|
ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$4,344.00
|
|
|
Service Code
|
HCPCS 27438 AS
|
| Hospital Charge Code |
27438
|
| Min. Negotiated Rate |
$692.22 |
| Max. Negotiated Rate |
$4,344.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,257.12
|
| Rate for Payer: Aetna of WY Medicare |
$814.38
|
| Rate for Payer: Beech Street Commercial |
$4,126.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,213.68
|
| Rate for Payer: Cigna of WY Commercial |
$4,257.12
|
| Rate for Payer: First Choice Health Commercial |
$3,909.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,126.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$814.38
|
| Rate for Payer: HealthUtah PPO |
$4,344.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,213.68
|
| Rate for Payer: Multiplan Medicare/VA |
$692.22
|
| Rate for Payer: One Health Plan of WY PPO |
$4,257.12
|
| Rate for Payer: PacificSource Commercial |
$3,909.60
|
| Rate for Payer: PHCS PPO |
$4,126.80
|
| Rate for Payer: Three Rivers PPO |
$3,258.00
|
| Rate for Payer: TriWest Veterans Administration |
$814.38
|
| Rate for Payer: United Healthcare Commercial |
$3,779.28
|
| Rate for Payer: United Healthcare Medicare |
$814.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,692.40
|
|
|
ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,363.00
|
|
|
Service Code
|
HCPCS 24366
|
| Hospital Charge Code |
24366
|
| Min. Negotiated Rate |
$562.99 |
| Max. Negotiated Rate |
$2,363.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,315.74
|
| Rate for Payer: Aetna of WY Medicare |
$662.34
|
| Rate for Payer: Beech Street Commercial |
$2,244.85
|
| Rate for Payer: Cash Price |
$1,654.10
|
| Rate for Payer: Cash Price |
$1,654.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,292.11
|
| Rate for Payer: Cigna of WY Commercial |
$2,315.74
|
| Rate for Payer: First Choice Health Commercial |
$2,126.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,244.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$662.34
|
| Rate for Payer: HealthUtah PPO |
$2,363.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,292.11
|
| Rate for Payer: Multiplan Medicare/VA |
$562.99
|
| Rate for Payer: One Health Plan of WY PPO |
$2,315.74
|
| Rate for Payer: PacificSource Commercial |
$2,126.70
|
| Rate for Payer: PHCS PPO |
$2,244.85
|
| Rate for Payer: Three Rivers PPO |
$1,772.25
|
| Rate for Payer: TriWest Veterans Administration |
$662.34
|
| Rate for Payer: United Healthcare Commercial |
$2,055.81
|
| Rate for Payer: United Healthcare Medicare |
$662.34
|
| Rate for Payer: WINHealth Partners Commercial |
$2,008.55
|
|
|
ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,363.00
|
|
|
Service Code
|
HCPCS 24366 AS
|
| Hospital Charge Code |
24366
|
| Min. Negotiated Rate |
$562.99 |
| Max. Negotiated Rate |
$2,363.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,315.74
|
| Rate for Payer: Aetna of WY Medicare |
$662.34
|
| Rate for Payer: Beech Street Commercial |
$2,244.85
|
| Rate for Payer: Cash Price |
$1,654.10
|
| Rate for Payer: Cash Price |
$1,654.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,292.11
|
| Rate for Payer: Cigna of WY Commercial |
$2,315.74
|
| Rate for Payer: First Choice Health Commercial |
$2,126.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,244.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$662.34
|
| Rate for Payer: HealthUtah PPO |
$2,363.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,292.11
|
| Rate for Payer: Multiplan Medicare/VA |
$562.99
|
| Rate for Payer: One Health Plan of WY PPO |
$2,315.74
|
| Rate for Payer: PacificSource Commercial |
$2,126.70
|
| Rate for Payer: PHCS PPO |
$2,244.85
|
| Rate for Payer: Three Rivers PPO |
$1,772.25
|
| Rate for Payer: TriWest Veterans Administration |
$662.34
|
| Rate for Payer: United Healthcare Commercial |
$2,055.81
|
| Rate for Payer: United Healthcare Medicare |
$662.34
|
| Rate for Payer: WINHealth Partners Commercial |
$2,008.55
|
|
|
ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,363.00
|
|
|
Service Code
|
HCPCS 24366 80
|
| Hospital Charge Code |
24366
|
| Min. Negotiated Rate |
$562.99 |
| Max. Negotiated Rate |
$2,363.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,315.74
|
| Rate for Payer: Aetna of WY Medicare |
$662.34
|
| Rate for Payer: Beech Street Commercial |
$2,244.85
|
| Rate for Payer: Cash Price |
$1,654.10
|
| Rate for Payer: Cash Price |
$1,654.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,292.11
|
| Rate for Payer: Cigna of WY Commercial |
$2,315.74
|
| Rate for Payer: First Choice Health Commercial |
$2,126.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,244.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$662.34
|
| Rate for Payer: HealthUtah PPO |
$2,363.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,292.11
|
| Rate for Payer: Multiplan Medicare/VA |
$562.99
|
| Rate for Payer: One Health Plan of WY PPO |
$2,315.74
|
| Rate for Payer: PacificSource Commercial |
$2,126.70
|
| Rate for Payer: PHCS PPO |
$2,244.85
|
| Rate for Payer: Three Rivers PPO |
$1,772.25
|
| Rate for Payer: TriWest Veterans Administration |
$662.34
|
| Rate for Payer: United Healthcare Commercial |
$2,055.81
|
| Rate for Payer: United Healthcare Medicare |
$662.34
|
| Rate for Payer: WINHealth Partners Commercial |
$2,008.55
|
|
|
ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$4,801.00
|
|
|
Service Code
|
HCPCS 29851
|
| Hospital Charge Code |
29851
|
| Min. Negotiated Rate |
$763.38 |
| Max. Negotiated Rate |
$4,801.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,704.98
|
| Rate for Payer: Aetna of WY Medicare |
$898.09
|
| Rate for Payer: Beech Street Commercial |
$4,560.95
|
| Rate for Payer: Cash Price |
$3,360.70
|
| Rate for Payer: Cash Price |
$3,360.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,656.97
|
| Rate for Payer: Cigna of WY Commercial |
$4,704.98
|
| Rate for Payer: First Choice Health Commercial |
$4,320.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,560.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$898.09
|
| Rate for Payer: HealthUtah PPO |
$4,801.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,656.97
|
| Rate for Payer: Multiplan Medicare/VA |
$763.38
|
| Rate for Payer: One Health Plan of WY PPO |
$4,704.98
|
| Rate for Payer: PacificSource Commercial |
$4,320.90
|
| Rate for Payer: PHCS PPO |
$4,560.95
|
| Rate for Payer: Three Rivers PPO |
$3,600.75
|
| Rate for Payer: TriWest Veterans Administration |
$898.09
|
| Rate for Payer: United Healthcare Commercial |
$4,176.87
|
| Rate for Payer: United Healthcare Medicare |
$898.09
|
| Rate for Payer: WINHealth Partners Commercial |
$4,080.85
|
|
|
ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$4,801.00
|
|
|
Service Code
|
HCPCS 29851 80
|
| Hospital Charge Code |
29851
|
| Min. Negotiated Rate |
$763.38 |
| Max. Negotiated Rate |
$4,801.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,704.98
|
| Rate for Payer: Aetna of WY Medicare |
$898.09
|
| Rate for Payer: Beech Street Commercial |
$4,560.95
|
| Rate for Payer: Cash Price |
$3,360.70
|
| Rate for Payer: Cash Price |
$3,360.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,656.97
|
| Rate for Payer: Cigna of WY Commercial |
$4,704.98
|
| Rate for Payer: First Choice Health Commercial |
$4,320.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,560.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$898.09
|
| Rate for Payer: HealthUtah PPO |
$4,801.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,656.97
|
| Rate for Payer: Multiplan Medicare/VA |
$763.38
|
| Rate for Payer: One Health Plan of WY PPO |
$4,704.98
|
| Rate for Payer: PacificSource Commercial |
$4,320.90
|
| Rate for Payer: PHCS PPO |
$4,560.95
|
| Rate for Payer: Three Rivers PPO |
$3,600.75
|
| Rate for Payer: TriWest Veterans Administration |
$898.09
|
| Rate for Payer: United Healthcare Commercial |
$4,176.87
|
| Rate for Payer: United Healthcare Medicare |
$898.09
|
| Rate for Payer: WINHealth Partners Commercial |
$4,080.85
|
|
|
ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$4,801.00
|
|
|
Service Code
|
HCPCS 29851 AS
|
| Hospital Charge Code |
29851
|
| Min. Negotiated Rate |
$763.38 |
| Max. Negotiated Rate |
$4,801.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,704.98
|
| Rate for Payer: Aetna of WY Medicare |
$898.09
|
| Rate for Payer: Beech Street Commercial |
$4,560.95
|
| Rate for Payer: Cash Price |
$3,360.70
|
| Rate for Payer: Cash Price |
$3,360.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,656.97
|
| Rate for Payer: Cigna of WY Commercial |
$4,704.98
|
| Rate for Payer: First Choice Health Commercial |
$4,320.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,560.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$898.09
|
| Rate for Payer: HealthUtah PPO |
$4,801.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,656.97
|
| Rate for Payer: Multiplan Medicare/VA |
$763.38
|
| Rate for Payer: One Health Plan of WY PPO |
$4,704.98
|
| Rate for Payer: PacificSource Commercial |
$4,320.90
|
| Rate for Payer: PHCS PPO |
$4,560.95
|
| Rate for Payer: Three Rivers PPO |
$3,600.75
|
| Rate for Payer: TriWest Veterans Administration |
$898.09
|
| Rate for Payer: United Healthcare Commercial |
$4,176.87
|
| Rate for Payer: United Healthcare Medicare |
$898.09
|
| Rate for Payer: WINHealth Partners Commercial |
$4,080.85
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 29898
|
| Hospital Charge Code |
29898
|
| Min. Negotiated Rate |
$463.03 |
| Max. Negotiated Rate |
$1,945.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,906.10
|
| Rate for Payer: Aetna of WY Medicare |
$544.74
|
| Rate for Payer: Beech Street Commercial |
$1,847.75
|
| Rate for Payer: Cash Price |
$1,361.50
|
| Rate for Payer: Cash Price |
$1,361.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,886.65
|
| Rate for Payer: Cigna of WY Commercial |
$1,906.10
|
| Rate for Payer: First Choice Health Commercial |
$1,750.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,847.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$544.74
|
| Rate for Payer: HealthUtah PPO |
$1,945.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,886.65
|
| Rate for Payer: Multiplan Medicare/VA |
$463.03
|
| Rate for Payer: One Health Plan of WY PPO |
$1,906.10
|
| Rate for Payer: PacificSource Commercial |
$1,750.50
|
| Rate for Payer: PHCS PPO |
$1,847.75
|
| Rate for Payer: Three Rivers PPO |
$1,458.75
|
| Rate for Payer: TriWest Veterans Administration |
$544.74
|
| Rate for Payer: United Healthcare Commercial |
$1,692.15
|
| Rate for Payer: United Healthcare Medicare |
$544.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,653.25
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 29898 AS
|
| Hospital Charge Code |
29898
|
| Min. Negotiated Rate |
$463.03 |
| Max. Negotiated Rate |
$1,945.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,906.10
|
| Rate for Payer: Aetna of WY Medicare |
$544.74
|
| Rate for Payer: Beech Street Commercial |
$1,847.75
|
| Rate for Payer: Cash Price |
$1,361.50
|
| Rate for Payer: Cash Price |
$1,361.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,886.65
|
| Rate for Payer: Cigna of WY Commercial |
$1,906.10
|
| Rate for Payer: First Choice Health Commercial |
$1,750.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,847.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$544.74
|
| Rate for Payer: HealthUtah PPO |
$1,945.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,886.65
|
| Rate for Payer: Multiplan Medicare/VA |
$463.03
|
| Rate for Payer: One Health Plan of WY PPO |
$1,906.10
|
| Rate for Payer: PacificSource Commercial |
$1,750.50
|
| Rate for Payer: PHCS PPO |
$1,847.75
|
| Rate for Payer: Three Rivers PPO |
$1,458.75
|
| Rate for Payer: TriWest Veterans Administration |
$544.74
|
| Rate for Payer: United Healthcare Commercial |
$1,692.15
|
| Rate for Payer: United Healthcare Medicare |
$544.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,653.25
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 29898 80
|
| Hospital Charge Code |
29898
|
| Min. Negotiated Rate |
$463.03 |
| Max. Negotiated Rate |
$1,945.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,906.10
|
| Rate for Payer: Aetna of WY Medicare |
$544.74
|
| Rate for Payer: Beech Street Commercial |
$1,847.75
|
| Rate for Payer: Cash Price |
$1,361.50
|
| Rate for Payer: Cash Price |
$1,361.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,886.65
|
| Rate for Payer: Cigna of WY Commercial |
$1,906.10
|
| Rate for Payer: First Choice Health Commercial |
$1,750.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,847.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$544.74
|
| Rate for Payer: HealthUtah PPO |
$1,945.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,886.65
|
| Rate for Payer: Multiplan Medicare/VA |
$463.03
|
| Rate for Payer: One Health Plan of WY PPO |
$1,906.10
|
| Rate for Payer: PacificSource Commercial |
$1,750.50
|
| Rate for Payer: PHCS PPO |
$1,847.75
|
| Rate for Payer: Three Rivers PPO |
$1,458.75
|
| Rate for Payer: TriWest Veterans Administration |
$544.74
|
| Rate for Payer: United Healthcare Commercial |
$1,692.15
|
| Rate for Payer: United Healthcare Medicare |
$544.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,653.25
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 29897
|
| Hospital Charge Code |
29897
|
| Min. Negotiated Rate |
$409.55 |
| Max. Negotiated Rate |
$2,403.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,354.94
|
| Rate for Payer: Aetna of WY Medicare |
$481.82
|
| Rate for Payer: Beech Street Commercial |
$2,282.85
|
| Rate for Payer: Cash Price |
$1,682.10
|
| Rate for Payer: Cash Price |
$1,682.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,330.91
|
| Rate for Payer: Cigna of WY Commercial |
$2,354.94
|
| Rate for Payer: First Choice Health Commercial |
$2,162.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,282.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$481.82
|
| Rate for Payer: HealthUtah PPO |
$2,403.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,330.91
|
| Rate for Payer: Multiplan Medicare/VA |
$409.55
|
| Rate for Payer: One Health Plan of WY PPO |
$2,354.94
|
| Rate for Payer: PacificSource Commercial |
$2,162.70
|
| Rate for Payer: PHCS PPO |
$2,282.85
|
| Rate for Payer: Three Rivers PPO |
$1,802.25
|
| Rate for Payer: TriWest Veterans Administration |
$481.82
|
| Rate for Payer: United Healthcare Commercial |
$2,090.61
|
| Rate for Payer: United Healthcare Medicare |
$481.82
|
| Rate for Payer: WINHealth Partners Commercial |
$2,042.55
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 29897 AS
|
| Hospital Charge Code |
29897
|
| Min. Negotiated Rate |
$409.55 |
| Max. Negotiated Rate |
$2,403.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,354.94
|
| Rate for Payer: Aetna of WY Medicare |
$481.82
|
| Rate for Payer: Beech Street Commercial |
$2,282.85
|
| Rate for Payer: Cash Price |
$1,682.10
|
| Rate for Payer: Cash Price |
$1,682.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,330.91
|
| Rate for Payer: Cigna of WY Commercial |
$2,354.94
|
| Rate for Payer: First Choice Health Commercial |
$2,162.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,282.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$481.82
|
| Rate for Payer: HealthUtah PPO |
$2,403.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,330.91
|
| Rate for Payer: Multiplan Medicare/VA |
$409.55
|
| Rate for Payer: One Health Plan of WY PPO |
$2,354.94
|
| Rate for Payer: PacificSource Commercial |
$2,162.70
|
| Rate for Payer: PHCS PPO |
$2,282.85
|
| Rate for Payer: Three Rivers PPO |
$1,802.25
|
| Rate for Payer: TriWest Veterans Administration |
$481.82
|
| Rate for Payer: United Healthcare Commercial |
$2,090.61
|
| Rate for Payer: United Healthcare Medicare |
$481.82
|
| Rate for Payer: WINHealth Partners Commercial |
$2,042.55
|
|
|
ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$7,922.00
|
|
|
Service Code
|
HCPCS 29895
|
| Hospital Charge Code |
29895
|
| Min. Negotiated Rate |
$383.08 |
| Max. Negotiated Rate |
$7,922.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,763.56
|
| Rate for Payer: Aetna of WY Medicare |
$450.68
|
| Rate for Payer: Beech Street Commercial |
$7,525.90
|
| Rate for Payer: Cash Price |
$5,545.40
|
| Rate for Payer: Cash Price |
$5,545.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,684.34
|
| Rate for Payer: Cigna of WY Commercial |
$7,763.56
|
| Rate for Payer: First Choice Health Commercial |
$7,129.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,525.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$450.68
|
| Rate for Payer: HealthUtah PPO |
$7,922.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,684.34
|
| Rate for Payer: Multiplan Medicare/VA |
$383.08
|
| Rate for Payer: One Health Plan of WY PPO |
$7,763.56
|
| Rate for Payer: PacificSource Commercial |
$7,129.80
|
| Rate for Payer: PHCS PPO |
$7,525.90
|
| Rate for Payer: Three Rivers PPO |
$5,941.50
|
| Rate for Payer: TriWest Veterans Administration |
$450.68
|
| Rate for Payer: United Healthcare Commercial |
$6,892.14
|
| Rate for Payer: United Healthcare Medicare |
$450.68
|
| Rate for Payer: WINHealth Partners Commercial |
$6,733.70
|
|
|
ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$7,922.00
|
|
|
Service Code
|
HCPCS 29895 80
|
| Hospital Charge Code |
29895
|
| Min. Negotiated Rate |
$383.08 |
| Max. Negotiated Rate |
$7,922.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,763.56
|
| Rate for Payer: Aetna of WY Medicare |
$450.68
|
| Rate for Payer: Beech Street Commercial |
$7,525.90
|
| Rate for Payer: Cash Price |
$5,545.40
|
| Rate for Payer: Cash Price |
$5,545.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,684.34
|
| Rate for Payer: Cigna of WY Commercial |
$7,763.56
|
| Rate for Payer: First Choice Health Commercial |
$7,129.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,525.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$450.68
|
| Rate for Payer: HealthUtah PPO |
$7,922.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,684.34
|
| Rate for Payer: Multiplan Medicare/VA |
$383.08
|
| Rate for Payer: One Health Plan of WY PPO |
$7,763.56
|
| Rate for Payer: PacificSource Commercial |
$7,129.80
|
| Rate for Payer: PHCS PPO |
$7,525.90
|
| Rate for Payer: Three Rivers PPO |
$5,941.50
|
| Rate for Payer: TriWest Veterans Administration |
$450.68
|
| Rate for Payer: United Healthcare Commercial |
$6,892.14
|
| Rate for Payer: United Healthcare Medicare |
$450.68
|
| Rate for Payer: WINHealth Partners Commercial |
$6,733.70
|
|
|
ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$6,031.00
|
|
|
Service Code
|
HCPCS 29894 AS
|
| Hospital Charge Code |
29894
|
| Min. Negotiated Rate |
$417.12 |
| Max. Negotiated Rate |
$6,031.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,910.38
|
| Rate for Payer: Aetna of WY Medicare |
$490.73
|
| Rate for Payer: Beech Street Commercial |
$5,729.45
|
| Rate for Payer: Cash Price |
$4,221.70
|
| Rate for Payer: Cash Price |
$4,221.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,850.07
|
| Rate for Payer: Cigna of WY Commercial |
$5,910.38
|
| Rate for Payer: First Choice Health Commercial |
$5,427.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,729.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$490.73
|
| Rate for Payer: HealthUtah PPO |
$6,031.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,850.07
|
| Rate for Payer: Multiplan Medicare/VA |
$417.12
|
| Rate for Payer: One Health Plan of WY PPO |
$5,910.38
|
| Rate for Payer: PacificSource Commercial |
$5,427.90
|
| Rate for Payer: PHCS PPO |
$5,729.45
|
| Rate for Payer: Three Rivers PPO |
$4,523.25
|
| Rate for Payer: TriWest Veterans Administration |
$490.73
|
| Rate for Payer: United Healthcare Commercial |
$5,246.97
|
| Rate for Payer: United Healthcare Medicare |
$490.73
|
| Rate for Payer: WINHealth Partners Commercial |
$5,126.35
|
|
|
ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$6,031.00
|
|
|
Service Code
|
HCPCS 29894
|
| Hospital Charge Code |
29894
|
| Min. Negotiated Rate |
$417.12 |
| Max. Negotiated Rate |
$6,031.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,910.38
|
| Rate for Payer: Aetna of WY Medicare |
$490.73
|
| Rate for Payer: Beech Street Commercial |
$5,729.45
|
| Rate for Payer: Cash Price |
$4,221.70
|
| Rate for Payer: Cash Price |
$4,221.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,850.07
|
| Rate for Payer: Cigna of WY Commercial |
$5,910.38
|
| Rate for Payer: First Choice Health Commercial |
$5,427.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,729.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$490.73
|
| Rate for Payer: HealthUtah PPO |
$6,031.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,850.07
|
| Rate for Payer: Multiplan Medicare/VA |
$417.12
|
| Rate for Payer: One Health Plan of WY PPO |
$5,910.38
|
| Rate for Payer: PacificSource Commercial |
$5,427.90
|
| Rate for Payer: PHCS PPO |
$5,729.45
|
| Rate for Payer: Three Rivers PPO |
$4,523.25
|
| Rate for Payer: TriWest Veterans Administration |
$490.73
|
| Rate for Payer: United Healthcare Commercial |
$5,246.97
|
| Rate for Payer: United Healthcare Medicare |
$490.73
|
| Rate for Payer: WINHealth Partners Commercial |
$5,126.35
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$3,056.00
|
|
|
Service Code
|
HCPCS 29838
|
| Hospital Charge Code |
29838
|
| Min. Negotiated Rate |
$493.35 |
| Max. Negotiated Rate |
$3,056.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,994.88
|
| Rate for Payer: Aetna of WY Medicare |
$580.41
|
| Rate for Payer: Beech Street Commercial |
$2,903.20
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,964.32
|
| Rate for Payer: Cigna of WY Commercial |
$2,994.88
|
| Rate for Payer: First Choice Health Commercial |
$2,750.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,903.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$580.41
|
| Rate for Payer: HealthUtah PPO |
$3,056.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,964.32
|
| Rate for Payer: Multiplan Medicare/VA |
$493.35
|
| Rate for Payer: One Health Plan of WY PPO |
$2,994.88
|
| Rate for Payer: PacificSource Commercial |
$2,750.40
|
| Rate for Payer: PHCS PPO |
$2,903.20
|
| Rate for Payer: Three Rivers PPO |
$2,292.00
|
| Rate for Payer: TriWest Veterans Administration |
$580.41
|
| Rate for Payer: United Healthcare Commercial |
$2,658.72
|
| Rate for Payer: United Healthcare Medicare |
$580.41
|
| Rate for Payer: WINHealth Partners Commercial |
$2,597.60
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$5,685.00
|
|
|
Service Code
|
HCPCS 29837 AS
|
| Hospital Charge Code |
29837
|
| Min. Negotiated Rate |
$435.37 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,571.30
|
| Rate for Payer: Aetna of WY Medicare |
$512.20
|
| Rate for Payer: Beech Street Commercial |
$5,400.75
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,514.45
|
| Rate for Payer: Cigna of WY Commercial |
$5,571.30
|
| Rate for Payer: First Choice Health Commercial |
$5,116.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,400.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$512.20
|
| Rate for Payer: HealthUtah PPO |
$5,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,514.45
|
| Rate for Payer: Multiplan Medicare/VA |
$435.37
|
| Rate for Payer: One Health Plan of WY PPO |
$5,571.30
|
| Rate for Payer: PacificSource Commercial |
$5,116.50
|
| Rate for Payer: PHCS PPO |
$5,400.75
|
| Rate for Payer: Three Rivers PPO |
$4,263.75
|
| Rate for Payer: TriWest Veterans Administration |
$512.20
|
| Rate for Payer: United Healthcare Commercial |
$4,945.95
|
| Rate for Payer: United Healthcare Medicare |
$512.20
|
| Rate for Payer: WINHealth Partners Commercial |
$4,832.25
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$5,685.00
|
|
|
Service Code
|
HCPCS 29837 80
|
| Hospital Charge Code |
29837
|
| Min. Negotiated Rate |
$435.37 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,571.30
|
| Rate for Payer: Aetna of WY Medicare |
$512.20
|
| Rate for Payer: Beech Street Commercial |
$5,400.75
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,514.45
|
| Rate for Payer: Cigna of WY Commercial |
$5,571.30
|
| Rate for Payer: First Choice Health Commercial |
$5,116.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,400.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$512.20
|
| Rate for Payer: HealthUtah PPO |
$5,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,514.45
|
| Rate for Payer: Multiplan Medicare/VA |
$435.37
|
| Rate for Payer: One Health Plan of WY PPO |
$5,571.30
|
| Rate for Payer: PacificSource Commercial |
$5,116.50
|
| Rate for Payer: PHCS PPO |
$5,400.75
|
| Rate for Payer: Three Rivers PPO |
$4,263.75
|
| Rate for Payer: TriWest Veterans Administration |
$512.20
|
| Rate for Payer: United Healthcare Commercial |
$4,945.95
|
| Rate for Payer: United Healthcare Medicare |
$512.20
|
| Rate for Payer: WINHealth Partners Commercial |
$4,832.25
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$5,685.00
|
|
|
Service Code
|
HCPCS 29837
|
| Hospital Charge Code |
29837
|
| Min. Negotiated Rate |
$435.37 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,571.30
|
| Rate for Payer: Aetna of WY Medicare |
$512.20
|
| Rate for Payer: Beech Street Commercial |
$5,400.75
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,514.45
|
| Rate for Payer: Cigna of WY Commercial |
$5,571.30
|
| Rate for Payer: First Choice Health Commercial |
$5,116.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,400.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$512.20
|
| Rate for Payer: HealthUtah PPO |
$5,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,514.45
|
| Rate for Payer: Multiplan Medicare/VA |
$435.37
|
| Rate for Payer: One Health Plan of WY PPO |
$5,571.30
|
| Rate for Payer: PacificSource Commercial |
$5,116.50
|
| Rate for Payer: PHCS PPO |
$5,400.75
|
| Rate for Payer: Three Rivers PPO |
$4,263.75
|
| Rate for Payer: TriWest Veterans Administration |
$512.20
|
| Rate for Payer: United Healthcare Commercial |
$4,945.95
|
| Rate for Payer: United Healthcare Medicare |
$512.20
|
| Rate for Payer: WINHealth Partners Commercial |
$4,832.25
|
|
|
ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$2,624.00
|
|
|
Service Code
|
HCPCS 29835 80
|
| Hospital Charge Code |
29835
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$2,624.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,571.52
|
| Rate for Payer: Aetna of WY Medicare |
$497.88
|
| Rate for Payer: Beech Street Commercial |
$2,492.80
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,545.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,571.52
|
| Rate for Payer: First Choice Health Commercial |
$2,361.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,492.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$497.88
|
| Rate for Payer: HealthUtah PPO |
$2,624.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,545.28
|
| Rate for Payer: Multiplan Medicare/VA |
$423.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2,571.52
|
| Rate for Payer: PacificSource Commercial |
$2,361.60
|
| Rate for Payer: PHCS PPO |
$2,492.80
|
| Rate for Payer: Three Rivers PPO |
$1,968.00
|
| Rate for Payer: TriWest Veterans Administration |
$497.88
|
| Rate for Payer: United Healthcare Commercial |
$2,282.88
|
| Rate for Payer: United Healthcare Medicare |
$497.88
|
| Rate for Payer: WINHealth Partners Commercial |
$2,230.40
|
|
|
ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$2,624.00
|
|
|
Service Code
|
HCPCS 29835
|
| Hospital Charge Code |
29835
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$2,624.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,571.52
|
| Rate for Payer: Aetna of WY Medicare |
$497.88
|
| Rate for Payer: Beech Street Commercial |
$2,492.80
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,545.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,571.52
|
| Rate for Payer: First Choice Health Commercial |
$2,361.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,492.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$497.88
|
| Rate for Payer: HealthUtah PPO |
$2,624.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,545.28
|
| Rate for Payer: Multiplan Medicare/VA |
$423.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2,571.52
|
| Rate for Payer: PacificSource Commercial |
$2,361.60
|
| Rate for Payer: PHCS PPO |
$2,492.80
|
| Rate for Payer: Three Rivers PPO |
$1,968.00
|
| Rate for Payer: TriWest Veterans Administration |
$497.88
|
| Rate for Payer: United Healthcare Commercial |
$2,282.88
|
| Rate for Payer: United Healthcare Medicare |
$497.88
|
| Rate for Payer: WINHealth Partners Commercial |
$2,230.40
|
|
|
ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$5,685.00
|
|
|
Service Code
|
HCPCS 29834 80
|
| Hospital Charge Code |
29834
|
| Min. Negotiated Rate |
$408.13 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,571.30
|
| Rate for Payer: Aetna of WY Medicare |
$480.15
|
| Rate for Payer: Beech Street Commercial |
$5,400.75
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,514.45
|
| Rate for Payer: Cigna of WY Commercial |
$5,571.30
|
| Rate for Payer: First Choice Health Commercial |
$5,116.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,400.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$480.15
|
| Rate for Payer: HealthUtah PPO |
$5,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,514.45
|
| Rate for Payer: Multiplan Medicare/VA |
$408.13
|
| Rate for Payer: One Health Plan of WY PPO |
$5,571.30
|
| Rate for Payer: PacificSource Commercial |
$5,116.50
|
| Rate for Payer: PHCS PPO |
$5,400.75
|
| Rate for Payer: Three Rivers PPO |
$4,263.75
|
| Rate for Payer: TriWest Veterans Administration |
$480.15
|
| Rate for Payer: United Healthcare Commercial |
$4,945.95
|
| Rate for Payer: United Healthcare Medicare |
$480.15
|
| Rate for Payer: WINHealth Partners Commercial |
$4,832.25
|
|
|
ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$5,685.00
|
|
|
Service Code
|
HCPCS 29834 AS
|
| Hospital Charge Code |
29834
|
| Min. Negotiated Rate |
$408.13 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,571.30
|
| Rate for Payer: Aetna of WY Medicare |
$480.15
|
| Rate for Payer: Beech Street Commercial |
$5,400.75
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,514.45
|
| Rate for Payer: Cigna of WY Commercial |
$5,571.30
|
| Rate for Payer: First Choice Health Commercial |
$5,116.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,400.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$480.15
|
| Rate for Payer: HealthUtah PPO |
$5,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,514.45
|
| Rate for Payer: Multiplan Medicare/VA |
$408.13
|
| Rate for Payer: One Health Plan of WY PPO |
$5,571.30
|
| Rate for Payer: PacificSource Commercial |
$5,116.50
|
| Rate for Payer: PHCS PPO |
$5,400.75
|
| Rate for Payer: Three Rivers PPO |
$4,263.75
|
| Rate for Payer: TriWest Veterans Administration |
$480.15
|
| Rate for Payer: United Healthcare Commercial |
$4,945.95
|
| Rate for Payer: United Healthcare Medicare |
$480.15
|
| Rate for Payer: WINHealth Partners Commercial |
$4,832.25
|
|
|
ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$5,685.00
|
|
|
Service Code
|
HCPCS 29834
|
| Hospital Charge Code |
29834
|
| Min. Negotiated Rate |
$408.13 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,571.30
|
| Rate for Payer: Aetna of WY Medicare |
$480.15
|
| Rate for Payer: Beech Street Commercial |
$5,400.75
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,514.45
|
| Rate for Payer: Cigna of WY Commercial |
$5,571.30
|
| Rate for Payer: First Choice Health Commercial |
$5,116.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,400.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$480.15
|
| Rate for Payer: HealthUtah PPO |
$5,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,514.45
|
| Rate for Payer: Multiplan Medicare/VA |
$408.13
|
| Rate for Payer: One Health Plan of WY PPO |
$5,571.30
|
| Rate for Payer: PacificSource Commercial |
$5,116.50
|
| Rate for Payer: PHCS PPO |
$5,400.75
|
| Rate for Payer: Three Rivers PPO |
$4,263.75
|
| Rate for Payer: TriWest Veterans Administration |
$480.15
|
| Rate for Payer: United Healthcare Commercial |
$4,945.95
|
| Rate for Payer: United Healthcare Medicare |
$480.15
|
| Rate for Payer: WINHealth Partners Commercial |
$4,832.25
|
|
