|
EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$8,505.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$599.48 |
| Max. Negotiated Rate |
$8,505.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,334.90
|
| Rate for Payer: Aetna of WY Medicare |
$705.27
|
| Rate for Payer: Beech Street Commercial |
$8,079.75
|
| Rate for Payer: Cash Price |
$5,953.50
|
| Rate for Payer: Cash Price |
$5,953.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$8,249.85
|
| Rate for Payer: Cigna of WY Commercial |
$8,334.90
|
| Rate for Payer: First Choice Health Commercial |
$7,654.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,079.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$705.27
|
| Rate for Payer: HealthUtah PPO |
$8,505.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,249.85
|
| Rate for Payer: Multiplan Medicare/VA |
$599.48
|
| Rate for Payer: One Health Plan of WY PPO |
$8,334.90
|
| Rate for Payer: PacificSource Commercial |
$7,654.50
|
| Rate for Payer: PHCS PPO |
$8,079.75
|
| Rate for Payer: Three Rivers PPO |
$6,378.75
|
| Rate for Payer: TriWest Veterans Administration |
$705.27
|
| Rate for Payer: United Healthcare Commercial |
$8,079.75
|
| Rate for Payer: WINHealth Partners Commercial |
$7,229.25
|
|
|
EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$2,027.00
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$298.30 |
| Max. Negotiated Rate |
$2,027.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,986.46
|
| Rate for Payer: Aetna of WY Medicare |
$350.94
|
| Rate for Payer: Beech Street Commercial |
$1,925.65
|
| Rate for Payer: Cash Price |
$1,418.90
|
| Rate for Payer: Cash Price |
$1,418.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,966.19
|
| Rate for Payer: Cigna of WY Commercial |
$1,986.46
|
| Rate for Payer: First Choice Health Commercial |
$1,824.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,925.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$350.94
|
| Rate for Payer: HealthUtah PPO |
$2,027.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,966.19
|
| Rate for Payer: Multiplan Medicare/VA |
$298.30
|
| Rate for Payer: One Health Plan of WY PPO |
$1,986.46
|
| Rate for Payer: PacificSource Commercial |
$1,824.30
|
| Rate for Payer: PHCS PPO |
$1,925.65
|
| Rate for Payer: Three Rivers PPO |
$1,520.25
|
| Rate for Payer: TriWest Veterans Administration |
$350.94
|
| Rate for Payer: United Healthcare Commercial |
$1,925.65
|
| Rate for Payer: WINHealth Partners Commercial |
$1,722.95
|
|
|
EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$3,044.00
|
|
|
Service Code
|
HCPCS 23073 AS
|
| Min. Negotiated Rate |
$570.78 |
| Max. Negotiated Rate |
$3,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,983.12
|
| Rate for Payer: Beech Street Commercial |
$2,891.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,952.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,983.12
|
| Rate for Payer: First Choice Health Commercial |
$2,739.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,891.80
|
| Rate for Payer: HealthUtah PPO |
$3,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,952.68
|
| Rate for Payer: One Health Plan of WY PPO |
$2,983.12
|
| Rate for Payer: PacificSource Commercial |
$2,739.60
|
| Rate for Payer: PHCS PPO |
$2,891.80
|
| Rate for Payer: Three Rivers PPO |
$2,283.00
|
| Rate for Payer: United Healthcare Commercial |
$2,891.80
|
| Rate for Payer: WINHealth Partners Commercial |
$2,587.40
|
|
|
EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$3,044.00
|
|
|
Service Code
|
HCPCS 23073 80
|
| Min. Negotiated Rate |
$570.78 |
| Max. Negotiated Rate |
$3,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,983.12
|
| Rate for Payer: Beech Street Commercial |
$2,891.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,952.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,983.12
|
| Rate for Payer: First Choice Health Commercial |
$2,739.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,891.80
|
| Rate for Payer: HealthUtah PPO |
$3,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,952.68
|
| Rate for Payer: One Health Plan of WY PPO |
$2,983.12
|
| Rate for Payer: PacificSource Commercial |
$2,739.60
|
| Rate for Payer: PHCS PPO |
$2,891.80
|
| Rate for Payer: Three Rivers PPO |
$2,283.00
|
| Rate for Payer: United Healthcare Commercial |
$2,891.80
|
| Rate for Payer: WINHealth Partners Commercial |
$2,587.40
|
|
|
EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$3,044.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$570.78 |
| Max. Negotiated Rate |
$3,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,983.12
|
| Rate for Payer: Aetna of WY Medicare |
$671.50
|
| Rate for Payer: Beech Street Commercial |
$2,891.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,952.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,983.12
|
| Rate for Payer: First Choice Health Commercial |
$2,739.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,891.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$671.50
|
| Rate for Payer: HealthUtah PPO |
$3,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,952.68
|
| Rate for Payer: Multiplan Medicare/VA |
$570.78
|
| Rate for Payer: One Health Plan of WY PPO |
$2,983.12
|
| Rate for Payer: PacificSource Commercial |
$2,739.60
|
| Rate for Payer: PHCS PPO |
$2,891.80
|
| Rate for Payer: Three Rivers PPO |
$2,283.00
|
| Rate for Payer: TriWest Veterans Administration |
$671.50
|
| Rate for Payer: United Healthcare Commercial |
$2,891.80
|
| Rate for Payer: WINHealth Partners Commercial |
$2,587.40
|
|
|
EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$7,403.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$618.30 |
| Max. Negotiated Rate |
$7,403.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,254.94
|
| Rate for Payer: Aetna of WY Medicare |
$727.41
|
| Rate for Payer: Beech Street Commercial |
$7,032.85
|
| Rate for Payer: Cash Price |
$5,182.10
|
| Rate for Payer: Cash Price |
$5,182.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,180.91
|
| Rate for Payer: Cigna of WY Commercial |
$7,254.94
|
| Rate for Payer: First Choice Health Commercial |
$6,662.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,032.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$727.41
|
| Rate for Payer: HealthUtah PPO |
$7,403.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,180.91
|
| Rate for Payer: Multiplan Medicare/VA |
$618.30
|
| Rate for Payer: One Health Plan of WY PPO |
$7,254.94
|
| Rate for Payer: PacificSource Commercial |
$6,662.70
|
| Rate for Payer: PHCS PPO |
$7,032.85
|
| Rate for Payer: Three Rivers PPO |
$5,552.25
|
| Rate for Payer: TriWest Veterans Administration |
$727.41
|
| Rate for Payer: United Healthcare Commercial |
$7,032.85
|
| Rate for Payer: WINHealth Partners Commercial |
$6,292.55
|
|
|
EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$5,147.00
|
|
|
Service Code
|
HCPCS 27328 AS
|
| Min. Negotiated Rate |
$3,860.25 |
| Max. Negotiated Rate |
$5,147.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,044.06
|
| Rate for Payer: Beech Street Commercial |
$4,889.65
|
| Rate for Payer: Cash Price |
$3,602.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,992.59
|
| Rate for Payer: Cigna of WY Commercial |
$5,044.06
|
| Rate for Payer: First Choice Health Commercial |
$4,632.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,889.65
|
| Rate for Payer: HealthUtah PPO |
$5,147.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,992.59
|
| Rate for Payer: One Health Plan of WY PPO |
$5,044.06
|
| Rate for Payer: PacificSource Commercial |
$4,632.30
|
| Rate for Payer: PHCS PPO |
$4,889.65
|
| Rate for Payer: Three Rivers PPO |
$3,860.25
|
| Rate for Payer: United Healthcare Commercial |
$4,889.65
|
| Rate for Payer: WINHealth Partners Commercial |
$4,374.95
|
|
|
EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$2,655.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$512.76 |
| Max. Negotiated Rate |
$2,655.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,601.90
|
| Rate for Payer: Aetna of WY Medicare |
$603.25
|
| Rate for Payer: Beech Street Commercial |
$2,522.25
|
| Rate for Payer: Cash Price |
$1,858.50
|
| Rate for Payer: Cash Price |
$1,858.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,575.35
|
| Rate for Payer: Cigna of WY Commercial |
$2,601.90
|
| Rate for Payer: First Choice Health Commercial |
$2,389.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,522.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.25
|
| Rate for Payer: HealthUtah PPO |
$2,655.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,575.35
|
| Rate for Payer: Multiplan Medicare/VA |
$512.76
|
| Rate for Payer: One Health Plan of WY PPO |
$2,601.90
|
| Rate for Payer: PacificSource Commercial |
$2,389.50
|
| Rate for Payer: PHCS PPO |
$2,522.25
|
| Rate for Payer: Three Rivers PPO |
$1,991.25
|
| Rate for Payer: TriWest Veterans Administration |
$603.25
|
| Rate for Payer: United Healthcare Commercial |
$2,522.25
|
| Rate for Payer: WINHealth Partners Commercial |
$2,256.75
|
|
|
EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$721.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$333.52 |
| Max. Negotiated Rate |
$721.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$706.58
|
| Rate for Payer: Aetna of WY Medicare |
$392.38
|
| Rate for Payer: Beech Street Commercial |
$684.95
|
| Rate for Payer: Cash Price |
$504.70
|
| Rate for Payer: Cash Price |
$504.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$699.37
|
| Rate for Payer: Cigna of WY Commercial |
$706.58
|
| Rate for Payer: First Choice Health Commercial |
$648.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$684.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$392.38
|
| Rate for Payer: HealthUtah PPO |
$721.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$699.37
|
| Rate for Payer: Multiplan Medicare/VA |
$333.52
|
| Rate for Payer: One Health Plan of WY PPO |
$706.58
|
| Rate for Payer: PacificSource Commercial |
$648.90
|
| Rate for Payer: PHCS PPO |
$684.95
|
| Rate for Payer: Three Rivers PPO |
$540.75
|
| Rate for Payer: TriWest Veterans Administration |
$392.38
|
| Rate for Payer: United Healthcare Commercial |
$684.95
|
| Rate for Payer: WINHealth Partners Commercial |
$612.85
|
|
|
EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$273.18 |
| Max. Negotiated Rate |
$1,058.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,036.84
|
| Rate for Payer: Aetna of WY Medicare |
$321.39
|
| Rate for Payer: Beech Street Commercial |
$1,005.10
|
| Rate for Payer: Cash Price |
$740.60
|
| Rate for Payer: Cash Price |
$740.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,026.26
|
| Rate for Payer: Cigna of WY Commercial |
$1,036.84
|
| Rate for Payer: First Choice Health Commercial |
$952.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,005.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$321.39
|
| Rate for Payer: HealthUtah PPO |
$1,058.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,026.26
|
| Rate for Payer: Multiplan Medicare/VA |
$273.18
|
| Rate for Payer: One Health Plan of WY PPO |
$1,036.84
|
| Rate for Payer: PacificSource Commercial |
$952.20
|
| Rate for Payer: PHCS PPO |
$1,005.10
|
| Rate for Payer: Three Rivers PPO |
$793.50
|
| Rate for Payer: TriWest Veterans Administration |
$321.39
|
| Rate for Payer: United Healthcare Commercial |
$1,005.10
|
| Rate for Payer: WINHealth Partners Commercial |
$899.30
|
|
|
EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,456.00
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$278.44 |
| Max. Negotiated Rate |
$1,456.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,426.88
|
| Rate for Payer: Aetna of WY Medicare |
$327.58
|
| Rate for Payer: Beech Street Commercial |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,412.32
|
| Rate for Payer: Cigna of WY Commercial |
$1,426.88
|
| Rate for Payer: First Choice Health Commercial |
$1,310.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,383.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$327.58
|
| Rate for Payer: HealthUtah PPO |
$1,456.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,412.32
|
| Rate for Payer: Multiplan Medicare/VA |
$278.44
|
| Rate for Payer: One Health Plan of WY PPO |
$1,426.88
|
| Rate for Payer: PacificSource Commercial |
$1,310.40
|
| Rate for Payer: PHCS PPO |
$1,383.20
|
| Rate for Payer: Three Rivers PPO |
$1,092.00
|
| Rate for Payer: TriWest Veterans Administration |
$327.58
|
| Rate for Payer: United Healthcare Commercial |
$1,383.20
|
| Rate for Payer: WINHealth Partners Commercial |
$1,237.60
|
|
|
EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$1,796.00
|
|
|
Service Code
|
HCPCS 26116
|
| Min. Negotiated Rate |
$437.56 |
| Max. Negotiated Rate |
$1,796.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,760.08
|
| Rate for Payer: Aetna of WY Medicare |
$514.78
|
| Rate for Payer: Beech Street Commercial |
$1,706.20
|
| Rate for Payer: Cash Price |
$1,257.20
|
| Rate for Payer: Cash Price |
$1,257.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,742.12
|
| Rate for Payer: Cigna of WY Commercial |
$1,760.08
|
| Rate for Payer: First Choice Health Commercial |
$1,616.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,706.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$514.78
|
| Rate for Payer: HealthUtah PPO |
$1,796.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,742.12
|
| Rate for Payer: Multiplan Medicare/VA |
$437.56
|
| Rate for Payer: One Health Plan of WY PPO |
$1,760.08
|
| Rate for Payer: PacificSource Commercial |
$1,616.40
|
| Rate for Payer: PHCS PPO |
$1,706.20
|
| Rate for Payer: Three Rivers PPO |
$1,347.00
|
| Rate for Payer: TriWest Veterans Administration |
$514.78
|
| Rate for Payer: United Healthcare Commercial |
$1,706.20
|
| Rate for Payer: WINHealth Partners Commercial |
$1,526.60
|
|
|
EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$1,581.00
|
|
|
Service Code
|
HCPCS 42450 80
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$1,581.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,549.38
|
| Rate for Payer: Beech Street Commercial |
$1,501.95
|
| Rate for Payer: Cash Price |
$1,106.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,533.57
|
| Rate for Payer: Cigna of WY Commercial |
$1,549.38
|
| Rate for Payer: First Choice Health Commercial |
$1,422.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,501.95
|
| Rate for Payer: HealthUtah PPO |
$1,581.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,533.57
|
| Rate for Payer: One Health Plan of WY PPO |
$1,549.38
|
| Rate for Payer: PacificSource Commercial |
$1,422.90
|
| Rate for Payer: PHCS PPO |
$1,501.95
|
| Rate for Payer: Three Rivers PPO |
$1,185.75
|
| Rate for Payer: United Healthcare Commercial |
$1,501.95
|
| Rate for Payer: WINHealth Partners Commercial |
$1,343.85
|
|
|
EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$1,581.00
|
|
|
Service Code
|
HCPCS 42450
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$1,581.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,549.38
|
| Rate for Payer: Aetna of WY Medicare |
$355.76
|
| Rate for Payer: Beech Street Commercial |
$1,501.95
|
| Rate for Payer: Cash Price |
$1,106.70
|
| Rate for Payer: Cash Price |
$1,106.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,533.57
|
| Rate for Payer: Cigna of WY Commercial |
$1,549.38
|
| Rate for Payer: First Choice Health Commercial |
$1,422.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,501.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$355.76
|
| Rate for Payer: HealthUtah PPO |
$1,581.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,533.57
|
| Rate for Payer: Multiplan Medicare/VA |
$302.40
|
| Rate for Payer: One Health Plan of WY PPO |
$1,549.38
|
| Rate for Payer: PacificSource Commercial |
$1,422.90
|
| Rate for Payer: PHCS PPO |
$1,501.95
|
| Rate for Payer: Three Rivers PPO |
$1,185.75
|
| Rate for Payer: TriWest Veterans Administration |
$355.76
|
| Rate for Payer: United Healthcare Commercial |
$1,501.95
|
| Rate for Payer: WINHealth Partners Commercial |
$1,343.85
|
|
|
EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,527.00
|
|
|
Service Code
|
HCPCS 20103 AS
|
| Min. Negotiated Rate |
$281.42 |
| Max. Negotiated Rate |
$1,527.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,496.46
|
| Rate for Payer: Beech Street Commercial |
$1,450.65
|
| Rate for Payer: Cash Price |
$1,068.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,481.19
|
| Rate for Payer: Cigna of WY Commercial |
$1,496.46
|
| Rate for Payer: First Choice Health Commercial |
$1,374.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,450.65
|
| Rate for Payer: HealthUtah PPO |
$1,527.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,481.19
|
| Rate for Payer: One Health Plan of WY PPO |
$1,496.46
|
| Rate for Payer: PacificSource Commercial |
$1,374.30
|
| Rate for Payer: PHCS PPO |
$1,450.65
|
| Rate for Payer: Three Rivers PPO |
$1,145.25
|
| Rate for Payer: United Healthcare Commercial |
$1,450.65
|
| Rate for Payer: WINHealth Partners Commercial |
$1,297.95
|
|
|
EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,527.00
|
|
|
Service Code
|
HCPCS 20103
|
| Min. Negotiated Rate |
$281.42 |
| Max. Negotiated Rate |
$1,527.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,496.46
|
| Rate for Payer: Aetna of WY Medicare |
$331.08
|
| Rate for Payer: Beech Street Commercial |
$1,450.65
|
| Rate for Payer: Cash Price |
$1,068.90
|
| Rate for Payer: Cash Price |
$1,068.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,481.19
|
| Rate for Payer: Cigna of WY Commercial |
$1,496.46
|
| Rate for Payer: First Choice Health Commercial |
$1,374.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,450.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$331.08
|
| Rate for Payer: HealthUtah PPO |
$1,527.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,481.19
|
| Rate for Payer: Multiplan Medicare/VA |
$281.42
|
| Rate for Payer: One Health Plan of WY PPO |
$1,496.46
|
| Rate for Payer: PacificSource Commercial |
$1,374.30
|
| Rate for Payer: PHCS PPO |
$1,450.65
|
| Rate for Payer: Three Rivers PPO |
$1,145.25
|
| Rate for Payer: TriWest Veterans Administration |
$331.08
|
| Rate for Payer: United Healthcare Commercial |
$1,450.65
|
| Rate for Payer: WINHealth Partners Commercial |
$1,297.95
|
|
|
EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$2,553.00
|
|
|
Service Code
|
HCPCS 20100 80
|
| Min. Negotiated Rate |
$484.65 |
| Max. Negotiated Rate |
$2,553.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,501.94
|
| Rate for Payer: Beech Street Commercial |
$2,425.35
|
| Rate for Payer: Cash Price |
$1,787.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,476.41
|
| Rate for Payer: Cigna of WY Commercial |
$2,501.94
|
| Rate for Payer: First Choice Health Commercial |
$2,297.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,425.35
|
| Rate for Payer: HealthUtah PPO |
$2,553.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,476.41
|
| Rate for Payer: One Health Plan of WY PPO |
$2,501.94
|
| Rate for Payer: PacificSource Commercial |
$2,297.70
|
| Rate for Payer: PHCS PPO |
$2,425.35
|
| Rate for Payer: Three Rivers PPO |
$1,914.75
|
| Rate for Payer: United Healthcare Commercial |
$2,425.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2,170.05
|
|
|
EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$2,553.00
|
|
|
Service Code
|
HCPCS 20100
|
| Min. Negotiated Rate |
$484.65 |
| Max. Negotiated Rate |
$2,553.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,501.94
|
| Rate for Payer: Aetna of WY Medicare |
$570.18
|
| Rate for Payer: Beech Street Commercial |
$2,425.35
|
| Rate for Payer: Cash Price |
$1,787.10
|
| Rate for Payer: Cash Price |
$1,787.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,476.41
|
| Rate for Payer: Cigna of WY Commercial |
$2,501.94
|
| Rate for Payer: First Choice Health Commercial |
$2,297.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,425.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$570.18
|
| Rate for Payer: HealthUtah PPO |
$2,553.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,476.41
|
| Rate for Payer: Multiplan Medicare/VA |
$484.65
|
| Rate for Payer: One Health Plan of WY PPO |
$2,501.94
|
| Rate for Payer: PacificSource Commercial |
$2,297.70
|
| Rate for Payer: PHCS PPO |
$2,425.35
|
| Rate for Payer: Three Rivers PPO |
$1,914.75
|
| Rate for Payer: TriWest Veterans Administration |
$570.18
|
| Rate for Payer: United Healthcare Commercial |
$2,425.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2,170.05
|
|
|
EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX
|
Professional
|
Both
|
$4,579.00
|
|
|
Service Code
|
HCPCS 49000
|
| Min. Negotiated Rate |
$621.50 |
| Max. Negotiated Rate |
$4,579.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,487.42
|
| Rate for Payer: Aetna of WY Medicare |
$731.18
|
| Rate for Payer: Beech Street Commercial |
$4,350.05
|
| Rate for Payer: Cash Price |
$3,205.30
|
| Rate for Payer: Cash Price |
$3,205.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,441.63
|
| Rate for Payer: Cigna of WY Commercial |
$4,487.42
|
| Rate for Payer: First Choice Health Commercial |
$4,121.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,350.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$731.18
|
| Rate for Payer: HealthUtah PPO |
$4,579.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,441.63
|
| Rate for Payer: Multiplan Medicare/VA |
$621.50
|
| Rate for Payer: One Health Plan of WY PPO |
$4,487.42
|
| Rate for Payer: PacificSource Commercial |
$4,121.10
|
| Rate for Payer: PHCS PPO |
$4,350.05
|
| Rate for Payer: Three Rivers PPO |
$3,434.25
|
| Rate for Payer: TriWest Veterans Administration |
$731.18
|
| Rate for Payer: United Healthcare Commercial |
$4,350.05
|
| Rate for Payer: WINHealth Partners Commercial |
$3,892.15
|
|
|
EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX
|
Professional
|
Both
|
$915.00
|
|
|
Service Code
|
HCPCS 49000 AS
|
| Min. Negotiated Rate |
$686.25 |
| Max. Negotiated Rate |
$915.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$896.70
|
| Rate for Payer: Beech Street Commercial |
$869.25
|
| Rate for Payer: Cash Price |
$640.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$887.55
|
| Rate for Payer: Cigna of WY Commercial |
$896.70
|
| Rate for Payer: First Choice Health Commercial |
$823.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$869.25
|
| Rate for Payer: HealthUtah PPO |
$915.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$887.55
|
| Rate for Payer: One Health Plan of WY PPO |
$896.70
|
| Rate for Payer: PacificSource Commercial |
$823.50
|
| Rate for Payer: PHCS PPO |
$869.25
|
| Rate for Payer: Three Rivers PPO |
$686.25
|
| Rate for Payer: United Healthcare Commercial |
$869.25
|
| Rate for Payer: WINHealth Partners Commercial |
$777.75
|
|
|
EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX
|
Professional
|
Both
|
$915.00
|
|
|
Service Code
|
HCPCS 49000 80
|
| Min. Negotiated Rate |
$686.25 |
| Max. Negotiated Rate |
$915.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$896.70
|
| Rate for Payer: Beech Street Commercial |
$869.25
|
| Rate for Payer: Cash Price |
$640.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$887.55
|
| Rate for Payer: Cigna of WY Commercial |
$896.70
|
| Rate for Payer: First Choice Health Commercial |
$823.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$869.25
|
| Rate for Payer: HealthUtah PPO |
$915.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$887.55
|
| Rate for Payer: One Health Plan of WY PPO |
$896.70
|
| Rate for Payer: PacificSource Commercial |
$823.50
|
| Rate for Payer: PHCS PPO |
$869.25
|
| Rate for Payer: Three Rivers PPO |
$686.25
|
| Rate for Payer: United Healthcare Commercial |
$869.25
|
| Rate for Payer: WINHealth Partners Commercial |
$777.75
|
|
|
EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK
|
Professional
|
Both
|
$1,130.00
|
|
|
Service Code
|
HCPCS 20102
|
| Min. Negotiated Rate |
$207.54 |
| Max. Negotiated Rate |
$1,130.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,107.40
|
| Rate for Payer: Aetna of WY Medicare |
$244.17
|
| Rate for Payer: Beech Street Commercial |
$1,073.50
|
| Rate for Payer: Cash Price |
$791.00
|
| Rate for Payer: Cash Price |
$791.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,096.10
|
| Rate for Payer: Cigna of WY Commercial |
$1,107.40
|
| Rate for Payer: First Choice Health Commercial |
$1,017.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,073.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$244.17
|
| Rate for Payer: HealthUtah PPO |
$1,130.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,096.10
|
| Rate for Payer: Multiplan Medicare/VA |
$207.54
|
| Rate for Payer: One Health Plan of WY PPO |
$1,107.40
|
| Rate for Payer: PacificSource Commercial |
$1,017.00
|
| Rate for Payer: PHCS PPO |
$1,073.50
|
| Rate for Payer: Three Rivers PPO |
$847.50
|
| Rate for Payer: TriWest Veterans Administration |
$244.17
|
| Rate for Payer: United Healthcare Commercial |
$1,073.50
|
| Rate for Payer: WINHealth Partners Commercial |
$960.50
|
|
|
EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD
|
Professional
|
Both
|
$512.00
|
|
|
Service Code
|
HCPCS 35840 AS
|
| Min. Negotiated Rate |
$384.00 |
| Max. Negotiated Rate |
$512.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$501.76
|
| Rate for Payer: Beech Street Commercial |
$486.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$496.64
|
| Rate for Payer: Cigna of WY Commercial |
$501.76
|
| Rate for Payer: First Choice Health Commercial |
$460.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$486.40
|
| Rate for Payer: HealthUtah PPO |
$512.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$496.64
|
| Rate for Payer: One Health Plan of WY PPO |
$501.76
|
| Rate for Payer: PacificSource Commercial |
$460.80
|
| Rate for Payer: PHCS PPO |
$486.40
|
| Rate for Payer: Three Rivers PPO |
$384.00
|
| Rate for Payer: United Healthcare Commercial |
$486.40
|
| Rate for Payer: WINHealth Partners Commercial |
$435.20
|
|
|
EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD
|
Professional
|
Both
|
$512.00
|
|
|
Service Code
|
HCPCS 35840 80
|
| Min. Negotiated Rate |
$384.00 |
| Max. Negotiated Rate |
$512.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$501.76
|
| Rate for Payer: Beech Street Commercial |
$486.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$496.64
|
| Rate for Payer: Cigna of WY Commercial |
$501.76
|
| Rate for Payer: First Choice Health Commercial |
$460.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$486.40
|
| Rate for Payer: HealthUtah PPO |
$512.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$496.64
|
| Rate for Payer: One Health Plan of WY PPO |
$501.76
|
| Rate for Payer: PacificSource Commercial |
$460.80
|
| Rate for Payer: PHCS PPO |
$486.40
|
| Rate for Payer: Three Rivers PPO |
$384.00
|
| Rate for Payer: United Healthcare Commercial |
$486.40
|
| Rate for Payer: WINHealth Partners Commercial |
$435.20
|
|
|
EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD
|
Professional
|
Both
|
$2,560.00
|
|
|
Service Code
|
HCPCS 35840
|
| Min. Negotiated Rate |
$970.93 |
| Max. Negotiated Rate |
$2,560.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,508.80
|
| Rate for Payer: Aetna of WY Medicare |
$1,142.27
|
| Rate for Payer: Beech Street Commercial |
$2,432.00
|
| Rate for Payer: Cash Price |
$1,792.00
|
| Rate for Payer: Cash Price |
$1,792.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,483.20
|
| Rate for Payer: Cigna of WY Commercial |
$2,508.80
|
| Rate for Payer: First Choice Health Commercial |
$2,304.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,432.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,142.27
|
| Rate for Payer: HealthUtah PPO |
$2,560.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,483.20
|
| Rate for Payer: Multiplan Medicare/VA |
$970.93
|
| Rate for Payer: One Health Plan of WY PPO |
$2,508.80
|
| Rate for Payer: PacificSource Commercial |
$2,304.00
|
| Rate for Payer: PHCS PPO |
$2,432.00
|
| Rate for Payer: Three Rivers PPO |
$1,920.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,142.27
|
| Rate for Payer: United Healthcare Commercial |
$2,432.00
|
| Rate for Payer: WINHealth Partners Commercial |
$2,176.00
|
|
