|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9602360002
|
|
Hospital Revenue Code
|
960
|
| 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
|
$721.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$319.33 |
| Max. Negotiated Rate |
$684.95 |
| Rate for Payer: Aetna of VT Commercial |
$684.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$645.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$319.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$645.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$434.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$612.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$584.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$573.20
|
| Rate for Payer: Cash Price |
$360.50
|
| Rate for Payer: Cigna Commercial |
$576.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$576.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$576.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$324.45
|
| Rate for Payer: Multiplan Commercial |
$670.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$612.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$324.45
|
| Rate for Payer: United Healthcare Commercial |
$684.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$324.45
|
| Rate for Payer: United Healthcare VA CCN |
$324.45
|
|
|
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
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
5102457601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$310.59 |
| Max. Negotiated Rate |
$595.96 |
| Rate for Payer: Aetna of VT Commercial |
$595.96
|
| 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 |
$319.91
|
| 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 |
$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 |
$317.00
|
| Rate for Payer: Cash Price |
$317.00
|
| 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 |
$589.62
|
| 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
|
$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
|
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
|
Facility
|
IP
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$789.69 |
| 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 |
$789.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$789.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$906.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$896.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$853.60
|
| 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: Multiplan Commercial |
$992.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$906.95
|
| Rate for Payer: United Healthcare Commercial |
$1,013.65
|
|
|
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
|
IP
|
$647.28
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
4502456001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$479.05 |
| 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 |
$479.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$479.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$550.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$543.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$517.82
|
| 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: Multiplan Commercial |
$601.97
|
| Rate for Payer: MVP Health Care of NY Commercial |
$550.19
|
| Rate for Payer: United Healthcare Commercial |
$614.92
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457602
|
|
Hospital Revenue Code
|
960
|
| 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
|
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
|
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
|
$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
|
$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
|
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
|
Professional
|
Both
|
$731.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$345.66 |
| Max. Negotiated Rate |
$687.14 |
| Rate for Payer: Aetna of VT Commercial |
$687.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$654.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$356.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$654.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$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 |
$365.50
|
| Rate for Payer: Cash Price |
$365.50
|
| 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 |
$679.83
|
| 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
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$437.85 |
| Max. Negotiated Rate |
$1,264.30 |
| Rate for Payer: Aetna of VT Commercial |
$1,264.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,204.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$450.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,204.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$612.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$865.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$865.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$503.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$865.54
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cigna Commercial |
$830.35
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$812.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$812.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$491.49
|
| Rate for Payer: Multiplan Commercial |
$1,250.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$437.85
|
| Rate for Payer: United Healthcare Commercial |
$673.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$437.85
|
| Rate for Payer: United Healthcare VA CCN |
$437.85
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$1,670.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$329.99 |
| Max. Negotiated Rate |
$1,569.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,569.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,496.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$339.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,496.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$461.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$491.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$491.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$379.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$491.35
|
| Rate for Payer: Cash Price |
$835.00
|
| Rate for Payer: Cash Price |
$835.00
|
| Rate for Payer: Cigna Commercial |
$624.50
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$590.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$590.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$359.22
|
| Rate for Payer: Multiplan Commercial |
$1,553.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$468.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare Commercial |
$507.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare VA CCN |
$329.99
|
|
|
TREAT HUMERUS FRACTURE
|
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
|
OP
|
$244.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
5102453001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.07 |
| 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 |
$218.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$108.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$218.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$146.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$207.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$197.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$109.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$193.98
|
| 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: Martins Point Health Care Commercial |
$109.80
|
| Rate for Payer: Multiplan Commercial |
$226.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$207.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$109.80
|
| Rate for Payer: United Healthcare Commercial |
$231.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109.80
|
| Rate for Payer: United Healthcare VA CCN |
$109.80
|
|
|
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
|
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
|
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
|
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
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457602
|
|
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
|
|
