|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
9812753201
|
|
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 KNEE FRACTURE
|
Professional
|
Both
|
$1,267.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
9602753202
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$554.60 |
| Max. Negotiated Rate |
$1,190.98 |
| Rate for Payer: Aetna of VT Commercial |
$1,190.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,135.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$571.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,135.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$776.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,086.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,086.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$637.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,086.37
|
| Rate for Payer: Cash Price |
$633.50
|
| Rate for Payer: Cash Price |
$633.50
|
| Rate for Payer: Cigna Commercial |
$1,049.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$990.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$990.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$596.36
|
| Rate for Payer: Multiplan Commercial |
$1,178.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$787.53
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$554.60
|
| Rate for Payer: United Healthcare Commercial |
$853.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$554.60
|
| Rate for Payer: United Healthcare VA CCN |
$554.60
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$3,004.00
|
|
|
Service Code
|
CPT 27535
|
| Hospital Charge Code |
9822753501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,223.26 |
| Max. Negotiated Rate |
$2,853.80 |
| Rate for Payer: Aetna of VT Commercial |
$2,853.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,223.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,223.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,553.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,523.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,403.20
|
| Rate for Payer: Cash Price |
$1,502.00
|
| Rate for Payer: Cigna Commercial |
$2,403.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,403.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,403.20
|
| Rate for Payer: Multiplan Commercial |
$2,793.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,553.40
|
| Rate for Payer: United Healthcare Commercial |
$2,853.80
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$1,267.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
9812753202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$937.71 |
| Max. Negotiated Rate |
$1,203.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,203.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$937.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$937.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,076.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,064.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,013.60
|
| Rate for Payer: Cash Price |
$633.50
|
| Rate for Payer: Cigna Commercial |
$1,013.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,013.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,013.60
|
| Rate for Payer: Multiplan Commercial |
$1,178.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,076.95
|
| Rate for Payer: United Healthcare Commercial |
$1,203.65
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$1,267.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
9822753201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$937.71 |
| Max. Negotiated Rate |
$1,203.65 |
| Rate for Payer: Aetna of VT Commercial |
$1,203.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$937.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$937.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,076.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,064.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,013.60
|
| Rate for Payer: Cash Price |
$633.50
|
| Rate for Payer: Cigna Commercial |
$1,013.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,013.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,013.60
|
| Rate for Payer: Multiplan Commercial |
$1,178.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,076.95
|
| Rate for Payer: United Healthcare Commercial |
$1,203.65
|
|
|
TREAT KNEE FRACTURE
|
Professional
|
Both
|
$3,585.00
|
|
|
Service Code
|
CPT 27536
|
| Hospital Charge Code |
9822753601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,110.35 |
| Max. Negotiated Rate |
$3,369.90 |
| Rate for Payer: Aetna of VT Commercial |
$3,369.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,211.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,211.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,554.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,614.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,614.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,276.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,614.78
|
| Rate for Payer: Cash Price |
$1,792.50
|
| Rate for Payer: Cash Price |
$1,792.50
|
| Rate for Payer: Cigna Commercial |
$2,102.64
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,858.17
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,858.17
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,110.35
|
| Rate for Payer: Multiplan Commercial |
$3,334.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,576.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,110.35
|
| Rate for Payer: United Healthcare Commercial |
$1,708.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,110.35
|
| Rate for Payer: United Healthcare VA CCN |
$1,110.35
|
|
|
TREAT KNEE FRACTURE
|
Professional
|
Both
|
$2,688.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
5102753201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$554.60 |
| Max. Negotiated Rate |
$2,526.72 |
| Rate for Payer: Aetna of VT Commercial |
$2,526.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,408.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$571.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,408.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$776.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,086.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,086.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$637.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,086.37
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cigna Commercial |
$1,049.13
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$990.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$990.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$596.36
|
| Rate for Payer: Multiplan Commercial |
$2,499.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$787.53
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$554.60
|
| Rate for Payer: United Healthcare Commercial |
$853.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$554.60
|
| Rate for Payer: United Healthcare VA CCN |
$554.60
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$710.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
9812670002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$314.46 |
| Max. Negotiated Rate |
$674.50 |
| Rate for Payer: Aetna of VT Commercial |
$674.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$314.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$427.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$603.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$575.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$319.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$564.45
|
| Rate for Payer: Cash Price |
$355.00
|
| Rate for Payer: Cigna Commercial |
$568.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$568.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$568.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$319.50
|
| Rate for Payer: Multiplan Commercial |
$660.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$603.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$319.50
|
| Rate for Payer: United Healthcare Commercial |
$674.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$319.50
|
| Rate for Payer: United Healthcare VA CCN |
$319.50
|
|
|
TREAT KNUCKLE DISLOCATION
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
9812670002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$307.82 |
| Max. Negotiated Rate |
$667.40 |
| Rate for Payer: Aetna of VT Commercial |
$667.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$636.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$317.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$636.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$430.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$429.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$429.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$353.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$429.10
|
| Rate for Payer: Cash Price |
$355.00
|
| Rate for Payer: Cash Price |
$355.00
|
| Rate for Payer: Cigna Commercial |
$580.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$553.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$553.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$335.12
|
| Rate for Payer: Multiplan Commercial |
$660.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$437.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$307.82
|
| Rate for Payer: United Healthcare Commercial |
$473.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$307.82
|
| Rate for Payer: United Healthcare VA CCN |
$307.82
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
9812670001
|
|
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 KNUCKLE DISLOCATION
|
Facility
|
IP
|
$710.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
9812670002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$525.47 |
| Max. Negotiated Rate |
$674.50 |
| Rate for Payer: Aetna of VT Commercial |
$674.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$525.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$525.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$603.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$596.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$568.00
|
| Rate for Payer: Cash Price |
$355.00
|
| Rate for Payer: Cigna Commercial |
$568.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$568.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$568.00
|
| Rate for Payer: Multiplan Commercial |
$660.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$603.50
|
| Rate for Payer: United Healthcare Commercial |
$674.50
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$1,616.00
|
|
|
Service Code
|
CPT 26715
|
| Hospital Charge Code |
9822671501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$715.73 |
| Max. Negotiated Rate |
$1,535.20 |
| Rate for Payer: Aetna of VT Commercial |
$1,535.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,447.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$715.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,447.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$972.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,373.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,308.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$727.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,284.72
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cigna Commercial |
$1,292.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,292.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,292.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$727.20
|
| Rate for Payer: Multiplan Commercial |
$1,502.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,373.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$727.20
|
| Rate for Payer: United Healthcare Commercial |
$1,535.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$727.20
|
| Rate for Payer: United Healthcare VA CCN |
$727.20
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$654.78
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
4502670001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.00 |
| Max. Negotiated Rate |
$622.04 |
| Rate for Payer: Aetna of VT Commercial |
$622.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$586.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$290.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$586.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$394.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$556.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$530.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$294.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$520.55
|
| Rate for Payer: Cash Price |
$327.39
|
| Rate for Payer: Cigna Commercial |
$523.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$523.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$523.82
|
| Rate for Payer: Martins Point Health Care Commercial |
$294.65
|
| Rate for Payer: Multiplan Commercial |
$608.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$556.56
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$294.65
|
| Rate for Payer: United Healthcare Commercial |
$622.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$294.65
|
| Rate for Payer: United Healthcare VA CCN |
$294.65
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
9812670001
|
|
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 KNUCKLE DISLOCATION
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
9812670001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$580.89 |
| 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 |
$317.05
|
| 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 |
$430.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$429.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$429.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$353.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$429.10
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$580.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$553.90
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$553.90
|
| Rate for Payer: Martins Point Health Care Commercial |
$335.12
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$437.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$307.82
|
| Rate for Payer: United Healthcare Commercial |
$473.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$307.82
|
| Rate for Payer: United Healthcare VA CCN |
$307.82
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
IP
|
$654.78
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
4502670001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$484.60 |
| Max. Negotiated Rate |
$622.04 |
| Rate for Payer: Aetna of VT Commercial |
$622.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$484.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$484.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$556.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$550.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$523.82
|
| Rate for Payer: Cash Price |
$327.39
|
| Rate for Payer: Cigna Commercial |
$523.82
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$523.82
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$523.82
|
| Rate for Payer: Multiplan Commercial |
$608.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$556.56
|
| Rate for Payer: United Healthcare Commercial |
$622.04
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
IP
|
$1,616.00
|
|
|
Service Code
|
CPT 26715
|
| Hospital Charge Code |
9822671501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,196.00 |
| Max. Negotiated Rate |
$1,535.20 |
| Rate for Payer: Aetna of VT Commercial |
$1,535.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,196.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,196.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,373.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,357.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,292.80
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cigna Commercial |
$1,292.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,292.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,292.80
|
| Rate for Payer: Multiplan Commercial |
$1,502.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,373.60
|
| Rate for Payer: United Healthcare Commercial |
$1,535.20
|
|
|
TREAT KNUCKLE DISLOCATION
|
Professional
|
Both
|
$1,616.00
|
|
|
Service Code
|
CPT 26715
|
| Hospital Charge Code |
9822671501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$551.14 |
| Max. Negotiated Rate |
$1,519.04 |
| Rate for Payer: Aetna of VT Commercial |
$1,519.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,447.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$567.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,447.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$771.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$802.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$802.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$633.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$802.66
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cigna Commercial |
$1,041.89
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$913.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$913.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$551.14
|
| Rate for Payer: Multiplan Commercial |
$1,502.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$782.63
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$551.15
|
| Rate for Payer: United Healthcare Commercial |
$847.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$551.15
|
| Rate for Payer: United Healthcare VA CCN |
$551.15
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$4,017.00
|
|
|
Service Code
|
CPT 27828
|
| Hospital Charge Code |
9822782801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,972.98 |
| Max. Negotiated Rate |
$3,816.15 |
| Rate for Payer: Aetna of VT Commercial |
$3,816.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,972.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,972.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,414.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,374.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,213.60
|
| Rate for Payer: Cash Price |
$2,008.50
|
| Rate for Payer: Cigna Commercial |
$3,213.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,213.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,213.60
|
| Rate for Payer: Multiplan Commercial |
$3,735.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,414.45
|
| Rate for Payer: United Healthcare Commercial |
$3,816.15
|
|
|
TREAT LOWER LEG FRACTURE
|
Professional
|
Both
|
$1,745.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9812782502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$473.33 |
| Max. Negotiated Rate |
$1,640.30 |
| Rate for Payer: Aetna of VT Commercial |
$1,640.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,563.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$487.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,563.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$662.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$944.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$944.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$544.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$944.38
|
| Rate for Payer: Cash Price |
$872.50
|
| Rate for Payer: Cash Price |
$872.50
|
| Rate for Payer: Cigna Commercial |
$892.85
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$876.37
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$876.37
|
| Rate for Payer: Martins Point Health Care Commercial |
$528.25
|
| Rate for Payer: Multiplan Commercial |
$1,622.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$672.13
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$473.33
|
| Rate for Payer: United Healthcare Commercial |
$728.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$473.33
|
| Rate for Payer: United Healthcare VA CCN |
$473.33
|
|
|
TREAT LOWER LEG FRACTURE
|
Professional
|
Both
|
$974.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9602782401
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$300.71 |
| Max. Negotiated Rate |
$915.56 |
| Rate for Payer: Aetna of VT Commercial |
$915.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$872.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$309.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$872.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$420.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$512.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$512.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$345.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$512.59
|
| Rate for Payer: Cash Price |
$487.00
|
| Rate for Payer: Cash Price |
$487.00
|
| Rate for Payer: Cigna Commercial |
$567.27
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$511.73
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$511.73
|
| Rate for Payer: Martins Point Health Care Commercial |
$310.67
|
| Rate for Payer: Multiplan Commercial |
$905.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$427.01
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$300.71
|
| Rate for Payer: United Healthcare Commercial |
$462.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$300.71
|
| Rate for Payer: United Healthcare VA CCN |
$300.71
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$1,745.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9812782502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,291.47 |
| Max. Negotiated Rate |
$1,657.75 |
| Rate for Payer: Aetna of VT Commercial |
$1,657.75
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,291.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,291.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,483.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,465.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,396.00
|
| Rate for Payer: Cash Price |
$872.50
|
| Rate for Payer: Cigna Commercial |
$1,396.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,396.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,396.00
|
| Rate for Payer: Multiplan Commercial |
$1,622.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,483.25
|
| Rate for Payer: United Healthcare Commercial |
$1,657.75
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9602782402
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$233.87 |
| Max. Negotiated Rate |
$300.20 |
| Rate for Payer: Aetna of VT Commercial |
$300.20
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$233.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$233.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$268.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$265.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$252.80
|
| Rate for Payer: Cash Price |
$158.00
|
| Rate for Payer: Cigna Commercial |
$252.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$252.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$293.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$268.60
|
| Rate for Payer: United Healthcare Commercial |
$300.20
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$1,069.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
5102782501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$791.17 |
| Max. Negotiated Rate |
$1,015.55 |
| Rate for Payer: Aetna of VT Commercial |
$1,015.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$791.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$791.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$908.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$897.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$855.20
|
| Rate for Payer: Cash Price |
$534.50
|
| Rate for Payer: Cigna Commercial |
$855.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$855.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$855.20
|
| Rate for Payer: Multiplan Commercial |
$994.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$908.65
|
| Rate for Payer: United Healthcare Commercial |
$1,015.55
|
|
|
TREAT LOWER LEG FRACTURE
|
Professional
|
Both
|
$4,017.00
|
|
|
Service Code
|
CPT 27828
|
| Hospital Charge Code |
9822782801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,239.89 |
| Max. Negotiated Rate |
$3,775.98 |
| Rate for Payer: Aetna of VT Commercial |
$3,775.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,598.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,277.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,598.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,735.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,836.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,836.19
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,425.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,836.19
|
| Rate for Payer: Cash Price |
$2,008.50
|
| Rate for Payer: Cash Price |
$2,008.50
|
| Rate for Payer: Cigna Commercial |
$2,360.04
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,065.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,065.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,239.89
|
| Rate for Payer: Multiplan Commercial |
$3,735.81
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,760.64
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,239.89
|
| Rate for Payer: United Healthcare Commercial |
$1,907.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,239.89
|
| Rate for Payer: United Healthcare VA CCN |
$1,239.89
|
|
