|
TREATMENT OF TOE FRACTURE
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
5102851001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.02 |
| Max. Negotiated Rate |
$226.58 |
| Rate for Payer: Aetna of VT Commercial |
$207.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$168.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$138.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$175.47
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cigna Commercial |
$226.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$195.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$195.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.02
|
| Rate for Payer: Multiplan Commercial |
$205.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare Commercial |
$184.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare VA CCN |
$120.02
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
9602851002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$127.56 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Aetna of VT Commercial |
$273.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$127.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$173.38
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$233.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$129.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$228.96
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$230.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$129.60
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$129.60
|
| Rate for Payer: United Healthcare Commercial |
$273.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.60
|
| Rate for Payer: United Healthcare VA CCN |
$129.60
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
IP
|
$407.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
9812851501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$301.22 |
| Max. Negotiated Rate |
$386.65 |
| Rate for Payer: Aetna of VT Commercial |
$386.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$301.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$301.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$345.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$341.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$325.60
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna Commercial |
$325.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$325.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$325.60
|
| Rate for Payer: Multiplan Commercial |
$378.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$345.95
|
| Rate for Payer: United Healthcare Commercial |
$386.65
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
OP
|
$526.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
9602851501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$232.97 |
| Max. Negotiated Rate |
$499.70 |
| Rate for Payer: Aetna of VT Commercial |
$499.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$471.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$232.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$471.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$316.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$447.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$426.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$236.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$418.17
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cigna Commercial |
$420.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$420.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$420.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$236.70
|
| Rate for Payer: Multiplan Commercial |
$489.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$447.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$236.70
|
| Rate for Payer: United Healthcare Commercial |
$499.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$236.70
|
| Rate for Payer: United Healthcare VA CCN |
$236.70
|
|
|
TREATMENT OF TOE FRACTURE
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
9812851501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$141.79 |
| Max. Negotiated Rate |
$382.58 |
| Rate for Payer: Aetna of VT Commercial |
$382.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$364.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$146.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$364.63
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$198.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$199.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$199.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$163.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$199.80
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna Commercial |
$268.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$263.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$263.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$162.35
|
| Rate for Payer: Multiplan Commercial |
$378.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$201.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$141.79
|
| Rate for Payer: United Healthcare Commercial |
$218.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$141.79
|
| Rate for Payer: United Healthcare VA CCN |
$141.79
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
OP
|
$508.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
9602851001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$224.99 |
| Max. Negotiated Rate |
$482.60 |
| Rate for Payer: Aetna of VT Commercial |
$482.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$455.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$224.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$455.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$305.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$431.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$411.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$228.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$403.86
|
| Rate for Payer: Cash Price |
$254.00
|
| Rate for Payer: Cigna Commercial |
$406.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$406.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$406.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$228.60
|
| Rate for Payer: Multiplan Commercial |
$472.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$431.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$228.60
|
| Rate for Payer: United Healthcare Commercial |
$482.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$228.60
|
| Rate for Payer: United Healthcare VA CCN |
$228.60
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
OP
|
$318.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
9602851502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$140.84 |
| Max. Negotiated Rate |
$302.10 |
| Rate for Payer: Aetna of VT Commercial |
$302.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$284.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$140.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$284.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$191.44
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$270.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$143.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$252.81
|
| Rate for Payer: Cash Price |
$159.00
|
| Rate for Payer: Cigna Commercial |
$254.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$254.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$254.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$143.10
|
| Rate for Payer: Multiplan Commercial |
$295.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$270.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$143.10
|
| Rate for Payer: United Healthcare Commercial |
$302.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.10
|
| Rate for Payer: United Healthcare VA CCN |
$143.10
|
|
|
TREATMENT OF TOE FRACTURE
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
9812851002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$120.02 |
| Max. Negotiated Rate |
$270.72 |
| Rate for Payer: Aetna of VT Commercial |
$270.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$168.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$138.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$175.47
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$226.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$195.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$195.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.02
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare Commercial |
$184.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare VA CCN |
$120.02
|
|
|
TREATMENT OF TOE FRACTURE
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
9602851501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$141.79 |
| Max. Negotiated Rate |
$494.44 |
| Rate for Payer: Aetna of VT Commercial |
$494.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$471.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$146.04
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$471.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$198.51
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$199.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$199.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$163.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$199.80
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cigna Commercial |
$268.83
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$263.32
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$263.32
|
| Rate for Payer: Martins Point Health Care Commercial |
$162.35
|
| Rate for Payer: Multiplan Commercial |
$489.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$201.34
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$141.79
|
| Rate for Payer: United Healthcare Commercial |
$218.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$141.79
|
| Rate for Payer: United Healthcare VA CCN |
$141.79
|
|
|
TREATMENT OF TOE FRACTURE
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
9602851002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$120.02 |
| Max. Negotiated Rate |
$270.72 |
| Rate for Payer: Aetna of VT Commercial |
$270.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$123.62
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$258.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$168.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$138.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$175.47
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$226.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$195.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$195.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.02
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare Commercial |
$184.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare VA CCN |
$120.02
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
IP
|
$318.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
9812851502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$235.35 |
| Max. Negotiated Rate |
$302.10 |
| Rate for Payer: Aetna of VT Commercial |
$302.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$235.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$235.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$270.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$267.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$254.40
|
| Rate for Payer: Cash Price |
$159.00
|
| Rate for Payer: Cigna Commercial |
$254.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$254.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$254.40
|
| Rate for Payer: Multiplan Commercial |
$295.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$270.30
|
| Rate for Payer: United Healthcare Commercial |
$302.10
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
IP
|
$526.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
9602851501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$389.29 |
| Max. Negotiated Rate |
$499.70 |
| Rate for Payer: Aetna of VT Commercial |
$499.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$389.29
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$389.29
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$447.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$441.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$420.80
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cigna Commercial |
$420.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$420.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$420.80
|
| Rate for Payer: Multiplan Commercial |
$489.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$447.10
|
| Rate for Payer: United Healthcare Commercial |
$499.70
|
|
|
TREATMENT OF TOE FRACTURE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
9812851001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$226.58 |
| 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 |
$123.62
|
| 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 |
$168.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$175.47
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$138.02
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$175.47
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$226.58
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$195.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$195.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$120.02
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$170.43
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare Commercial |
$184.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$120.02
|
| Rate for Payer: United Healthcare VA CCN |
$120.02
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
9812851001
|
|
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 TOE FRACTURE
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
5102851001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$97.88 |
| Max. Negotiated Rate |
$209.95 |
| Rate for Payer: Aetna of VT Commercial |
$209.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$97.88
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$197.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$133.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$187.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$179.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$175.69
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cigna Commercial |
$176.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$176.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$176.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$99.45
|
| Rate for Payer: Multiplan Commercial |
$205.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$187.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$99.45
|
| Rate for Payer: United Healthcare Commercial |
$209.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$99.45
|
| Rate for Payer: United Healthcare VA CCN |
$99.45
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
9812851002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$213.15 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Aetna of VT Commercial |
$273.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$241.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$230.40
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$230.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$230.40
|
| Rate for Payer: Multiplan Commercial |
$267.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$244.80
|
| Rate for Payer: United Healthcare Commercial |
$273.60
|
|
|
TREATMENT OF TOE FRACTURE
|
Facility
|
IP
|
$208.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
5102851501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$153.94 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna of VT Commercial |
$197.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$153.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$153.94
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$176.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$174.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$166.40
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cigna Commercial |
$166.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$166.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$166.40
|
| Rate for Payer: Multiplan Commercial |
$193.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$176.80
|
| Rate for Payer: United Healthcare Commercial |
$197.60
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
5102660001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$80.16 |
| Max. Negotiated Rate |
$171.95 |
| Rate for Payer: Aetna of VT Commercial |
$171.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$162.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$80.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$162.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$108.96
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$153.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$146.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$81.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$143.90
|
| Rate for Payer: Cash Price |
$90.50
|
| Rate for Payer: Cigna Commercial |
$144.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$144.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$144.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$81.45
|
| Rate for Payer: Multiplan Commercial |
$168.33
|
| Rate for Payer: MVP Health Care of NY Commercial |
$153.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$81.45
|
| Rate for Payer: United Healthcare Commercial |
$171.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.45
|
| Rate for Payer: United Healthcare VA CCN |
$81.45
|
|
|
TREAT METACARPAL FRACTURE
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9602660502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$293.72 |
| Max. Negotiated Rate |
$803.70 |
| Rate for Payer: Aetna of VT Commercial |
$803.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$765.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$302.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$765.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$411.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$509.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$509.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$337.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$509.72
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Cigna Commercial |
$555.46
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$536.41
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$536.41
|
| Rate for Payer: Martins Point Health Care Commercial |
$326.48
|
| Rate for Payer: Multiplan Commercial |
$795.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$417.08
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$293.72
|
| Rate for Payer: United Healthcare Commercial |
$451.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$293.72
|
| Rate for Payer: United Healthcare VA CCN |
$293.72
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$855.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9602660502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$378.68 |
| Max. Negotiated Rate |
$812.25 |
| Rate for Payer: Aetna of VT Commercial |
$812.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$765.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$765.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$514.71
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$726.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$692.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$384.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$679.73
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Cigna Commercial |
$684.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$684.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$684.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$384.75
|
| Rate for Payer: Multiplan Commercial |
$795.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$726.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$384.75
|
| Rate for Payer: United Healthcare Commercial |
$812.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$384.75
|
| Rate for Payer: United Healthcare VA CCN |
$384.75
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
IP
|
$647.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
9602660002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$478.84 |
| Max. Negotiated Rate |
$614.65 |
| Rate for Payer: Aetna of VT Commercial |
$614.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$478.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$478.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$549.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$543.48
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$517.60
|
| Rate for Payer: Cash Price |
$323.50
|
| Rate for Payer: Cigna Commercial |
$517.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$517.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$517.60
|
| Rate for Payer: Multiplan Commercial |
$601.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$549.95
|
| Rate for Payer: United Healthcare Commercial |
$614.65
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
IP
|
$855.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9602660502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$632.79 |
| Max. Negotiated Rate |
$812.25 |
| Rate for Payer: Aetna of VT Commercial |
$812.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$632.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$632.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$726.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$718.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$684.00
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Cigna Commercial |
$684.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$684.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$684.00
|
| Rate for Payer: Multiplan Commercial |
$795.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$726.75
|
| Rate for Payer: United Healthcare Commercial |
$812.25
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
IP
|
$955.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9812660501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$706.80 |
| Max. Negotiated Rate |
$907.25 |
| Rate for Payer: Aetna of VT Commercial |
$907.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$706.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$706.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$811.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$802.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$764.00
|
| Rate for Payer: Cash Price |
$477.50
|
| Rate for Payer: Cigna Commercial |
$764.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$764.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$764.00
|
| Rate for Payer: Multiplan Commercial |
$888.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$811.75
|
| Rate for Payer: United Healthcare Commercial |
$907.25
|
|
|
TREAT METACARPAL FRACTURE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
9812660001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$540.11 |
| 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 |
$295.41
|
| 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 |
$401.53
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$368.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$368.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$329.83
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$368.04
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$540.11
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$493.22
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$493.22
|
| Rate for Payer: Martins Point Health Care Commercial |
$300.94
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$407.27
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$286.81
|
| Rate for Payer: United Healthcare Commercial |
$441.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.81
|
| Rate for Payer: United Healthcare VA CCN |
$286.81
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$955.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9812660501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$422.97 |
| Max. Negotiated Rate |
$907.25 |
| Rate for Payer: Aetna of VT Commercial |
$907.25
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$855.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$422.97
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$855.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$574.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$811.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$773.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$429.75
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$759.23
|
| Rate for Payer: Cash Price |
$477.50
|
| Rate for Payer: Cigna Commercial |
$764.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$764.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$764.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$429.75
|
| Rate for Payer: Multiplan Commercial |
$888.15
|
| Rate for Payer: MVP Health Care of NY Commercial |
$811.75
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$429.75
|
| Rate for Payer: United Healthcare Commercial |
$907.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$429.75
|
| Rate for Payer: United Healthcare VA CCN |
$429.75
|
|
