|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$303.04
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
4502465001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$224.28 |
| Max. Negotiated Rate |
$287.89 |
| Rate for Payer: Aetna of VT Commercial |
$287.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$224.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$254.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$242.43
|
| Rate for Payer: Cash Price |
$151.52
|
| Rate for Payer: Cigna Commercial |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$242.43
|
| Rate for Payer: Multiplan Commercial |
$281.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$257.58
|
| Rate for Payer: United Healthcare Commercial |
$287.89
|
|
|
TREAT RADIUS FRACTURE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9812465001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$232.93 |
| Max. Negotiated Rate |
$462.88 |
| Rate for Payer: Aetna of VT Commercial |
$244.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$253.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$344.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$383.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$383.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$282.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$383.65
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cigna Commercial |
$462.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$434.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$434.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$264.24
|
| Rate for Payer: Multiplan Commercial |
$241.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$349.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$245.93
|
| Rate for Payer: United Healthcare Commercial |
$378.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$245.93
|
| Rate for Payer: United Healthcare VA CCN |
$245.93
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$1,892.22
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
4502465501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,400.43 |
| Max. Negotiated Rate |
$1,797.61 |
| Rate for Payer: Aetna of VT Commercial |
$1,797.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,400.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,400.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,608.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,589.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,513.78
|
| Rate for Payer: Cash Price |
$946.11
|
| Rate for Payer: Cigna Commercial |
$1,513.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,513.78
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,513.78
|
| Rate for Payer: Multiplan Commercial |
$1,759.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,608.39
|
| Rate for Payer: United Healthcare Commercial |
$1,797.61
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9822465501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$848.15 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,088.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$848.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$848.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$974.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$962.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$916.80
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$916.80
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.10
|
| Rate for Payer: United Healthcare Commercial |
$1,088.70
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$1,892.22
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
4502465501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$838.06 |
| Max. Negotiated Rate |
$1,797.61 |
| Rate for Payer: Aetna of VT Commercial |
$1,797.61
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,695.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$838.06
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,695.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,139.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,608.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,532.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$851.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,504.31
|
| Rate for Payer: Cash Price |
$946.11
|
| Rate for Payer: Cigna Commercial |
$1,513.78
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,513.78
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,513.78
|
| Rate for Payer: Martins Point Health Care Commercial |
$851.50
|
| Rate for Payer: Multiplan Commercial |
$1,759.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,608.39
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$851.50
|
| Rate for Payer: United Healthcare Commercial |
$1,797.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$851.50
|
| Rate for Payer: United Healthcare VA CCN |
$851.50
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$303.04
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
4502465001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$134.22 |
| Max. Negotiated Rate |
$287.89 |
| Rate for Payer: Aetna of VT Commercial |
$287.89
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$271.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$134.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$271.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$182.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$257.58
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$245.46
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$136.37
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$240.92
|
| Rate for Payer: Cash Price |
$151.52
|
| Rate for Payer: Cigna Commercial |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$242.43
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$242.43
|
| Rate for Payer: Martins Point Health Care Commercial |
$136.37
|
| Rate for Payer: Multiplan Commercial |
$281.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$257.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$136.37
|
| Rate for Payer: United Healthcare Commercial |
$287.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$136.37
|
| Rate for Payer: United Healthcare VA CCN |
$136.37
|
|
|
TREAT RADIUS FRACTURE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9602465002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$232.93 |
| Max. Negotiated Rate |
$462.88 |
| Rate for Payer: Aetna of VT Commercial |
$244.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$253.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$344.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$383.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$383.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$282.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$383.65
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cigna Commercial |
$462.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$434.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$434.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$264.24
|
| Rate for Payer: Multiplan Commercial |
$241.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$349.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$245.93
|
| Rate for Payer: United Healthcare Commercial |
$378.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$245.93
|
| Rate for Payer: United Healthcare VA CCN |
$245.93
|
|
|
TREAT RADIUS FRACTURE
|
Professional
|
Both
|
$2,020.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
9822466501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$628.73 |
| Max. Negotiated Rate |
$1,898.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,898.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,809.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$647.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,809.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$880.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,001.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,001.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$723.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,001.43
|
| Rate for Payer: Cash Price |
$1,010.00
|
| Rate for Payer: Cash Price |
$1,010.00
|
| Rate for Payer: Cigna Commercial |
$1,188.02
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,044.04
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,044.04
|
| Rate for Payer: Martins Point Health Care Commercial |
$628.73
|
| Rate for Payer: Multiplan Commercial |
$1,878.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$892.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$628.73
|
| Rate for Payer: United Healthcare Commercial |
$967.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$628.73
|
| Rate for Payer: United Healthcare VA CCN |
$628.73
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$18,611.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
5102466501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8,242.81 |
| Max. Negotiated Rate |
$17,680.45 |
| Rate for Payer: Aetna of VT Commercial |
$17,680.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$16,673.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$8,242.81
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$16,673.59
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$11,203.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$15,819.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$15,074.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$8,374.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$14,795.75
|
| Rate for Payer: Cash Price |
$9,305.50
|
| Rate for Payer: Cigna Commercial |
$14,888.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$14,888.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$14,888.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$8,374.95
|
| Rate for Payer: Multiplan Commercial |
$17,308.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15,819.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$8,374.95
|
| Rate for Payer: United Healthcare Commercial |
$17,680.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,374.95
|
| Rate for Payer: United Healthcare VA CCN |
$8,374.95
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9602465502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$848.15 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,088.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$848.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$848.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$974.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$962.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$916.80
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$916.80
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.10
|
| Rate for Payer: United Healthcare Commercial |
$1,088.70
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$20,631.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
9602466501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$9,137.47 |
| Max. Negotiated Rate |
$19,599.45 |
| Rate for Payer: Aetna of VT Commercial |
$19,599.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$18,483.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$9,137.47
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$18,483.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$12,419.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$17,536.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$16,711.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$9,283.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$16,401.65
|
| Rate for Payer: Cash Price |
$10,315.50
|
| Rate for Payer: Cigna Commercial |
$16,504.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$16,504.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$16,504.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$9,283.95
|
| Rate for Payer: Multiplan Commercial |
$19,186.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$17,536.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$9,283.95
|
| Rate for Payer: United Healthcare Commercial |
$19,599.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,283.95
|
| Rate for Payer: United Healthcare VA CCN |
$9,283.95
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$3,038.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9602465501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,248.42 |
| Max. Negotiated Rate |
$2,886.10 |
| Rate for Payer: Aetna of VT Commercial |
$2,886.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$2,248.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,248.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,582.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,551.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,430.40
|
| Rate for Payer: Cash Price |
$1,519.00
|
| Rate for Payer: Cigna Commercial |
$2,430.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$2,430.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$2,430.40
|
| Rate for Payer: Multiplan Commercial |
$2,825.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,582.30
|
| Rate for Payer: United Healthcare Commercial |
$2,886.10
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$2,020.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
9602466502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,495.00 |
| Max. Negotiated Rate |
$1,919.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,919.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,495.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,495.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,717.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,696.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,616.00
|
| Rate for Payer: Cash Price |
$1,010.00
|
| Rate for Payer: Cigna Commercial |
$1,616.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,616.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,616.00
|
| Rate for Payer: Multiplan Commercial |
$1,878.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,717.00
|
| Rate for Payer: United Healthcare Commercial |
$1,919.00
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9822465501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$507.56 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,088.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$507.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$689.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$974.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$928.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$515.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$911.07
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$916.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$515.70
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare Commercial |
$1,088.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare VA CCN |
$515.70
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9812465501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$848.15 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,088.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$848.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$848.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$974.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$962.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$916.80
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$916.80
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.10
|
| Rate for Payer: United Healthcare Commercial |
$1,088.70
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9602465002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$115.15 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Aetna of VT Commercial |
$247.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$115.15
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$232.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$156.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$221.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$210.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$206.70
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cigna Commercial |
$208.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$208.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$208.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$117.00
|
| Rate for Payer: Multiplan Commercial |
$241.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$221.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$117.00
|
| Rate for Payer: United Healthcare Commercial |
$247.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$117.00
|
| Rate for Payer: United Healthcare VA CCN |
$117.00
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9812465502
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$507.56 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,088.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$507.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$689.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$974.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$928.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$515.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$911.07
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$916.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$515.70
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare Commercial |
$1,088.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare VA CCN |
$515.70
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$304.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
5102465001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$224.99 |
| Max. Negotiated Rate |
$288.80 |
| Rate for Payer: Aetna of VT Commercial |
$288.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$224.99
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$224.99
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$258.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$255.36
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$243.20
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cigna Commercial |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$243.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$243.20
|
| Rate for Payer: Multiplan Commercial |
$282.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$258.40
|
| Rate for Payer: United Healthcare Commercial |
$288.80
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9602465502
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$507.56 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,088.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$507.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$689.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$974.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$928.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$515.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$911.07
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$916.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$515.70
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare Commercial |
$1,088.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare VA CCN |
$515.70
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9602465002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$192.43 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Aetna of VT Commercial |
$247.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$192.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$192.43
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$221.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$218.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$208.00
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cigna Commercial |
$208.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$208.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$208.00
|
| Rate for Payer: Multiplan Commercial |
$241.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$221.00
|
| Rate for Payer: United Healthcare Commercial |
$247.00
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9812465501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$507.56 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna of VT Commercial |
$1,088.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$507.56
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$689.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$974.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$928.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$515.70
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$911.07
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$916.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$916.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$515.70
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare Commercial |
$1,088.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$515.70
|
| Rate for Payer: United Healthcare VA CCN |
$515.70
|
|
|
TREAT RADIUS FRACTURE
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9602465001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$245.93 |
| Max. Negotiated Rate |
$529.22 |
| Rate for Payer: Aetna of VT Commercial |
$529.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$504.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$253.31
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$504.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$344.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$383.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$383.65
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$282.82
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$383.65
|
| Rate for Payer: Cash Price |
$281.50
|
| Rate for Payer: Cash Price |
$281.50
|
| Rate for Payer: Cigna Commercial |
$462.88
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$434.07
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$434.07
|
| Rate for Payer: Martins Point Health Care Commercial |
$264.24
|
| Rate for Payer: Multiplan Commercial |
$523.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$349.22
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$245.93
|
| Rate for Payer: United Healthcare Commercial |
$378.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$245.93
|
| Rate for Payer: United Healthcare VA CCN |
$245.93
|
|
|
TREAT RADIUS FRACTURE
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9812465501
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$395.48 |
| Max. Negotiated Rate |
$1,077.24 |
| Rate for Payer: Aetna of VT Commercial |
$1,077.24
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$407.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,026.70
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$553.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$758.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$758.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$454.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$758.28
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cash Price |
$573.00
|
| Rate for Payer: Cigna Commercial |
$751.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$726.71
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$726.71
|
| Rate for Payer: Martins Point Health Care Commercial |
$440.77
|
| Rate for Payer: Multiplan Commercial |
$1,065.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$561.58
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$395.48
|
| Rate for Payer: United Healthcare Commercial |
$608.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$395.48
|
| Rate for Payer: United Healthcare VA CCN |
$395.48
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$2,020.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
9822466501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$894.66 |
| Max. Negotiated Rate |
$1,919.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,919.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,809.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$894.66
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,809.72
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,216.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,717.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,636.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$909.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,605.90
|
| Rate for Payer: Cash Price |
$1,010.00
|
| Rate for Payer: Cigna Commercial |
$1,616.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,616.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,616.00
|
| Rate for Payer: Martins Point Health Care Commercial |
$909.00
|
| Rate for Payer: Multiplan Commercial |
$1,878.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,717.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$909.00
|
| Rate for Payer: United Healthcare Commercial |
$1,919.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$909.00
|
| Rate for Payer: United Healthcare VA CCN |
$909.00
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$2,020.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
9822466501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,495.00 |
| Max. Negotiated Rate |
$1,919.00 |
| Rate for Payer: Aetna of VT Commercial |
$1,919.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,495.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,495.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,717.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,696.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,616.00
|
| Rate for Payer: Cash Price |
$1,010.00
|
| Rate for Payer: Cigna Commercial |
$1,616.00
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,616.00
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,616.00
|
| Rate for Payer: Multiplan Commercial |
$1,878.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,717.00
|
| Rate for Payer: United Healthcare Commercial |
$1,919.00
|
|
