|
ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,501.00
|
|
|
Service Code
|
HCPCS 29915 80
|
| Hospital Charge Code |
29915
|
| Min. Negotiated Rate |
$834.01 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,430.98
|
| Rate for Payer: Aetna of WY Medicare |
$981.19
|
| Rate for Payer: Beech Street Commercial |
$3,325.95
|
| Rate for Payer: Cash Price |
$2,450.70
|
| Rate for Payer: Cash Price |
$2,450.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,395.97
|
| Rate for Payer: Cigna of WY Commercial |
$3,430.98
|
| Rate for Payer: First Choice Health Commercial |
$3,150.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,325.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$981.19
|
| Rate for Payer: HealthUtah PPO |
$3,501.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,395.97
|
| Rate for Payer: Multiplan Medicare/VA |
$834.01
|
| Rate for Payer: One Health Plan of WY PPO |
$3,430.98
|
| Rate for Payer: PacificSource Commercial |
$3,150.90
|
| Rate for Payer: PHCS PPO |
$3,325.95
|
| Rate for Payer: Three Rivers PPO |
$2,625.75
|
| Rate for Payer: TriWest Veterans Administration |
$981.19
|
| Rate for Payer: United Healthcare Commercial |
$3,045.87
|
| Rate for Payer: United Healthcare Medicare |
$981.19
|
| Rate for Payer: WINHealth Partners Commercial |
$2,975.85
|
|
|
ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,501.00
|
|
|
Service Code
|
HCPCS 29915
|
| Hospital Charge Code |
29915
|
| Min. Negotiated Rate |
$834.01 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,430.98
|
| Rate for Payer: Aetna of WY Medicare |
$981.19
|
| Rate for Payer: Beech Street Commercial |
$3,325.95
|
| Rate for Payer: Cash Price |
$2,450.70
|
| Rate for Payer: Cash Price |
$2,450.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,395.97
|
| Rate for Payer: Cigna of WY Commercial |
$3,430.98
|
| Rate for Payer: First Choice Health Commercial |
$3,150.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,325.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$981.19
|
| Rate for Payer: HealthUtah PPO |
$3,501.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,395.97
|
| Rate for Payer: Multiplan Medicare/VA |
$834.01
|
| Rate for Payer: One Health Plan of WY PPO |
$3,430.98
|
| Rate for Payer: PacificSource Commercial |
$3,150.90
|
| Rate for Payer: PHCS PPO |
$3,325.95
|
| Rate for Payer: Three Rivers PPO |
$2,625.75
|
| Rate for Payer: TriWest Veterans Administration |
$981.19
|
| Rate for Payer: United Healthcare Commercial |
$3,045.87
|
| Rate for Payer: United Healthcare Medicare |
$981.19
|
| Rate for Payer: WINHealth Partners Commercial |
$2,975.85
|
|
|
ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,501.00
|
|
|
Service Code
|
HCPCS 29915 AS
|
| Hospital Charge Code |
29915
|
| Min. Negotiated Rate |
$834.01 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,430.98
|
| Rate for Payer: Aetna of WY Medicare |
$981.19
|
| Rate for Payer: Beech Street Commercial |
$3,325.95
|
| Rate for Payer: Cash Price |
$2,450.70
|
| Rate for Payer: Cash Price |
$2,450.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,395.97
|
| Rate for Payer: Cigna of WY Commercial |
$3,430.98
|
| Rate for Payer: First Choice Health Commercial |
$3,150.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,325.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$981.19
|
| Rate for Payer: HealthUtah PPO |
$3,501.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,395.97
|
| Rate for Payer: Multiplan Medicare/VA |
$834.01
|
| Rate for Payer: One Health Plan of WY PPO |
$3,430.98
|
| Rate for Payer: PacificSource Commercial |
$3,150.90
|
| Rate for Payer: PHCS PPO |
$3,325.95
|
| Rate for Payer: Three Rivers PPO |
$2,625.75
|
| Rate for Payer: TriWest Veterans Administration |
$981.19
|
| Rate for Payer: United Healthcare Commercial |
$3,045.87
|
| Rate for Payer: United Healthcare Medicare |
$981.19
|
| Rate for Payer: WINHealth Partners Commercial |
$2,975.85
|
|
|
ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 29914
|
| Hospital Charge Code |
29914
|
| Min. Negotiated Rate |
$813.93 |
| Max. Negotiated Rate |
$3,418.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,349.64
|
| Rate for Payer: Aetna of WY Medicare |
$957.57
|
| Rate for Payer: Beech Street Commercial |
$3,247.10
|
| Rate for Payer: Cash Price |
$2,392.60
|
| Rate for Payer: Cash Price |
$2,392.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,315.46
|
| Rate for Payer: Cigna of WY Commercial |
$3,349.64
|
| Rate for Payer: First Choice Health Commercial |
$3,076.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,247.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$957.57
|
| Rate for Payer: HealthUtah PPO |
$3,418.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,315.46
|
| Rate for Payer: Multiplan Medicare/VA |
$813.93
|
| Rate for Payer: One Health Plan of WY PPO |
$3,349.64
|
| Rate for Payer: PacificSource Commercial |
$3,076.20
|
| Rate for Payer: PHCS PPO |
$3,247.10
|
| Rate for Payer: Three Rivers PPO |
$2,563.50
|
| Rate for Payer: TriWest Veterans Administration |
$957.57
|
| Rate for Payer: United Healthcare Commercial |
$2,973.66
|
| Rate for Payer: United Healthcare Medicare |
$957.57
|
| Rate for Payer: WINHealth Partners Commercial |
$2,905.30
|
|
|
ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 29914 AS
|
| Hospital Charge Code |
29914
|
| Min. Negotiated Rate |
$813.93 |
| Max. Negotiated Rate |
$3,418.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,349.64
|
| Rate for Payer: Aetna of WY Medicare |
$957.57
|
| Rate for Payer: Beech Street Commercial |
$3,247.10
|
| Rate for Payer: Cash Price |
$2,392.60
|
| Rate for Payer: Cash Price |
$2,392.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,315.46
|
| Rate for Payer: Cigna of WY Commercial |
$3,349.64
|
| Rate for Payer: First Choice Health Commercial |
$3,076.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,247.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$957.57
|
| Rate for Payer: HealthUtah PPO |
$3,418.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,315.46
|
| Rate for Payer: Multiplan Medicare/VA |
$813.93
|
| Rate for Payer: One Health Plan of WY PPO |
$3,349.64
|
| Rate for Payer: PacificSource Commercial |
$3,076.20
|
| Rate for Payer: PHCS PPO |
$3,247.10
|
| Rate for Payer: Three Rivers PPO |
$2,563.50
|
| Rate for Payer: TriWest Veterans Administration |
$957.57
|
| Rate for Payer: United Healthcare Commercial |
$2,973.66
|
| Rate for Payer: United Healthcare Medicare |
$957.57
|
| Rate for Payer: WINHealth Partners Commercial |
$2,905.30
|
|
|
ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 29914 80
|
| Hospital Charge Code |
29914
|
| Min. Negotiated Rate |
$813.93 |
| Max. Negotiated Rate |
$3,418.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,349.64
|
| Rate for Payer: Aetna of WY Medicare |
$957.57
|
| Rate for Payer: Beech Street Commercial |
$3,247.10
|
| Rate for Payer: Cash Price |
$2,392.60
|
| Rate for Payer: Cash Price |
$2,392.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,315.46
|
| Rate for Payer: Cigna of WY Commercial |
$3,349.64
|
| Rate for Payer: First Choice Health Commercial |
$3,076.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,247.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$957.57
|
| Rate for Payer: HealthUtah PPO |
$3,418.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,315.46
|
| Rate for Payer: Multiplan Medicare/VA |
$813.93
|
| Rate for Payer: One Health Plan of WY PPO |
$3,349.64
|
| Rate for Payer: PacificSource Commercial |
$3,076.20
|
| Rate for Payer: PHCS PPO |
$3,247.10
|
| Rate for Payer: Three Rivers PPO |
$2,563.50
|
| Rate for Payer: TriWest Veterans Administration |
$957.57
|
| Rate for Payer: United Healthcare Commercial |
$2,973.66
|
| Rate for Payer: United Healthcare Medicare |
$957.57
|
| Rate for Payer: WINHealth Partners Commercial |
$2,905.30
|
|
|
ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,487.00
|
|
|
Service Code
|
HCPCS 29916 80
|
| Hospital Charge Code |
29916
|
| Min. Negotiated Rate |
$830.61 |
| Max. Negotiated Rate |
$3,487.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,417.26
|
| Rate for Payer: Aetna of WY Medicare |
$977.19
|
| Rate for Payer: Beech Street Commercial |
$3,312.65
|
| Rate for Payer: Cash Price |
$2,440.90
|
| Rate for Payer: Cash Price |
$2,440.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,382.39
|
| Rate for Payer: Cigna of WY Commercial |
$3,417.26
|
| Rate for Payer: First Choice Health Commercial |
$3,138.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,312.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$977.19
|
| Rate for Payer: HealthUtah PPO |
$3,487.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,382.39
|
| Rate for Payer: Multiplan Medicare/VA |
$830.61
|
| Rate for Payer: One Health Plan of WY PPO |
$3,417.26
|
| Rate for Payer: PacificSource Commercial |
$3,138.30
|
| Rate for Payer: PHCS PPO |
$3,312.65
|
| Rate for Payer: Three Rivers PPO |
$2,615.25
|
| Rate for Payer: TriWest Veterans Administration |
$977.19
|
| Rate for Payer: United Healthcare Commercial |
$3,033.69
|
| Rate for Payer: United Healthcare Medicare |
$977.19
|
| Rate for Payer: WINHealth Partners Commercial |
$2,963.95
|
|
|
ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,487.00
|
|
|
Service Code
|
HCPCS 29916 AS
|
| Hospital Charge Code |
29916
|
| Min. Negotiated Rate |
$830.61 |
| Max. Negotiated Rate |
$3,487.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,417.26
|
| Rate for Payer: Aetna of WY Medicare |
$977.19
|
| Rate for Payer: Beech Street Commercial |
$3,312.65
|
| Rate for Payer: Cash Price |
$2,440.90
|
| Rate for Payer: Cash Price |
$2,440.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,382.39
|
| Rate for Payer: Cigna of WY Commercial |
$3,417.26
|
| Rate for Payer: First Choice Health Commercial |
$3,138.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,312.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$977.19
|
| Rate for Payer: HealthUtah PPO |
$3,487.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,382.39
|
| Rate for Payer: Multiplan Medicare/VA |
$830.61
|
| Rate for Payer: One Health Plan of WY PPO |
$3,417.26
|
| Rate for Payer: PacificSource Commercial |
$3,138.30
|
| Rate for Payer: PHCS PPO |
$3,312.65
|
| Rate for Payer: Three Rivers PPO |
$2,615.25
|
| Rate for Payer: TriWest Veterans Administration |
$977.19
|
| Rate for Payer: United Healthcare Commercial |
$3,033.69
|
| Rate for Payer: United Healthcare Medicare |
$977.19
|
| Rate for Payer: WINHealth Partners Commercial |
$2,963.95
|
|
|
ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,487.00
|
|
|
Service Code
|
HCPCS 29916
|
| Hospital Charge Code |
29916
|
| Min. Negotiated Rate |
$830.61 |
| Max. Negotiated Rate |
$3,487.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,417.26
|
| Rate for Payer: Aetna of WY Medicare |
$977.19
|
| Rate for Payer: Beech Street Commercial |
$3,312.65
|
| Rate for Payer: Cash Price |
$2,440.90
|
| Rate for Payer: Cash Price |
$2,440.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,382.39
|
| Rate for Payer: Cigna of WY Commercial |
$3,417.26
|
| Rate for Payer: First Choice Health Commercial |
$3,138.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,312.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$977.19
|
| Rate for Payer: HealthUtah PPO |
$3,487.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,382.39
|
| Rate for Payer: Multiplan Medicare/VA |
$830.61
|
| Rate for Payer: One Health Plan of WY PPO |
$3,417.26
|
| Rate for Payer: PacificSource Commercial |
$3,138.30
|
| Rate for Payer: PHCS PPO |
$3,312.65
|
| Rate for Payer: Three Rivers PPO |
$2,615.25
|
| Rate for Payer: TriWest Veterans Administration |
$977.19
|
| Rate for Payer: United Healthcare Commercial |
$3,033.69
|
| Rate for Payer: United Healthcare Medicare |
$977.19
|
| Rate for Payer: WINHealth Partners Commercial |
$2,963.95
|
|
|
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$2,114.00
|
|
|
Service Code
|
HCPCS 29870
|
| Hospital Charge Code |
29870
|
| Min. Negotiated Rate |
$341.54 |
| Max. Negotiated Rate |
$2,114.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,071.72
|
| Rate for Payer: Aetna of WY Medicare |
$401.81
|
| Rate for Payer: Beech Street Commercial |
$2,008.30
|
| Rate for Payer: Cash Price |
$1,479.80
|
| Rate for Payer: Cash Price |
$1,479.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,050.58
|
| Rate for Payer: Cigna of WY Commercial |
$2,071.72
|
| Rate for Payer: First Choice Health Commercial |
$1,902.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,008.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$401.81
|
| Rate for Payer: HealthUtah PPO |
$2,114.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,050.58
|
| Rate for Payer: Multiplan Medicare/VA |
$341.54
|
| Rate for Payer: One Health Plan of WY PPO |
$2,071.72
|
| Rate for Payer: PacificSource Commercial |
$1,902.60
|
| Rate for Payer: PHCS PPO |
$2,008.30
|
| Rate for Payer: Three Rivers PPO |
$1,585.50
|
| Rate for Payer: TriWest Veterans Administration |
$401.81
|
| Rate for Payer: United Healthcare Commercial |
$1,839.18
|
| Rate for Payer: United Healthcare Medicare |
$401.81
|
| Rate for Payer: WINHealth Partners Commercial |
$1,796.90
|
|
|
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$4,228.00
|
|
|
Service Code
|
HCPCS 29870 50
|
| Hospital Charge Code |
29870
|
| Min. Negotiated Rate |
$341.54 |
| Max. Negotiated Rate |
$4,228.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,143.44
|
| Rate for Payer: Aetna of WY Medicare |
$401.81
|
| Rate for Payer: Beech Street Commercial |
$4,016.60
|
| Rate for Payer: Cash Price |
$2,959.60
|
| Rate for Payer: Cash Price |
$2,959.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,101.16
|
| Rate for Payer: Cigna of WY Commercial |
$4,143.44
|
| Rate for Payer: First Choice Health Commercial |
$3,805.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,016.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$401.81
|
| Rate for Payer: HealthUtah PPO |
$4,228.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,101.16
|
| Rate for Payer: Multiplan Medicare/VA |
$341.54
|
| Rate for Payer: One Health Plan of WY PPO |
$4,143.44
|
| Rate for Payer: PacificSource Commercial |
$3,805.20
|
| Rate for Payer: PHCS PPO |
$4,016.60
|
| Rate for Payer: Three Rivers PPO |
$3,171.00
|
| Rate for Payer: TriWest Veterans Administration |
$401.81
|
| Rate for Payer: United Healthcare Commercial |
$3,678.36
|
| Rate for Payer: United Healthcare Medicare |
$401.81
|
| Rate for Payer: WINHealth Partners Commercial |
$3,593.80
|
|
|
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$2,114.00
|
|
|
Service Code
|
HCPCS 29870 80
|
| Hospital Charge Code |
29870
|
| Min. Negotiated Rate |
$341.54 |
| Max. Negotiated Rate |
$2,114.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,071.72
|
| Rate for Payer: Aetna of WY Medicare |
$401.81
|
| Rate for Payer: Beech Street Commercial |
$2,008.30
|
| Rate for Payer: Cash Price |
$1,479.80
|
| Rate for Payer: Cash Price |
$1,479.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,050.58
|
| Rate for Payer: Cigna of WY Commercial |
$2,071.72
|
| Rate for Payer: First Choice Health Commercial |
$1,902.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,008.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$401.81
|
| Rate for Payer: HealthUtah PPO |
$2,114.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,050.58
|
| Rate for Payer: Multiplan Medicare/VA |
$341.54
|
| Rate for Payer: One Health Plan of WY PPO |
$2,071.72
|
| Rate for Payer: PacificSource Commercial |
$1,902.60
|
| Rate for Payer: PHCS PPO |
$2,008.30
|
| Rate for Payer: Three Rivers PPO |
$1,585.50
|
| Rate for Payer: TriWest Veterans Administration |
$401.81
|
| Rate for Payer: United Healthcare Commercial |
$1,839.18
|
| Rate for Payer: United Healthcare Medicare |
$401.81
|
| Rate for Payer: WINHealth Partners Commercial |
$1,796.90
|
|
|
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$2,114.00
|
|
|
Service Code
|
HCPCS 29870 AS
|
| Hospital Charge Code |
29870
|
| Min. Negotiated Rate |
$341.54 |
| Max. Negotiated Rate |
$2,114.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,071.72
|
| Rate for Payer: Aetna of WY Medicare |
$401.81
|
| Rate for Payer: Beech Street Commercial |
$2,008.30
|
| Rate for Payer: Cash Price |
$1,479.80
|
| Rate for Payer: Cash Price |
$1,479.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,050.58
|
| Rate for Payer: Cigna of WY Commercial |
$2,071.72
|
| Rate for Payer: First Choice Health Commercial |
$1,902.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,008.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$401.81
|
| Rate for Payer: HealthUtah PPO |
$2,114.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,050.58
|
| Rate for Payer: Multiplan Medicare/VA |
$341.54
|
| Rate for Payer: One Health Plan of WY PPO |
$2,071.72
|
| Rate for Payer: PacificSource Commercial |
$1,902.60
|
| Rate for Payer: PHCS PPO |
$2,008.30
|
| Rate for Payer: Three Rivers PPO |
$1,585.50
|
| Rate for Payer: TriWest Veterans Administration |
$401.81
|
| Rate for Payer: United Healthcare Commercial |
$1,839.18
|
| Rate for Payer: United Healthcare Medicare |
$401.81
|
| Rate for Payer: WINHealth Partners Commercial |
$1,796.90
|
|
|
ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$2,649.00
|
|
|
Service Code
|
HCPCS 29871 AS
|
| Hospital Charge Code |
29871
|
| Min. Negotiated Rate |
$427.72 |
| Max. Negotiated Rate |
$2,649.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,596.02
|
| Rate for Payer: Aetna of WY Medicare |
$503.20
|
| Rate for Payer: Beech Street Commercial |
$2,516.55
|
| Rate for Payer: Cash Price |
$1,854.30
|
| Rate for Payer: Cash Price |
$1,854.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,569.53
|
| Rate for Payer: Cigna of WY Commercial |
$2,596.02
|
| Rate for Payer: First Choice Health Commercial |
$2,384.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,516.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$503.20
|
| Rate for Payer: HealthUtah PPO |
$2,649.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,569.53
|
| Rate for Payer: Multiplan Medicare/VA |
$427.72
|
| Rate for Payer: One Health Plan of WY PPO |
$2,596.02
|
| Rate for Payer: PacificSource Commercial |
$2,384.10
|
| Rate for Payer: PHCS PPO |
$2,516.55
|
| Rate for Payer: Three Rivers PPO |
$1,986.75
|
| Rate for Payer: TriWest Veterans Administration |
$503.20
|
| Rate for Payer: United Healthcare Commercial |
$2,304.63
|
| Rate for Payer: United Healthcare Medicare |
$503.20
|
| Rate for Payer: WINHealth Partners Commercial |
$2,251.65
|
|
|
ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$2,649.00
|
|
|
Service Code
|
HCPCS 29871 80
|
| Hospital Charge Code |
29871
|
| Min. Negotiated Rate |
$427.72 |
| Max. Negotiated Rate |
$2,649.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,596.02
|
| Rate for Payer: Aetna of WY Medicare |
$503.20
|
| Rate for Payer: Beech Street Commercial |
$2,516.55
|
| Rate for Payer: Cash Price |
$1,854.30
|
| Rate for Payer: Cash Price |
$1,854.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,569.53
|
| Rate for Payer: Cigna of WY Commercial |
$2,596.02
|
| Rate for Payer: First Choice Health Commercial |
$2,384.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,516.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$503.20
|
| Rate for Payer: HealthUtah PPO |
$2,649.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,569.53
|
| Rate for Payer: Multiplan Medicare/VA |
$427.72
|
| Rate for Payer: One Health Plan of WY PPO |
$2,596.02
|
| Rate for Payer: PacificSource Commercial |
$2,384.10
|
| Rate for Payer: PHCS PPO |
$2,516.55
|
| Rate for Payer: Three Rivers PPO |
$1,986.75
|
| Rate for Payer: TriWest Veterans Administration |
$503.20
|
| Rate for Payer: United Healthcare Commercial |
$2,304.63
|
| Rate for Payer: United Healthcare Medicare |
$503.20
|
| Rate for Payer: WINHealth Partners Commercial |
$2,251.65
|
|
|
ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$2,649.00
|
|
|
Service Code
|
HCPCS 29871
|
| Hospital Charge Code |
29871
|
| Min. Negotiated Rate |
$427.72 |
| Max. Negotiated Rate |
$2,649.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,596.02
|
| Rate for Payer: Aetna of WY Medicare |
$503.20
|
| Rate for Payer: Beech Street Commercial |
$2,516.55
|
| Rate for Payer: Cash Price |
$1,854.30
|
| Rate for Payer: Cash Price |
$1,854.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,569.53
|
| Rate for Payer: Cigna of WY Commercial |
$2,596.02
|
| Rate for Payer: First Choice Health Commercial |
$2,384.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,516.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$503.20
|
| Rate for Payer: HealthUtah PPO |
$2,649.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,569.53
|
| Rate for Payer: Multiplan Medicare/VA |
$427.72
|
| Rate for Payer: One Health Plan of WY PPO |
$2,596.02
|
| Rate for Payer: PacificSource Commercial |
$2,384.10
|
| Rate for Payer: PHCS PPO |
$2,516.55
|
| Rate for Payer: Three Rivers PPO |
$1,986.75
|
| Rate for Payer: TriWest Veterans Administration |
$503.20
|
| Rate for Payer: United Healthcare Commercial |
$2,304.63
|
| Rate for Payer: United Healthcare Medicare |
$503.20
|
| Rate for Payer: WINHealth Partners Commercial |
$2,251.65
|
|
|
ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$5,459.00
|
|
|
Service Code
|
HCPCS 29873 50
|
| Hospital Charge Code |
29873
|
| Min. Negotiated Rate |
$448.42 |
| Max. Negotiated Rate |
$5,459.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,349.82
|
| Rate for Payer: Aetna of WY Medicare |
$527.55
|
| Rate for Payer: Beech Street Commercial |
$5,186.05
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,295.23
|
| Rate for Payer: Cigna of WY Commercial |
$5,349.82
|
| Rate for Payer: First Choice Health Commercial |
$4,913.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,186.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$527.55
|
| Rate for Payer: HealthUtah PPO |
$5,459.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,295.23
|
| Rate for Payer: Multiplan Medicare/VA |
$448.42
|
| Rate for Payer: One Health Plan of WY PPO |
$5,349.82
|
| Rate for Payer: PacificSource Commercial |
$4,913.10
|
| Rate for Payer: PHCS PPO |
$5,186.05
|
| Rate for Payer: Three Rivers PPO |
$4,094.25
|
| Rate for Payer: TriWest Veterans Administration |
$527.55
|
| Rate for Payer: United Healthcare Commercial |
$4,749.33
|
| Rate for Payer: United Healthcare Medicare |
$527.55
|
| Rate for Payer: WINHealth Partners Commercial |
$4,640.15
|
|
|
ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$2,730.00
|
|
|
Service Code
|
HCPCS 29873
|
| Hospital Charge Code |
29873
|
| Min. Negotiated Rate |
$448.42 |
| Max. Negotiated Rate |
$2,730.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,675.40
|
| Rate for Payer: Aetna of WY Medicare |
$527.55
|
| Rate for Payer: Beech Street Commercial |
$2,593.50
|
| Rate for Payer: Cash Price |
$1,911.00
|
| Rate for Payer: Cash Price |
$1,911.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,648.10
|
| Rate for Payer: Cigna of WY Commercial |
$2,675.40
|
| Rate for Payer: First Choice Health Commercial |
$2,457.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,593.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$527.55
|
| Rate for Payer: HealthUtah PPO |
$2,730.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,648.10
|
| Rate for Payer: Multiplan Medicare/VA |
$448.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,675.40
|
| Rate for Payer: PacificSource Commercial |
$2,457.00
|
| Rate for Payer: PHCS PPO |
$2,593.50
|
| Rate for Payer: Three Rivers PPO |
$2,047.50
|
| Rate for Payer: TriWest Veterans Administration |
$527.55
|
| Rate for Payer: United Healthcare Commercial |
$2,375.10
|
| Rate for Payer: United Healthcare Medicare |
$527.55
|
| Rate for Payer: WINHealth Partners Commercial |
$2,320.50
|
|
|
ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$2,730.00
|
|
|
Service Code
|
HCPCS 29873 AS
|
| Hospital Charge Code |
29873
|
| Min. Negotiated Rate |
$448.42 |
| Max. Negotiated Rate |
$2,730.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,675.40
|
| Rate for Payer: Aetna of WY Medicare |
$527.55
|
| Rate for Payer: Beech Street Commercial |
$2,593.50
|
| Rate for Payer: Cash Price |
$1,911.00
|
| Rate for Payer: Cash Price |
$1,911.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,648.10
|
| Rate for Payer: Cigna of WY Commercial |
$2,675.40
|
| Rate for Payer: First Choice Health Commercial |
$2,457.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,593.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$527.55
|
| Rate for Payer: HealthUtah PPO |
$2,730.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,648.10
|
| Rate for Payer: Multiplan Medicare/VA |
$448.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,675.40
|
| Rate for Payer: PacificSource Commercial |
$2,457.00
|
| Rate for Payer: PHCS PPO |
$2,593.50
|
| Rate for Payer: Three Rivers PPO |
$2,047.50
|
| Rate for Payer: TriWest Veterans Administration |
$527.55
|
| Rate for Payer: United Healthcare Commercial |
$2,375.10
|
| Rate for Payer: United Healthcare Medicare |
$527.55
|
| Rate for Payer: WINHealth Partners Commercial |
$2,320.50
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$5,418.00
|
|
|
Service Code
|
HCPCS 29866 80
|
| Hospital Charge Code |
29866
|
| Min. Negotiated Rate |
$865.09 |
| Max. Negotiated Rate |
$5,418.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,309.64
|
| Rate for Payer: Aetna of WY Medicare |
$1,017.75
|
| Rate for Payer: Beech Street Commercial |
$5,147.10
|
| Rate for Payer: Cash Price |
$3,792.60
|
| Rate for Payer: Cash Price |
$3,792.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,255.46
|
| Rate for Payer: Cigna of WY Commercial |
$5,309.64
|
| Rate for Payer: First Choice Health Commercial |
$4,876.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,147.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,017.75
|
| Rate for Payer: HealthUtah PPO |
$5,418.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,255.46
|
| Rate for Payer: Multiplan Medicare/VA |
$865.09
|
| Rate for Payer: One Health Plan of WY PPO |
$5,309.64
|
| Rate for Payer: PacificSource Commercial |
$4,876.20
|
| Rate for Payer: PHCS PPO |
$5,147.10
|
| Rate for Payer: Three Rivers PPO |
$4,063.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,017.75
|
| Rate for Payer: United Healthcare Commercial |
$4,713.66
|
| Rate for Payer: United Healthcare Medicare |
$1,017.75
|
| Rate for Payer: WINHealth Partners Commercial |
$4,605.30
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$5,418.00
|
|
|
Service Code
|
HCPCS 29866 AS
|
| Hospital Charge Code |
29866
|
| Min. Negotiated Rate |
$865.09 |
| Max. Negotiated Rate |
$5,418.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,309.64
|
| Rate for Payer: Aetna of WY Medicare |
$1,017.75
|
| Rate for Payer: Beech Street Commercial |
$5,147.10
|
| Rate for Payer: Cash Price |
$3,792.60
|
| Rate for Payer: Cash Price |
$3,792.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,255.46
|
| Rate for Payer: Cigna of WY Commercial |
$5,309.64
|
| Rate for Payer: First Choice Health Commercial |
$4,876.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,147.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,017.75
|
| Rate for Payer: HealthUtah PPO |
$5,418.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,255.46
|
| Rate for Payer: Multiplan Medicare/VA |
$865.09
|
| Rate for Payer: One Health Plan of WY PPO |
$5,309.64
|
| Rate for Payer: PacificSource Commercial |
$4,876.20
|
| Rate for Payer: PHCS PPO |
$5,147.10
|
| Rate for Payer: Three Rivers PPO |
$4,063.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,017.75
|
| Rate for Payer: United Healthcare Commercial |
$4,713.66
|
| Rate for Payer: United Healthcare Medicare |
$1,017.75
|
| Rate for Payer: WINHealth Partners Commercial |
$4,605.30
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$5,418.00
|
|
|
Service Code
|
HCPCS 29866
|
| Hospital Charge Code |
29866
|
| Min. Negotiated Rate |
$865.09 |
| Max. Negotiated Rate |
$5,418.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,309.64
|
| Rate for Payer: Aetna of WY Medicare |
$1,017.75
|
| Rate for Payer: Beech Street Commercial |
$5,147.10
|
| Rate for Payer: Cash Price |
$3,792.60
|
| Rate for Payer: Cash Price |
$3,792.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,255.46
|
| Rate for Payer: Cigna of WY Commercial |
$5,309.64
|
| Rate for Payer: First Choice Health Commercial |
$4,876.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,147.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,017.75
|
| Rate for Payer: HealthUtah PPO |
$5,418.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,255.46
|
| Rate for Payer: Multiplan Medicare/VA |
$865.09
|
| Rate for Payer: One Health Plan of WY PPO |
$5,309.64
|
| Rate for Payer: PacificSource Commercial |
$4,876.20
|
| Rate for Payer: PHCS PPO |
$5,147.10
|
| Rate for Payer: Three Rivers PPO |
$4,063.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,017.75
|
| Rate for Payer: United Healthcare Commercial |
$4,713.66
|
| Rate for Payer: United Healthcare Medicare |
$1,017.75
|
| Rate for Payer: WINHealth Partners Commercial |
$4,605.30
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT
|
Professional
|
Both
|
$6,594.00
|
|
|
Service Code
|
HCPCS 29867
|
| Hospital Charge Code |
29867
|
| Min. Negotiated Rate |
$1,047.36 |
| Max. Negotiated Rate |
$6,594.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,462.12
|
| Rate for Payer: Aetna of WY Medicare |
$1,232.19
|
| Rate for Payer: Beech Street Commercial |
$6,264.30
|
| Rate for Payer: Cash Price |
$4,615.80
|
| Rate for Payer: Cash Price |
$4,615.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,396.18
|
| Rate for Payer: Cigna of WY Commercial |
$6,462.12
|
| Rate for Payer: First Choice Health Commercial |
$5,934.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,264.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,232.19
|
| Rate for Payer: HealthUtah PPO |
$6,594.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,396.18
|
| Rate for Payer: Multiplan Medicare/VA |
$1,047.36
|
| Rate for Payer: One Health Plan of WY PPO |
$6,462.12
|
| Rate for Payer: PacificSource Commercial |
$5,934.60
|
| Rate for Payer: PHCS PPO |
$6,264.30
|
| Rate for Payer: Three Rivers PPO |
$4,945.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,232.19
|
| Rate for Payer: United Healthcare Commercial |
$5,736.78
|
| Rate for Payer: United Healthcare Medicare |
$1,232.19
|
| Rate for Payer: WINHealth Partners Commercial |
$5,604.90
|
|
|
ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,773.00
|
|
|
Service Code
|
HCPCS 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$445.92 |
| Max. Negotiated Rate |
$2,773.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,717.54
|
| Rate for Payer: Aetna of WY Medicare |
$524.61
|
| Rate for Payer: Beech Street Commercial |
$2,634.35
|
| Rate for Payer: Cash Price |
$1,941.10
|
| Rate for Payer: Cash Price |
$1,941.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,689.81
|
| Rate for Payer: Cigna of WY Commercial |
$2,717.54
|
| Rate for Payer: First Choice Health Commercial |
$2,495.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,634.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$524.61
|
| Rate for Payer: HealthUtah PPO |
$2,773.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,689.81
|
| Rate for Payer: Multiplan Medicare/VA |
$445.92
|
| Rate for Payer: One Health Plan of WY PPO |
$2,717.54
|
| Rate for Payer: PacificSource Commercial |
$2,495.70
|
| Rate for Payer: PHCS PPO |
$2,634.35
|
| Rate for Payer: Three Rivers PPO |
$2,079.75
|
| Rate for Payer: TriWest Veterans Administration |
$524.61
|
| Rate for Payer: United Healthcare Commercial |
$2,412.51
|
| Rate for Payer: United Healthcare Medicare |
$524.61
|
| Rate for Payer: WINHealth Partners Commercial |
$2,357.05
|
|
|
ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,773.00
|
|
|
Service Code
|
HCPCS 29874 AS
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$445.92 |
| Max. Negotiated Rate |
$2,773.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,717.54
|
| Rate for Payer: Aetna of WY Medicare |
$524.61
|
| Rate for Payer: Beech Street Commercial |
$2,634.35
|
| Rate for Payer: Cash Price |
$1,941.10
|
| Rate for Payer: Cash Price |
$1,941.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,689.81
|
| Rate for Payer: Cigna of WY Commercial |
$2,717.54
|
| Rate for Payer: First Choice Health Commercial |
$2,495.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,634.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$524.61
|
| Rate for Payer: HealthUtah PPO |
$2,773.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,689.81
|
| Rate for Payer: Multiplan Medicare/VA |
$445.92
|
| Rate for Payer: One Health Plan of WY PPO |
$2,717.54
|
| Rate for Payer: PacificSource Commercial |
$2,495.70
|
| Rate for Payer: PHCS PPO |
$2,634.35
|
| Rate for Payer: Three Rivers PPO |
$2,079.75
|
| Rate for Payer: TriWest Veterans Administration |
$524.61
|
| Rate for Payer: United Healthcare Commercial |
$2,412.51
|
| Rate for Payer: United Healthcare Medicare |
$524.61
|
| Rate for Payer: WINHealth Partners Commercial |
$2,357.05
|
|
