|
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
|
Professional
|
Both
|
$874.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$332.31 |
| Max. Negotiated Rate |
$821.56 |
| Rate for Payer: Aetna of VT Commercial |
$821.56
|
| 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 |
$342.28
|
| 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 |
$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 |
$437.00
|
| Rate for Payer: Cash Price |
$437.00
|
| 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 |
$812.82
|
| 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
|
IP
|
$874.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$646.85 |
| 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 |
$646.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$646.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$742.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$734.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$699.20
|
| 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: Multiplan Commercial |
$812.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$742.90
|
| Rate for Payer: United Healthcare Commercial |
$830.30
|
|
|
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
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
9812756202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$359.69 |
| 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 |
$359.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$359.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$413.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$408.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$388.80
|
| 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: Multiplan Commercial |
$451.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$413.10
|
| Rate for Payer: United Healthcare Commercial |
$461.70
|
|
|
TREAT KNEECAP FRACTURE
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9822752001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$290.27 |
| Max. Negotiated Rate |
$561.92 |
| Rate for Payer: Aetna of VT Commercial |
$304.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$306.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$416.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$462.92
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$561.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.95
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$422.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare Commercial |
$457.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare VA CCN |
$297.57
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9812752001
|
|
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
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9822752001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$143.50 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna of VT Commercial |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$143.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$195.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$275.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$262.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$257.58
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$145.80
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$275.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$145.80
|
| Rate for Payer: United Healthcare Commercial |
$307.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$145.80
|
| Rate for Payer: United Healthcare VA CCN |
$145.80
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
OP
|
$2,456.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
9822752401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,087.76 |
| Max. Negotiated Rate |
$2,333.20 |
| Rate for Payer: Aetna of VT Commercial |
$2,333.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,200.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,087.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,200.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,478.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,087.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,989.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,105.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,952.52
|
| Rate for Payer: Cash Price |
$1,228.00
|
| Rate for Payer: Cigna Commercial |
$1,964.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,964.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,964.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,105.20
|
| Rate for Payer: Multiplan Commercial |
$2,284.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,087.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,105.20
|
| Rate for Payer: United Healthcare Commercial |
$2,333.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,105.20
|
| Rate for Payer: United Healthcare VA CCN |
$1,105.20
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9812752002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$239.79 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna of VT Commercial |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$239.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$239.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$275.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$272.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$259.20
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.20
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$275.40
|
| Rate for Payer: United Healthcare Commercial |
$307.80
|
|
|
TREAT KNEECAP FRACTURE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9812752001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$561.92 |
| 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 |
$306.50
|
| 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 |
$416.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$462.92
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$561.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.95
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$422.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare Commercial |
$457.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare VA CCN |
$297.57
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
5102752001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$115.15 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Aetna of VT Commercial |
$247.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$115.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$156.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$221.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$210.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$206.70
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cigna Commercial |
$208.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$208.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$208.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$117.00
|
| Rate for Payer: Multiplan Commercial |
$241.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$221.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$117.00
|
| Rate for Payer: United Healthcare Commercial |
$247.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$117.00
|
| Rate for Payer: United Healthcare VA CCN |
$117.00
|
|
|
TREAT KNEECAP FRACTURE
|
Professional
|
Both
|
$2,456.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
9822752401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$711.73 |
| Max. Negotiated Rate |
$2,308.64 |
| Rate for Payer: Aetna of VT Commercial |
$2,308.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,200.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$733.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,200.33
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$996.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,111.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,111.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$818.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,111.52
|
| Rate for Payer: Cash Price |
$1,228.00
|
| Rate for Payer: Cash Price |
$1,228.00
|
| Rate for Payer: Cigna Commercial |
$1,347.57
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,187.52
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,187.52
|
| Rate for Payer: Martins Point Health Care Commercial |
$711.73
|
| Rate for Payer: Multiplan Commercial |
$2,284.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,010.66
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$711.73
|
| Rate for Payer: United Healthcare Commercial |
$1,094.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$711.73
|
| Rate for Payer: United Healthcare VA CCN |
$711.73
|
|
|
TREAT KNEECAP FRACTURE
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9602752002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$290.27 |
| Max. Negotiated Rate |
$561.92 |
| Rate for Payer: Aetna of VT Commercial |
$304.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$306.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$416.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$462.92
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$561.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.95
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$422.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare Commercial |
$457.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare VA CCN |
$297.57
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
OP
|
$584.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9602752001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$258.65 |
| Max. Negotiated Rate |
$554.80 |
| Rate for Payer: Aetna of VT Commercial |
$554.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$523.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$258.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$523.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$351.57
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$496.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$473.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$262.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$464.28
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cigna Commercial |
$467.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$467.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$467.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$262.80
|
| Rate for Payer: Multiplan Commercial |
$543.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$496.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$262.80
|
| Rate for Payer: United Healthcare Commercial |
$554.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$262.80
|
| Rate for Payer: United Healthcare VA CCN |
$262.80
|
|
|
TREAT KNEECAP FRACTURE
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9602752001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$297.57 |
| Max. Negotiated Rate |
$561.92 |
| Rate for Payer: Aetna of VT Commercial |
$548.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$523.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$306.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$523.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$416.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$462.92
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cigna Commercial |
$561.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.95
|
| Rate for Payer: Multiplan Commercial |
$543.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$422.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare Commercial |
$457.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare VA CCN |
$297.57
|
|
|
TREAT KNEECAP FRACTURE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
5102752001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$232.93 |
| Max. Negotiated Rate |
$561.92 |
| Rate for Payer: Aetna of VT Commercial |
$244.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$306.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$416.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$462.92
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cigna Commercial |
$561.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.95
|
| Rate for Payer: Multiplan Commercial |
$241.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$422.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare Commercial |
$457.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare VA CCN |
$297.57
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9812752002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$143.50 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna of VT Commercial |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$143.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$195.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$275.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$262.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$257.58
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$145.80
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$275.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$145.80
|
| Rate for Payer: United Healthcare Commercial |
$307.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$145.80
|
| Rate for Payer: United Healthcare VA CCN |
$145.80
|
|
|
TREAT KNEECAP FRACTURE
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9812752002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$290.27 |
| Max. Negotiated Rate |
$561.92 |
| Rate for Payer: Aetna of VT Commercial |
$304.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$306.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$416.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$462.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$342.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$462.92
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$561.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$530.76
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$530.76
|
| Rate for Payer: Martins Point Health Care Commercial |
$322.95
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$422.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare Commercial |
$457.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$297.57
|
| Rate for Payer: United Healthcare VA CCN |
$297.57
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
IP
|
$259.41
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
4502752001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$191.99 |
| Max. Negotiated Rate |
$246.44 |
| Rate for Payer: Aetna of VT Commercial |
$246.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$191.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$191.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$220.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$217.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$207.53
|
| Rate for Payer: Cash Price |
$129.71
|
| Rate for Payer: Cigna Commercial |
$207.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$207.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$207.53
|
| Rate for Payer: Multiplan Commercial |
$241.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$220.50
|
| Rate for Payer: United Healthcare Commercial |
$246.44
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
IP
|
$584.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9602752001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$432.22 |
| Max. Negotiated Rate |
$554.80 |
| Rate for Payer: Aetna of VT Commercial |
$554.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$432.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$432.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$496.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$490.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$467.20
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cigna Commercial |
$467.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$467.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$467.20
|
| Rate for Payer: Multiplan Commercial |
$543.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$496.40
|
| Rate for Payer: United Healthcare Commercial |
$554.80
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
OP
|
$259.41
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
4502752001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$114.89 |
| Max. Negotiated Rate |
$246.44 |
| Rate for Payer: Aetna of VT Commercial |
$246.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$232.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$114.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$232.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$156.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$220.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$210.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$116.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$206.23
|
| Rate for Payer: Cash Price |
$129.71
|
| Rate for Payer: Cigna Commercial |
$207.53
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$207.53
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$207.53
|
| Rate for Payer: Martins Point Health Care Commercial |
$116.73
|
| Rate for Payer: Multiplan Commercial |
$241.25
|
| Rate for Payer: MVP Health Care of NY Commercial |
$220.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$116.73
|
| Rate for Payer: United Healthcare Commercial |
$246.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$116.73
|
| Rate for Payer: United Healthcare VA CCN |
$116.73
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9602752002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$239.79 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna of VT Commercial |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$239.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$239.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$275.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$272.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$259.20
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.20
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$275.40
|
| Rate for Payer: United Healthcare Commercial |
$307.80
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9822752001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$239.79 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna of VT Commercial |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$239.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$239.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$275.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$272.16
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$259.20
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.20
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$275.40
|
| Rate for Payer: United Healthcare Commercial |
$307.80
|
|
|
TREAT KNEECAP FRACTURE
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
9602752002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$143.50 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna of VT Commercial |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$143.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$290.27
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$195.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$275.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$262.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$145.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$257.58
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$259.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$259.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$145.80
|
| Rate for Payer: Multiplan Commercial |
$301.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$275.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$145.80
|
| Rate for Payer: United Healthcare Commercial |
$307.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$145.80
|
| Rate for Payer: United Healthcare VA CCN |
$145.80
|
|
