|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
7612060501
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.54 |
| Max. Negotiated Rate |
$331.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$324.38
|
| Rate for Payer: Altius Auto/Workers Compensation |
$317.76
|
| Rate for Payer: Altius Commercial |
$317.76
|
| Rate for Payer: Beech Street Commercial |
$324.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$271.75
|
| Rate for Payer: Cash Price |
$231.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$321.07
|
| Rate for Payer: Cigna of WY Commercial |
$324.38
|
| Rate for Payer: Entrust Commercial |
$314.45
|
| Rate for Payer: First Choice Health Commercial |
$314.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$314.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$218.46
|
| Rate for Payer: HealthUtah PPO |
$331.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$321.07
|
| Rate for Payer: Multiplan Medicare/VA |
$207.54
|
| Rate for Payer: One Health Plan of WY PPO |
$324.38
|
| Rate for Payer: PacificSource Commercial |
$297.90
|
| Rate for Payer: PHCS PPO |
$324.38
|
| Rate for Payer: Three Rivers PPO |
$248.25
|
| Rate for Payer: TriWest Veterans Administration |
$218.46
|
| Rate for Payer: United Healthcare Commercial |
$287.97
|
| Rate for Payer: United Healthcare Medicare |
$218.46
|
| Rate for Payer: WINHealth Partners Commercial |
$314.45
|
| Rate for Payer: Wise Provider Network Commercial |
$314.45
|
|
|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
HCPCS 20605 50
|
| Hospital Charge Code |
5102060501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$38.57 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$68.60
|
| Rate for Payer: Aetna of WY Medicare |
$46.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$67.20
|
| Rate for Payer: Altius Commercial |
$67.20
|
| Rate for Payer: Beech Street Commercial |
$68.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$57.47
|
| Rate for Payer: Cash Price |
$49.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$67.90
|
| Rate for Payer: Cigna of WY Commercial |
$68.60
|
| Rate for Payer: Entrust Commercial |
$66.50
|
| Rate for Payer: First Choice Health Commercial |
$66.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$66.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$40.60
|
| Rate for Payer: HealthUtah PPO |
$70.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$67.90
|
| Rate for Payer: Multiplan Medicare/VA |
$38.57
|
| Rate for Payer: One Health Plan of WY PPO |
$68.60
|
| Rate for Payer: PacificSource Commercial |
$63.00
|
| Rate for Payer: PHCS PPO |
$68.60
|
| Rate for Payer: Three Rivers PPO |
$52.50
|
| Rate for Payer: TriWest Veterans Administration |
$40.60
|
| Rate for Payer: United Healthcare Commercial |
$60.90
|
| Rate for Payer: United Healthcare Medicare |
$40.60
|
| Rate for Payer: WINHealth Partners Commercial |
$68.60
|
| Rate for Payer: Wise Provider Network Commercial |
$66.50
|
|
|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
7612060501
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.38 |
| Max. Negotiated Rate |
$331.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$324.38
|
| Rate for Payer: Aetna of WY Medicare |
$218.46
|
| Rate for Payer: Altius Auto/Workers Compensation |
$317.76
|
| Rate for Payer: Altius Commercial |
$317.76
|
| Rate for Payer: Beech Street Commercial |
$324.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$271.75
|
| Rate for Payer: Cash Price |
$231.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$321.07
|
| Rate for Payer: Cigna of WY Commercial |
$324.38
|
| Rate for Payer: Entrust Commercial |
$314.45
|
| Rate for Payer: First Choice Health Commercial |
$314.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$314.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$191.98
|
| Rate for Payer: HealthUtah PPO |
$331.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$321.07
|
| Rate for Payer: Multiplan Medicare/VA |
$182.38
|
| Rate for Payer: One Health Plan of WY PPO |
$324.38
|
| Rate for Payer: PacificSource Commercial |
$297.90
|
| Rate for Payer: PHCS PPO |
$324.38
|
| Rate for Payer: Three Rivers PPO |
$248.25
|
| Rate for Payer: TriWest Veterans Administration |
$191.98
|
| Rate for Payer: United Healthcare Commercial |
$287.97
|
| Rate for Payer: United Healthcare Medicare |
$191.98
|
| Rate for Payer: WINHealth Partners Commercial |
$324.38
|
| Rate for Payer: Wise Provider Network Commercial |
$314.45
|
|
|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US
|
Facility
|
IP
|
$35.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
5102060501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$35.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$34.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$33.60
|
| Rate for Payer: Altius Commercial |
$33.60
|
| Rate for Payer: Beech Street Commercial |
$34.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$28.74
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$33.95
|
| Rate for Payer: Cigna of WY Commercial |
$34.30
|
| Rate for Payer: Entrust Commercial |
$33.25
|
| Rate for Payer: First Choice Health Commercial |
$33.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$33.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.10
|
| Rate for Payer: HealthUtah PPO |
$35.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$33.95
|
| Rate for Payer: Multiplan Medicare/VA |
$21.94
|
| Rate for Payer: One Health Plan of WY PPO |
$34.30
|
| Rate for Payer: PacificSource Commercial |
$31.50
|
| Rate for Payer: PHCS PPO |
$34.30
|
| Rate for Payer: Three Rivers PPO |
$26.25
|
| Rate for Payer: TriWest Veterans Administration |
$23.10
|
| Rate for Payer: United Healthcare Commercial |
$30.45
|
| Rate for Payer: United Healthcare Medicare |
$23.10
|
| Rate for Payer: WINHealth Partners Commercial |
$33.25
|
| Rate for Payer: Wise Provider Network Commercial |
$33.25
|
|
|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/US
|
Facility
|
OP
|
$1,215.00
|
|
|
Service Code
|
HCPCS 20606
|
| Hospital Charge Code |
3202060601
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$669.46 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,190.70
|
| Rate for Payer: Aetna of WY Medicare |
$801.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,166.40
|
| Rate for Payer: Altius Commercial |
$1,166.40
|
| Rate for Payer: Beech Street Commercial |
$1,190.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$997.52
|
| Rate for Payer: Cash Price |
$850.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,178.55
|
| Rate for Payer: Cigna of WY Commercial |
$1,190.70
|
| Rate for Payer: Entrust Commercial |
$1,154.25
|
| Rate for Payer: First Choice Health Commercial |
$1,154.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,154.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$704.70
|
| Rate for Payer: HealthUtah PPO |
$1,215.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,178.55
|
| Rate for Payer: Multiplan Medicare/VA |
$669.46
|
| Rate for Payer: One Health Plan of WY PPO |
$1,190.70
|
| Rate for Payer: PacificSource Commercial |
$1,093.50
|
| Rate for Payer: PHCS PPO |
$1,190.70
|
| Rate for Payer: Three Rivers PPO |
$911.25
|
| Rate for Payer: TriWest Veterans Administration |
$704.70
|
| Rate for Payer: United Healthcare Commercial |
$1,057.05
|
| Rate for Payer: United Healthcare Medicare |
$704.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,190.70
|
| Rate for Payer: Wise Provider Network Commercial |
$1,154.25
|
|
|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/US
|
Facility
|
OP
|
$3,100.00
|
|
|
Service Code
|
HCPCS 20606
|
| Hospital Charge Code |
4022060601
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,708.10 |
| Max. Negotiated Rate |
$3,100.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,038.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,046.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2,976.00
|
| Rate for Payer: Altius Commercial |
$2,976.00
|
| Rate for Payer: Beech Street Commercial |
$3,038.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,545.10
|
| Rate for Payer: Cash Price |
$2,170.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,007.00
|
| Rate for Payer: Cigna of WY Commercial |
$3,038.00
|
| Rate for Payer: Entrust Commercial |
$2,945.00
|
| Rate for Payer: First Choice Health Commercial |
$2,945.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,945.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,798.00
|
| Rate for Payer: HealthUtah PPO |
$3,100.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,007.00
|
| Rate for Payer: Multiplan Medicare/VA |
$1,708.10
|
| Rate for Payer: One Health Plan of WY PPO |
$3,038.00
|
| Rate for Payer: PacificSource Commercial |
$2,790.00
|
| Rate for Payer: PHCS PPO |
$3,038.00
|
| Rate for Payer: Three Rivers PPO |
$2,325.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,798.00
|
| Rate for Payer: United Healthcare Commercial |
$2,697.00
|
| Rate for Payer: United Healthcare Medicare |
$1,798.00
|
| Rate for Payer: WINHealth Partners Commercial |
$3,038.00
|
| Rate for Payer: Wise Provider Network Commercial |
$2,945.00
|
|
|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/US
|
Facility
|
IP
|
$1,215.00
|
|
|
Service Code
|
HCPCS 20606
|
| Hospital Charge Code |
3202060601
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$761.80 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,190.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,166.40
|
| Rate for Payer: Altius Commercial |
$1,166.40
|
| Rate for Payer: Beech Street Commercial |
$1,190.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$997.52
|
| Rate for Payer: Cash Price |
$850.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,178.55
|
| Rate for Payer: Cigna of WY Commercial |
$1,190.70
|
| Rate for Payer: Entrust Commercial |
$1,154.25
|
| Rate for Payer: First Choice Health Commercial |
$1,154.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,154.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$801.90
|
| Rate for Payer: HealthUtah PPO |
$1,215.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,178.55
|
| Rate for Payer: Multiplan Medicare/VA |
$761.80
|
| Rate for Payer: One Health Plan of WY PPO |
$1,190.70
|
| Rate for Payer: PacificSource Commercial |
$1,093.50
|
| Rate for Payer: PHCS PPO |
$1,190.70
|
| Rate for Payer: Three Rivers PPO |
$911.25
|
| Rate for Payer: TriWest Veterans Administration |
$801.90
|
| Rate for Payer: United Healthcare Commercial |
$1,057.05
|
| Rate for Payer: United Healthcare Medicare |
$801.90
|
| Rate for Payer: WINHealth Partners Commercial |
$1,154.25
|
| Rate for Payer: Wise Provider Network Commercial |
$1,154.25
|
|
|
HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/US
|
Facility
|
IP
|
$3,100.00
|
|
|
Service Code
|
HCPCS 20606
|
| Hospital Charge Code |
4022060601
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,943.70 |
| Max. Negotiated Rate |
$3,100.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,038.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2,976.00
|
| Rate for Payer: Altius Commercial |
$2,976.00
|
| Rate for Payer: Beech Street Commercial |
$3,038.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,545.10
|
| Rate for Payer: Cash Price |
$2,170.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,007.00
|
| Rate for Payer: Cigna of WY Commercial |
$3,038.00
|
| Rate for Payer: Entrust Commercial |
$2,945.00
|
| Rate for Payer: First Choice Health Commercial |
$2,945.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,945.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,046.00
|
| Rate for Payer: HealthUtah PPO |
$3,100.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,007.00
|
| Rate for Payer: Multiplan Medicare/VA |
$1,943.70
|
| Rate for Payer: One Health Plan of WY PPO |
$3,038.00
|
| Rate for Payer: PacificSource Commercial |
$2,790.00
|
| Rate for Payer: PHCS PPO |
$3,038.00
|
| Rate for Payer: Three Rivers PPO |
$2,325.00
|
| Rate for Payer: TriWest Veterans Administration |
$2,046.00
|
| Rate for Payer: United Healthcare Commercial |
$2,697.00
|
| Rate for Payer: United Healthcare Medicare |
$2,046.00
|
| Rate for Payer: WINHealth Partners Commercial |
$2,945.00
|
| Rate for Payer: Wise Provider Network Commercial |
$2,945.00
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
HCPCS 20610 50
|
| Hospital Charge Code |
5102061001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.14 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Aetna of WY Medicare |
$60.06
|
| Rate for Payer: Altius Auto/Workers Compensation |
$87.36
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.71
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.78
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$50.14
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$52.78
|
| Rate for Payer: United Healthcare Commercial |
$79.17
|
| Rate for Payer: United Healthcare Medicare |
$52.78
|
| Rate for Payer: WINHealth Partners Commercial |
$89.18
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$534.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
7612061001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$294.23 |
| Max. Negotiated Rate |
$534.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$523.32
|
| Rate for Payer: Aetna of WY Medicare |
$352.44
|
| Rate for Payer: Altius Auto/Workers Compensation |
$512.64
|
| Rate for Payer: Altius Commercial |
$512.64
|
| Rate for Payer: Beech Street Commercial |
$523.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$438.41
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$517.98
|
| Rate for Payer: Cigna of WY Commercial |
$523.32
|
| Rate for Payer: Entrust Commercial |
$507.30
|
| Rate for Payer: First Choice Health Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$309.72
|
| Rate for Payer: HealthUtah PPO |
$534.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$517.98
|
| Rate for Payer: Multiplan Medicare/VA |
$294.23
|
| Rate for Payer: One Health Plan of WY PPO |
$523.32
|
| Rate for Payer: PacificSource Commercial |
$480.60
|
| Rate for Payer: PHCS PPO |
$523.32
|
| Rate for Payer: Three Rivers PPO |
$400.50
|
| Rate for Payer: TriWest Veterans Administration |
$309.72
|
| Rate for Payer: United Healthcare Commercial |
$464.58
|
| Rate for Payer: United Healthcare Medicare |
$309.72
|
| Rate for Payer: WINHealth Partners Commercial |
$523.32
|
| Rate for Payer: Wise Provider Network Commercial |
$507.30
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$534.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
7612061001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$334.82 |
| Max. Negotiated Rate |
$534.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$523.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$512.64
|
| Rate for Payer: Altius Commercial |
$512.64
|
| Rate for Payer: Beech Street Commercial |
$523.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$438.41
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$517.98
|
| Rate for Payer: Cigna of WY Commercial |
$523.32
|
| Rate for Payer: Entrust Commercial |
$507.30
|
| Rate for Payer: First Choice Health Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$352.44
|
| Rate for Payer: HealthUtah PPO |
$534.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$517.98
|
| Rate for Payer: Multiplan Medicare/VA |
$334.82
|
| Rate for Payer: One Health Plan of WY PPO |
$523.32
|
| Rate for Payer: PacificSource Commercial |
$480.60
|
| Rate for Payer: PHCS PPO |
$523.32
|
| Rate for Payer: Three Rivers PPO |
$400.50
|
| Rate for Payer: TriWest Veterans Administration |
$352.44
|
| Rate for Payer: United Healthcare Commercial |
$464.58
|
| Rate for Payer: United Healthcare Medicare |
$352.44
|
| Rate for Payer: WINHealth Partners Commercial |
$507.30
|
| Rate for Payer: Wise Provider Network Commercial |
$507.30
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$685.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
3202061001
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$429.50 |
| Max. Negotiated Rate |
$685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$671.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$657.60
|
| Rate for Payer: Altius Commercial |
$657.60
|
| Rate for Payer: Beech Street Commercial |
$671.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$562.38
|
| Rate for Payer: Cash Price |
$479.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$664.45
|
| Rate for Payer: Cigna of WY Commercial |
$671.30
|
| Rate for Payer: Entrust Commercial |
$650.75
|
| Rate for Payer: First Choice Health Commercial |
$650.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$650.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$452.10
|
| Rate for Payer: HealthUtah PPO |
$685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$664.45
|
| Rate for Payer: Multiplan Medicare/VA |
$429.50
|
| Rate for Payer: One Health Plan of WY PPO |
$671.30
|
| Rate for Payer: PacificSource Commercial |
$616.50
|
| Rate for Payer: PHCS PPO |
$671.30
|
| Rate for Payer: Three Rivers PPO |
$513.75
|
| Rate for Payer: TriWest Veterans Administration |
$452.10
|
| Rate for Payer: United Healthcare Commercial |
$595.95
|
| Rate for Payer: United Healthcare Medicare |
$452.10
|
| Rate for Payer: WINHealth Partners Commercial |
$650.75
|
| Rate for Payer: Wise Provider Network Commercial |
$650.75
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
HCPCS 20610 50
|
| Hospital Charge Code |
5102061001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$57.06 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Altius Auto/Workers Compensation |
$87.36
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.71
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$60.06
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$57.06
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$60.06
|
| Rate for Payer: United Healthcare Commercial |
$79.17
|
| Rate for Payer: United Healthcare Medicare |
$60.06
|
| Rate for Payer: WINHealth Partners Commercial |
$86.45
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
5102061001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.10
|
| Rate for Payer: Aetna of WY Medicare |
$29.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$43.20
|
| Rate for Payer: Altius Commercial |
$43.20
|
| Rate for Payer: Beech Street Commercial |
$44.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$36.94
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$43.65
|
| Rate for Payer: Cigna of WY Commercial |
$44.10
|
| Rate for Payer: Entrust Commercial |
$42.75
|
| Rate for Payer: First Choice Health Commercial |
$42.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$42.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.10
|
| Rate for Payer: HealthUtah PPO |
$45.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$43.65
|
| Rate for Payer: Multiplan Medicare/VA |
$24.80
|
| Rate for Payer: One Health Plan of WY PPO |
$44.10
|
| Rate for Payer: PacificSource Commercial |
$40.50
|
| Rate for Payer: PHCS PPO |
$44.10
|
| Rate for Payer: Three Rivers PPO |
$33.75
|
| Rate for Payer: TriWest Veterans Administration |
$26.10
|
| Rate for Payer: United Healthcare Commercial |
$39.15
|
| Rate for Payer: United Healthcare Medicare |
$26.10
|
| Rate for Payer: WINHealth Partners Commercial |
$44.10
|
| Rate for Payer: Wise Provider Network Commercial |
$42.75
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$680.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
3522061001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$374.68 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$666.40
|
| Rate for Payer: Aetna of WY Medicare |
$448.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$652.80
|
| Rate for Payer: Altius Commercial |
$652.80
|
| Rate for Payer: Beech Street Commercial |
$666.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$558.28
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$659.60
|
| Rate for Payer: Cigna of WY Commercial |
$666.40
|
| Rate for Payer: Entrust Commercial |
$646.00
|
| Rate for Payer: First Choice Health Commercial |
$646.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$646.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$394.40
|
| Rate for Payer: HealthUtah PPO |
$680.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$659.60
|
| Rate for Payer: Multiplan Medicare/VA |
$374.68
|
| Rate for Payer: One Health Plan of WY PPO |
$666.40
|
| Rate for Payer: PacificSource Commercial |
$612.00
|
| Rate for Payer: PHCS PPO |
$666.40
|
| Rate for Payer: Three Rivers PPO |
$510.00
|
| Rate for Payer: TriWest Veterans Administration |
$394.40
|
| Rate for Payer: United Healthcare Commercial |
$591.60
|
| Rate for Payer: United Healthcare Medicare |
$394.40
|
| Rate for Payer: WINHealth Partners Commercial |
$666.40
|
| Rate for Payer: Wise Provider Network Commercial |
$646.00
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$680.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
3522061001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$426.36 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$666.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$652.80
|
| Rate for Payer: Altius Commercial |
$652.80
|
| Rate for Payer: Beech Street Commercial |
$666.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$558.28
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$659.60
|
| Rate for Payer: Cigna of WY Commercial |
$666.40
|
| Rate for Payer: Entrust Commercial |
$646.00
|
| Rate for Payer: First Choice Health Commercial |
$646.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$646.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$448.80
|
| Rate for Payer: HealthUtah PPO |
$680.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$659.60
|
| Rate for Payer: Multiplan Medicare/VA |
$426.36
|
| Rate for Payer: One Health Plan of WY PPO |
$666.40
|
| Rate for Payer: PacificSource Commercial |
$612.00
|
| Rate for Payer: PHCS PPO |
$666.40
|
| Rate for Payer: Three Rivers PPO |
$510.00
|
| Rate for Payer: TriWest Veterans Administration |
$448.80
|
| Rate for Payer: United Healthcare Commercial |
$591.60
|
| Rate for Payer: United Healthcare Medicare |
$448.80
|
| Rate for Payer: WINHealth Partners Commercial |
$646.00
|
| Rate for Payer: Wise Provider Network Commercial |
$646.00
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
5102061001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$28.22 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$43.20
|
| Rate for Payer: Altius Commercial |
$43.20
|
| Rate for Payer: Beech Street Commercial |
$44.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$36.94
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$43.65
|
| Rate for Payer: Cigna of WY Commercial |
$44.10
|
| Rate for Payer: Entrust Commercial |
$42.75
|
| Rate for Payer: First Choice Health Commercial |
$42.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$42.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.70
|
| Rate for Payer: HealthUtah PPO |
$45.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$43.65
|
| Rate for Payer: Multiplan Medicare/VA |
$28.22
|
| Rate for Payer: One Health Plan of WY PPO |
$44.10
|
| Rate for Payer: PacificSource Commercial |
$40.50
|
| Rate for Payer: PHCS PPO |
$44.10
|
| Rate for Payer: Three Rivers PPO |
$33.75
|
| Rate for Payer: TriWest Veterans Administration |
$29.70
|
| Rate for Payer: United Healthcare Commercial |
$39.15
|
| Rate for Payer: United Healthcare Medicare |
$29.70
|
| Rate for Payer: WINHealth Partners Commercial |
$42.75
|
| Rate for Payer: Wise Provider Network Commercial |
$42.75
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$685.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
3202061001
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$377.44 |
| Max. Negotiated Rate |
$685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$671.30
|
| Rate for Payer: Aetna of WY Medicare |
$452.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$657.60
|
| Rate for Payer: Altius Commercial |
$657.60
|
| Rate for Payer: Beech Street Commercial |
$671.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$562.38
|
| Rate for Payer: Cash Price |
$479.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$664.45
|
| Rate for Payer: Cigna of WY Commercial |
$671.30
|
| Rate for Payer: Entrust Commercial |
$650.75
|
| Rate for Payer: First Choice Health Commercial |
$650.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$650.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$397.30
|
| Rate for Payer: HealthUtah PPO |
$685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$664.45
|
| Rate for Payer: Multiplan Medicare/VA |
$377.44
|
| Rate for Payer: One Health Plan of WY PPO |
$671.30
|
| Rate for Payer: PacificSource Commercial |
$616.50
|
| Rate for Payer: PHCS PPO |
$671.30
|
| Rate for Payer: Three Rivers PPO |
$513.75
|
| Rate for Payer: TriWest Veterans Administration |
$397.30
|
| Rate for Payer: United Healthcare Commercial |
$595.95
|
| Rate for Payer: United Healthcare Medicare |
$397.30
|
| Rate for Payer: WINHealth Partners Commercial |
$671.30
|
| Rate for Payer: Wise Provider Network Commercial |
$650.75
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$92.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
5102061101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$92.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$90.16
|
| Rate for Payer: Aetna of WY Medicare |
$60.72
|
| Rate for Payer: Altius Auto/Workers Compensation |
$88.32
|
| Rate for Payer: Altius Commercial |
$88.32
|
| Rate for Payer: Beech Street Commercial |
$90.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$75.53
|
| Rate for Payer: Cash Price |
$64.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$89.24
|
| Rate for Payer: Cigna of WY Commercial |
$90.16
|
| Rate for Payer: Entrust Commercial |
$87.40
|
| Rate for Payer: First Choice Health Commercial |
$87.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$87.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$53.36
|
| Rate for Payer: HealthUtah PPO |
$92.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$89.24
|
| Rate for Payer: Multiplan Medicare/VA |
$50.69
|
| Rate for Payer: One Health Plan of WY PPO |
$90.16
|
| Rate for Payer: PacificSource Commercial |
$82.80
|
| Rate for Payer: PHCS PPO |
$90.16
|
| Rate for Payer: Three Rivers PPO |
$69.00
|
| Rate for Payer: TriWest Veterans Administration |
$53.36
|
| Rate for Payer: United Healthcare Commercial |
$80.04
|
| Rate for Payer: United Healthcare Medicare |
$53.36
|
| Rate for Payer: WINHealth Partners Commercial |
$90.16
|
| Rate for Payer: Wise Provider Network Commercial |
$87.40
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$534.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
7612061101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$294.23 |
| Max. Negotiated Rate |
$534.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$523.32
|
| Rate for Payer: Aetna of WY Medicare |
$352.44
|
| Rate for Payer: Altius Auto/Workers Compensation |
$512.64
|
| Rate for Payer: Altius Commercial |
$512.64
|
| Rate for Payer: Beech Street Commercial |
$523.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$438.41
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$517.98
|
| Rate for Payer: Cigna of WY Commercial |
$523.32
|
| Rate for Payer: Entrust Commercial |
$507.30
|
| Rate for Payer: First Choice Health Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$309.72
|
| Rate for Payer: HealthUtah PPO |
$534.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$517.98
|
| Rate for Payer: Multiplan Medicare/VA |
$294.23
|
| Rate for Payer: One Health Plan of WY PPO |
$523.32
|
| Rate for Payer: PacificSource Commercial |
$480.60
|
| Rate for Payer: PHCS PPO |
$523.32
|
| Rate for Payer: Three Rivers PPO |
$400.50
|
| Rate for Payer: TriWest Veterans Administration |
$309.72
|
| Rate for Payer: United Healthcare Commercial |
$464.58
|
| Rate for Payer: United Healthcare Medicare |
$309.72
|
| Rate for Payer: WINHealth Partners Commercial |
$523.32
|
| Rate for Payer: Wise Provider Network Commercial |
$507.30
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$92.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
5102061101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$57.68 |
| Max. Negotiated Rate |
$92.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$90.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$88.32
|
| Rate for Payer: Altius Commercial |
$88.32
|
| Rate for Payer: Beech Street Commercial |
$90.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$75.53
|
| Rate for Payer: Cash Price |
$64.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$89.24
|
| Rate for Payer: Cigna of WY Commercial |
$90.16
|
| Rate for Payer: Entrust Commercial |
$87.40
|
| Rate for Payer: First Choice Health Commercial |
$87.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$87.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$60.72
|
| Rate for Payer: HealthUtah PPO |
$92.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$89.24
|
| Rate for Payer: Multiplan Medicare/VA |
$57.68
|
| Rate for Payer: One Health Plan of WY PPO |
$90.16
|
| Rate for Payer: PacificSource Commercial |
$82.80
|
| Rate for Payer: PHCS PPO |
$90.16
|
| Rate for Payer: Three Rivers PPO |
$69.00
|
| Rate for Payer: TriWest Veterans Administration |
$60.72
|
| Rate for Payer: United Healthcare Commercial |
$80.04
|
| Rate for Payer: United Healthcare Medicare |
$60.72
|
| Rate for Payer: WINHealth Partners Commercial |
$87.40
|
| Rate for Payer: Wise Provider Network Commercial |
$87.40
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$1,345.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
4022061101
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$741.10 |
| Max. Negotiated Rate |
$1,345.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,318.10
|
| Rate for Payer: Aetna of WY Medicare |
$887.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,291.20
|
| Rate for Payer: Altius Commercial |
$1,291.20
|
| Rate for Payer: Beech Street Commercial |
$1,318.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,104.24
|
| Rate for Payer: Cash Price |
$941.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,304.65
|
| Rate for Payer: Cigna of WY Commercial |
$1,318.10
|
| Rate for Payer: Entrust Commercial |
$1,277.75
|
| Rate for Payer: First Choice Health Commercial |
$1,277.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,277.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$780.10
|
| Rate for Payer: HealthUtah PPO |
$1,345.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,304.65
|
| Rate for Payer: Multiplan Medicare/VA |
$741.10
|
| Rate for Payer: One Health Plan of WY PPO |
$1,318.10
|
| Rate for Payer: PacificSource Commercial |
$1,210.50
|
| Rate for Payer: PHCS PPO |
$1,318.10
|
| Rate for Payer: Three Rivers PPO |
$1,008.75
|
| Rate for Payer: TriWest Veterans Administration |
$780.10
|
| Rate for Payer: United Healthcare Commercial |
$1,170.15
|
| Rate for Payer: United Healthcare Medicare |
$780.10
|
| Rate for Payer: WINHealth Partners Commercial |
$1,318.10
|
| Rate for Payer: Wise Provider Network Commercial |
$1,277.75
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$534.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
7612061101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$334.82 |
| Max. Negotiated Rate |
$534.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$523.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$512.64
|
| Rate for Payer: Altius Commercial |
$512.64
|
| Rate for Payer: Beech Street Commercial |
$523.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$438.41
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$517.98
|
| Rate for Payer: Cigna of WY Commercial |
$523.32
|
| Rate for Payer: Entrust Commercial |
$507.30
|
| Rate for Payer: First Choice Health Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$507.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$352.44
|
| Rate for Payer: HealthUtah PPO |
$534.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$517.98
|
| Rate for Payer: Multiplan Medicare/VA |
$334.82
|
| Rate for Payer: One Health Plan of WY PPO |
$523.32
|
| Rate for Payer: PacificSource Commercial |
$480.60
|
| Rate for Payer: PHCS PPO |
$523.32
|
| Rate for Payer: Three Rivers PPO |
$400.50
|
| Rate for Payer: TriWest Veterans Administration |
$352.44
|
| Rate for Payer: United Healthcare Commercial |
$464.58
|
| Rate for Payer: United Healthcare Medicare |
$352.44
|
| Rate for Payer: WINHealth Partners Commercial |
$507.30
|
| Rate for Payer: Wise Provider Network Commercial |
$507.30
|
|
|
HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$1,345.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
4022061101
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$843.32 |
| Max. Negotiated Rate |
$1,345.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,318.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,291.20
|
| Rate for Payer: Altius Commercial |
$1,291.20
|
| Rate for Payer: Beech Street Commercial |
$1,318.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,104.24
|
| Rate for Payer: Cash Price |
$941.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,304.65
|
| Rate for Payer: Cigna of WY Commercial |
$1,318.10
|
| Rate for Payer: Entrust Commercial |
$1,277.75
|
| Rate for Payer: First Choice Health Commercial |
$1,277.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,277.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$887.70
|
| Rate for Payer: HealthUtah PPO |
$1,345.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,304.65
|
| Rate for Payer: Multiplan Medicare/VA |
$843.32
|
| Rate for Payer: One Health Plan of WY PPO |
$1,318.10
|
| Rate for Payer: PacificSource Commercial |
$1,210.50
|
| Rate for Payer: PHCS PPO |
$1,318.10
|
| Rate for Payer: Three Rivers PPO |
$1,008.75
|
| Rate for Payer: TriWest Veterans Administration |
$887.70
|
| Rate for Payer: United Healthcare Commercial |
$1,170.15
|
| Rate for Payer: United Healthcare Medicare |
$887.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,277.75
|
| Rate for Payer: Wise Provider Network Commercial |
$1,277.75
|
|
|
HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
7612060001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.38 |
| Max. Negotiated Rate |
$331.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$324.38
|
| Rate for Payer: Aetna of WY Medicare |
$218.46
|
| Rate for Payer: Altius Auto/Workers Compensation |
$317.76
|
| Rate for Payer: Altius Commercial |
$317.76
|
| Rate for Payer: Beech Street Commercial |
$324.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$271.75
|
| Rate for Payer: Cash Price |
$231.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$321.07
|
| Rate for Payer: Cigna of WY Commercial |
$324.38
|
| Rate for Payer: Entrust Commercial |
$314.45
|
| Rate for Payer: First Choice Health Commercial |
$314.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$314.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$191.98
|
| Rate for Payer: HealthUtah PPO |
$331.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$321.07
|
| Rate for Payer: Multiplan Medicare/VA |
$182.38
|
| Rate for Payer: One Health Plan of WY PPO |
$324.38
|
| Rate for Payer: PacificSource Commercial |
$297.90
|
| Rate for Payer: PHCS PPO |
$324.38
|
| Rate for Payer: Three Rivers PPO |
$248.25
|
| Rate for Payer: TriWest Veterans Administration |
$191.98
|
| Rate for Payer: United Healthcare Commercial |
$287.97
|
| Rate for Payer: United Healthcare Medicare |
$191.98
|
| Rate for Payer: WINHealth Partners Commercial |
$324.38
|
| Rate for Payer: Wise Provider Network Commercial |
$314.45
|
|
