|
EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM
|
Professional
|
Both
|
$744.00
|
|
|
Service Code
|
HCPCS 11621
|
| Hospital Charge Code |
11621
|
| Min. Negotiated Rate |
$122.52 |
| Max. Negotiated Rate |
$744.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$729.12
|
| Rate for Payer: Aetna of WY Medicare |
$144.14
|
| Rate for Payer: Beech Street Commercial |
$706.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$721.68
|
| Rate for Payer: Cigna of WY Commercial |
$729.12
|
| Rate for Payer: First Choice Health Commercial |
$669.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$706.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$144.14
|
| Rate for Payer: HealthUtah PPO |
$744.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$721.68
|
| Rate for Payer: Multiplan Medicare/VA |
$122.52
|
| Rate for Payer: One Health Plan of WY PPO |
$729.12
|
| Rate for Payer: PacificSource Commercial |
$669.60
|
| Rate for Payer: PHCS PPO |
$706.80
|
| Rate for Payer: Three Rivers PPO |
$558.00
|
| Rate for Payer: TriWest Veterans Administration |
$144.14
|
| Rate for Payer: United Healthcare Commercial |
$647.28
|
| Rate for Payer: United Healthcare Medicare |
$144.14
|
| Rate for Payer: WINHealth Partners Commercial |
$632.40
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$846.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
11622
|
| Min. Negotiated Rate |
$139.00 |
| Max. Negotiated Rate |
$846.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$829.08
|
| Rate for Payer: Aetna of WY Medicare |
$163.53
|
| Rate for Payer: Beech Street Commercial |
$803.70
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$820.62
|
| Rate for Payer: Cigna of WY Commercial |
$829.08
|
| Rate for Payer: First Choice Health Commercial |
$761.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$803.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.53
|
| Rate for Payer: HealthUtah PPO |
$846.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$820.62
|
| Rate for Payer: Multiplan Medicare/VA |
$139.00
|
| Rate for Payer: One Health Plan of WY PPO |
$829.08
|
| Rate for Payer: PacificSource Commercial |
$761.40
|
| Rate for Payer: PHCS PPO |
$803.70
|
| Rate for Payer: Three Rivers PPO |
$634.50
|
| Rate for Payer: TriWest Veterans Administration |
$163.53
|
| Rate for Payer: United Healthcare Commercial |
$736.02
|
| Rate for Payer: United Healthcare Medicare |
$163.53
|
| Rate for Payer: WINHealth Partners Commercial |
$719.10
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$1,052.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
11623
|
| Min. Negotiated Rate |
$171.05 |
| Max. Negotiated Rate |
$1,052.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,030.96
|
| Rate for Payer: Aetna of WY Medicare |
$201.23
|
| Rate for Payer: Beech Street Commercial |
$999.40
|
| Rate for Payer: Cash Price |
$736.40
|
| Rate for Payer: Cash Price |
$736.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,020.44
|
| Rate for Payer: Cigna of WY Commercial |
$1,030.96
|
| Rate for Payer: First Choice Health Commercial |
$946.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$999.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$201.23
|
| Rate for Payer: HealthUtah PPO |
$1,052.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,020.44
|
| Rate for Payer: Multiplan Medicare/VA |
$171.05
|
| Rate for Payer: One Health Plan of WY PPO |
$1,030.96
|
| Rate for Payer: PacificSource Commercial |
$946.80
|
| Rate for Payer: PHCS PPO |
$999.40
|
| Rate for Payer: Three Rivers PPO |
$789.00
|
| Rate for Payer: TriWest Veterans Administration |
$201.23
|
| Rate for Payer: United Healthcare Commercial |
$915.24
|
| Rate for Payer: United Healthcare Medicare |
$201.23
|
| Rate for Payer: WINHealth Partners Commercial |
$894.20
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 11624
|
| Hospital Charge Code |
11624
|
| Min. Negotiated Rate |
$194.11 |
| Max. Negotiated Rate |
$1,193.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,169.14
|
| Rate for Payer: Aetna of WY Medicare |
$228.37
|
| Rate for Payer: Beech Street Commercial |
$1,133.35
|
| Rate for Payer: Cash Price |
$835.10
|
| Rate for Payer: Cash Price |
$835.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,157.21
|
| Rate for Payer: Cigna of WY Commercial |
$1,169.14
|
| Rate for Payer: First Choice Health Commercial |
$1,073.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,133.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$228.37
|
| Rate for Payer: HealthUtah PPO |
$1,193.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,157.21
|
| Rate for Payer: Multiplan Medicare/VA |
$194.11
|
| Rate for Payer: One Health Plan of WY PPO |
$1,169.14
|
| Rate for Payer: PacificSource Commercial |
$1,073.70
|
| Rate for Payer: PHCS PPO |
$1,133.35
|
| Rate for Payer: Three Rivers PPO |
$894.75
|
| Rate for Payer: TriWest Veterans Administration |
$228.37
|
| Rate for Payer: United Healthcare Commercial |
$1,037.91
|
| Rate for Payer: United Healthcare Medicare |
$228.37
|
| Rate for Payer: WINHealth Partners Commercial |
$1,014.05
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
11626
|
| Min. Negotiated Rate |
$236.27 |
| Max. Negotiated Rate |
$1,468.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,438.64
|
| Rate for Payer: Aetna of WY Medicare |
$277.97
|
| Rate for Payer: Beech Street Commercial |
$1,394.60
|
| Rate for Payer: Cash Price |
$1,027.60
|
| Rate for Payer: Cash Price |
$1,027.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,423.96
|
| Rate for Payer: Cigna of WY Commercial |
$1,438.64
|
| Rate for Payer: First Choice Health Commercial |
$1,321.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,394.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$277.97
|
| Rate for Payer: HealthUtah PPO |
$1,468.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,423.96
|
| Rate for Payer: Multiplan Medicare/VA |
$236.27
|
| Rate for Payer: One Health Plan of WY PPO |
$1,438.64
|
| Rate for Payer: PacificSource Commercial |
$1,321.20
|
| Rate for Payer: PHCS PPO |
$1,394.60
|
| Rate for Payer: Three Rivers PPO |
$1,101.00
|
| Rate for Payer: TriWest Veterans Administration |
$277.97
|
| Rate for Payer: United Healthcare Commercial |
$1,277.16
|
| Rate for Payer: United Healthcare Medicare |
$277.97
|
| Rate for Payer: WINHealth Partners Commercial |
$1,247.80
|
|
|
EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$1,591.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
11606
|
| Min. Negotiated Rate |
$256.97 |
| Max. Negotiated Rate |
$1,591.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,559.18
|
| Rate for Payer: Aetna of WY Medicare |
$302.32
|
| Rate for Payer: Beech Street Commercial |
$1,511.45
|
| Rate for Payer: Cash Price |
$1,113.70
|
| Rate for Payer: Cash Price |
$1,113.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,543.27
|
| Rate for Payer: Cigna of WY Commercial |
$1,559.18
|
| Rate for Payer: First Choice Health Commercial |
$1,431.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,511.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$302.32
|
| Rate for Payer: HealthUtah PPO |
$1,591.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,543.27
|
| Rate for Payer: Multiplan Medicare/VA |
$256.97
|
| Rate for Payer: One Health Plan of WY PPO |
$1,559.18
|
| Rate for Payer: PacificSource Commercial |
$1,431.90
|
| Rate for Payer: PHCS PPO |
$1,511.45
|
| Rate for Payer: Three Rivers PPO |
$1,193.25
|
| Rate for Payer: TriWest Veterans Administration |
$302.32
|
| Rate for Payer: United Healthcare Commercial |
$1,384.17
|
| Rate for Payer: United Healthcare Medicare |
$302.32
|
| Rate for Payer: WINHealth Partners Commercial |
$1,352.35
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<
|
Professional
|
Both
|
$601.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
11600
|
| Min. Negotiated Rate |
$100.83 |
| Max. Negotiated Rate |
$601.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$588.98
|
| Rate for Payer: Aetna of WY Medicare |
$118.62
|
| Rate for Payer: Beech Street Commercial |
$570.95
|
| Rate for Payer: Cash Price |
$420.70
|
| Rate for Payer: Cash Price |
$420.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$582.97
|
| Rate for Payer: Cigna of WY Commercial |
$588.98
|
| Rate for Payer: First Choice Health Commercial |
$540.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$570.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$118.62
|
| Rate for Payer: HealthUtah PPO |
$601.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$582.97
|
| Rate for Payer: Multiplan Medicare/VA |
$100.83
|
| Rate for Payer: One Health Plan of WY PPO |
$588.98
|
| Rate for Payer: PacificSource Commercial |
$540.90
|
| Rate for Payer: PHCS PPO |
$570.95
|
| Rate for Payer: Three Rivers PPO |
$450.75
|
| Rate for Payer: TriWest Veterans Administration |
$118.62
|
| Rate for Payer: United Healthcare Commercial |
$522.87
|
| Rate for Payer: United Healthcare Medicare |
$118.62
|
| Rate for Payer: WINHealth Partners Commercial |
$510.85
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 11601
|
| Hospital Charge Code |
11601
|
| Min. Negotiated Rate |
$122.04 |
| Max. Negotiated Rate |
$741.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$726.18
|
| Rate for Payer: Aetna of WY Medicare |
$143.58
|
| Rate for Payer: Beech Street Commercial |
$703.95
|
| Rate for Payer: Cash Price |
$518.70
|
| Rate for Payer: Cash Price |
$518.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$718.77
|
| Rate for Payer: Cigna of WY Commercial |
$726.18
|
| Rate for Payer: First Choice Health Commercial |
$666.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$703.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$143.58
|
| Rate for Payer: HealthUtah PPO |
$741.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$718.77
|
| Rate for Payer: Multiplan Medicare/VA |
$122.04
|
| Rate for Payer: One Health Plan of WY PPO |
$726.18
|
| Rate for Payer: PacificSource Commercial |
$666.90
|
| Rate for Payer: PHCS PPO |
$703.95
|
| Rate for Payer: Three Rivers PPO |
$555.75
|
| Rate for Payer: TriWest Veterans Administration |
$143.58
|
| Rate for Payer: United Healthcare Commercial |
$644.67
|
| Rate for Payer: United Healthcare Medicare |
$143.58
|
| Rate for Payer: WINHealth Partners Commercial |
$629.85
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$807.00
|
|
|
Service Code
|
HCPCS 11602
|
| Hospital Charge Code |
11602
|
| Min. Negotiated Rate |
$132.62 |
| Max. Negotiated Rate |
$807.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$790.86
|
| Rate for Payer: Aetna of WY Medicare |
$156.02
|
| Rate for Payer: Beech Street Commercial |
$766.65
|
| Rate for Payer: Cash Price |
$564.90
|
| Rate for Payer: Cash Price |
$564.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$782.79
|
| Rate for Payer: Cigna of WY Commercial |
$790.86
|
| Rate for Payer: First Choice Health Commercial |
$726.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$766.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$156.02
|
| Rate for Payer: HealthUtah PPO |
$807.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$782.79
|
| Rate for Payer: Multiplan Medicare/VA |
$132.62
|
| Rate for Payer: One Health Plan of WY PPO |
$790.86
|
| Rate for Payer: PacificSource Commercial |
$726.30
|
| Rate for Payer: PHCS PPO |
$766.65
|
| Rate for Payer: Three Rivers PPO |
$605.25
|
| Rate for Payer: TriWest Veterans Administration |
$156.02
|
| Rate for Payer: United Healthcare Commercial |
$702.09
|
| Rate for Payer: United Healthcare Medicare |
$156.02
|
| Rate for Payer: WINHealth Partners Commercial |
$685.95
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$968.00
|
|
|
Service Code
|
HCPCS 11603
|
| Hospital Charge Code |
11603
|
| Min. Negotiated Rate |
$158.13 |
| Max. Negotiated Rate |
$968.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$948.64
|
| Rate for Payer: Aetna of WY Medicare |
$186.03
|
| Rate for Payer: Beech Street Commercial |
$919.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$938.96
|
| Rate for Payer: Cigna of WY Commercial |
$948.64
|
| Rate for Payer: First Choice Health Commercial |
$871.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$919.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$186.03
|
| Rate for Payer: HealthUtah PPO |
$968.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$938.96
|
| Rate for Payer: Multiplan Medicare/VA |
$158.13
|
| Rate for Payer: One Health Plan of WY PPO |
$948.64
|
| Rate for Payer: PacificSource Commercial |
$871.20
|
| Rate for Payer: PHCS PPO |
$919.60
|
| Rate for Payer: Three Rivers PPO |
$726.00
|
| Rate for Payer: TriWest Veterans Administration |
$186.03
|
| Rate for Payer: United Healthcare Commercial |
$842.16
|
| Rate for Payer: United Healthcare Medicare |
$186.03
|
| Rate for Payer: WINHealth Partners Commercial |
$822.80
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 11604
|
| Hospital Charge Code |
11604
|
| Min. Negotiated Rate |
$173.69 |
| Max. Negotiated Rate |
$1,066.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,044.68
|
| Rate for Payer: Aetna of WY Medicare |
$204.34
|
| Rate for Payer: Beech Street Commercial |
$1,012.70
|
| Rate for Payer: Cash Price |
$746.20
|
| Rate for Payer: Cash Price |
$746.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,034.02
|
| Rate for Payer: Cigna of WY Commercial |
$1,044.68
|
| Rate for Payer: First Choice Health Commercial |
$959.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,012.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$204.34
|
| Rate for Payer: HealthUtah PPO |
$1,066.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,034.02
|
| Rate for Payer: Multiplan Medicare/VA |
$173.69
|
| Rate for Payer: One Health Plan of WY PPO |
$1,044.68
|
| Rate for Payer: PacificSource Commercial |
$959.40
|
| Rate for Payer: PHCS PPO |
$1,012.70
|
| Rate for Payer: Three Rivers PPO |
$799.50
|
| Rate for Payer: TriWest Veterans Administration |
$204.34
|
| Rate for Payer: United Healthcare Commercial |
$927.42
|
| Rate for Payer: United Healthcare Medicare |
$204.34
|
| Rate for Payer: WINHealth Partners Commercial |
$906.10
|
|
|
EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS
|
Professional
|
Both
|
$3,498.00
|
|
|
Service Code
|
HCPCS 46230
|
| Hospital Charge Code |
46230
|
| Min. Negotiated Rate |
$142.43 |
| Max. Negotiated Rate |
$3,498.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,428.04
|
| Rate for Payer: Aetna of WY Medicare |
$167.56
|
| Rate for Payer: Beech Street Commercial |
$3,323.10
|
| Rate for Payer: Cash Price |
$2,448.60
|
| Rate for Payer: Cash Price |
$2,448.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,393.06
|
| Rate for Payer: Cigna of WY Commercial |
$3,428.04
|
| Rate for Payer: First Choice Health Commercial |
$3,148.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,323.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$167.56
|
| Rate for Payer: HealthUtah PPO |
$3,498.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,393.06
|
| Rate for Payer: Multiplan Medicare/VA |
$142.43
|
| Rate for Payer: One Health Plan of WY PPO |
$3,428.04
|
| Rate for Payer: PacificSource Commercial |
$3,148.20
|
| Rate for Payer: PHCS PPO |
$3,323.10
|
| Rate for Payer: Three Rivers PPO |
$2,623.50
|
| Rate for Payer: TriWest Veterans Administration |
$167.56
|
| Rate for Payer: United Healthcare Commercial |
$3,043.26
|
| Rate for Payer: United Healthcare Medicare |
$167.56
|
| Rate for Payer: WINHealth Partners Commercial |
$2,973.30
|
|
|
EXCISION NAIL MATRIX PERMANENT REMOVAL
|
Professional
|
Both
|
$509.00
|
|
|
Service Code
|
HCPCS 11750
|
| Hospital Charge Code |
11750
|
| Min. Negotiated Rate |
$84.23 |
| Max. Negotiated Rate |
$509.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$498.82
|
| Rate for Payer: Aetna of WY Medicare |
$99.09
|
| Rate for Payer: Beech Street Commercial |
$483.55
|
| Rate for Payer: Cash Price |
$356.30
|
| Rate for Payer: Cash Price |
$356.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$493.73
|
| Rate for Payer: Cigna of WY Commercial |
$498.82
|
| Rate for Payer: First Choice Health Commercial |
$458.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$483.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$99.09
|
| Rate for Payer: HealthUtah PPO |
$509.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$493.73
|
| Rate for Payer: Multiplan Medicare/VA |
$84.23
|
| Rate for Payer: One Health Plan of WY PPO |
$498.82
|
| Rate for Payer: PacificSource Commercial |
$458.10
|
| Rate for Payer: PHCS PPO |
$483.55
|
| Rate for Payer: Three Rivers PPO |
$381.75
|
| Rate for Payer: TriWest Veterans Administration |
$99.09
|
| Rate for Payer: United Healthcare Commercial |
$442.83
|
| Rate for Payer: United Healthcare Medicare |
$99.09
|
| Rate for Payer: WINHealth Partners Commercial |
$432.65
|
|
|
EXCISION NASAL POLYP EXTENSIVE
|
Professional
|
Both
|
$1,629.00
|
|
|
Service Code
|
HCPCS 30115
|
| Hospital Charge Code |
30115
|
| Min. Negotiated Rate |
$388.07 |
| Max. Negotiated Rate |
$1,629.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,596.42
|
| Rate for Payer: Aetna of WY Medicare |
$456.55
|
| Rate for Payer: Beech Street Commercial |
$1,547.55
|
| Rate for Payer: Cash Price |
$1,140.30
|
| Rate for Payer: Cash Price |
$1,140.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,580.13
|
| Rate for Payer: Cigna of WY Commercial |
$1,596.42
|
| Rate for Payer: First Choice Health Commercial |
$1,466.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,547.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$456.55
|
| Rate for Payer: HealthUtah PPO |
$1,629.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,580.13
|
| Rate for Payer: Multiplan Medicare/VA |
$388.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1,596.42
|
| Rate for Payer: PacificSource Commercial |
$1,466.10
|
| Rate for Payer: PHCS PPO |
$1,547.55
|
| Rate for Payer: Three Rivers PPO |
$1,221.75
|
| Rate for Payer: TriWest Veterans Administration |
$456.55
|
| Rate for Payer: United Healthcare Commercial |
$1,417.23
|
| Rate for Payer: United Healthcare Medicare |
$456.55
|
| Rate for Payer: WINHealth Partners Commercial |
$1,384.65
|
|
|
EXCISION NASAL POLYP EXTENSIVE
|
Professional
|
Both
|
$3,257.00
|
|
|
Service Code
|
HCPCS 30115 50
|
| Hospital Charge Code |
30115
|
| Min. Negotiated Rate |
$388.07 |
| Max. Negotiated Rate |
$3,257.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,191.86
|
| Rate for Payer: Aetna of WY Medicare |
$456.55
|
| Rate for Payer: Beech Street Commercial |
$3,094.15
|
| Rate for Payer: Cash Price |
$2,279.90
|
| Rate for Payer: Cash Price |
$2,279.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,159.29
|
| Rate for Payer: Cigna of WY Commercial |
$3,191.86
|
| Rate for Payer: First Choice Health Commercial |
$2,931.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,094.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$456.55
|
| Rate for Payer: HealthUtah PPO |
$3,257.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,159.29
|
| Rate for Payer: Multiplan Medicare/VA |
$388.07
|
| Rate for Payer: One Health Plan of WY PPO |
$3,191.86
|
| Rate for Payer: PacificSource Commercial |
$2,931.30
|
| Rate for Payer: PHCS PPO |
$3,094.15
|
| Rate for Payer: Three Rivers PPO |
$2,442.75
|
| Rate for Payer: TriWest Veterans Administration |
$456.55
|
| Rate for Payer: United Healthcare Commercial |
$2,833.59
|
| Rate for Payer: United Healthcare Medicare |
$456.55
|
| Rate for Payer: WINHealth Partners Commercial |
$2,768.45
|
|
|
EXCISION NASAL POLYP SIMPLE
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 30110
|
| Hospital Charge Code |
30110
|
| Min. Negotiated Rate |
$110.42 |
| Max. Negotiated Rate |
$872.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$854.56
|
| Rate for Payer: Aetna of WY Medicare |
$129.91
|
| Rate for Payer: Beech Street Commercial |
$828.40
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$845.84
|
| Rate for Payer: Cigna of WY Commercial |
$854.56
|
| Rate for Payer: First Choice Health Commercial |
$784.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$828.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$129.91
|
| Rate for Payer: HealthUtah PPO |
$872.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$845.84
|
| Rate for Payer: Multiplan Medicare/VA |
$110.42
|
| Rate for Payer: One Health Plan of WY PPO |
$854.56
|
| Rate for Payer: PacificSource Commercial |
$784.80
|
| Rate for Payer: PHCS PPO |
$828.40
|
| Rate for Payer: Three Rivers PPO |
$654.00
|
| Rate for Payer: TriWest Veterans Administration |
$129.91
|
| Rate for Payer: United Healthcare Commercial |
$758.64
|
| Rate for Payer: United Healthcare Medicare |
$129.91
|
| Rate for Payer: WINHealth Partners Commercial |
$741.20
|
|
|
EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$1,826.00
|
|
|
Service Code
|
HCPCS 24105 AS
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$304.05 |
| Max. Negotiated Rate |
$1,826.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,789.48
|
| Rate for Payer: Aetna of WY Medicare |
$357.71
|
| Rate for Payer: Beech Street Commercial |
$1,734.70
|
| Rate for Payer: Cash Price |
$1,278.20
|
| Rate for Payer: Cash Price |
$1,278.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,771.22
|
| Rate for Payer: Cigna of WY Commercial |
$1,789.48
|
| Rate for Payer: First Choice Health Commercial |
$1,643.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,734.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$357.71
|
| Rate for Payer: HealthUtah PPO |
$1,826.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,771.22
|
| Rate for Payer: Multiplan Medicare/VA |
$304.05
|
| Rate for Payer: One Health Plan of WY PPO |
$1,789.48
|
| Rate for Payer: PacificSource Commercial |
$1,643.40
|
| Rate for Payer: PHCS PPO |
$1,734.70
|
| Rate for Payer: Three Rivers PPO |
$1,369.50
|
| Rate for Payer: TriWest Veterans Administration |
$357.71
|
| Rate for Payer: United Healthcare Commercial |
$1,588.62
|
| Rate for Payer: United Healthcare Medicare |
$357.71
|
| Rate for Payer: WINHealth Partners Commercial |
$1,552.10
|
|
|
EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$1,826.00
|
|
|
Service Code
|
HCPCS 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$304.05 |
| Max. Negotiated Rate |
$1,826.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,789.48
|
| Rate for Payer: Aetna of WY Medicare |
$357.71
|
| Rate for Payer: Beech Street Commercial |
$1,734.70
|
| Rate for Payer: Cash Price |
$1,278.20
|
| Rate for Payer: Cash Price |
$1,278.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,771.22
|
| Rate for Payer: Cigna of WY Commercial |
$1,789.48
|
| Rate for Payer: First Choice Health Commercial |
$1,643.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,734.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$357.71
|
| Rate for Payer: HealthUtah PPO |
$1,826.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,771.22
|
| Rate for Payer: Multiplan Medicare/VA |
$304.05
|
| Rate for Payer: One Health Plan of WY PPO |
$1,789.48
|
| Rate for Payer: PacificSource Commercial |
$1,643.40
|
| Rate for Payer: PHCS PPO |
$1,734.70
|
| Rate for Payer: Three Rivers PPO |
$1,369.50
|
| Rate for Payer: TriWest Veterans Administration |
$357.71
|
| Rate for Payer: United Healthcare Commercial |
$1,588.62
|
| Rate for Payer: United Healthcare Medicare |
$357.71
|
| Rate for Payer: WINHealth Partners Commercial |
$1,552.10
|
|
|
EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$1,826.00
|
|
|
Service Code
|
HCPCS 24105 80
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$304.05 |
| Max. Negotiated Rate |
$1,826.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,789.48
|
| Rate for Payer: Aetna of WY Medicare |
$357.71
|
| Rate for Payer: Beech Street Commercial |
$1,734.70
|
| Rate for Payer: Cash Price |
$1,278.20
|
| Rate for Payer: Cash Price |
$1,278.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,771.22
|
| Rate for Payer: Cigna of WY Commercial |
$1,789.48
|
| Rate for Payer: First Choice Health Commercial |
$1,643.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,734.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$357.71
|
| Rate for Payer: HealthUtah PPO |
$1,826.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,771.22
|
| Rate for Payer: Multiplan Medicare/VA |
$304.05
|
| Rate for Payer: One Health Plan of WY PPO |
$1,789.48
|
| Rate for Payer: PacificSource Commercial |
$1,643.40
|
| Rate for Payer: PHCS PPO |
$1,734.70
|
| Rate for Payer: Three Rivers PPO |
$1,369.50
|
| Rate for Payer: TriWest Veterans Administration |
$357.71
|
| Rate for Payer: United Healthcare Commercial |
$1,588.62
|
| Rate for Payer: United Healthcare Medicare |
$357.71
|
| Rate for Payer: WINHealth Partners Commercial |
$1,552.10
|
|
|
EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$925.00
|
|
|
Service Code
|
HCPCS 11770
|
| Hospital Charge Code |
11770
|
| Min. Negotiated Rate |
$151.50 |
| Max. Negotiated Rate |
$925.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$906.50
|
| Rate for Payer: Aetna of WY Medicare |
$178.24
|
| Rate for Payer: Beech Street Commercial |
$878.75
|
| Rate for Payer: Cash Price |
$647.50
|
| Rate for Payer: Cash Price |
$647.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$897.25
|
| Rate for Payer: Cigna of WY Commercial |
$906.50
|
| Rate for Payer: First Choice Health Commercial |
$832.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$878.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$178.24
|
| Rate for Payer: HealthUtah PPO |
$925.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$897.25
|
| Rate for Payer: Multiplan Medicare/VA |
$151.50
|
| Rate for Payer: One Health Plan of WY PPO |
$906.50
|
| Rate for Payer: PacificSource Commercial |
$832.50
|
| Rate for Payer: PHCS PPO |
$878.75
|
| Rate for Payer: Three Rivers PPO |
$693.75
|
| Rate for Payer: TriWest Veterans Administration |
$178.24
|
| Rate for Payer: United Healthcare Commercial |
$804.75
|
| Rate for Payer: United Healthcare Medicare |
$178.24
|
| Rate for Payer: WINHealth Partners Commercial |
$786.25
|
|
|
EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 27340 AS
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$315.07 |
| Max. Negotiated Rate |
$1,323.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,296.54
|
| Rate for Payer: Aetna of WY Medicare |
$370.67
|
| Rate for Payer: Beech Street Commercial |
$1,256.85
|
| Rate for Payer: Cash Price |
$926.10
|
| Rate for Payer: Cash Price |
$926.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,283.31
|
| Rate for Payer: Cigna of WY Commercial |
$1,296.54
|
| Rate for Payer: First Choice Health Commercial |
$1,190.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,256.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$370.67
|
| Rate for Payer: HealthUtah PPO |
$1,323.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,283.31
|
| Rate for Payer: Multiplan Medicare/VA |
$315.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1,296.54
|
| Rate for Payer: PacificSource Commercial |
$1,190.70
|
| Rate for Payer: PHCS PPO |
$1,256.85
|
| Rate for Payer: Three Rivers PPO |
$992.25
|
| Rate for Payer: TriWest Veterans Administration |
$370.67
|
| Rate for Payer: United Healthcare Commercial |
$1,151.01
|
| Rate for Payer: United Healthcare Medicare |
$370.67
|
| Rate for Payer: WINHealth Partners Commercial |
$1,124.55
|
|
|
EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 27340 80
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$315.07 |
| Max. Negotiated Rate |
$1,323.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,296.54
|
| Rate for Payer: Aetna of WY Medicare |
$370.67
|
| Rate for Payer: Beech Street Commercial |
$1,256.85
|
| Rate for Payer: Cash Price |
$926.10
|
| Rate for Payer: Cash Price |
$926.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,283.31
|
| Rate for Payer: Cigna of WY Commercial |
$1,296.54
|
| Rate for Payer: First Choice Health Commercial |
$1,190.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,256.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$370.67
|
| Rate for Payer: HealthUtah PPO |
$1,323.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,283.31
|
| Rate for Payer: Multiplan Medicare/VA |
$315.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1,296.54
|
| Rate for Payer: PacificSource Commercial |
$1,190.70
|
| Rate for Payer: PHCS PPO |
$1,256.85
|
| Rate for Payer: Three Rivers PPO |
$992.25
|
| Rate for Payer: TriWest Veterans Administration |
$370.67
|
| Rate for Payer: United Healthcare Commercial |
$1,151.01
|
| Rate for Payer: United Healthcare Medicare |
$370.67
|
| Rate for Payer: WINHealth Partners Commercial |
$1,124.55
|
|
|
EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$315.07 |
| Max. Negotiated Rate |
$1,323.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,296.54
|
| Rate for Payer: Aetna of WY Medicare |
$370.67
|
| Rate for Payer: Beech Street Commercial |
$1,256.85
|
| Rate for Payer: Cash Price |
$926.10
|
| Rate for Payer: Cash Price |
$926.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,283.31
|
| Rate for Payer: Cigna of WY Commercial |
$1,296.54
|
| Rate for Payer: First Choice Health Commercial |
$1,190.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,256.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$370.67
|
| Rate for Payer: HealthUtah PPO |
$1,323.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,283.31
|
| Rate for Payer: Multiplan Medicare/VA |
$315.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1,296.54
|
| Rate for Payer: PacificSource Commercial |
$1,190.70
|
| Rate for Payer: PHCS PPO |
$1,256.85
|
| Rate for Payer: Three Rivers PPO |
$992.25
|
| Rate for Payer: TriWest Veterans Administration |
$370.67
|
| Rate for Payer: United Healthcare Commercial |
$1,151.01
|
| Rate for Payer: United Healthcare Medicare |
$370.67
|
| Rate for Payer: WINHealth Partners Commercial |
$1,124.55
|
|
|
EXCISION RADIAL HEAD
|
Professional
|
Both
|
$1,791.00
|
|
|
Service Code
|
HCPCS 24130 AS
|
| Hospital Charge Code |
24130
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,791.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,755.18
|
| Rate for Payer: Aetna of WY Medicare |
$501.93
|
| Rate for Payer: Beech Street Commercial |
$1,701.45
|
| Rate for Payer: Cash Price |
$1,253.70
|
| Rate for Payer: Cash Price |
$1,253.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,737.27
|
| Rate for Payer: Cigna of WY Commercial |
$1,755.18
|
| Rate for Payer: First Choice Health Commercial |
$1,611.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,701.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$501.93
|
| Rate for Payer: HealthUtah PPO |
$1,791.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,737.27
|
| Rate for Payer: Multiplan Medicare/VA |
$426.64
|
| Rate for Payer: One Health Plan of WY PPO |
$1,755.18
|
| Rate for Payer: PacificSource Commercial |
$1,611.90
|
| Rate for Payer: PHCS PPO |
$1,701.45
|
| Rate for Payer: Three Rivers PPO |
$1,343.25
|
| Rate for Payer: TriWest Veterans Administration |
$501.93
|
| Rate for Payer: United Healthcare Commercial |
$1,558.17
|
| Rate for Payer: United Healthcare Medicare |
$501.93
|
| Rate for Payer: WINHealth Partners Commercial |
$1,522.35
|
|
|
EXCISION RADIAL HEAD
|
Professional
|
Both
|
$1,791.00
|
|
|
Service Code
|
HCPCS 24130 80
|
| Hospital Charge Code |
24130
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,791.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,755.18
|
| Rate for Payer: Aetna of WY Medicare |
$501.93
|
| Rate for Payer: Beech Street Commercial |
$1,701.45
|
| Rate for Payer: Cash Price |
$1,253.70
|
| Rate for Payer: Cash Price |
$1,253.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,737.27
|
| Rate for Payer: Cigna of WY Commercial |
$1,755.18
|
| Rate for Payer: First Choice Health Commercial |
$1,611.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,701.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$501.93
|
| Rate for Payer: HealthUtah PPO |
$1,791.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,737.27
|
| Rate for Payer: Multiplan Medicare/VA |
$426.64
|
| Rate for Payer: One Health Plan of WY PPO |
$1,755.18
|
| Rate for Payer: PacificSource Commercial |
$1,611.90
|
| Rate for Payer: PHCS PPO |
$1,701.45
|
| Rate for Payer: Three Rivers PPO |
$1,343.25
|
| Rate for Payer: TriWest Veterans Administration |
$501.93
|
| Rate for Payer: United Healthcare Commercial |
$1,558.17
|
| Rate for Payer: United Healthcare Medicare |
$501.93
|
| Rate for Payer: WINHealth Partners Commercial |
$1,522.35
|
|
