|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$304.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
5102360001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$224.99 |
| Max. Negotiated Rate |
$288.80 |
| Rate for Payer: Aetna of VT Commercial |
$288.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$224.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$224.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$258.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$255.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$243.20
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cigna Commercial |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$243.20
|
| Rate for Payer: Multiplan Commercial |
$282.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$258.40
|
| Rate for Payer: United Healthcare Commercial |
$288.80
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$360.43 |
| Max. Negotiated Rate |
$462.65 |
| Rate for Payer: Aetna of VT Commercial |
$462.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$360.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$360.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$409.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$389.60
|
| Rate for Payer: Cash Price |
$243.50
|
| Rate for Payer: Cigna Commercial |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$389.60
|
| Rate for Payer: Multiplan Commercial |
$452.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.95
|
| Rate for Payer: United Healthcare Commercial |
$462.65
|
|
|
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
|
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
|
$854.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
9812457602
|
|
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
|
Facility
|
OP
|
$702.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
9812362001
|
|
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
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
5102360001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$272.35 |
| Max. Negotiated Rate |
$592.27 |
| Rate for Payer: Aetna of VT Commercial |
$285.76
|
| 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 |
$323.37
|
| 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 |
$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 |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| 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 |
$282.72
|
| 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
|
$487.00
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
9602453002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$215.69 |
| Max. Negotiated Rate |
$462.65 |
| Rate for Payer: Aetna of VT Commercial |
$462.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$215.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$293.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$394.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$219.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$387.17
|
| Rate for Payer: Cash Price |
$243.50
|
| Rate for Payer: Cigna Commercial |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$389.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$389.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$219.15
|
| Rate for Payer: Multiplan Commercial |
$452.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare Commercial |
$462.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$219.15
|
| Rate for Payer: United Healthcare VA CCN |
$219.15
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
9602456002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$285.79 |
| Max. Negotiated Rate |
$551.14 |
| Rate for Payer: Aetna of VT Commercial |
$299.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$300.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$285.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$408.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$530.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$530.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$335.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$530.87
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cigna Commercial |
$551.14
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$542.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$542.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$330.00
|
| Rate for Payer: Multiplan Commercial |
$296.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.87
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$291.46
|
| Rate for Payer: United Healthcare Commercial |
$448.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$291.46
|
| Rate for Payer: United Healthcare VA CCN |
$291.46
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$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
|
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
|
Facility
|
IP
|
$911.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
9812450002
|
|
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
|
$1,141.64
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
4502360501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$505.63 |
| 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 |
$1,022.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$505.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,022.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$687.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$970.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$924.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$513.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$907.60
|
| 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: Martins Point Health Care Commercial |
$513.74
|
| Rate for Payer: Multiplan Commercial |
$1,061.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$970.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$513.74
|
| Rate for Payer: United Healthcare Commercial |
$1,084.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$513.74
|
| Rate for Payer: United Healthcare VA CCN |
$513.74
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$672.10
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
4502450501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$497.42 |
| Max. Negotiated Rate |
$638.50 |
| Rate for Payer: Aetna of VT Commercial |
$638.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$497.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$497.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$571.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$564.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$537.68
|
| Rate for Payer: Cash Price |
$336.05
|
| Rate for Payer: Cigna Commercial |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$537.68
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$537.68
|
| Rate for Payer: Multiplan Commercial |
$625.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$571.28
|
| Rate for Payer: United Healthcare Commercial |
$638.50
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$1,345.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
9812450502
|
|
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
|
Facility
|
OP
|
$15,357.00
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
9602451601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$6,801.62 |
| Max. Negotiated Rate |
$14,589.15 |
| Rate for Payer: Aetna of VT Commercial |
$14,589.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$13,758.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$6,801.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$13,758.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$9,244.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$13,053.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$12,439.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$6,910.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$12,208.82
|
| Rate for Payer: Cash Price |
$7,678.50
|
| Rate for Payer: Cigna Commercial |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$12,285.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$12,285.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$6,910.65
|
| Rate for Payer: Multiplan Commercial |
$14,282.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$13,053.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$6,910.65
|
| Rate for Payer: United Healthcare Commercial |
$14,589.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,910.65
|
| Rate for Payer: United Healthcare VA CCN |
$6,910.65
|
|
|
TREAT HUMERUS FRACTURE
|
Professional
|
Both
|
$3,493.00
|
|
|
Service Code
|
CPT 24546
|
| Hospital Charge Code |
9822454601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$975.15 |
| Max. Negotiated Rate |
$3,283.42 |
| Rate for Payer: Aetna of VT Commercial |
$3,283.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,129.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,004.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,129.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,365.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,673.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,673.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,121.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,673.62
|
| Rate for Payer: Cash Price |
$1,746.50
|
| Rate for Payer: Cash Price |
$1,746.50
|
| Rate for Payer: Cigna Commercial |
$1,844.51
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,629.31
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,629.31
|
| Rate for Payer: Martins Point Health Care Commercial |
$975.16
|
| Rate for Payer: Multiplan Commercial |
$3,248.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,384.71
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$975.15
|
| Rate for Payer: United Healthcare Commercial |
$1,500.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$975.15
|
| Rate for Payer: United Healthcare VA CCN |
$975.15
|
|
|
TREAT KNEECAP DISLOCATION
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$387.09 |
| Max. Negotiated Rate |
$830.30 |
| Rate for Payer: Aetna of VT Commercial |
$830.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$783.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$387.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$783.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$526.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$742.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$707.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$393.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$694.83
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$699.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$699.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$699.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$393.30
|
| Rate for Payer: Multiplan Commercial |
$812.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$742.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$393.30
|
| Rate for Payer: United Healthcare Commercial |
$830.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$393.30
|
| Rate for Payer: United Healthcare VA CCN |
$393.30
|
|
|
TREAT KNEECAP DISLOCATION
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$215.25 |
| Max. Negotiated Rate |
$461.70 |
| Rate for Payer: Aetna of VT Commercial |
$461.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$435.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$215.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$435.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$292.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$393.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$218.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$386.37
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna Commercial |
$388.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$388.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$388.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$218.70
|
| Rate for Payer: Multiplan Commercial |
$451.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$218.70
|
| Rate for Payer: United Healthcare Commercial |
$461.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$218.70
|
| Rate for Payer: United Healthcare VA CCN |
$218.70
|
|
|
TREAT KNEECAP DISLOCATION
|
Professional
|
Both
|
$486.00
|
|
|
Service Code
|
CPT 27562
|
| Hospital Charge Code |
9812756202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$435.41 |
| Max. Negotiated Rate |
$893.34 |
| Rate for Payer: Aetna of VT Commercial |
$456.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$435.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$487.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$435.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$662.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$784.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$784.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$543.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$784.20
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna Commercial |
$893.34
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$785.34
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$785.34
|
| Rate for Payer: Martins Point Health Care Commercial |
$472.93
|
| Rate for Payer: Multiplan Commercial |
$451.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$671.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$472.93
|
| Rate for Payer: United Healthcare Commercial |
$727.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$472.93
|
| Rate for Payer: United Healthcare VA CCN |
$472.93
|
|
|
TREAT KNEECAP DISLOCATION
|
Facility
|
OP
|
$576.66
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
4502756001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$255.40 |
| Max. Negotiated Rate |
$547.83 |
| Rate for Payer: Aetna of VT Commercial |
$547.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$516.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$255.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$516.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$347.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$490.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$467.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$259.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$458.44
|
| Rate for Payer: Cash Price |
$288.33
|
| Rate for Payer: Cigna Commercial |
$461.33
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$461.33
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$461.33
|
| Rate for Payer: Martins Point Health Care Commercial |
$259.50
|
| Rate for Payer: Multiplan Commercial |
$536.29
|
| Rate for Payer: MVP Health Care of NY Commercial |
$490.16
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$259.50
|
| Rate for Payer: United Healthcare Commercial |
$547.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.50
|
| Rate for Payer: United Healthcare VA CCN |
$259.50
|
|
|
TREAT KNEECAP DISLOCATION
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$630.76 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$342.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$465.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$536.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$536.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$382.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$536.74
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$630.76
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$603.79
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$603.79
|
| Rate for Payer: Martins Point Health Care Commercial |
$365.40
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$471.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$332.31
|
| Rate for Payer: United Healthcare Commercial |
$511.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$332.31
|
| Rate for Payer: United Healthcare VA CCN |
$332.31
|
|
|
TREAT KNEECAP DISLOCATION
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
TREAT KNEECAP DISLOCATION
|
Facility
|
OP
|
$796.18
|
|
|
Service Code
|
CPT 27562
|
| Hospital Charge Code |
4502756201
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$352.63 |
| Max. Negotiated Rate |
$756.37 |
| Rate for Payer: Aetna of VT Commercial |
$756.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$713.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$352.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$713.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$479.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$676.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$644.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$358.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$632.96
|
| Rate for Payer: Cash Price |
$398.09
|
| Rate for Payer: Cigna Commercial |
$636.94
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$636.94
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$636.94
|
| Rate for Payer: Martins Point Health Care Commercial |
$358.28
|
| Rate for Payer: Multiplan Commercial |
$740.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$676.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$358.28
|
| Rate for Payer: United Healthcare Commercial |
$756.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$358.28
|
| Rate for Payer: United Healthcare VA CCN |
$358.28
|
|
|
TREAT KNEECAP DISLOCATION
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
