|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$5,521.56
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
4502779201
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,445.50 |
| 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 |
$4,946.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$2,445.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$4,946.77
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$3,323.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$4,693.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$4,472.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$2,484.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$4,389.64
|
| 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: Martins Point Health Care Commercial |
$2,484.70
|
| Rate for Payer: Multiplan Commercial |
$5,135.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,693.33
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$2,484.70
|
| Rate for Payer: United Healthcare Commercial |
$5,245.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,484.70
|
| Rate for Payer: United Healthcare VA CCN |
$2,484.70
|
|
|
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 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
|
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
|
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
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9812781802
|
|
Hospital Revenue Code
|
981
|
| 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
|
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
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9602780801
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$302.38 |
| Max. Negotiated Rate |
$976.66 |
| Rate for Payer: Aetna of VT Commercial |
$976.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$930.84
|
| 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 |
$930.84
|
| 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 |
$519.50
|
| Rate for Payer: Cash Price |
$519.50
|
| 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 |
$966.27
|
| 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
|
$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
|
$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
|
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
|
$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
|
$2,706.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9822779201
|
|
Hospital Revenue Code
|
982
|
| 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
|
Facility
|
OP
|
$2,469.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
9822781401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,093.52 |
| Max. Negotiated Rate |
$2,345.55 |
| Rate for Payer: Aetna of VT Commercial |
$2,345.55
|
| 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 |
$1,093.52
|
| 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 |
$1,486.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,098.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,999.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,111.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,962.86
|
| Rate for Payer: Cash Price |
$1,234.50
|
| Rate for Payer: Cigna Commercial |
$1,975.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,975.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,975.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,111.05
|
| Rate for Payer: Multiplan Commercial |
$2,296.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,098.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,111.05
|
| Rate for Payer: United Healthcare Commercial |
$2,345.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,111.05
|
| Rate for Payer: United Healthcare VA CCN |
$1,111.05
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$2,930.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9602781801
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,168.49 |
| Max. Negotiated Rate |
$2,783.50 |
| Rate for Payer: Aetna of VT Commercial |
$2,783.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,168.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,168.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,490.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,461.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,344.00
|
| Rate for Payer: Cash Price |
$1,465.00
|
| Rate for Payer: Cigna Commercial |
$2,344.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,344.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,344.00
|
| Rate for Payer: Multiplan Commercial |
$2,724.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,490.50
|
| Rate for Payer: United Healthcare Commercial |
$2,783.50
|
|
|
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
|
$673.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9602780802
|
|
Hospital Revenue Code
|
960
|
| 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
|
OP
|
$2,198.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9812781801
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$973.49 |
| Max. Negotiated Rate |
$2,088.10 |
| Rate for Payer: Aetna of VT Commercial |
$2,088.10
|
| 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 |
$973.49
|
| 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 |
$1,323.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,868.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,780.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$989.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,747.41
|
| Rate for Payer: Cash Price |
$1,099.00
|
| Rate for Payer: Cigna Commercial |
$1,758.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,758.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,758.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$989.10
|
| Rate for Payer: Multiplan Commercial |
$2,044.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,868.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$989.10
|
| Rate for Payer: United Healthcare Commercial |
$2,088.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$989.10
|
| Rate for Payer: United Healthcare VA CCN |
$989.10
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$861.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
9812781602
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$290.19 |
| Max. Negotiated Rate |
$809.34 |
| Rate for Payer: Aetna of VT Commercial |
$809.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$771.37
|
| 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 |
$771.37
|
| 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 |
$430.50
|
| Rate for Payer: Cash Price |
$430.50
|
| 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 |
$800.73
|
| 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 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 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 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
|
|
