|
EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,384.00
|
|
|
Service Code
|
HCPCS 27619
|
| Hospital Charge Code |
27619
|
| Min. Negotiated Rate |
$389.08 |
| Max. Negotiated Rate |
$2,384.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,336.32
|
| Rate for Payer: Aetna of WY Medicare |
$457.74
|
| Rate for Payer: Beech Street Commercial |
$2,264.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,312.48
|
| Rate for Payer: Cigna of WY Commercial |
$2,336.32
|
| Rate for Payer: First Choice Health Commercial |
$2,145.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,264.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$457.74
|
| Rate for Payer: HealthUtah PPO |
$2,384.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,312.48
|
| Rate for Payer: Multiplan Medicare/VA |
$389.08
|
| Rate for Payer: One Health Plan of WY PPO |
$2,336.32
|
| Rate for Payer: PacificSource Commercial |
$2,145.60
|
| Rate for Payer: PHCS PPO |
$2,264.80
|
| Rate for Payer: Three Rivers PPO |
$1,788.00
|
| Rate for Payer: TriWest Veterans Administration |
$457.74
|
| Rate for Payer: United Healthcare Commercial |
$2,074.08
|
| Rate for Payer: United Healthcare Medicare |
$457.74
|
| Rate for Payer: WINHealth Partners Commercial |
$2,026.40
|
|
|
EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,694.00
|
|
|
Service Code
|
HCPCS 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$253.88 |
| Max. Negotiated Rate |
$1,694.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,660.12
|
| Rate for Payer: Aetna of WY Medicare |
$298.68
|
| Rate for Payer: Beech Street Commercial |
$1,609.30
|
| Rate for Payer: Cash Price |
$1,185.80
|
| Rate for Payer: Cash Price |
$1,185.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,643.18
|
| Rate for Payer: Cigna of WY Commercial |
$1,660.12
|
| Rate for Payer: First Choice Health Commercial |
$1,524.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,609.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$298.68
|
| Rate for Payer: HealthUtah PPO |
$1,694.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,643.18
|
| Rate for Payer: Multiplan Medicare/VA |
$253.88
|
| Rate for Payer: One Health Plan of WY PPO |
$1,660.12
|
| Rate for Payer: PacificSource Commercial |
$1,524.60
|
| Rate for Payer: PHCS PPO |
$1,609.30
|
| Rate for Payer: Three Rivers PPO |
$1,270.50
|
| Rate for Payer: TriWest Veterans Administration |
$298.68
|
| Rate for Payer: United Healthcare Commercial |
$1,473.78
|
| Rate for Payer: United Healthcare Medicare |
$298.68
|
| Rate for Payer: WINHealth Partners Commercial |
$1,439.90
|
|
|
EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$1,575.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$254.07 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,543.50
|
| Rate for Payer: Aetna of WY Medicare |
$298.91
|
| Rate for Payer: Beech Street Commercial |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,102.50
|
| Rate for Payer: Cash Price |
$1,102.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,527.75
|
| Rate for Payer: Cigna of WY Commercial |
$1,543.50
|
| Rate for Payer: First Choice Health Commercial |
$1,417.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,496.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$298.91
|
| Rate for Payer: HealthUtah PPO |
$1,575.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,527.75
|
| Rate for Payer: Multiplan Medicare/VA |
$254.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1,543.50
|
| Rate for Payer: PacificSource Commercial |
$1,417.50
|
| Rate for Payer: PHCS PPO |
$1,496.25
|
| Rate for Payer: Three Rivers PPO |
$1,181.25
|
| Rate for Payer: TriWest Veterans Administration |
$298.91
|
| Rate for Payer: United Healthcare Commercial |
$1,370.25
|
| Rate for Payer: United Healthcare Medicare |
$298.91
|
| Rate for Payer: WINHealth Partners Commercial |
$1,338.75
|
|
|
EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,769.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$597.74 |
| Max. Negotiated Rate |
$3,769.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,693.62
|
| Rate for Payer: Aetna of WY Medicare |
$703.22
|
| Rate for Payer: Beech Street Commercial |
$3,580.55
|
| Rate for Payer: Cash Price |
$2,638.30
|
| Rate for Payer: Cash Price |
$2,638.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,655.93
|
| Rate for Payer: Cigna of WY Commercial |
$3,693.62
|
| Rate for Payer: First Choice Health Commercial |
$3,392.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,580.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$703.22
|
| Rate for Payer: HealthUtah PPO |
$3,769.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,655.93
|
| Rate for Payer: Multiplan Medicare/VA |
$597.74
|
| Rate for Payer: One Health Plan of WY PPO |
$3,693.62
|
| Rate for Payer: PacificSource Commercial |
$3,392.10
|
| Rate for Payer: PHCS PPO |
$3,580.55
|
| Rate for Payer: Three Rivers PPO |
$2,826.75
|
| Rate for Payer: TriWest Veterans Administration |
$703.22
|
| Rate for Payer: United Healthcare Commercial |
$3,279.03
|
| Rate for Payer: United Healthcare Medicare |
$703.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3,203.65
|
|
|
EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 27045
|
| Hospital Charge Code |
27045
|
| Min. Negotiated Rate |
$599.48 |
| Max. Negotiated Rate |
$2,517.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,466.66
|
| Rate for Payer: Aetna of WY Medicare |
$705.27
|
| Rate for Payer: Beech Street Commercial |
$2,391.15
|
| Rate for Payer: Cash Price |
$1,761.90
|
| Rate for Payer: Cash Price |
$1,761.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,441.49
|
| Rate for Payer: Cigna of WY Commercial |
$2,466.66
|
| Rate for Payer: First Choice Health Commercial |
$2,265.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,391.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$705.27
|
| Rate for Payer: HealthUtah PPO |
$2,517.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,441.49
|
| Rate for Payer: Multiplan Medicare/VA |
$599.48
|
| Rate for Payer: One Health Plan of WY PPO |
$2,466.66
|
| Rate for Payer: PacificSource Commercial |
$2,265.30
|
| Rate for Payer: PHCS PPO |
$2,391.15
|
| Rate for Payer: Three Rivers PPO |
$1,887.75
|
| Rate for Payer: TriWest Veterans Administration |
$705.27
|
| Rate for Payer: United Healthcare Commercial |
$2,189.79
|
| Rate for Payer: United Healthcare Medicare |
$705.27
|
| Rate for Payer: WINHealth Partners Commercial |
$2,139.45
|
|
|
EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 27045 AS
|
| Hospital Charge Code |
27045
|
| Min. Negotiated Rate |
$599.48 |
| Max. Negotiated Rate |
$2,517.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,466.66
|
| Rate for Payer: Aetna of WY Medicare |
$705.27
|
| Rate for Payer: Beech Street Commercial |
$2,391.15
|
| Rate for Payer: Cash Price |
$1,761.90
|
| Rate for Payer: Cash Price |
$1,761.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,441.49
|
| Rate for Payer: Cigna of WY Commercial |
$2,466.66
|
| Rate for Payer: First Choice Health Commercial |
$2,265.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,391.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$705.27
|
| Rate for Payer: HealthUtah PPO |
$2,517.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,441.49
|
| Rate for Payer: Multiplan Medicare/VA |
$599.48
|
| Rate for Payer: One Health Plan of WY PPO |
$2,466.66
|
| Rate for Payer: PacificSource Commercial |
$2,265.30
|
| Rate for Payer: PHCS PPO |
$2,391.15
|
| Rate for Payer: Three Rivers PPO |
$1,887.75
|
| Rate for Payer: TriWest Veterans Administration |
$705.27
|
| Rate for Payer: United Healthcare Commercial |
$2,189.79
|
| Rate for Payer: United Healthcare Medicare |
$705.27
|
| Rate for Payer: WINHealth Partners Commercial |
$2,139.45
|
|
|
EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$2,372.00
|
|
|
Service Code
|
HCPCS 27047
|
| Hospital Charge Code |
27047
|
| Min. Negotiated Rate |
$298.30 |
| Max. Negotiated Rate |
$2,372.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,324.56
|
| Rate for Payer: Aetna of WY Medicare |
$350.94
|
| Rate for Payer: Beech Street Commercial |
$2,253.40
|
| Rate for Payer: Cash Price |
$1,660.40
|
| Rate for Payer: Cash Price |
$1,660.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,300.84
|
| Rate for Payer: Cigna of WY Commercial |
$2,324.56
|
| Rate for Payer: First Choice Health Commercial |
$2,134.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,253.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$350.94
|
| Rate for Payer: HealthUtah PPO |
$2,372.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,300.84
|
| Rate for Payer: Multiplan Medicare/VA |
$298.30
|
| Rate for Payer: One Health Plan of WY PPO |
$2,324.56
|
| Rate for Payer: PacificSource Commercial |
$2,134.80
|
| Rate for Payer: PHCS PPO |
$2,253.40
|
| Rate for Payer: Three Rivers PPO |
$1,779.00
|
| Rate for Payer: TriWest Veterans Administration |
$350.94
|
| Rate for Payer: United Healthcare Commercial |
$2,063.64
|
| Rate for Payer: United Healthcare Medicare |
$350.94
|
| Rate for Payer: WINHealth Partners Commercial |
$2,016.20
|
|
|
EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$3,561.00
|
|
|
Service Code
|
HCPCS 23073 80
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$570.78 |
| Max. Negotiated Rate |
$3,561.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,489.78
|
| Rate for Payer: Aetna of WY Medicare |
$671.50
|
| Rate for Payer: Beech Street Commercial |
$3,382.95
|
| Rate for Payer: Cash Price |
$2,492.70
|
| Rate for Payer: Cash Price |
$2,492.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,454.17
|
| Rate for Payer: Cigna of WY Commercial |
$3,489.78
|
| Rate for Payer: First Choice Health Commercial |
$3,204.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,382.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$671.50
|
| Rate for Payer: HealthUtah PPO |
$3,561.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,454.17
|
| Rate for Payer: Multiplan Medicare/VA |
$570.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,489.78
|
| Rate for Payer: PacificSource Commercial |
$3,204.90
|
| Rate for Payer: PHCS PPO |
$3,382.95
|
| Rate for Payer: Three Rivers PPO |
$2,670.75
|
| Rate for Payer: TriWest Veterans Administration |
$671.50
|
| Rate for Payer: United Healthcare Commercial |
$3,098.07
|
| Rate for Payer: United Healthcare Medicare |
$671.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,026.85
|
|
|
EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$3,561.00
|
|
|
Service Code
|
HCPCS 23073 AS
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$570.78 |
| Max. Negotiated Rate |
$3,561.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,489.78
|
| Rate for Payer: Aetna of WY Medicare |
$671.50
|
| Rate for Payer: Beech Street Commercial |
$3,382.95
|
| Rate for Payer: Cash Price |
$2,492.70
|
| Rate for Payer: Cash Price |
$2,492.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,454.17
|
| Rate for Payer: Cigna of WY Commercial |
$3,489.78
|
| Rate for Payer: First Choice Health Commercial |
$3,204.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,382.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$671.50
|
| Rate for Payer: HealthUtah PPO |
$3,561.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,454.17
|
| Rate for Payer: Multiplan Medicare/VA |
$570.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,489.78
|
| Rate for Payer: PacificSource Commercial |
$3,204.90
|
| Rate for Payer: PHCS PPO |
$3,382.95
|
| Rate for Payer: Three Rivers PPO |
$2,670.75
|
| Rate for Payer: TriWest Veterans Administration |
$671.50
|
| Rate for Payer: United Healthcare Commercial |
$3,098.07
|
| Rate for Payer: United Healthcare Medicare |
$671.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,026.85
|
|
|
EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$3,561.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$570.78 |
| Max. Negotiated Rate |
$3,561.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,489.78
|
| Rate for Payer: Aetna of WY Medicare |
$671.50
|
| Rate for Payer: Beech Street Commercial |
$3,382.95
|
| Rate for Payer: Cash Price |
$2,492.70
|
| Rate for Payer: Cash Price |
$2,492.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,454.17
|
| Rate for Payer: Cigna of WY Commercial |
$3,489.78
|
| Rate for Payer: First Choice Health Commercial |
$3,204.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,382.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$671.50
|
| Rate for Payer: HealthUtah PPO |
$3,561.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,454.17
|
| Rate for Payer: Multiplan Medicare/VA |
$570.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,489.78
|
| Rate for Payer: PacificSource Commercial |
$3,204.90
|
| Rate for Payer: PHCS PPO |
$3,382.95
|
| Rate for Payer: Three Rivers PPO |
$2,670.75
|
| Rate for Payer: TriWest Veterans Administration |
$671.50
|
| Rate for Payer: United Healthcare Commercial |
$3,098.07
|
| Rate for Payer: United Healthcare Medicare |
$671.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,026.85
|
|
|
EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$8,662.00
|
|
|
Service Code
|
HCPCS 27339
|
| Hospital Charge Code |
27339
|
| Min. Negotiated Rate |
$618.30 |
| Max. Negotiated Rate |
$8,662.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,488.76
|
| Rate for Payer: Aetna of WY Medicare |
$727.41
|
| Rate for Payer: Beech Street Commercial |
$8,228.90
|
| Rate for Payer: Cash Price |
$6,063.40
|
| Rate for Payer: Cash Price |
$6,063.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$8,402.14
|
| Rate for Payer: Cigna of WY Commercial |
$8,488.76
|
| Rate for Payer: First Choice Health Commercial |
$7,795.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,228.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$727.41
|
| Rate for Payer: HealthUtah PPO |
$8,662.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,402.14
|
| Rate for Payer: Multiplan Medicare/VA |
$618.30
|
| Rate for Payer: One Health Plan of WY PPO |
$8,488.76
|
| Rate for Payer: PacificSource Commercial |
$7,795.80
|
| Rate for Payer: PHCS PPO |
$8,228.90
|
| Rate for Payer: Three Rivers PPO |
$6,496.50
|
| Rate for Payer: TriWest Veterans Administration |
$727.41
|
| Rate for Payer: United Healthcare Commercial |
$7,535.94
|
| Rate for Payer: United Healthcare Medicare |
$727.41
|
| Rate for Payer: WINHealth Partners Commercial |
$7,362.70
|
|
|
EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$2,153.00
|
|
|
Service Code
|
HCPCS 27328 AS
|
| Hospital Charge Code |
27328
|
| Min. Negotiated Rate |
$512.76 |
| Max. Negotiated Rate |
$2,153.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,109.94
|
| Rate for Payer: Aetna of WY Medicare |
$603.25
|
| Rate for Payer: Beech Street Commercial |
$2,045.35
|
| Rate for Payer: Cash Price |
$1,507.10
|
| Rate for Payer: Cash Price |
$1,507.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,088.41
|
| Rate for Payer: Cigna of WY Commercial |
$2,109.94
|
| Rate for Payer: First Choice Health Commercial |
$1,937.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,045.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.25
|
| Rate for Payer: HealthUtah PPO |
$2,153.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,088.41
|
| Rate for Payer: Multiplan Medicare/VA |
$512.76
|
| Rate for Payer: One Health Plan of WY PPO |
$2,109.94
|
| Rate for Payer: PacificSource Commercial |
$1,937.70
|
| Rate for Payer: PHCS PPO |
$2,045.35
|
| Rate for Payer: Three Rivers PPO |
$1,614.75
|
| Rate for Payer: TriWest Veterans Administration |
$603.25
|
| Rate for Payer: United Healthcare Commercial |
$1,873.11
|
| Rate for Payer: United Healthcare Medicare |
$603.25
|
| Rate for Payer: WINHealth Partners Commercial |
$1,830.05
|
|
|
EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$2,153.00
|
|
|
Service Code
|
HCPCS 27328
|
| Hospital Charge Code |
27328
|
| Min. Negotiated Rate |
$512.76 |
| Max. Negotiated Rate |
$2,153.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,109.94
|
| Rate for Payer: Aetna of WY Medicare |
$603.25
|
| Rate for Payer: Beech Street Commercial |
$2,045.35
|
| Rate for Payer: Cash Price |
$1,507.10
|
| Rate for Payer: Cash Price |
$1,507.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,088.41
|
| Rate for Payer: Cigna of WY Commercial |
$2,109.94
|
| Rate for Payer: First Choice Health Commercial |
$1,937.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,045.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.25
|
| Rate for Payer: HealthUtah PPO |
$2,153.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,088.41
|
| Rate for Payer: Multiplan Medicare/VA |
$512.76
|
| Rate for Payer: One Health Plan of WY PPO |
$2,109.94
|
| Rate for Payer: PacificSource Commercial |
$1,937.70
|
| Rate for Payer: PHCS PPO |
$2,045.35
|
| Rate for Payer: Three Rivers PPO |
$1,614.75
|
| Rate for Payer: TriWest Veterans Administration |
$603.25
|
| Rate for Payer: United Healthcare Commercial |
$1,873.11
|
| Rate for Payer: United Healthcare Medicare |
$603.25
|
| Rate for Payer: WINHealth Partners Commercial |
$1,830.05
|
|
|
EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$333.52 |
| Max. Negotiated Rate |
$844.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$827.12
|
| Rate for Payer: Aetna of WY Medicare |
$392.38
|
| Rate for Payer: Beech Street Commercial |
$801.80
|
| Rate for Payer: Cash Price |
$590.80
|
| Rate for Payer: Cash Price |
$590.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$818.68
|
| Rate for Payer: Cigna of WY Commercial |
$827.12
|
| Rate for Payer: First Choice Health Commercial |
$759.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$801.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$392.38
|
| Rate for Payer: HealthUtah PPO |
$844.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$818.68
|
| Rate for Payer: Multiplan Medicare/VA |
$333.52
|
| Rate for Payer: One Health Plan of WY PPO |
$827.12
|
| Rate for Payer: PacificSource Commercial |
$759.60
|
| Rate for Payer: PHCS PPO |
$801.80
|
| Rate for Payer: Three Rivers PPO |
$633.00
|
| Rate for Payer: TriWest Veterans Administration |
$392.38
|
| Rate for Payer: United Healthcare Commercial |
$734.28
|
| Rate for Payer: United Healthcare Medicare |
$392.38
|
| Rate for Payer: WINHealth Partners Commercial |
$717.40
|
|
|
EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 24075
|
| Hospital Charge Code |
24075
|
| Min. Negotiated Rate |
$273.18 |
| Max. Negotiated Rate |
$1,238.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,213.24
|
| Rate for Payer: Aetna of WY Medicare |
$321.39
|
| Rate for Payer: Beech Street Commercial |
$1,176.10
|
| Rate for Payer: Cash Price |
$866.60
|
| Rate for Payer: Cash Price |
$866.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,200.86
|
| Rate for Payer: Cigna of WY Commercial |
$1,213.24
|
| Rate for Payer: First Choice Health Commercial |
$1,114.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,176.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$321.39
|
| Rate for Payer: HealthUtah PPO |
$1,238.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,200.86
|
| Rate for Payer: Multiplan Medicare/VA |
$273.18
|
| Rate for Payer: One Health Plan of WY PPO |
$1,213.24
|
| Rate for Payer: PacificSource Commercial |
$1,114.20
|
| Rate for Payer: PHCS PPO |
$1,176.10
|
| Rate for Payer: Three Rivers PPO |
$928.50
|
| Rate for Payer: TriWest Veterans Administration |
$321.39
|
| Rate for Payer: United Healthcare Commercial |
$1,077.06
|
| Rate for Payer: United Healthcare Medicare |
$321.39
|
| Rate for Payer: WINHealth Partners Commercial |
$1,052.30
|
|
|
EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,704.00
|
|
|
Service Code
|
HCPCS 26115
|
| Hospital Charge Code |
26115
|
| Min. Negotiated Rate |
$278.44 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,669.92
|
| Rate for Payer: Aetna of WY Medicare |
$327.58
|
| Rate for Payer: Beech Street Commercial |
$1,618.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,652.88
|
| Rate for Payer: Cigna of WY Commercial |
$1,669.92
|
| Rate for Payer: First Choice Health Commercial |
$1,533.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,618.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$327.58
|
| Rate for Payer: HealthUtah PPO |
$1,704.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,652.88
|
| Rate for Payer: Multiplan Medicare/VA |
$278.44
|
| Rate for Payer: One Health Plan of WY PPO |
$1,669.92
|
| Rate for Payer: PacificSource Commercial |
$1,533.60
|
| Rate for Payer: PHCS PPO |
$1,618.80
|
| Rate for Payer: Three Rivers PPO |
$1,278.00
|
| Rate for Payer: TriWest Veterans Administration |
$327.58
|
| Rate for Payer: United Healthcare Commercial |
$1,482.48
|
| Rate for Payer: United Healthcare Medicare |
$327.58
|
| Rate for Payer: WINHealth Partners Commercial |
$1,448.40
|
|
|
EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$2,101.00
|
|
|
Service Code
|
HCPCS 26116
|
| Hospital Charge Code |
26116
|
| Min. Negotiated Rate |
$437.56 |
| Max. Negotiated Rate |
$2,101.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,058.98
|
| Rate for Payer: Aetna of WY Medicare |
$514.78
|
| Rate for Payer: Beech Street Commercial |
$1,995.95
|
| Rate for Payer: Cash Price |
$1,470.70
|
| Rate for Payer: Cash Price |
$1,470.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,037.97
|
| Rate for Payer: Cigna of WY Commercial |
$2,058.98
|
| Rate for Payer: First Choice Health Commercial |
$1,890.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,995.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$514.78
|
| Rate for Payer: HealthUtah PPO |
$2,101.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,037.97
|
| Rate for Payer: Multiplan Medicare/VA |
$437.56
|
| Rate for Payer: One Health Plan of WY PPO |
$2,058.98
|
| Rate for Payer: PacificSource Commercial |
$1,890.90
|
| Rate for Payer: PHCS PPO |
$1,995.95
|
| Rate for Payer: Three Rivers PPO |
$1,575.75
|
| Rate for Payer: TriWest Veterans Administration |
$514.78
|
| Rate for Payer: United Healthcare Commercial |
$1,827.87
|
| Rate for Payer: United Healthcare Medicare |
$514.78
|
| Rate for Payer: WINHealth Partners Commercial |
$1,785.85
|
|
|
EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 55535
|
| Hospital Charge Code |
55535
|
| Min. Negotiated Rate |
$354.04 |
| Max. Negotiated Rate |
$1,572.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,540.56
|
| Rate for Payer: Aetna of WY Medicare |
$416.52
|
| Rate for Payer: Beech Street Commercial |
$1,493.40
|
| Rate for Payer: Cash Price |
$1,100.40
|
| Rate for Payer: Cash Price |
$1,100.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,524.84
|
| Rate for Payer: Cigna of WY Commercial |
$1,540.56
|
| Rate for Payer: First Choice Health Commercial |
$1,414.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,493.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$416.52
|
| Rate for Payer: HealthUtah PPO |
$1,572.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,524.84
|
| Rate for Payer: Multiplan Medicare/VA |
$354.04
|
| Rate for Payer: One Health Plan of WY PPO |
$1,540.56
|
| Rate for Payer: PacificSource Commercial |
$1,414.80
|
| Rate for Payer: PHCS PPO |
$1,493.40
|
| Rate for Payer: Three Rivers PPO |
$1,179.00
|
| Rate for Payer: TriWest Veterans Administration |
$416.52
|
| Rate for Payer: United Healthcare Commercial |
$1,367.64
|
| Rate for Payer: United Healthcare Medicare |
$416.52
|
| Rate for Payer: WINHealth Partners Commercial |
$1,336.20
|
|
|
EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$1,850.00
|
|
|
Service Code
|
HCPCS 42450
|
| Hospital Charge Code |
42450
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$1,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,813.00
|
| Rate for Payer: Aetna of WY Medicare |
$355.76
|
| Rate for Payer: Beech Street Commercial |
$1,757.50
|
| Rate for Payer: Cash Price |
$1,295.00
|
| Rate for Payer: Cash Price |
$1,295.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,794.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,813.00
|
| Rate for Payer: First Choice Health Commercial |
$1,665.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,757.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$355.76
|
| Rate for Payer: HealthUtah PPO |
$1,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,794.50
|
| Rate for Payer: Multiplan Medicare/VA |
$302.40
|
| Rate for Payer: One Health Plan of WY PPO |
$1,813.00
|
| Rate for Payer: PacificSource Commercial |
$1,665.00
|
| Rate for Payer: PHCS PPO |
$1,757.50
|
| Rate for Payer: Three Rivers PPO |
$1,387.50
|
| Rate for Payer: TriWest Veterans Administration |
$355.76
|
| Rate for Payer: United Healthcare Commercial |
$1,609.50
|
| Rate for Payer: United Healthcare Medicare |
$355.76
|
| Rate for Payer: WINHealth Partners Commercial |
$1,572.50
|
|
|
EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$1,850.00
|
|
|
Service Code
|
HCPCS 42450 80
|
| Hospital Charge Code |
42450
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$1,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,813.00
|
| Rate for Payer: Aetna of WY Medicare |
$355.76
|
| Rate for Payer: Beech Street Commercial |
$1,757.50
|
| Rate for Payer: Cash Price |
$1,295.00
|
| Rate for Payer: Cash Price |
$1,295.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,794.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,813.00
|
| Rate for Payer: First Choice Health Commercial |
$1,665.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,757.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$355.76
|
| Rate for Payer: HealthUtah PPO |
$1,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,794.50
|
| Rate for Payer: Multiplan Medicare/VA |
$302.40
|
| Rate for Payer: One Health Plan of WY PPO |
$1,813.00
|
| Rate for Payer: PacificSource Commercial |
$1,665.00
|
| Rate for Payer: PHCS PPO |
$1,757.50
|
| Rate for Payer: Three Rivers PPO |
$1,387.50
|
| Rate for Payer: TriWest Veterans Administration |
$355.76
|
| Rate for Payer: United Healthcare Commercial |
$1,609.50
|
| Rate for Payer: United Healthcare Medicare |
$355.76
|
| Rate for Payer: WINHealth Partners Commercial |
$1,572.50
|
|
|
EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,787.00
|
|
|
Service Code
|
HCPCS 20103 AS
|
| Hospital Charge Code |
20103
|
| Min. Negotiated Rate |
$281.42 |
| Max. Negotiated Rate |
$1,787.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,751.26
|
| Rate for Payer: Aetna of WY Medicare |
$331.08
|
| Rate for Payer: Beech Street Commercial |
$1,697.65
|
| Rate for Payer: Cash Price |
$1,250.90
|
| Rate for Payer: Cash Price |
$1,250.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,733.39
|
| Rate for Payer: Cigna of WY Commercial |
$1,751.26
|
| Rate for Payer: First Choice Health Commercial |
$1,608.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,697.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$331.08
|
| Rate for Payer: HealthUtah PPO |
$1,787.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,733.39
|
| Rate for Payer: Multiplan Medicare/VA |
$281.42
|
| Rate for Payer: One Health Plan of WY PPO |
$1,751.26
|
| Rate for Payer: PacificSource Commercial |
$1,608.30
|
| Rate for Payer: PHCS PPO |
$1,697.65
|
| Rate for Payer: Three Rivers PPO |
$1,340.25
|
| Rate for Payer: TriWest Veterans Administration |
$331.08
|
| Rate for Payer: United Healthcare Commercial |
$1,554.69
|
| Rate for Payer: United Healthcare Medicare |
$331.08
|
| Rate for Payer: WINHealth Partners Commercial |
$1,518.95
|
|
|
EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,787.00
|
|
|
Service Code
|
HCPCS 20103
|
| Hospital Charge Code |
20103
|
| Min. Negotiated Rate |
$281.42 |
| Max. Negotiated Rate |
$1,787.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,751.26
|
| Rate for Payer: Aetna of WY Medicare |
$331.08
|
| Rate for Payer: Beech Street Commercial |
$1,697.65
|
| Rate for Payer: Cash Price |
$1,250.90
|
| Rate for Payer: Cash Price |
$1,250.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,733.39
|
| Rate for Payer: Cigna of WY Commercial |
$1,751.26
|
| Rate for Payer: First Choice Health Commercial |
$1,608.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,697.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$331.08
|
| Rate for Payer: HealthUtah PPO |
$1,787.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,733.39
|
| Rate for Payer: Multiplan Medicare/VA |
$281.42
|
| Rate for Payer: One Health Plan of WY PPO |
$1,751.26
|
| Rate for Payer: PacificSource Commercial |
$1,608.30
|
| Rate for Payer: PHCS PPO |
$1,697.65
|
| Rate for Payer: Three Rivers PPO |
$1,340.25
|
| Rate for Payer: TriWest Veterans Administration |
$331.08
|
| Rate for Payer: United Healthcare Commercial |
$1,554.69
|
| Rate for Payer: United Healthcare Medicare |
$331.08
|
| Rate for Payer: WINHealth Partners Commercial |
$1,518.95
|
|
|
EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$2,987.00
|
|
|
Service Code
|
HCPCS 20100
|
| Hospital Charge Code |
20100
|
| Min. Negotiated Rate |
$484.65 |
| Max. Negotiated Rate |
$2,987.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,927.26
|
| Rate for Payer: Aetna of WY Medicare |
$570.18
|
| Rate for Payer: Beech Street Commercial |
$2,837.65
|
| Rate for Payer: Cash Price |
$2,090.90
|
| Rate for Payer: Cash Price |
$2,090.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,897.39
|
| Rate for Payer: Cigna of WY Commercial |
$2,927.26
|
| Rate for Payer: First Choice Health Commercial |
$2,688.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,837.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$570.18
|
| Rate for Payer: HealthUtah PPO |
$2,987.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,897.39
|
| Rate for Payer: Multiplan Medicare/VA |
$484.65
|
| Rate for Payer: One Health Plan of WY PPO |
$2,927.26
|
| Rate for Payer: PacificSource Commercial |
$2,688.30
|
| Rate for Payer: PHCS PPO |
$2,837.65
|
| Rate for Payer: Three Rivers PPO |
$2,240.25
|
| Rate for Payer: TriWest Veterans Administration |
$570.18
|
| Rate for Payer: United Healthcare Commercial |
$2,598.69
|
| Rate for Payer: United Healthcare Medicare |
$570.18
|
| Rate for Payer: WINHealth Partners Commercial |
$2,538.95
|
|
|
EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$2,987.00
|
|
|
Service Code
|
HCPCS 20100 80
|
| Hospital Charge Code |
20100
|
| Min. Negotiated Rate |
$484.65 |
| Max. Negotiated Rate |
$2,987.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,927.26
|
| Rate for Payer: Aetna of WY Medicare |
$570.18
|
| Rate for Payer: Beech Street Commercial |
$2,837.65
|
| Rate for Payer: Cash Price |
$2,090.90
|
| Rate for Payer: Cash Price |
$2,090.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,897.39
|
| Rate for Payer: Cigna of WY Commercial |
$2,927.26
|
| Rate for Payer: First Choice Health Commercial |
$2,688.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,837.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$570.18
|
| Rate for Payer: HealthUtah PPO |
$2,987.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,897.39
|
| Rate for Payer: Multiplan Medicare/VA |
$484.65
|
| Rate for Payer: One Health Plan of WY PPO |
$2,927.26
|
| Rate for Payer: PacificSource Commercial |
$2,688.30
|
| Rate for Payer: PHCS PPO |
$2,837.65
|
| Rate for Payer: Three Rivers PPO |
$2,240.25
|
| Rate for Payer: TriWest Veterans Administration |
$570.18
|
| Rate for Payer: United Healthcare Commercial |
$2,598.69
|
| Rate for Payer: United Healthcare Medicare |
$570.18
|
| Rate for Payer: WINHealth Partners Commercial |
$2,538.95
|
|
|
EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX
|
Professional
|
Both
|
$1,661.00
|
|
|
Service Code
|
HCPCS 49000
|
| Hospital Charge Code |
49000
|
| Min. Negotiated Rate |
$621.50 |
| Max. Negotiated Rate |
$1,661.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,627.78
|
| Rate for Payer: Aetna of WY Medicare |
$731.18
|
| Rate for Payer: Beech Street Commercial |
$1,577.95
|
| Rate for Payer: Cash Price |
$1,162.70
|
| Rate for Payer: Cash Price |
$1,162.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,611.17
|
| Rate for Payer: Cigna of WY Commercial |
$1,627.78
|
| Rate for Payer: First Choice Health Commercial |
$1,494.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,577.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$731.18
|
| Rate for Payer: HealthUtah PPO |
$1,661.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,611.17
|
| Rate for Payer: Multiplan Medicare/VA |
$621.50
|
| Rate for Payer: One Health Plan of WY PPO |
$1,627.78
|
| Rate for Payer: PacificSource Commercial |
$1,494.90
|
| Rate for Payer: PHCS PPO |
$1,577.95
|
| Rate for Payer: Three Rivers PPO |
$1,245.75
|
| Rate for Payer: TriWest Veterans Administration |
$731.18
|
| Rate for Payer: United Healthcare Commercial |
$1,445.07
|
| Rate for Payer: United Healthcare Medicare |
$731.18
|
| Rate for Payer: WINHealth Partners Commercial |
$1,411.85
|
|
