|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9602360001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$313.95 |
| Max. Negotiated Rate |
$874.20 |
| Rate for Payer: Aetna of VT Commercial |
$874.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$833.19
|
| 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 |
$833.19
|
| 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 |
$465.00
|
| Rate for Payer: Cash Price |
$465.00
|
| Rate for Payer: Cigna Commercial |
$592.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$544.65
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$544.65
|
| Rate for Payer: Martins Point Health Care Commercial |
$331.61
|
| Rate for Payer: Multiplan Commercial |
$864.90
|
| 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
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$995.43 |
| Max. Negotiated Rate |
$1,277.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,277.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$995.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$995.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,143.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,129.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,076.00
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cigna Commercial |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,076.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,076.00
|
| Rate for Payer: Multiplan Commercial |
$1,250.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,143.25
|
| Rate for Payer: United Healthcare Commercial |
$1,277.75
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$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
|
$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
|
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
|
$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
|
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
|
$2,741.00
|
|
|
Service Code
|
CPT 24582
|
| Hospital Charge Code |
9822458201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,028.61 |
| Max. Negotiated Rate |
$2,603.95 |
| Rate for Payer: Aetna of VT Commercial |
$2,603.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,028.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,028.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,329.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,302.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,192.80
|
| Rate for Payer: Cash Price |
$1,370.50
|
| Rate for Payer: Cigna Commercial |
$2,192.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,192.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,192.80
|
| Rate for Payer: Multiplan Commercial |
$2,549.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,329.85
|
| Rate for Payer: United Healthcare Commercial |
$2,603.95
|
|
|
TREAT HUMERUS FRACTURE
|
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
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9812360001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$277.70 |
| Max. Negotiated Rate |
$595.65 |
| Rate for Payer: Aetna of VT Commercial |
$595.65
|
| 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 |
$277.70
|
| 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 |
$377.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$532.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$507.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$282.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$498.46
|
| Rate for Payer: Cash Price |
$313.50
|
| Rate for Payer: Cigna Commercial |
$501.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$501.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$501.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$282.15
|
| Rate for Payer: Multiplan Commercial |
$583.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$532.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.15
|
| Rate for Payer: United Healthcare Commercial |
$595.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.15
|
| Rate for Payer: United Healthcare VA CCN |
$282.15
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$303.04
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
4502360001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$224.28 |
| Max. Negotiated Rate |
$287.89 |
| Rate for Payer: Aetna of VT Commercial |
$287.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$254.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$242.43
|
| Rate for Payer: Cash Price |
$151.52
|
| Rate for Payer: Cigna Commercial |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$242.43
|
| Rate for Payer: Multiplan Commercial |
$281.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$257.58
|
| Rate for Payer: United Healthcare Commercial |
$287.89
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$2,322.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$807.78 |
| Max. Negotiated Rate |
$2,182.68 |
| Rate for Payer: Aetna of VT Commercial |
$2,182.68
|
| 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 |
$832.01
|
| 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 |
$1,130.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$928.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,548.78
|
| Rate for Payer: Cash Price |
$1,161.00
|
| Rate for Payer: Cash Price |
$1,161.00
|
| Rate for Payer: Cigna Commercial |
$1,530.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,349.02
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,349.02
|
| Rate for Payer: Martins Point Health Care Commercial |
$807.78
|
| Rate for Payer: Multiplan Commercial |
$2,159.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,147.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare Commercial |
$1,242.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare VA CCN |
$807.78
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$759.47
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
4502450001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$336.37 |
| 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 |
$680.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$336.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$680.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$457.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$645.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$615.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$341.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$603.78
|
| 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: Martins Point Health Care Commercial |
$341.76
|
| Rate for Payer: Multiplan Commercial |
$706.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$645.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$341.76
|
| Rate for Payer: United Healthcare Commercial |
$721.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$341.76
|
| Rate for Payer: United Healthcare VA CCN |
$341.76
|
|
|
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
|
IP
|
$1,141.64
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
4502360501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$844.93 |
| Max. Negotiated Rate |
$1,084.56 |
| Rate for Payer: Aetna of VT Commercial |
$1,084.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$844.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$844.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$970.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$958.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$913.31
|
| Rate for Payer: Cash Price |
$570.82
|
| Rate for Payer: Cigna Commercial |
$913.31
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$913.31
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$913.31
|
| Rate for Payer: Multiplan Commercial |
$1,061.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$970.39
|
| Rate for Payer: United Healthcare Commercial |
$1,084.56
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$627.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
9602360002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$464.04 |
| Max. Negotiated Rate |
$595.65 |
| Rate for Payer: Aetna of VT Commercial |
$595.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$464.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$464.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$532.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$526.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$501.60
|
| Rate for Payer: Cash Price |
$313.50
|
| Rate for Payer: Cigna Commercial |
$501.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$501.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$501.60
|
| Rate for Payer: Multiplan Commercial |
$583.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$532.95
|
| Rate for Payer: United Healthcare Commercial |
$595.65
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$731.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$323.76 |
| Max. Negotiated Rate |
$694.45 |
| Rate for Payer: Aetna of VT Commercial |
$694.45
|
| 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 |
$323.76
|
| 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 |
$440.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$621.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$592.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$328.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$581.14
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Cigna Commercial |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$584.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$328.95
|
| Rate for Payer: Multiplan Commercial |
$679.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$328.95
|
| Rate for Payer: United Healthcare Commercial |
$694.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$328.95
|
| Rate for Payer: United Healthcare VA CCN |
$328.95
|
|
|
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
|
$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
|
|
|
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
|
IP
|
$731.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$541.01 |
| Max. Negotiated Rate |
$694.45 |
| Rate for Payer: Aetna of VT Commercial |
$694.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$541.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$541.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$621.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$614.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$584.80
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Cigna Commercial |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$584.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$584.80
|
| Rate for Payer: Multiplan Commercial |
$679.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$621.35
|
| Rate for Payer: United Healthcare Commercial |
$694.45
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457601
|
|
Hospital Revenue Code
|
981
|
| 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
|
Professional
|
Both
|
$13,035.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
5102451601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$807.78 |
| Max. Negotiated Rate |
$12,252.90 |
| Rate for Payer: Aetna of VT Commercial |
$12,252.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$11,678.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$832.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$11,678.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,130.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,548.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$928.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,548.78
|
| Rate for Payer: Cash Price |
$6,517.50
|
| Rate for Payer: Cash Price |
$6,517.50
|
| Rate for Payer: Cigna Commercial |
$1,530.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,349.02
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,349.02
|
| Rate for Payer: Martins Point Health Care Commercial |
$807.78
|
| Rate for Payer: Multiplan Commercial |
$12,122.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,147.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare Commercial |
$1,242.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$807.78
|
| Rate for Payer: United Healthcare VA CCN |
$807.78
|
|
|
TREAT HUMERUS FRACTURE
|
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
|
IP
|
$633.84
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
4502457601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$469.10 |
| 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 |
$469.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$469.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$538.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$532.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$507.07
|
| 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: Multiplan Commercial |
$589.47
|
| Rate for Payer: MVP Health Care of NY Commercial |
$538.76
|
| Rate for Payer: United Healthcare Commercial |
$602.15
|
|
