|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$2,807.00
|
|
|
Service Code
|
CPT 27540
|
| Hospital Charge Code |
9822754001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,077.46 |
| Max. Negotiated Rate |
$2,666.65 |
| Rate for Payer: Aetna of VT Commercial |
$2,666.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,077.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,077.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,385.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,357.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,245.60
|
| Rate for Payer: Cash Price |
$1,403.50
|
| Rate for Payer: Cigna Commercial |
$2,245.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,245.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,245.60
|
| Rate for Payer: Multiplan Commercial |
$2,610.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,385.95
|
| Rate for Payer: United Healthcare Commercial |
$2,666.65
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$2,688.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
5102753201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,989.39 |
| Max. Negotiated Rate |
$2,553.60 |
| Rate for Payer: Aetna of VT Commercial |
$2,553.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,989.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,989.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,284.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,257.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,150.40
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cigna Commercial |
$2,150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,150.40
|
| Rate for Payer: Multiplan Commercial |
$2,499.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,284.80
|
| Rate for Payer: United Healthcare Commercial |
$2,553.60
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
OP
|
$3,585.00
|
|
|
Service Code
|
CPT 27536
|
| Hospital Charge Code |
9822753601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,587.80 |
| Max. Negotiated Rate |
$3,405.75 |
| Rate for Payer: Aetna of VT Commercial |
$3,405.75
|
| 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 |
$1,587.80
|
| 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 |
$2,158.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,047.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,903.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,613.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,850.07
|
| Rate for Payer: Cash Price |
$1,792.50
|
| Rate for Payer: Cigna Commercial |
$2,868.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,868.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,868.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,613.25
|
| Rate for Payer: Multiplan Commercial |
$3,334.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,047.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,613.25
|
| Rate for Payer: United Healthcare Commercial |
$3,405.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,613.25
|
| Rate for Payer: United Healthcare VA CCN |
$1,613.25
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
OP
|
$3,955.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
9602753201
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,751.67 |
| Max. Negotiated Rate |
$3,757.25 |
| Rate for Payer: Aetna of VT Commercial |
$3,757.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,543.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,751.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,543.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$2,380.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$3,361.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$3,203.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,779.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$3,144.22
|
| Rate for Payer: Cash Price |
$1,977.50
|
| Rate for Payer: Cigna Commercial |
$3,164.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$3,164.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$3,164.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,779.75
|
| Rate for Payer: Multiplan Commercial |
$3,678.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,361.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,779.75
|
| Rate for Payer: United Healthcare Commercial |
$3,757.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,779.75
|
| Rate for Payer: United Healthcare VA CCN |
$1,779.75
|
|
|
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
|
$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
|
Facility
|
OP
|
$2,688.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
5102753201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,190.52 |
| Max. Negotiated Rate |
$2,553.60 |
| Rate for Payer: Aetna of VT Commercial |
$2,553.60
|
| 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 |
$1,190.52
|
| 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 |
$1,618.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,284.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,177.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,209.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,136.96
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cigna Commercial |
$2,150.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,150.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,150.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,209.60
|
| Rate for Payer: Multiplan Commercial |
$2,499.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,284.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,209.60
|
| Rate for Payer: United Healthcare Commercial |
$2,553.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,209.60
|
| Rate for Payer: United Healthcare VA CCN |
$1,209.60
|
|
|
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
|
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
|
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
|
$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
|
$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
|
$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
|
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
|
$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
|
$1,616.00
|
|
|
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 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
|
$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 LOWER LEG FRACTURE
|
Facility
|
IP
|
$2,814.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9602782501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,082.64 |
| Max. Negotiated Rate |
$2,673.30 |
| Rate for Payer: Aetna of VT Commercial |
$2,673.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,082.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,082.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,391.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,363.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,251.20
|
| Rate for Payer: Cash Price |
$1,407.00
|
| Rate for Payer: Cigna Commercial |
$2,251.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,251.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,251.20
|
| Rate for Payer: Multiplan Commercial |
$2,617.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,391.90
|
| Rate for Payer: United Healthcare Commercial |
$2,673.30
|
|
|
TREAT LOWER LEG FRACTURE
|
Professional
|
Both
|
$3,437.00
|
|
|
Service Code
|
CPT 27827
|
| Hospital Charge Code |
9822782701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,053.12 |
| Max. Negotiated Rate |
$3,230.78 |
| Rate for Payer: Aetna of VT Commercial |
$3,230.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$3,079.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,084.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$3,079.21
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,474.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,508.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,508.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,211.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,508.21
|
| Rate for Payer: Cash Price |
$1,718.50
|
| Rate for Payer: Cash Price |
$1,718.50
|
| Rate for Payer: Cigna Commercial |
$2,001.49
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,752.23
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,752.23
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,053.13
|
| Rate for Payer: Multiplan Commercial |
$3,196.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,495.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,053.12
|
| Rate for Payer: United Healthcare Commercial |
$1,620.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,053.12
|
| Rate for Payer: United Healthcare VA CCN |
$1,053.12
|
|
|
TREAT LOWER LEG FRACTURE
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9812782402
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$283.10 |
| Max. Negotiated Rate |
$567.27 |
| Rate for Payer: Aetna of VT Commercial |
$297.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$283.10
|
| 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 |
$283.10
|
| 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 |
$158.00
|
| Rate for Payer: Cash Price |
$158.00
|
| 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 |
$293.88
|
| 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
|
OP
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9822782401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$139.96 |
| 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 |
$283.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$139.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$283.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$190.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$268.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$255.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$142.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$251.22
|
| 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: Martins Point Health Care Commercial |
$142.20
|
| Rate for Payer: Multiplan Commercial |
$293.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$268.60
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$142.20
|
| Rate for Payer: United Healthcare Commercial |
$300.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$142.20
|
| Rate for Payer: United Healthcare VA CCN |
$142.20
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$562.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9812782501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$415.94 |
| Max. Negotiated Rate |
$533.90 |
| Rate for Payer: Aetna of VT Commercial |
$533.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$415.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$415.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$477.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$472.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$449.60
|
| Rate for Payer: Cash Price |
$281.00
|
| Rate for Payer: Cigna Commercial |
$449.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$449.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$449.60
|
| Rate for Payer: Multiplan Commercial |
$522.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$477.70
|
| Rate for Payer: United Healthcare Commercial |
$533.90
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$1,745.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9822782501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$772.86 |
| 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 |
$1,563.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$772.86
|
| 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 |
$1,050.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,483.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,413.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$785.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,387.28
|
| 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: Martins Point Health Care Commercial |
$785.25
|
| Rate for Payer: Multiplan Commercial |
$1,622.85
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,483.25
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$785.25
|
| Rate for Payer: United Healthcare Commercial |
$1,657.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$785.25
|
| Rate for Payer: United Healthcare VA CCN |
$785.25
|
|
|
TREAT LOWER LEG FRACTURE
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9602782402
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$283.10 |
| Max. Negotiated Rate |
$567.27 |
| Rate for Payer: Aetna of VT Commercial |
$297.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$283.10
|
| 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 |
$283.10
|
| 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 |
$158.00
|
| Rate for Payer: Cash Price |
$158.00
|
| 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 |
$293.88
|
| 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
|
|
