|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$18,611.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
5102466501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13,774.00 |
| 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 |
$13,774.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$13,774.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$15,819.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$15,633.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$14,888.80
|
| 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: Multiplan Commercial |
$17,308.23
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15,819.35
|
| Rate for Payer: United Healthcare Commercial |
$17,680.45
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9812465001
|
|
Hospital Revenue Code
|
981
|
| 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
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9812465001
|
|
Hospital Revenue Code
|
981
|
| 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
|
IP
|
$563.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9602465001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$416.68 |
| Max. Negotiated Rate |
$534.85 |
| Rate for Payer: Aetna of VT Commercial |
$534.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$416.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$416.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$478.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$472.92
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$450.40
|
| Rate for Payer: Cash Price |
$281.50
|
| Rate for Payer: Cigna Commercial |
$450.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$450.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$450.40
|
| Rate for Payer: Multiplan Commercial |
$523.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$478.55
|
| Rate for Payer: United Healthcare Commercial |
$534.85
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9812465002
|
|
Hospital Revenue Code
|
981
|
| 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
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9812465002
|
|
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
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
5102465001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$245.93 |
| Max. Negotiated Rate |
$462.88 |
| Rate for Payer: Aetna of VT Commercial |
$285.76
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$272.35
|
| 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 |
$272.35
|
| 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 |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| 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 |
$282.72
|
| 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 |
9812465502
|
|
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
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9822465501
|
|
Hospital Revenue Code
|
982
|
| 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
|
$304.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
5102465001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$134.64 |
| 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 |
$272.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$134.64
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$272.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$183.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$258.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$246.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$136.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$241.68
|
| 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: Martins Point Health Care Commercial |
$136.80
|
| Rate for Payer: Multiplan Commercial |
$282.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$258.40
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$136.80
|
| Rate for Payer: United Healthcare Commercial |
$288.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$136.80
|
| Rate for Payer: United Healthcare VA CCN |
$136.80
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
OP
|
$3,038.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9602465501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,345.53 |
| 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 |
$2,721.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$1,345.53
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$2,721.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,828.88
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$2,582.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$2,460.78
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$1,367.10
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$2,415.21
|
| 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: Martins Point Health Care Commercial |
$1,367.10
|
| Rate for Payer: Multiplan Commercial |
$2,825.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$2,582.30
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$1,367.10
|
| Rate for Payer: United Healthcare Commercial |
$2,886.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,367.10
|
| Rate for Payer: United Healthcare VA CCN |
$1,367.10
|
|
|
TREAT RADIUS FRACTURE
|
Professional
|
Both
|
$1,893.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
5102465501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$395.48 |
| Max. Negotiated Rate |
$1,779.42 |
| Rate for Payer: Aetna of VT Commercial |
$1,779.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,695.94
|
| 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 |
$1,695.94
|
| 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 |
$946.50
|
| Rate for Payer: Cash Price |
$946.50
|
| 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 |
$1,760.49
|
| 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
|
IP
|
$20,631.00
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
9602466501
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$15,269.00 |
| 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 |
$15,269.00
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$15,269.00
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$17,536.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$17,330.04
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$16,504.80
|
| 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: Multiplan Commercial |
$19,186.83
|
| Rate for Payer: MVP Health Care of NY Commercial |
$17,536.35
|
| Rate for Payer: United Healthcare Commercial |
$19,599.45
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9812465502
|
|
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
|
$1,893.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
5102465501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$838.41 |
| Max. Negotiated Rate |
$1,798.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,798.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,695.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$838.41
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,695.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,139.59
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,609.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,533.33
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$851.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,504.93
|
| Rate for Payer: Cash Price |
$946.50
|
| Rate for Payer: Cigna Commercial |
$1,514.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,514.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,514.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$851.85
|
| Rate for Payer: Multiplan Commercial |
$1,760.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,609.05
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$851.85
|
| Rate for Payer: United Healthcare Commercial |
$1,798.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$851.85
|
| Rate for Payer: United Healthcare VA CCN |
$851.85
|
|
|
TREAT RADIUS FRACTURE
|
Facility
|
IP
|
$1,893.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
5102465501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,401.01 |
| Max. Negotiated Rate |
$1,798.35 |
| Rate for Payer: Aetna of VT Commercial |
$1,798.35
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,401.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,401.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,609.05
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,590.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,514.40
|
| Rate for Payer: Cash Price |
$946.50
|
| Rate for Payer: Cigna Commercial |
$1,514.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,514.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,514.40
|
| Rate for Payer: Multiplan Commercial |
$1,760.49
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,609.05
|
| Rate for Payer: United Healthcare Commercial |
$1,798.35
|
|
|
TREAT RADIUS FRACTURE
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
9602465502
|
|
Hospital Revenue Code
|
960
|
| 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
|
$563.00
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
9602465001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$249.35 |
| Max. Negotiated Rate |
$534.85 |
| Rate for Payer: Aetna of VT Commercial |
$534.85
|
| 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 |
$249.35
|
| 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 |
$338.93
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$478.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$456.03
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$253.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$447.58
|
| Rate for Payer: Cash Price |
$281.50
|
| Rate for Payer: Cigna Commercial |
$450.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$450.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$450.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$253.35
|
| Rate for Payer: Multiplan Commercial |
$523.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$478.55
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$253.35
|
| Rate for Payer: United Healthcare Commercial |
$534.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$253.35
|
| Rate for Payer: United Healthcare VA CCN |
$253.35
|
|
|
TREAT SHOULDER BLADE FX
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
9812357002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$233.26 |
| Max. Negotiated Rate |
$577.16 |
| Rate for Payer: Aetna of VT Commercial |
$577.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$550.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$248.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$550.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$338.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$310.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$310.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$277.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$310.86
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cigna Commercial |
$454.95
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$384.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$384.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$233.26
|
| Rate for Payer: Multiplan Commercial |
$571.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$343.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$241.62
|
| Rate for Payer: United Healthcare Commercial |
$371.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$241.62
|
| Rate for Payer: United Healthcare VA CCN |
$241.62
|
|
|
TREAT SHOULDER BLADE FX
|
Facility
|
IP
|
$614.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
9812357001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$454.42 |
| Max. Negotiated Rate |
$583.30 |
| Rate for Payer: Aetna of VT Commercial |
$583.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$454.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$454.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$521.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$515.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$491.20
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cigna Commercial |
$491.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$491.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$491.20
|
| Rate for Payer: Multiplan Commercial |
$571.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$521.90
|
| Rate for Payer: United Healthcare Commercial |
$583.30
|
|
|
TREAT SHOULDER BLADE FX
|
Facility
|
OP
|
$303.04
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
4502357001
|
|
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 SHOULDER BLADE FX
|
Facility
|
IP
|
$614.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
9812357002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$454.42 |
| Max. Negotiated Rate |
$583.30 |
| Rate for Payer: Aetna of VT Commercial |
$583.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$454.42
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$454.42
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$521.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$515.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$491.20
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cigna Commercial |
$491.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$491.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$491.20
|
| Rate for Payer: Multiplan Commercial |
$571.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$521.90
|
| Rate for Payer: United Healthcare Commercial |
$583.30
|
|
|
TREAT SHOULDER BLADE FX
|
Facility
|
OP
|
$614.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
9812357002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$271.94 |
| Max. Negotiated Rate |
$583.30 |
| Rate for Payer: Aetna of VT Commercial |
$583.30
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$550.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$271.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$550.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$369.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$521.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$497.34
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$276.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$488.13
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cigna Commercial |
$491.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$491.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$491.20
|
| Rate for Payer: Martins Point Health Care Commercial |
$276.30
|
| Rate for Payer: Multiplan Commercial |
$571.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$521.90
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$276.30
|
| Rate for Payer: United Healthcare Commercial |
$583.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$276.30
|
| Rate for Payer: United Healthcare VA CCN |
$276.30
|
|
|
TREAT SHOULDER BLADE FX
|
Facility
|
IP
|
$303.04
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
4502357001
|
|
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 SHOULDER BLADE FX
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
9812357001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$233.26 |
| Max. Negotiated Rate |
$577.16 |
| Rate for Payer: Aetna of VT Commercial |
$577.16
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$550.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$248.87
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$550.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$338.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$310.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$310.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$277.86
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$310.86
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cigna Commercial |
$454.95
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$384.69
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$384.69
|
| Rate for Payer: Martins Point Health Care Commercial |
$233.26
|
| Rate for Payer: Multiplan Commercial |
$571.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$343.10
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$241.62
|
| Rate for Payer: United Healthcare Commercial |
$371.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$241.62
|
| Rate for Payer: United Healthcare VA CCN |
$241.62
|
|
