|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$2,303.00
|
|
|
Service Code
|
CPT 24575
|
| Hospital Charge Code |
9822457501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,020.00 |
| 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 |
$2,063.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,020.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,063.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,386.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,957.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,865.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,036.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,830.88
|
| 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: Martins Point Health Care Commercial |
$1,036.35
|
| Rate for Payer: Multiplan Commercial |
$2,141.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,957.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,036.35
|
| Rate for Payer: United Healthcare Commercial |
$2,187.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,036.35
|
| Rate for Payer: United Healthcare VA CCN |
$1,036.35
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$414.12 |
| Max. Negotiated Rate |
$1,002.98 |
| Rate for Payer: Aetna of VT Commercial |
$1,002.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$955.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$426.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$955.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$579.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$730.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$730.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$476.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$730.66
|
| Rate for Payer: Cash Price |
$533.50
|
| Rate for Payer: Cash Price |
$533.50
|
| Rate for Payer: Cigna Commercial |
$785.29
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$757.05
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$757.05
|
| Rate for Payer: Martins Point Health Care Commercial |
$458.13
|
| Rate for Payer: Multiplan Commercial |
$992.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$588.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$414.12
|
| Rate for Payer: United Healthcare Commercial |
$637.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$414.12
|
| Rate for Payer: United Healthcare VA CCN |
$414.12
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$2,582.00
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
9822453801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,143.57 |
| 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 |
$2,313.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,143.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,313.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,554.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,194.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,091.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,161.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,052.69
|
| 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: Martins Point Health Care Commercial |
$1,161.90
|
| Rate for Payer: Multiplan Commercial |
$2,401.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,194.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,161.90
|
| Rate for Payer: United Healthcare Commercial |
$2,452.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,161.90
|
| Rate for Payer: United Healthcare VA CCN |
$1,161.90
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$310.59 |
| Max. Negotiated Rate |
$802.76 |
| Rate for Payer: Aetna of VT Commercial |
$802.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$319.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$765.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$434.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$469.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$469.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$357.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$469.97
|
| Rate for Payer: Cash Price |
$427.00
|
| Rate for Payer: Cash Price |
$427.00
|
| Rate for Payer: Cigna Commercial |
$588.03
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$573.44
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$573.44
|
| Rate for Payer: Martins Point Health Care Commercial |
$349.46
|
| Rate for Payer: Multiplan Commercial |
$794.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$441.04
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$310.59
|
| Rate for Payer: United Healthcare Commercial |
$477.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$310.59
|
| Rate for Payer: United Healthcare VA CCN |
$310.59
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
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
|
Facility
|
IP
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360501
|
|
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
|
Professional
|
Both
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457601
|
|
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
|
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
|
$2,741.00
|
|
|
Service Code
|
CPT 24582
|
| Hospital Charge Code |
9822458201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,213.99 |
| 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 |
$2,455.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,213.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,455.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,650.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,329.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,220.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,233.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,179.09
|
| 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: Martins Point Health Care Commercial |
$1,233.45
|
| Rate for Payer: Multiplan Commercial |
$2,549.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,329.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,233.45
|
| Rate for Payer: United Healthcare Commercial |
$2,603.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,233.45
|
| Rate for Payer: United Healthcare VA CCN |
$1,233.45
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$13,035.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
5102451601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9,647.20 |
| 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 |
$9,647.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$9,647.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$11,079.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$10,949.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$10,428.00
|
| 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: Multiplan Commercial |
$12,122.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$11,079.75
|
| Rate for Payer: United Healthcare Commercial |
$12,383.25
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
9812360502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$414.12 |
| Max. Negotiated Rate |
$1,002.98 |
| Rate for Payer: Aetna of VT Commercial |
$1,002.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$955.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$426.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$955.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$579.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$730.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$730.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$476.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$730.66
|
| Rate for Payer: Cash Price |
$533.50
|
| Rate for Payer: Cash Price |
$533.50
|
| Rate for Payer: Cigna Commercial |
$785.29
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$757.05
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$757.05
|
| Rate for Payer: Martins Point Health Care Commercial |
$458.13
|
| Rate for Payer: Multiplan Commercial |
$992.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$588.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$414.12
|
| Rate for Payer: United Healthcare Commercial |
$637.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$414.12
|
| Rate for Payer: United Healthcare VA CCN |
$414.12
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$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
|
IP
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9812450001
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9812456002
|
|
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
|
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
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$519.55 |
| 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 |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$596.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$589.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$561.60
|
| 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: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$596.70
|
| Rate for Payer: United Healthcare Commercial |
$666.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9602457602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$632.05 |
| Max. Negotiated Rate |
$811.30 |
| Rate for Payer: Aetna of VT Commercial |
$811.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$632.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$632.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$725.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$717.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$683.20
|
| Rate for Payer: Cash Price |
$427.00
|
| Rate for Payer: Cigna Commercial |
$683.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$683.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$683.20
|
| Rate for Payer: Multiplan Commercial |
$794.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$725.90
|
| Rate for Payer: United Healthcare Commercial |
$811.30
|
|
|
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
|
$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
|
$2,018.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9602450501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$893.77 |
| Max. Negotiated Rate |
$1,917.10 |
| Rate for Payer: Aetna of VT Commercial |
$1,917.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,807.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$893.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,807.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,214.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,715.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,634.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$908.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,604.31
|
| Rate for Payer: Cash Price |
$1,009.00
|
| Rate for Payer: Cigna Commercial |
$1,614.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,614.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,614.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$908.10
|
| Rate for Payer: Multiplan Commercial |
$1,876.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,715.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$908.10
|
| Rate for Payer: United Healthcare Commercial |
$1,917.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$908.10
|
| Rate for Payer: United Healthcare VA CCN |
$908.10
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450501
|
|
Hospital Revenue Code
|
981
|
| 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
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$257.89 |
| Max. Negotiated Rate |
$659.88 |
| Rate for Payer: Aetna of VT Commercial |
$659.88
|
| 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 |
$265.63
|
| 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 |
$361.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$433.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$433.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$433.93
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cigna Commercial |
$486.69
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$443.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$443.33
|
| Rate for Payer: Martins Point Health Care Commercial |
$269.77
|
| Rate for Payer: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$366.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$257.89
|
| Rate for Payer: United Healthcare Commercial |
$396.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$257.89
|
| Rate for Payer: United Healthcare VA CCN |
$257.89
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9812450001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$329.99 |
| Max. Negotiated Rate |
$856.34 |
| Rate for Payer: Aetna of VT Commercial |
$856.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$816.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$339.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$816.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$461.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$491.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$491.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$379.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$491.35
|
| Rate for Payer: Cash Price |
$455.50
|
| Rate for Payer: Cash Price |
$455.50
|
| Rate for Payer: Cigna Commercial |
$624.50
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$590.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$590.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$359.22
|
| Rate for Payer: Multiplan Commercial |
$847.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$468.59
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare Commercial |
$507.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$329.99
|
| Rate for Payer: United Healthcare VA CCN |
$329.99
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$519.55 |
| 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 |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$519.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$596.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$589.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$561.60
|
| 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: Multiplan Commercial |
$652.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$596.70
|
| Rate for Payer: United Healthcare Commercial |
$666.90
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,670.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9602450001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$739.64 |
| Max. Negotiated Rate |
$1,586.50 |
| Rate for Payer: Aetna of VT Commercial |
$1,586.50
|
| 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 |
$739.64
|
| 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 |
$1,005.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,419.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,352.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$751.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,327.65
|
| Rate for Payer: Cash Price |
$835.00
|
| Rate for Payer: Cigna Commercial |
$1,336.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,336.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,336.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$751.50
|
| Rate for Payer: Multiplan Commercial |
$1,553.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,419.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$751.50
|
| Rate for Payer: United Healthcare Commercial |
$1,586.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$751.50
|
| Rate for Payer: United Healthcare VA CCN |
$751.50
|
|
