|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$2,787.00
|
|
|
Service Code
|
CPT 27822
|
| Hospital Charge Code |
9822782201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$822.43 |
| Max. Negotiated Rate |
$2,619.78 |
| Rate for Payer: Aetna of VT Commercial |
$2,619.78
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,496.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$847.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,496.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,151.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,366.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,366.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$945.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,366.10
|
| Rate for Payer: Cash Price |
$1,393.50
|
| Rate for Payer: Cash Price |
$1,393.50
|
| Rate for Payer: Cigna Commercial |
$1,567.42
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,364.97
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,364.97
|
| Rate for Payer: Martins Point Health Care Commercial |
$822.44
|
| Rate for Payer: Multiplan Commercial |
$2,591.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,167.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$822.43
|
| Rate for Payer: United Healthcare Commercial |
$1,265.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$822.43
|
| Rate for Payer: United Healthcare VA CCN |
$822.43
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
5102778601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$272.35 |
| Max. Negotiated Rate |
$536.05 |
| Rate for Payer: Aetna of VT Commercial |
$285.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$272.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$272.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cigna Commercial |
$536.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$309.57
|
| Rate for Payer: Multiplan Commercial |
$282.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare Commercial |
$434.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare VA CCN |
$282.58
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9602778602
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$282.58 |
| Max. Negotiated Rate |
$536.05 |
| Rate for Payer: Aetna of VT Commercial |
$300.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cigna Commercial |
$536.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$309.57
|
| Rate for Payer: Multiplan Commercial |
$297.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare Commercial |
$434.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare VA CCN |
$282.58
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9812779201
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$1,160.54 |
| 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 |
$629.11
|
| 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 |
$855.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$702.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$901.86
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$1,160.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,013.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,013.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$610.79
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$867.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare Commercial |
$939.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare VA CCN |
$610.79
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1,463.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9602781001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,082.77 |
| Max. Negotiated Rate |
$1,389.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,389.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,082.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,082.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,243.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,228.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,170.40
|
| Rate for Payer: Cash Price |
$731.50
|
| Rate for Payer: Cigna Commercial |
$1,170.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,170.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,170.40
|
| Rate for Payer: Multiplan Commercial |
$1,360.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,243.55
|
| Rate for Payer: United Healthcare Commercial |
$1,389.85
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$529.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
5102781001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$391.51 |
| Max. Negotiated Rate |
$502.55 |
| Rate for Payer: Aetna of VT Commercial |
$502.55
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$391.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$391.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$449.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$444.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$423.20
|
| Rate for Payer: Cash Price |
$264.50
|
| Rate for Payer: Cigna Commercial |
$423.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$423.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$423.20
|
| Rate for Payer: Multiplan Commercial |
$491.97
|
| Rate for Payer: MVP Health Care of NY Commercial |
$449.65
|
| Rate for Payer: United Healthcare Commercial |
$502.55
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
9812781601
|
|
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
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
9812781601
|
|
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
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$2,706.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9822779201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$610.79 |
| Max. Negotiated Rate |
$2,543.64 |
| Rate for Payer: Aetna of VT Commercial |
$2,543.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,424.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$629.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,424.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$855.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$702.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$901.86
|
| Rate for Payer: Cash Price |
$1,353.00
|
| Rate for Payer: Cash Price |
$1,353.00
|
| Rate for Payer: Cigna Commercial |
$1,160.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,013.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,013.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$610.79
|
| Rate for Payer: Multiplan Commercial |
$2,516.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$867.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare Commercial |
$939.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare VA CCN |
$610.79
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9822781801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$624.93 |
| Max. Negotiated Rate |
$1,340.45 |
| Rate for Payer: Aetna of VT Commercial |
$1,340.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,264.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$624.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,264.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$849.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,199.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,142.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$634.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,121.74
|
| Rate for Payer: Cash Price |
$705.50
|
| Rate for Payer: Cigna Commercial |
$1,128.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,128.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,128.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$634.95
|
| Rate for Payer: Multiplan Commercial |
$1,312.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,199.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$634.95
|
| Rate for Payer: United Healthcare Commercial |
$1,340.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$634.95
|
| Rate for Payer: United Healthcare VA CCN |
$634.95
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 27822
|
| Hospital Charge Code |
9822782201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,234.36 |
| Max. Negotiated Rate |
$2,647.65 |
| Rate for Payer: Aetna of VT Commercial |
$2,647.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,496.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,234.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,496.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,677.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,368.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,257.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,254.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,215.66
|
| Rate for Payer: Cash Price |
$1,393.50
|
| Rate for Payer: Cigna Commercial |
$2,229.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,229.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,229.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,254.15
|
| Rate for Payer: Multiplan Commercial |
$2,591.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,368.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,254.15
|
| Rate for Payer: United Healthcare Commercial |
$2,647.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,254.15
|
| Rate for Payer: United Healthcare VA CCN |
$1,254.15
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9602778601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$282.58 |
| Max. Negotiated Rate |
$585.62 |
| Rate for Payer: Aetna of VT Commercial |
$585.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$558.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$558.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$311.50
|
| Rate for Payer: Cash Price |
$311.50
|
| Rate for Payer: Cigna Commercial |
$536.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$309.57
|
| Rate for Payer: Multiplan Commercial |
$579.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare Commercial |
$434.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare VA CCN |
$282.58
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9822778601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$282.58 |
| Max. Negotiated Rate |
$536.05 |
| Rate for Payer: Aetna of VT Commercial |
$300.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cigna Commercial |
$536.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$309.57
|
| Rate for Payer: Multiplan Commercial |
$297.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare Commercial |
$434.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare VA CCN |
$282.58
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$2,198.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9812781801
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$424.95 |
| Max. Negotiated Rate |
$2,066.12 |
| Rate for Payer: Aetna of VT Commercial |
$2,066.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,969.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$437.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,969.19
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$594.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$742.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$742.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$488.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$742.42
|
| Rate for Payer: Cash Price |
$1,099.00
|
| Rate for Payer: Cash Price |
$1,099.00
|
| Rate for Payer: Cigna Commercial |
$804.75
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$794.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$794.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$479.55
|
| Rate for Payer: Multiplan Commercial |
$2,044.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$603.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$424.95
|
| Rate for Payer: United Healthcare Commercial |
$653.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$424.95
|
| Rate for Payer: United Healthcare VA CCN |
$424.95
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9812778602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$282.58 |
| Max. Negotiated Rate |
$536.05 |
| Rate for Payer: Aetna of VT Commercial |
$300.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cigna Commercial |
$536.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$309.57
|
| Rate for Payer: Multiplan Commercial |
$297.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare Commercial |
$434.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare VA CCN |
$282.58
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$934.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9602781002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$413.67 |
| Max. Negotiated Rate |
$887.30 |
| Rate for Payer: Aetna of VT Commercial |
$887.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$836.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$413.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$836.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$562.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$793.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$756.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$420.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$742.53
|
| Rate for Payer: Cash Price |
$467.00
|
| Rate for Payer: Cigna Commercial |
$747.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$747.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$747.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$420.30
|
| Rate for Payer: Multiplan Commercial |
$868.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$793.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$420.30
|
| Rate for Payer: United Healthcare Commercial |
$887.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$420.30
|
| Rate for Payer: United Healthcare VA CCN |
$420.30
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9602780802
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$302.38 |
| Max. Negotiated Rate |
$632.62 |
| Rate for Payer: Aetna of VT Commercial |
$632.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$311.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$423.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$534.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$534.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$347.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$534.80
|
| Rate for Payer: Cash Price |
$336.50
|
| Rate for Payer: Cash Price |
$336.50
|
| Rate for Payer: Cigna Commercial |
$572.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$546.71
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$546.71
|
| Rate for Payer: Martins Point Health Care Commercial |
$333.21
|
| Rate for Payer: Multiplan Commercial |
$625.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$429.38
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$302.38
|
| Rate for Payer: United Healthcare Commercial |
$465.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$302.38
|
| Rate for Payer: United Healthcare VA CCN |
$302.38
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$934.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9602781002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$691.25 |
| Max. Negotiated Rate |
$887.30 |
| Rate for Payer: Aetna of VT Commercial |
$887.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$691.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$691.25
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$793.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$784.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$747.20
|
| Rate for Payer: Cash Price |
$467.00
|
| Rate for Payer: Cigna Commercial |
$747.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$747.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$747.20
|
| Rate for Payer: Multiplan Commercial |
$868.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$793.90
|
| Rate for Payer: United Healthcare Commercial |
$887.30
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$673.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9602780802
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$298.07 |
| Max. Negotiated Rate |
$639.35 |
| Rate for Payer: Aetna of VT Commercial |
$639.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$298.07
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$405.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$572.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$545.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$302.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$535.03
|
| Rate for Payer: Cash Price |
$336.50
|
| Rate for Payer: Cigna Commercial |
$538.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$538.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$538.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$302.85
|
| Rate for Payer: Multiplan Commercial |
$625.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$572.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$302.85
|
| Rate for Payer: United Healthcare Commercial |
$639.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$302.85
|
| Rate for Payer: United Healthcare VA CCN |
$302.85
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9812779201
|
|
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
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$2,706.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9812779202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$610.79 |
| Max. Negotiated Rate |
$2,543.64 |
| Rate for Payer: Aetna of VT Commercial |
$2,543.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,424.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$629.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,424.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$855.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$702.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$901.86
|
| Rate for Payer: Cash Price |
$1,353.00
|
| Rate for Payer: Cash Price |
$1,353.00
|
| Rate for Payer: Cigna Commercial |
$1,160.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,013.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,013.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$610.79
|
| Rate for Payer: Multiplan Commercial |
$2,516.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$867.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare Commercial |
$939.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare VA CCN |
$610.79
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9812780801
|
|
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
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9812779201
|
|
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
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
5102781801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$424.95 |
| Max. Negotiated Rate |
$1,427.86 |
| Rate for Payer: Aetna of VT Commercial |
$1,427.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,360.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$437.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,360.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$594.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$742.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$742.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$488.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$742.42
|
| Rate for Payer: Cash Price |
$759.50
|
| Rate for Payer: Cash Price |
$759.50
|
| Rate for Payer: Cigna Commercial |
$804.75
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$794.08
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$794.08
|
| Rate for Payer: Martins Point Health Care Commercial |
$479.55
|
| Rate for Payer: Multiplan Commercial |
$1,412.67
|
| Rate for Payer: MVP Health Care of NY Commercial |
$603.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$424.95
|
| Rate for Payer: United Healthcare Commercial |
$653.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$424.95
|
| Rate for Payer: United Healthcare VA CCN |
$424.95
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1,463.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9602781001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$647.96 |
| Max. Negotiated Rate |
$1,389.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,389.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,310.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$647.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,310.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$880.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,243.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,185.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$658.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,163.09
|
| Rate for Payer: Cash Price |
$731.50
|
| Rate for Payer: Cigna Commercial |
$1,170.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,170.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,170.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$658.35
|
| Rate for Payer: Multiplan Commercial |
$1,360.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,243.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$658.35
|
| Rate for Payer: United Healthcare Commercial |
$1,389.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$658.35
|
| Rate for Payer: United Healthcare VA CCN |
$658.35
|
|
