|
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
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9822781801
|
|
Hospital Revenue Code
|
982
|
| 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
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 27822
|
| Hospital Charge Code |
9822782201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,234.36 |
| Max. Negotiated Rate |
$2,647.65 |
| Rate for Payer: Aetna of VT Commercial |
$2,647.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,496.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,234.36
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,496.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,677.77
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,368.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,257.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,254.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,215.66
|
| Rate for Payer: Cash Price |
$1,393.50
|
| Rate for Payer: Cigna Commercial |
$2,229.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,229.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,229.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$1,254.15
|
| Rate for Payer: Multiplan Commercial |
$2,591.91
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,368.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,254.15
|
| Rate for Payer: United Healthcare Commercial |
$2,647.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,254.15
|
| Rate for Payer: United Healthcare VA CCN |
$1,254.15
|
|
|
TREATMENT OF ANKLE FRACTURE
|
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
|
Facility
|
OP
|
$1,463.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
9602781001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$647.96 |
| Max. Negotiated Rate |
$1,389.85 |
| Rate for Payer: Aetna of VT Commercial |
$1,389.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,310.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$647.96
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,310.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$880.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,243.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,185.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$658.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,163.09
|
| Rate for Payer: Cash Price |
$731.50
|
| Rate for Payer: Cigna Commercial |
$1,170.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,170.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,170.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$658.35
|
| Rate for Payer: Multiplan Commercial |
$1,360.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,243.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$658.35
|
| Rate for Payer: United Healthcare Commercial |
$1,389.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$658.35
|
| Rate for Payer: United Healthcare VA CCN |
$658.35
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$529.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
5102781001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$413.89 |
| Max. Negotiated Rate |
$784.55 |
| Rate for Payer: Aetna of VT Commercial |
$497.26
|
| 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 |
$426.31
|
| 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 |
$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 |
$264.50
|
| Rate for Payer: Cash Price |
$264.50
|
| 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 |
$491.97
|
| 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
|
$367.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
5102780801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$162.54 |
| Max. Negotiated Rate |
$348.65 |
| Rate for Payer: Aetna of VT Commercial |
$348.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$328.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$162.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$328.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$220.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$311.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$297.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$165.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$291.76
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cigna Commercial |
$293.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$293.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$293.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$165.15
|
| Rate for Payer: Multiplan Commercial |
$341.31
|
| Rate for Payer: MVP Health Care of NY Commercial |
$311.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$165.15
|
| Rate for Payer: United Healthcare Commercial |
$348.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$165.15
|
| Rate for Payer: United Healthcare VA CCN |
$165.15
|
|
|
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
|
Facility
|
OP
|
$703.12
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
4502781601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$311.41 |
| 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 |
$629.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$311.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$629.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$423.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$597.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$569.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$316.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$558.98
|
| 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: Martins Point Health Care Commercial |
$316.40
|
| Rate for Payer: Multiplan Commercial |
$653.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$597.65
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$316.40
|
| Rate for Payer: United Healthcare Commercial |
$667.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$316.40
|
| Rate for Payer: United Healthcare VA CCN |
$316.40
|
|
|
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
|
OP
|
$1,411.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
9822781801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$624.93 |
| Max. Negotiated Rate |
$1,340.45 |
| Rate for Payer: Aetna of VT Commercial |
$1,340.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,264.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$624.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,264.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$849.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,199.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,142.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$634.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,121.74
|
| Rate for Payer: Cash Price |
$705.50
|
| Rate for Payer: Cigna Commercial |
$1,128.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,128.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,128.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$634.95
|
| Rate for Payer: Multiplan Commercial |
$1,312.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,199.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$634.95
|
| Rate for Payer: United Healthcare Commercial |
$1,340.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$634.95
|
| Rate for Payer: United Healthcare VA CCN |
$634.95
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$366.04
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
4502780801
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.91 |
| Max. Negotiated Rate |
$347.74 |
| Rate for Payer: Aetna of VT Commercial |
$347.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$270.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$270.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$311.13
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$307.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$292.83
|
| Rate for Payer: Cash Price |
$183.02
|
| Rate for Payer: Cigna Commercial |
$292.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$292.83
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$292.83
|
| Rate for Payer: Multiplan Commercial |
$340.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$311.13
|
| Rate for Payer: United Healthcare Commercial |
$347.74
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$2,706.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9822779201
|
|
Hospital Revenue Code
|
982
|
| 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
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
9812780801
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
9822778601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$282.58 |
| Max. Negotiated Rate |
$536.05 |
| Rate for Payer: Aetna of VT Commercial |
$300.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$286.69
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$454.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.97
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$454.64
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cigna Commercial |
$536.05
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$507.62
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$507.62
|
| Rate for Payer: Martins Point Health Care Commercial |
$309.57
|
| Rate for Payer: Multiplan Commercial |
$297.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.26
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare Commercial |
$434.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.58
|
| Rate for Payer: United Healthcare VA CCN |
$282.58
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$2,469.00
|
|
|
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
|
$1.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
9812779201
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$1,160.54 |
| Rate for Payer: Aetna of VT Commercial |
$0.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$629.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$855.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$901.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$702.41
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$901.86
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$1,160.54
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,013.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,013.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$610.79
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$867.32
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare Commercial |
$939.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$610.79
|
| Rate for Payer: United Healthcare VA CCN |
$610.79
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$3,198.00
|
|
|
Service Code
|
CPT 27823
|
| Hospital Charge Code |
9822782301
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,416.39 |
| 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 |
$2,865.09
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,416.39
|
| 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 |
$1,925.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,718.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,590.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,439.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,542.41
|
| 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: Martins Point Health Care Commercial |
$1,439.10
|
| Rate for Payer: Multiplan Commercial |
$2,974.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,718.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,439.10
|
| Rate for Payer: United Healthcare Commercial |
$3,038.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,439.10
|
| Rate for Payer: United Healthcare VA CCN |
$1,439.10
|
|
|
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 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 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 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
|
|
