|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9812780801
|
|
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
|
$1.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
9812781601
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$549.33 |
| 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 |
$298.90
|
| 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 |
$406.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$487.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$487.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$333.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$487.95
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$549.33
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$538.47
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$538.47
|
| Rate for Payer: Martins Point Health Care Commercial |
$327.78
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$412.07
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$290.19
|
| Rate for Payer: United Healthcare Commercial |
$446.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$290.19
|
| Rate for Payer: United Healthcare VA CCN |
$290.19
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$303.04
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
4502778601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$224.28 |
| Max. Negotiated Rate |
$287.89 |
| Rate for Payer: Aetna of VT Commercial |
$287.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$254.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$242.43
|
| Rate for Payer: Cash Price |
$151.52
|
| Rate for Payer: Cigna Commercial |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$242.43
|
| Rate for Payer: Multiplan Commercial |
$281.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$257.58
|
| Rate for Payer: United Healthcare Commercial |
$287.89
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$303.04
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
4502778601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$134.22 |
| Max. Negotiated Rate |
$287.89 |
| Rate for Payer: Aetna of VT Commercial |
$287.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$271.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$134.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$271.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$182.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$245.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$136.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$240.92
|
| Rate for Payer: Cash Price |
$151.52
|
| Rate for Payer: Cigna Commercial |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$242.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.37
|
| Rate for Payer: Multiplan Commercial |
$281.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$257.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$136.37
|
| Rate for Payer: United Healthcare Commercial |
$287.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$136.37
|
| Rate for Payer: United Healthcare VA CCN |
$136.37
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$2,706.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9812779202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$2,002.71 |
| 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 |
$2,002.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,002.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,300.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,273.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,164.80
|
| 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: Multiplan Commercial |
$2,516.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,300.10
|
| Rate for Payer: United Healthcare Commercial |
$2,570.70
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9812780802
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$498.09 |
| 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 |
$498.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$498.09
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$572.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$565.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$538.40
|
| 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: Multiplan Commercial |
$625.89
|
| Rate for Payer: MVP Health Care of NY Commercial |
$572.05
|
| Rate for Payer: United Healthcare Commercial |
$639.35
|
|
|
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
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9602781002
|
|
Hospital Revenue Code
|
960
|
| 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
|
IP
|
$3,198.00
|
|
|
Service Code
|
CPT 27823
|
| Hospital Charge Code |
9822782301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$2,366.84 |
| Max. Negotiated Rate |
$3,038.10 |
| Rate for Payer: Aetna of VT Commercial |
$3,038.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,366.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,366.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,718.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,686.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,558.40
|
| Rate for Payer: Cash Price |
$1,599.00
|
| Rate for Payer: Cigna Commercial |
$2,558.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,558.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,558.40
|
| Rate for Payer: Multiplan Commercial |
$2,974.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,718.30
|
| Rate for Payer: United Healthcare Commercial |
$3,038.10
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$528.37
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
4502781001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$391.05 |
| Max. Negotiated Rate |
$501.95 |
| Rate for Payer: Aetna of VT Commercial |
$501.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$391.05
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$391.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$449.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$443.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$422.70
|
| Rate for Payer: Cash Price |
$264.18
|
| Rate for Payer: Cigna Commercial |
$422.70
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$422.70
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$422.70
|
| Rate for Payer: Multiplan Commercial |
$491.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$449.11
|
| Rate for Payer: United Healthcare Commercial |
$501.95
|
|
|
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
|
Facility
|
OP
|
$623.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9602778601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$275.93 |
| Max. Negotiated Rate |
$591.85 |
| Rate for Payer: Aetna of VT Commercial |
$591.85
|
| 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 |
$275.93
|
| 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 |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$529.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$504.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$280.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$495.29
|
| Rate for Payer: Cash Price |
$311.50
|
| Rate for Payer: Cigna Commercial |
$498.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$498.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$498.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$280.35
|
| Rate for Payer: Multiplan Commercial |
$579.39
|
| Rate for Payer: MVP Health Care of NY Commercial |
$529.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$280.35
|
| Rate for Payer: United Healthcare Commercial |
$591.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.35
|
| Rate for Payer: United Healthcare VA CCN |
$280.35
|
|
|
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
|
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
|
IP
|
$703.12
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
4502781601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$520.38 |
| Max. Negotiated Rate |
$667.96 |
| Rate for Payer: Aetna of VT Commercial |
$667.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$520.38
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$520.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$597.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$590.62
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$562.50
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cigna Commercial |
$562.50
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$562.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$562.50
|
| Rate for Payer: Multiplan Commercial |
$653.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$597.65
|
| Rate for Payer: United Healthcare Commercial |
$667.96
|
|
|
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 ANKLE FRACTURE
|
Facility
|
IP
|
$1,518.95
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
4502781801
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,124.17 |
| Max. Negotiated Rate |
$1,443.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,443.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,124.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,124.17
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,291.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,275.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,215.16
|
| Rate for Payer: Cash Price |
$759.48
|
| Rate for Payer: Cigna Commercial |
$1,215.16
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,215.16
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,215.16
|
| Rate for Payer: Multiplan Commercial |
$1,412.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,291.11
|
| Rate for Payer: United Healthcare Commercial |
$1,443.00
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$320.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9812778602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$236.83 |
| Max. Negotiated Rate |
$304.00 |
| Rate for Payer: Aetna of VT Commercial |
$304.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$236.83
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$236.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$272.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$268.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$256.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cigna Commercial |
$256.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$256.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$256.00
|
| Rate for Payer: Multiplan Commercial |
$297.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$272.00
|
| Rate for Payer: United Healthcare Commercial |
$304.00
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$320.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9812778602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$141.73 |
| Max. Negotiated Rate |
$304.00 |
| Rate for Payer: Aetna of VT Commercial |
$304.00
|
| 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 |
$141.73
|
| 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 |
$192.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$272.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$259.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$144.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$254.40
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cigna Commercial |
$256.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$256.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$256.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$144.00
|
| Rate for Payer: Multiplan Commercial |
$297.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$272.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$144.00
|
| Rate for Payer: United Healthcare Commercial |
$304.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$144.00
|
| Rate for Payer: United Healthcare VA CCN |
$144.00
|
|
|
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
|
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
|
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
|
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
|
|
|
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
|
|
