|
TREAT METACARPAL FRACTURE
|
Professional
|
Both
|
$1,485.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9602660501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$293.72 |
| Max. Negotiated Rate |
$1,395.90 |
| Rate for Payer: Aetna of VT Commercial |
$1,395.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,330.41
|
| 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 |
$1,330.41
|
| 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 |
$742.50
|
| Rate for Payer: Cash Price |
$742.50
|
| 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 |
$1,381.05
|
| 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
|
$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
|
|
|
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
|
$647.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
9812660002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$286.81 |
| Max. Negotiated Rate |
$608.18 |
| Rate for Payer: Aetna of VT Commercial |
$608.18
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$579.65
|
| 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 |
$579.65
|
| 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 |
$323.50
|
| Rate for Payer: Cash Price |
$323.50
|
| 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 |
$601.71
|
| 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
|
Professional
|
Both
|
$2,761.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
9602661501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$553.56 |
| Max. Negotiated Rate |
$2,595.34 |
| Rate for Payer: Aetna of VT Commercial |
$2,595.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,473.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$570.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,473.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$774.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$770.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$770.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$636.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$770.39
|
| Rate for Payer: Cash Price |
$1,380.50
|
| Rate for Payer: Cash Price |
$1,380.50
|
| Rate for Payer: Cigna Commercial |
$1,045.59
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$917.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$917.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$553.56
|
| Rate for Payer: Multiplan Commercial |
$2,567.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$786.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$553.56
|
| Rate for Payer: United Healthcare Commercial |
$851.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$553.56
|
| Rate for Payer: United Healthcare VA CCN |
$553.56
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
5102660501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$279.03 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna of VT Commercial |
$598.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$564.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$279.03
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$564.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$379.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$535.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$510.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$283.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$500.85
|
| Rate for Payer: Cash Price |
$315.00
|
| Rate for Payer: Cigna Commercial |
$504.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$504.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$504.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$585.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$535.50
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$283.50
|
| Rate for Payer: United Healthcare Commercial |
$598.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$283.50
|
| Rate for Payer: United Healthcare VA CCN |
$283.50
|
|
|
TREAT METACARPAL FRACTURE
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9812660502
|
|
Hospital Revenue Code
|
981
|
| 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
|
IP
|
$1,433.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
9602661502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,060.56 |
| Max. Negotiated Rate |
$1,361.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,361.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,060.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,060.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,218.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,203.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,146.40
|
| Rate for Payer: Cash Price |
$716.50
|
| Rate for Payer: Cigna Commercial |
$1,146.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,146.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,146.40
|
| Rate for Payer: Multiplan Commercial |
$1,332.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,218.05
|
| Rate for Payer: United Healthcare Commercial |
$1,361.35
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
IP
|
$1,360.00
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
9822660801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,006.54 |
| Max. Negotiated Rate |
$1,292.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,292.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,006.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,006.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,156.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,142.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,088.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cigna Commercial |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,088.00
|
| Rate for Payer: Multiplan Commercial |
$1,264.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,156.00
|
| Rate for Payer: United Healthcare Commercial |
$1,292.00
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$647.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
9602660002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$286.56 |
| 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 |
$579.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$286.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$579.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$389.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$549.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$524.07
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$291.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$514.37
|
| 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: Martins Point Health Care Commercial |
$291.15
|
| Rate for Payer: Multiplan Commercial |
$601.71
|
| Rate for Payer: MVP Health Care of NY Commercial |
$549.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$291.15
|
| Rate for Payer: United Healthcare Commercial |
$614.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$291.15
|
| Rate for Payer: United Healthcare VA CCN |
$291.15
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
IP
|
$180.69
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
4502660001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$133.73 |
| Max. Negotiated Rate |
$171.66 |
| Rate for Payer: Aetna of VT Commercial |
$171.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$133.73
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$133.73
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$153.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$144.55
|
| Rate for Payer: Cash Price |
$90.34
|
| Rate for Payer: Cigna Commercial |
$144.55
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$144.55
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$144.55
|
| Rate for Payer: Multiplan Commercial |
$168.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$153.59
|
| Rate for Payer: United Healthcare Commercial |
$171.66
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$855.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9812660502
|
|
Hospital Revenue Code
|
981
|
| 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
|
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
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
5102660801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$465.15 |
| Max. Negotiated Rate |
$1,278.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,278.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$479.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$651.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$678.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$678.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$534.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$678.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cigna Commercial |
$881.31
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$768.37
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$768.37
|
| Rate for Payer: Martins Point Health Care Commercial |
$465.15
|
| Rate for Payer: Multiplan Commercial |
$1,264.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$660.51
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$465.15
|
| Rate for Payer: United Healthcare Commercial |
$715.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$465.15
|
| Rate for Payer: United Healthcare VA CCN |
$465.15
|
|
|
TREAT METACARPAL FRACTURE
|
Professional
|
Both
|
$955.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
9812660501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$293.72 |
| Max. Negotiated Rate |
$897.70 |
| Rate for Payer: Aetna of VT Commercial |
$897.70
|
| 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 |
$302.53
|
| 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 |
$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 |
$477.50
|
| Rate for Payer: Cash Price |
$477.50
|
| 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 |
$888.15
|
| 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
|
$1,360.00
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
9822660801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$602.34 |
| Max. Negotiated Rate |
$1,292.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,292.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$602.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$818.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,156.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,101.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$612.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,081.20
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cigna Commercial |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,088.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$612.00
|
| Rate for Payer: Multiplan Commercial |
$1,264.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,156.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$612.00
|
| Rate for Payer: United Healthcare Commercial |
$1,292.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$612.00
|
| Rate for Payer: United Healthcare VA CCN |
$612.00
|
|
|
TREAT METACARPAL FRACTURE
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
9822660801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$465.15 |
| Max. Negotiated Rate |
$1,278.40 |
| Rate for Payer: Aetna of VT Commercial |
$1,278.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$479.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$651.21
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$678.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$678.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$534.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$678.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cigna Commercial |
$881.31
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$768.37
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$768.37
|
| Rate for Payer: Martins Point Health Care Commercial |
$465.15
|
| Rate for Payer: Multiplan Commercial |
$1,264.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$660.51
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$465.15
|
| Rate for Payer: United Healthcare Commercial |
$715.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$465.15
|
| Rate for Payer: United Healthcare VA CCN |
$465.15
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
IP
|
$1,433.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
9822661501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,060.56 |
| Max. Negotiated Rate |
$1,361.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,361.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,060.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,060.56
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,218.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,203.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,146.40
|
| Rate for Payer: Cash Price |
$716.50
|
| Rate for Payer: Cigna Commercial |
$1,146.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,146.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,146.40
|
| Rate for Payer: Multiplan Commercial |
$1,332.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,218.05
|
| Rate for Payer: United Healthcare Commercial |
$1,361.35
|
|
|
TREAT METACARPAL FRACTURE
|
Professional
|
Both
|
$1,433.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
9822661501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$553.56 |
| Max. Negotiated Rate |
$1,347.02 |
| Rate for Payer: Aetna of VT Commercial |
$1,347.02
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,283.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$570.17
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,283.82
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$774.98
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$770.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$770.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$636.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$770.39
|
| Rate for Payer: Cash Price |
$716.50
|
| Rate for Payer: Cash Price |
$716.50
|
| Rate for Payer: Cigna Commercial |
$1,045.59
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$917.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$917.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$553.56
|
| Rate for Payer: Multiplan Commercial |
$1,332.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$786.06
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$553.56
|
| Rate for Payer: United Healthcare Commercial |
$851.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$553.56
|
| Rate for Payer: United Healthcare VA CCN |
$553.56
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$1,360.00
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
5102660801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$602.34 |
| Max. Negotiated Rate |
$1,292.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,292.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$602.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,218.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$818.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,156.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,101.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$612.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,081.20
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cigna Commercial |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,088.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$612.00
|
| Rate for Payer: Multiplan Commercial |
$1,264.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,156.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$612.00
|
| Rate for Payer: United Healthcare Commercial |
$1,292.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$612.00
|
| Rate for Payer: United Healthcare VA CCN |
$612.00
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$827.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
9602660001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$366.28 |
| Max. Negotiated Rate |
$785.65 |
| Rate for Payer: Aetna of VT Commercial |
$785.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$740.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$366.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$740.91
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$497.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$702.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$669.87
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$372.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$657.47
|
| Rate for Payer: Cash Price |
$413.50
|
| Rate for Payer: Cigna Commercial |
$661.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$661.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$661.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$372.15
|
| Rate for Payer: Multiplan Commercial |
$769.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$702.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$372.15
|
| Rate for Payer: United Healthcare Commercial |
$785.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$372.15
|
| Rate for Payer: United Healthcare VA CCN |
$372.15
|
|
|
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
|
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
|
Facility
|
IP
|
$1,360.00
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
5102660801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,006.54 |
| Max. Negotiated Rate |
$1,292.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,292.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,006.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,006.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,156.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,142.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,088.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cigna Commercial |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,088.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,088.00
|
| Rate for Payer: Multiplan Commercial |
$1,264.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,156.00
|
| Rate for Payer: United Healthcare Commercial |
$1,292.00
|
|
|
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
|
|
