90
|
| Rate for Payer: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$596.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$315.90
|
| Rate for Payer: United Healthcare Commercial |
$666.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$315.90
|
| Rate for Payer: United Healthcare VA CCN |
$315.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453002
|
|
Hospital Revenue Code
|
960
|
| 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
|
OP
|
$672.10
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
4502450501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.67 |
| Max. Negotiated Rate |
$638.50 |
| Rate for Payer: Aetna of VT Commercial |
$638.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$602.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$297.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$602.13
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$404.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$571.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$544.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$302.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$534.32
|
| Rate for Payer: Cash Price |
$336.05
|
| Rate for Payer: Cigna Commercial |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$537.68
|
| Rate for Payer: Martins Point Health Care Commercial |
$302.44
|
| Rate for Payer: Multiplan Commercial |
$625.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$571.28
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$302.44
|
| Rate for Payer: United Healthcare Commercial |
$638.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$302.44
|
| Rate for Payer: United Healthcare VA CCN |
$302.44
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
5102450001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$336.60 |
| Max. Negotiated Rate |
$722.00 |
| Rate for Payer: Aetna of VT Commercial |
$722.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$680.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$336.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$680.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$457.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$646.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$615.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$604.20
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cigna Commercial |
$608.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$608.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$608.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$342.00
|
| Rate for Payer: Multiplan Commercial |
$706.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$646.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$342.00
|
| Rate for Payer: United Healthcare Commercial |
$722.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$342.00
|
| Rate for Payer: United Healthcare VA CCN |
$342.00
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9812456001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$141.29 |
| Max. Negotiated Rate |
$303.05 |
| Rate for Payer: Aetna of VT Commercial |
$303.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$141.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$192.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$271.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$258.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$143.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$253.60
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cigna Commercial |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$255.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$255.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$143.55
|
| Rate for Payer: Multiplan Commercial |
$296.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$271.15
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$143.55
|
| Rate for Payer: United Healthcare Commercial |
$303.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.55
|
| Rate for Payer: United Healthcare VA CCN |
$143.55
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
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
|
OP
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9602450502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$595.70 |
| Max. Negotiated Rate |
$1,277.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,277.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,204.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$595.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,204.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$809.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,143.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,089.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$605.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,069.28
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cigna Commercial |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,076.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$605.25
|
| Rate for Payer: Multiplan Commercial |
$1,250.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,143.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$605.25
|
| Rate for Payer: United Healthcare Commercial |
$1,277.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$605.25
|
| Rate for Payer: United Healthcare VA CCN |
$605.25
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$304.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
5102360001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$134.64 |
| Max. Negotiated Rate |
$288.80 |
| Rate for Payer: Aetna of VT Commercial |
$288.80
|
| 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 |
$134.64
|
| 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 |
$183.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$258.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$246.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$136.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$241.68
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cigna Commercial |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$243.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.80
|
| Rate for Payer: Multiplan Commercial |
$282.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$258.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$136.80
|
| Rate for Payer: United Healthcare Commercial |
$288.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$136.80
|
| Rate for Payer: United Healthcare VA CCN |
$136.80
|
|
|
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
|
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
|
Facility
|
OP
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450002
|
|
Hospital Revenue Code
|
960
|
| 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
|
$304.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
5102360001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$224.99 |
| Max. Negotiated Rate |
$288.80 |
| Rate for Payer: Aetna of VT Commercial |
$288.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$224.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$224.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$258.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$255.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$243.20
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cigna Commercial |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$243.20
|
| Rate for Payer: Multiplan Commercial |
$282.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$258.40
|
| Rate for Payer: United Healthcare Commercial |
$288.80
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$674.23 |
| Max. Negotiated Rate |
$865.45 |
| Rate for Payer: Aetna of VT Commercial |
$865.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$674.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$674.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$774.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$765.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$728.80
|
| Rate for Payer: Cash Price |
$455.50
|
| Rate for Payer: Cigna Commercial |
$728.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$728.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$728.80
|
| Rate for Payer: Multiplan Commercial |
$847.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$774.35
|
| Rate for Payer: United Healthcare Commercial |
$865.45
|
|
