|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$657.62
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
4502782401
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$291.26 |
| Max. Negotiated Rate |
$624.74 |
| Rate for Payer: Aetna of VT Commercial |
$624.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$589.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.26
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$589.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$558.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$532.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$295.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$522.81
|
| Rate for Payer: Cash Price |
$328.81
|
| Rate for Payer: Cigna Commercial |
$526.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$526.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$526.10
|
| Rate for Payer: Martins Point Health Care Commercial |
$295.93
|
| Rate for Payer: Multiplan Commercial |
$611.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$558.98
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$295.93
|
| Rate for Payer: United Healthcare Commercial |
$624.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$295.93
|
| Rate for Payer: United Healthcare VA CCN |
$295.93
|
|
|
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
|
Professional
|
Both
|
$1,069.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
5102782501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$473.33 |
| Max. Negotiated Rate |
$1,004.86 |
| Rate for Payer: Aetna of VT Commercial |
$1,004.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$957.72
|
| 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 |
$957.72
|
| 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 |
$534.50
|
| Rate for Payer: Cash Price |
$534.50
|
| 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 |
$994.17
|
| 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
|
$658.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
5102782401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$300.71 |
| Max. Negotiated Rate |
$618.52 |
| Rate for Payer: Aetna of VT Commercial |
$618.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$589.50
|
| 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 |
$589.50
|
| 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 |
$329.00
|
| Rate for Payer: Cash Price |
$329.00
|
| 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 |
$611.94
|
| 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
|
$1,745.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9812782502
|
|
Hospital Revenue Code
|
981
|
| 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
|
Facility
|
OP
|
$3,437.00
|
|
|
Service Code
|
CPT 27827
|
| Hospital Charge Code |
9822782701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,522.25 |
| Max. Negotiated Rate |
$3,265.15 |
| Rate for Payer: Aetna of VT Commercial |
$3,265.15
|
| 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 |
$1,522.25
|
| 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 |
$2,069.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,921.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,783.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,546.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,732.41
|
| Rate for Payer: Cash Price |
$1,718.50
|
| Rate for Payer: Cigna Commercial |
$2,749.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,749.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,749.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,546.65
|
| Rate for Payer: Multiplan Commercial |
$3,196.41
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,921.45
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,546.65
|
| Rate for Payer: United Healthcare Commercial |
$3,265.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,546.65
|
| Rate for Payer: United Healthcare VA CCN |
$1,546.65
|
|
|
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
|
$658.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
5102782401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$486.99 |
| Max. Negotiated Rate |
$625.10 |
| Rate for Payer: Aetna of VT Commercial |
$625.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$486.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$486.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$559.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$552.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$526.40
|
| Rate for Payer: Cash Price |
$329.00
|
| Rate for Payer: Cigna Commercial |
$526.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$526.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$526.40
|
| Rate for Payer: Multiplan Commercial |
$611.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$559.30
|
| Rate for Payer: United Healthcare Commercial |
$625.10
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9602782402
|
|
Hospital Revenue Code
|
960
|
| 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
|
OP
|
$562.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9812782501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$248.91 |
| 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 |
$503.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$248.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$503.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$338.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$477.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$455.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$252.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$446.79
|
| 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: Martins Point Health Care Commercial |
$252.90
|
| Rate for Payer: Multiplan Commercial |
$522.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$477.70
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$252.90
|
| Rate for Payer: United Healthcare Commercial |
$533.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$252.90
|
| Rate for Payer: United Healthcare VA CCN |
$252.90
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9812782401
|
|
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 LOWER LEG FRACTURE
|
Facility
|
IP
|
$1,068.12
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
4502782501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$790.52 |
| Max. Negotiated Rate |
$1,014.71 |
| Rate for Payer: Aetna of VT Commercial |
$1,014.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$790.52
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$790.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$907.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$897.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$854.50
|
| Rate for Payer: Cash Price |
$534.06
|
| Rate for Payer: Cigna Commercial |
$854.50
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$854.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$854.50
|
| Rate for Payer: Multiplan Commercial |
$993.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$907.90
|
| Rate for Payer: United Healthcare Commercial |
$1,014.71
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$657.62
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
4502782401
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$486.70 |
| Max. Negotiated Rate |
$624.74 |
| Rate for Payer: Aetna of VT Commercial |
$624.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$486.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$486.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$558.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$552.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$526.10
|
| Rate for Payer: Cash Price |
$328.81
|
| Rate for Payer: Cigna Commercial |
$526.10
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$526.10
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$526.10
|
| Rate for Payer: Multiplan Commercial |
$611.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$558.98
|
| Rate for Payer: United Healthcare Commercial |
$624.74
|
|
|
TREAT LOWER LEG FRACTURE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9812782401
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$567.27 |
| 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 |
$309.73
|
| 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 |
$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 |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| 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 |
$0.93
|
| 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
|
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
|
Facility
|
IP
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9812782402
|
|
Hospital Revenue Code
|
981
|
| 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
|
Professional
|
Both
|
$1,745.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9822782501
|
|
Hospital Revenue Code
|
982
|
| 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
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9822782401
|
|
Hospital Revenue Code
|
982
|
| 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
|
$1,068.12
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
4502782501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$473.07 |
| Max. Negotiated Rate |
$1,014.71 |
| Rate for Payer: Aetna of VT Commercial |
$1,014.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$956.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$473.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$956.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$643.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$907.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$865.18
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$480.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$849.16
|
| Rate for Payer: Cash Price |
$534.06
|
| Rate for Payer: Cigna Commercial |
$854.50
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$854.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$854.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$480.65
|
| Rate for Payer: Multiplan Commercial |
$993.35
|
| Rate for Payer: MVP Health Care of NY Commercial |
$907.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$480.65
|
| Rate for Payer: United Healthcare Commercial |
$1,014.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$480.65
|
| Rate for Payer: United Healthcare VA CCN |
$480.65
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$1,745.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
9602782502
|
|
Hospital Revenue Code
|
960
|
| 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
|
$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
|
Facility
|
OP
|
$658.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
5102782401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$291.43 |
| Max. Negotiated Rate |
$625.10 |
| Rate for Payer: Aetna of VT Commercial |
$625.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$589.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$589.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$396.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$559.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$532.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$296.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$523.11
|
| Rate for Payer: Cash Price |
$329.00
|
| Rate for Payer: Cigna Commercial |
$526.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$526.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$526.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$296.10
|
| Rate for Payer: Multiplan Commercial |
$611.94
|
| Rate for Payer: MVP Health Care of NY Commercial |
$559.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$296.10
|
| Rate for Payer: United Healthcare Commercial |
$625.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$296.10
|
| Rate for Payer: United Healthcare VA CCN |
$296.10
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$1,069.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
5102782501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$473.46 |
| 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 |
$957.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$473.46
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$957.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$643.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$908.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$865.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$481.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$849.86
|
| 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: Martins Point Health Care Commercial |
$481.05
|
| Rate for Payer: Multiplan Commercial |
$994.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$908.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$481.05
|
| Rate for Payer: United Healthcare Commercial |
$1,015.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$481.05
|
| Rate for Payer: United Healthcare VA CCN |
$481.05
|
|
|
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
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$316.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
9812782402
|
|
Hospital Revenue Code
|
981
|
| 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
|
|
