|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$2,706.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9812779202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,198.49 |
| Max. Negotiated Rate |
$2,570.70 |
| Rate for Payer: Aetna of VT Commercial |
$2,570.70
|
| 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 |
$1,198.49
|
| 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 |
$1,629.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,300.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,191.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,217.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,151.27
|
| Rate for Payer: Cash Price |
$1,353.00
|
| Rate for Payer: Cigna Commercial |
$2,164.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,164.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,164.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,217.70
|
| Rate for Payer: Multiplan Commercial |
$2,516.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,300.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,217.70
|
| Rate for Payer: United Healthcare Commercial |
$2,570.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,217.70
|
| Rate for Payer: United Healthcare VA CCN |
$1,217.70
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$2,469.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
9822781401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$721.03 |
| Max. Negotiated Rate |
$2,320.86 |
| Rate for Payer: Aetna of VT Commercial |
$2,320.86
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,211.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$742.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,211.98
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,009.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,229.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,229.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$829.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,229.21
|
| Rate for Payer: Cash Price |
$1,234.50
|
| Rate for Payer: Cash Price |
$1,234.50
|
| Rate for Payer: Cigna Commercial |
$1,368.15
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,199.87
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,199.87
|
| Rate for Payer: Martins Point Health Care Commercial |
$721.03
|
| Rate for Payer: Multiplan Commercial |
$2,296.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,023.88
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$721.04
|
| Rate for Payer: United Healthcare Commercial |
$1,109.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$721.04
|
| Rate for Payer: United Healthcare VA CCN |
$721.04
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9812780802
|
|
Hospital Revenue Code
|
981
|
| 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
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9812781002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$413.89 |
| Max. Negotiated Rate |
$877.96 |
| Rate for Payer: Aetna of VT Commercial |
$877.96
|
| 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 |
$426.31
|
| 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 |
$579.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$737.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$737.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$475.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$737.58
|
| Rate for Payer: Cash Price |
$467.00
|
| Rate for Payer: Cash Price |
$467.00
|
| Rate for Payer: Cigna Commercial |
$784.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$764.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$764.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$462.07
|
| Rate for Payer: Multiplan Commercial |
$868.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$587.72
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$413.89
|
| Rate for Payer: United Healthcare Commercial |
$636.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$413.89
|
| Rate for Payer: United Healthcare VA CCN |
$413.89
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$934.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9812781002
|
|
Hospital Revenue Code
|
981
|
| 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
|
$3,198.00
|
|
|
Service Code
|
CPT 27823
|
| Hospital Charge Code |
9822782301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$924.79 |
| Max. Negotiated Rate |
$3,006.12 |
| Rate for Payer: Aetna of VT Commercial |
$3,006.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,865.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$952.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,865.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,294.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,542.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,542.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,063.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,542.20
|
| Rate for Payer: Cash Price |
$1,599.00
|
| Rate for Payer: Cash Price |
$1,599.00
|
| Rate for Payer: Cigna Commercial |
$1,760.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,537.26
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,537.26
|
| Rate for Payer: Martins Point Health Care Commercial |
$924.79
|
| Rate for Payer: Multiplan Commercial |
$2,974.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,313.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$924.79
|
| Rate for Payer: United Healthcare Commercial |
$1,422.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$924.79
|
| Rate for Payer: United Healthcare VA CCN |
$924.79
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$972.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9812781001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$719.38 |
| Max. Negotiated Rate |
$923.40 |
| Rate for Payer: Aetna of VT Commercial |
$923.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$719.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$719.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$826.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$816.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$777.60
|
| Rate for Payer: Cash Price |
$486.00
|
| Rate for Payer: Cigna Commercial |
$777.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$777.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$777.60
|
| Rate for Payer: Multiplan Commercial |
$903.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$826.20
|
| Rate for Payer: United Healthcare Commercial |
$923.40
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9812781802
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$424.95 |
| Max. Negotiated Rate |
$1,326.34 |
| Rate for Payer: Aetna of VT Commercial |
$1,326.34
|
| 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 |
$437.70
|
| 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 |
$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 |
$705.50
|
| Rate for Payer: Cash Price |
$705.50
|
| 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 |
$1,312.23
|
| 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
|
IP
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9602781802
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,044.28 |
| 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 |
$1,044.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,044.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,199.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,185.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,128.80
|
| 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: Multiplan Commercial |
$1,312.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,199.35
|
| Rate for Payer: United Healthcare Commercial |
$1,340.45
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9812781802
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$1,044.28 |
| 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 |
$1,044.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,044.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,199.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,185.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,128.80
|
| 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: Multiplan Commercial |
$1,312.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,199.35
|
| Rate for Payer: United Healthcare Commercial |
$1,340.45
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$2,787.00
|
|
|
Service Code
|
CPT 27822
|
| Hospital Charge Code |
9822782201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,062.66 |
| 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 |
$2,062.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,062.66
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,368.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,341.08
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,229.60
|
| 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: Multiplan Commercial |
$2,591.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,368.95
|
| Rate for Payer: United Healthcare Commercial |
$2,647.65
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9812778601
|
|
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
|
OP
|
$673.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9812780802
|
|
Hospital Revenue Code
|
981
|
| 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
|
$529.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
5102781001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$234.29 |
| 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 |
$473.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$234.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$473.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$318.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$449.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$428.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$238.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$420.56
|
| 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: Martins Point Health Care Commercial |
$238.05
|
| Rate for Payer: Multiplan Commercial |
$491.97
|
| Rate for Payer: MVP Health Care of NY Commercial |
$449.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$238.05
|
| Rate for Payer: United Healthcare Commercial |
$502.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$238.05
|
| Rate for Payer: United Healthcare VA CCN |
$238.05
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9822781801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,044.28 |
| 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 |
$1,044.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,044.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,199.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,185.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,128.80
|
| 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: Multiplan Commercial |
$1,312.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,199.35
|
| Rate for Payer: United Healthcare Commercial |
$1,340.45
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9812778601
|
|
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
|
$972.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9812781001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$430.50 |
| Max. Negotiated Rate |
$923.40 |
| Rate for Payer: Aetna of VT Commercial |
$923.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$870.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$430.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$870.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$585.14
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$826.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$787.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$437.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$772.74
|
| Rate for Payer: Cash Price |
$486.00
|
| Rate for Payer: Cigna Commercial |
$777.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$777.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$777.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$437.40
|
| Rate for Payer: Multiplan Commercial |
$903.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$826.20
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$437.40
|
| Rate for Payer: United Healthcare Commercial |
$923.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$437.40
|
| Rate for Payer: United Healthcare VA CCN |
$437.40
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$5,521.56
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
4502779201
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,086.51 |
| Max. Negotiated Rate |
$5,245.48 |
| Rate for Payer: Aetna of VT Commercial |
$5,245.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$4,086.51
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,086.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,693.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,638.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,417.25
|
| Rate for Payer: Cash Price |
$2,760.78
|
| Rate for Payer: Cigna Commercial |
$4,417.25
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$4,417.25
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$4,417.25
|
| Rate for Payer: Multiplan Commercial |
$5,135.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,693.33
|
| Rate for Payer: United Healthcare Commercial |
$5,245.48
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$934.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9812781002
|
|
Hospital Revenue Code
|
981
|
| 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 BLADDER LESION
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
9825172001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$40.43 |
| Max. Negotiated Rate |
$342.16 |
| Rate for Payer: Aetna of VT Commercial |
$342.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$41.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$56.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$215.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$215.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$46.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$215.98
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cigna Commercial |
$70.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$137.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$137.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$84.12
|
| Rate for Payer: Multiplan Commercial |
$338.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$57.41
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$40.43
|
| Rate for Payer: United Healthcare Commercial |
$62.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.43
|
| Rate for Payer: United Healthcare VA CCN |
$40.43
|
|
|
TREATMENT OF BLADDER LESION
|
Facility
|
IP
|
$364.00
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
9825172001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$269.40 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna of VT Commercial |
$345.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$269.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$269.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$309.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$305.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$291.20
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cigna Commercial |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$291.20
|
| Rate for Payer: Multiplan Commercial |
$338.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$309.40
|
| Rate for Payer: United Healthcare Commercial |
$345.80
|
|
|
TREATMENT OF BLADDER LESION
|
Facility
|
OP
|
$364.00
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
9825172001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$161.22 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna of VT Commercial |
$345.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$161.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$326.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$219.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$309.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$294.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$163.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$289.38
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cigna Commercial |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$291.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$291.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$163.80
|
| Rate for Payer: Multiplan Commercial |
$338.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$309.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$163.80
|
| Rate for Payer: United Healthcare Commercial |
$345.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$163.80
|
| Rate for Payer: United Healthcare VA CCN |
$163.80
|
|
|
TREATMENT OF FOOT INFECTION
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
CPT 28002
|
| Hospital Charge Code |
9822800201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$132.17 |
| Max. Negotiated Rate |
$878.90 |
| Rate for Payer: Aetna of VT Commercial |
$878.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$837.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$136.14
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$837.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$185.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$599.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$599.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$152.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$599.95
|
| Rate for Payer: Cash Price |
$467.50
|
| Rate for Payer: Cash Price |
$467.50
|
| Rate for Payer: Cigna Commercial |
$251.06
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$374.93
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$374.93
|
| Rate for Payer: Martins Point Health Care Commercial |
$231.10
|
| Rate for Payer: Multiplan Commercial |
$869.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$187.68
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$132.17
|
| Rate for Payer: United Healthcare Commercial |
$203.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$132.17
|
| Rate for Payer: United Healthcare VA CCN |
$132.17
|
|
|
TREATMENT OF FOOT INFECTION
|
Facility
|
OP
|
$935.00
|
|
|
Service Code
|
CPT 28002
|
| Hospital Charge Code |
9822800201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$414.11 |
| Max. Negotiated Rate |
$888.25 |
| Rate for Payer: Aetna of VT Commercial |
$888.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$837.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$414.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$837.67
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$562.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$794.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$757.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$743.33
|
| Rate for Payer: Cash Price |
$467.50
|
| Rate for Payer: Cigna Commercial |
$748.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$748.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$748.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$420.75
|
| Rate for Payer: Multiplan Commercial |
$869.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$794.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$420.75
|
| Rate for Payer: United Healthcare Commercial |
$888.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$420.75
|
| Rate for Payer: United Healthcare VA CCN |
$420.75
|
|
|
TREATMENT OF FOOT INFECTION
|
Facility
|
IP
|
$935.00
|
|
|
Service Code
|
CPT 28002
|
| Hospital Charge Code |
9822800201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$691.99 |
| Max. Negotiated Rate |
$888.25 |
| Rate for Payer: Aetna of VT Commercial |
$888.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$691.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$691.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$794.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$785.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$748.00
|
| Rate for Payer: Cash Price |
$467.50
|
| Rate for Payer: Cigna Commercial |
$748.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$748.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$748.00
|
| Rate for Payer: Multiplan Commercial |
$869.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$794.75
|
| Rate for Payer: United Healthcare Commercial |
$888.25
|
|
