|
TREAT ULNAR FRACTURE
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
9602467002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$684.32 |
| Rate for Payer: Aetna of VT Commercial |
$684.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$652.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$273.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$652.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$371.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$305.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$409.61
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cigna Commercial |
$501.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$478.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$478.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$291.18
|
| Rate for Payer: Multiplan Commercial |
$677.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$377.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare Commercial |
$408.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare VA CCN |
$265.49
|
|
|
TREAT ULNAR FRACTURE
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
5102467001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$250.80 |
| Rate for Payer: Aetna of VT Commercial |
$250.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$195.39
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$195.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$224.40
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$221.76
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$211.20
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cigna Commercial |
$211.20
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$211.20
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$211.20
|
| Rate for Payer: Multiplan Commercial |
$245.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$224.40
|
| Rate for Payer: United Healthcare Commercial |
$250.80
|
|
|
TREAT ULNAR FRACTURE
|
Facility
|
OP
|
$728.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
9602467002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$322.43 |
| Max. Negotiated Rate |
$691.60 |
| Rate for Payer: Aetna of VT Commercial |
$691.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$652.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$322.43
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$652.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$438.26
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$618.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$589.68
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$327.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$578.76
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cigna Commercial |
$582.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$582.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$582.40
|
| Rate for Payer: Martins Point Health Care Commercial |
$327.60
|
| Rate for Payer: Multiplan Commercial |
$677.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$618.80
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$327.60
|
| Rate for Payer: United Healthcare Commercial |
$691.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$327.60
|
| Rate for Payer: United Healthcare VA CCN |
$327.60
|
|
|
TREAT ULNAR FRACTURE
|
Facility
|
IP
|
$728.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
9602467002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$538.79 |
| Max. Negotiated Rate |
$691.60 |
| Rate for Payer: Aetna of VT Commercial |
$691.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$538.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$538.79
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$618.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$611.52
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$582.40
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cigna Commercial |
$582.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$582.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$582.40
|
| Rate for Payer: Multiplan Commercial |
$677.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$618.80
|
| Rate for Payer: United Healthcare Commercial |
$691.60
|
|
|
TREAT ULNAR FRACTURE
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
9812467001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$216.11 |
| Max. Negotiated Rate |
$277.40 |
| Rate for Payer: Aetna of VT Commercial |
$277.40
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$216.11
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$216.11
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$248.20
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$245.28
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$233.60
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cigna Commercial |
$233.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$233.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$233.60
|
| Rate for Payer: Multiplan Commercial |
$271.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$248.20
|
| Rate for Payer: United Healthcare Commercial |
$277.40
|
|
|
TREAT ULNAR FRACTURE
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
9602467001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$931.54 |
| Rate for Payer: Aetna of VT Commercial |
$931.54
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$887.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$273.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$887.84
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$371.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$305.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$409.61
|
| Rate for Payer: Cash Price |
$495.50
|
| Rate for Payer: Cash Price |
$495.50
|
| Rate for Payer: Cigna Commercial |
$501.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$478.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$478.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$291.18
|
| Rate for Payer: Multiplan Commercial |
$921.63
|
| Rate for Payer: MVP Health Care of NY Commercial |
$377.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare Commercial |
$408.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare VA CCN |
$265.49
|
|
|
TREAT ULNAR FRACTURE
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
9812467001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$261.60 |
| Max. Negotiated Rate |
$501.21 |
| Rate for Payer: Aetna of VT Commercial |
$274.48
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$261.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$273.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$261.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$371.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$305.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$409.61
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cigna Commercial |
$501.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$478.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$478.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$291.18
|
| Rate for Payer: Multiplan Commercial |
$271.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$377.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare Commercial |
$408.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare VA CCN |
$265.49
|
|
|
TREAT ULNAR FRACTURE
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
9812467002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$684.32 |
| Rate for Payer: Aetna of VT Commercial |
$684.32
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$652.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$273.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$652.22
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$371.69
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$409.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$305.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$409.61
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cigna Commercial |
$501.21
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$478.30
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$478.30
|
| Rate for Payer: Martins Point Health Care Commercial |
$291.18
|
| Rate for Payer: Multiplan Commercial |
$677.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$377.00
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare Commercial |
$408.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$265.49
|
| Rate for Payer: United Healthcare VA CCN |
$265.49
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
IP
|
$683.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
5102562201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$505.49 |
| Max. Negotiated Rate |
$648.85 |
| Rate for Payer: Aetna of VT Commercial |
$648.85
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$505.49
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$505.49
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$580.55
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$573.72
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$546.40
|
| Rate for Payer: Cash Price |
$341.50
|
| Rate for Payer: Cigna Commercial |
$546.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$546.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$546.40
|
| Rate for Payer: Multiplan Commercial |
$635.19
|
| Rate for Payer: MVP Health Care of NY Commercial |
$580.55
|
| Rate for Payer: United Healthcare Commercial |
$648.85
|
|
|
TREAT WRIST BONE FRACTURE
|
Professional
|
Both
|
$1,270.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
9812562402
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$436.35 |
| Max. Negotiated Rate |
$1,193.80 |
| Rate for Payer: Aetna of VT Commercial |
$1,193.80
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,137.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$449.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,137.79
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$610.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$794.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$794.06
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$501.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$794.06
|
| Rate for Payer: Cash Price |
$635.00
|
| Rate for Payer: Cash Price |
$635.00
|
| Rate for Payer: Cigna Commercial |
$823.75
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$796.14
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$796.14
|
| Rate for Payer: Martins Point Health Care Commercial |
$483.24
|
| Rate for Payer: Multiplan Commercial |
$1,181.10
|
| Rate for Payer: MVP Health Care of NY Commercial |
$619.62
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$436.35
|
| Rate for Payer: United Healthcare Commercial |
$671.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$436.35
|
| Rate for Payer: United Healthcare VA CCN |
$436.35
|
|
|
TREAT WRIST BONE FRACTURE
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
9812562202
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$282.53 |
| Max. Negotiated Rate |
$750.12 |
| Rate for Payer: Aetna of VT Commercial |
$750.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$714.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$714.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$418.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$418.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$418.63
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$533.17
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$503.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$503.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$306.94
|
| Rate for Payer: Multiplan Commercial |
$742.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.53
|
| Rate for Payer: United Healthcare Commercial |
$434.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.53
|
| Rate for Payer: United Healthcare VA CCN |
$282.53
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
9812562201
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
9812562401
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.84
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
9602565002
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$637.23 |
| Max. Negotiated Rate |
$817.95 |
| Rate for Payer: Aetna of VT Commercial |
$817.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$637.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$637.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$723.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$688.80
|
| Rate for Payer: Cash Price |
$430.50
|
| Rate for Payer: Cigna Commercial |
$688.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$688.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$688.80
|
| Rate for Payer: Multiplan Commercial |
$800.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.85
|
| Rate for Payer: United Healthcare Commercial |
$817.95
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
OP
|
$2,151.00
|
|
|
Service Code
|
CPT 25628
|
| Hospital Charge Code |
9822562801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$952.68 |
| Max. Negotiated Rate |
$2,043.45 |
| Rate for Payer: Aetna of VT Commercial |
$2,043.45
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,927.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$952.68
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,927.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$1,294.90
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,828.35
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,742.31
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$967.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,710.05
|
| Rate for Payer: Cash Price |
$1,075.50
|
| Rate for Payer: Cigna Commercial |
$1,720.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,720.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,720.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$967.95
|
| Rate for Payer: Multiplan Commercial |
$2,000.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,828.35
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$967.95
|
| Rate for Payer: United Healthcare Commercial |
$2,043.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$967.95
|
| Rate for Payer: United Healthcare VA CCN |
$967.95
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
9812562401
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
TREAT WRIST BONE FRACTURE
|
Professional
|
Both
|
$1,768.00
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
9602565001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$302.30 |
| Max. Negotiated Rate |
$1,661.92 |
| Rate for Payer: Aetna of VT Commercial |
$1,661.92
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,583.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$311.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,583.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$423.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$537.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$347.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$537.61
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cigna Commercial |
$570.94
|
| 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 |
$326.06
|
| Rate for Payer: Multiplan Commercial |
$1,644.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$429.27
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$302.30
|
| Rate for Payer: United Healthcare Commercial |
$465.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$302.30
|
| Rate for Payer: United Healthcare VA CCN |
$302.30
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
9812565001
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna of VT Commercial |
$0.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$0.44
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$0.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$0.45
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$0.80
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna Commercial |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$0.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$0.80
|
| Rate for Payer: Martins Point Health Care Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.93
|
| Rate for Payer: MVP Health Care of NY Commercial |
$0.85
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare Commercial |
$0.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.45
|
| Rate for Payer: United Healthcare VA CCN |
$0.45
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
IP
|
$1,768.00
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
9602565001
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,308.50 |
| Max. Negotiated Rate |
$1,679.60 |
| Rate for Payer: Aetna of VT Commercial |
$1,679.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,308.50
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,308.50
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,502.80
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,485.12
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,414.40
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cigna Commercial |
$1,414.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,414.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,414.40
|
| Rate for Payer: Multiplan Commercial |
$1,644.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,502.80
|
| Rate for Payer: United Healthcare Commercial |
$1,679.60
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
OP
|
$907.00
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
5102565001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$401.71 |
| Max. Negotiated Rate |
$861.65 |
| Rate for Payer: Aetna of VT Commercial |
$861.65
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$812.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$401.71
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$812.58
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$546.01
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$770.95
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$734.67
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$408.15
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$721.07
|
| Rate for Payer: Cash Price |
$453.50
|
| Rate for Payer: Cigna Commercial |
$725.60
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$725.60
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$725.60
|
| Rate for Payer: Martins Point Health Care Commercial |
$408.15
|
| Rate for Payer: Multiplan Commercial |
$843.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$770.95
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$408.15
|
| Rate for Payer: United Healthcare Commercial |
$861.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$408.15
|
| Rate for Payer: United Healthcare VA CCN |
$408.15
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
IP
|
$798.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
9602562202
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$590.60 |
| Max. Negotiated Rate |
$758.10 |
| Rate for Payer: Aetna of VT Commercial |
$758.10
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$590.60
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$590.60
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$678.30
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$670.32
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$638.40
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$638.40
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$638.40
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$638.40
|
| Rate for Payer: Multiplan Commercial |
$742.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$678.30
|
| Rate for Payer: United Healthcare Commercial |
$758.10
|
|
|
TREAT WRIST BONE FRACTURE
|
Professional
|
Both
|
$2,151.00
|
|
|
Service Code
|
CPT 25628
|
| Hospital Charge Code |
9822562801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$685.99 |
| Max. Negotiated Rate |
$2,021.94 |
| Rate for Payer: Aetna of VT Commercial |
$2,021.94
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$1,927.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$706.57
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$1,927.08
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$960.39
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$1,204.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$1,204.27
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$788.89
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$1,204.27
|
| Rate for Payer: Cash Price |
$1,075.50
|
| Rate for Payer: Cash Price |
$1,075.50
|
| Rate for Payer: Cigna Commercial |
$1,295.92
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$1,139.18
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$1,139.18
|
| Rate for Payer: Martins Point Health Care Commercial |
$685.99
|
| Rate for Payer: Multiplan Commercial |
$2,000.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$974.11
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$685.99
|
| Rate for Payer: United Healthcare Commercial |
$1,055.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$685.99
|
| Rate for Payer: United Healthcare VA CCN |
$685.99
|
|
|
TREAT WRIST BONE FRACTURE
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
9822562201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$282.53 |
| Max. Negotiated Rate |
$750.12 |
| Rate for Payer: Aetna of VT Commercial |
$750.12
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$714.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$291.01
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$714.93
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$395.54
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$418.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$418.63
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$324.91
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$418.63
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$533.17
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$503.50
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$503.50
|
| Rate for Payer: Martins Point Health Care Commercial |
$306.94
|
| Rate for Payer: Multiplan Commercial |
$742.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$401.19
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$282.53
|
| Rate for Payer: United Healthcare Commercial |
$434.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.53
|
| Rate for Payer: United Healthcare VA CCN |
$282.53
|
|
|
TREAT WRIST BONE FRACTURE
|
Professional
|
Both
|
$861.00
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
9812565002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$302.30 |
| Max. Negotiated Rate |
$809.34 |
| Rate for Payer: Aetna of VT Commercial |
$809.34
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$771.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Qualified Health Plan |
$311.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$771.37
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP On Exchange |
$423.22
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$537.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$537.61
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Medicare Advantage |
$347.64
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$537.61
|
| Rate for Payer: Cash Price |
$430.50
|
| Rate for Payer: Cash Price |
$430.50
|
| Rate for Payer: Cigna Commercial |
$570.94
|
| 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 |
$326.06
|
| Rate for Payer: Multiplan Commercial |
$800.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$429.27
|
| Rate for Payer: MVP Health Care of NY Medicare Advantage |
$302.30
|
| Rate for Payer: United Healthcare Commercial |
$465.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$302.30
|
| Rate for Payer: United Healthcare VA CCN |
$302.30
|
|
|
TREAT WRIST BONE FRACTURE
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
9812565002
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$637.23 |
| Max. Negotiated Rate |
$817.95 |
| Rate for Payer: Aetna of VT Commercial |
$817.95
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire Commercial |
$637.23
|
| Rate for Payer: Blue Cross Blue Shield of New Hampshire SHOP Off Exchange |
$637.23
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Commercial |
$731.85
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Managed Care |
$723.24
|
| Rate for Payer: Blue Cross Blue Shield of Vermont Vermont Health Plan |
$688.80
|
| Rate for Payer: Cash Price |
$430.50
|
| Rate for Payer: Cigna Commercial |
$688.80
|
| Rate for Payer: Harvard Pilgrim Health Care HMO |
$688.80
|
| Rate for Payer: Harvard Pilgrim Health Care PPO |
$688.80
|
| Rate for Payer: Multiplan Commercial |
$800.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$731.85
|
| Rate for Payer: United Healthcare Commercial |
$817.95
|
|
