|
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 SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$6,742.00
|
|
|
Service Code
|
HCPCS 29876 50
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$539.62 |
| Max. Negotiated Rate |
$6,742.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,607.16
|
| Rate for Payer: Aetna of WY Medicare |
$634.85
|
| Rate for Payer: Beech Street Commercial |
$6,404.90
|
| Rate for Payer: Cash Price |
$4,719.40
|
| Rate for Payer: Cash Price |
$4,719.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,539.74
|
| Rate for Payer: Cigna of WY Commercial |
$6,607.16
|
| Rate for Payer: First Choice Health Commercial |
$6,067.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,404.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$634.85
|
| Rate for Payer: HealthUtah PPO |
$6,742.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,539.74
|
| Rate for Payer: Multiplan Medicare/VA |
$539.62
|
| Rate for Payer: One Health Plan of WY PPO |
$6,607.16
|
| Rate for Payer: PacificSource Commercial |
$6,067.80
|
| Rate for Payer: PHCS PPO |
$6,404.90
|
| Rate for Payer: Three Rivers PPO |
$5,056.50
|
| Rate for Payer: TriWest Veterans Administration |
$634.85
|
| Rate for Payer: United Healthcare Commercial |
$5,865.54
|
| Rate for Payer: United Healthcare Medicare |
$634.85
|
| Rate for Payer: WINHealth Partners Commercial |
$5,730.70
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$3,371.00
|
|
|
Service Code
|
HCPCS 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$539.62 |
| Max. Negotiated Rate |
$3,371.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,303.58
|
| Rate for Payer: Aetna of WY Medicare |
$634.85
|
| Rate for Payer: Beech Street Commercial |
$3,202.45
|
| Rate for Payer: Cash Price |
$2,359.70
|
| Rate for Payer: Cash Price |
$2,359.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,269.87
|
| Rate for Payer: Cigna of WY Commercial |
$3,303.58
|
| Rate for Payer: First Choice Health Commercial |
$3,033.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,202.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$634.85
|
| Rate for Payer: HealthUtah PPO |
$3,371.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,269.87
|
| Rate for Payer: Multiplan Medicare/VA |
$539.62
|
| Rate for Payer: One Health Plan of WY PPO |
$3,303.58
|
| Rate for Payer: PacificSource Commercial |
$3,033.90
|
| Rate for Payer: PHCS PPO |
$3,202.45
|
| Rate for Payer: Three Rivers PPO |
$2,528.25
|
| Rate for Payer: TriWest Veterans Administration |
$634.85
|
| Rate for Payer: United Healthcare Commercial |
$2,932.77
|
| Rate for Payer: United Healthcare Medicare |
$634.85
|
| Rate for Payer: WINHealth Partners Commercial |
$2,865.35
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$3,371.00
|
|
|
Service Code
|
HCPCS 29876 80
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$539.62 |
| Max. Negotiated Rate |
$3,371.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,303.58
|
| Rate for Payer: Aetna of WY Medicare |
$634.85
|
| Rate for Payer: Beech Street Commercial |
$3,202.45
|
| Rate for Payer: Cash Price |
$2,359.70
|
| Rate for Payer: Cash Price |
$2,359.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,269.87
|
| Rate for Payer: Cigna of WY Commercial |
$3,303.58
|
| Rate for Payer: First Choice Health Commercial |
$3,033.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,202.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$634.85
|
| Rate for Payer: HealthUtah PPO |
$3,371.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,269.87
|
| Rate for Payer: Multiplan Medicare/VA |
$539.62
|
| Rate for Payer: One Health Plan of WY PPO |
$3,303.58
|
| Rate for Payer: PacificSource Commercial |
$3,033.90
|
| Rate for Payer: PHCS PPO |
$3,202.45
|
| Rate for Payer: Three Rivers PPO |
$2,528.25
|
| Rate for Payer: TriWest Veterans Administration |
$634.85
|
| Rate for Payer: United Healthcare Commercial |
$2,932.77
|
| Rate for Payer: United Healthcare Medicare |
$634.85
|
| Rate for Payer: WINHealth Partners Commercial |
$2,865.35
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$3,371.00
|
|
|
Service Code
|
HCPCS 29876 AS
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$539.62 |
| Max. Negotiated Rate |
$3,371.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,303.58
|
| Rate for Payer: Aetna of WY Medicare |
$634.85
|
| Rate for Payer: Beech Street Commercial |
$3,202.45
|
| Rate for Payer: Cash Price |
$2,359.70
|
| Rate for Payer: Cash Price |
$2,359.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,269.87
|
| Rate for Payer: Cigna of WY Commercial |
$3,303.58
|
| Rate for Payer: First Choice Health Commercial |
$3,033.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,202.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$634.85
|
| Rate for Payer: HealthUtah PPO |
$3,371.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,269.87
|
| Rate for Payer: Multiplan Medicare/VA |
$539.62
|
| Rate for Payer: One Health Plan of WY PPO |
$3,303.58
|
| Rate for Payer: PacificSource Commercial |
$3,033.90
|
| Rate for Payer: PHCS PPO |
$3,202.45
|
| Rate for Payer: Three Rivers PPO |
$2,528.25
|
| Rate for Payer: TriWest Veterans Administration |
$634.85
|
| Rate for Payer: United Healthcare Commercial |
$2,932.77
|
| Rate for Payer: United Healthcare Medicare |
$634.85
|
| Rate for Payer: WINHealth Partners Commercial |
$2,865.35
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$2,560.00
|
|
|
Service Code
|
HCPCS 29875 AS
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$412.22 |
| 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 |
$484.96
|
| 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 |
$484.96
|
| Rate for Payer: HealthUtah PPO |
$2,560.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,483.20
|
| Rate for Payer: Multiplan Medicare/VA |
$412.22
|
| 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 |
$484.96
|
| Rate for Payer: United Healthcare Commercial |
$2,227.20
|
| Rate for Payer: United Healthcare Medicare |
$484.96
|
| Rate for Payer: WINHealth Partners Commercial |
$2,176.00
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$2,560.00
|
|
|
Service Code
|
HCPCS 29875 80
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$412.22 |
| 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 |
$484.96
|
| 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 |
$484.96
|
| Rate for Payer: HealthUtah PPO |
$2,560.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,483.20
|
| Rate for Payer: Multiplan Medicare/VA |
$412.22
|
| 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 |
$484.96
|
| Rate for Payer: United Healthcare Commercial |
$2,227.20
|
| Rate for Payer: United Healthcare Medicare |
$484.96
|
| Rate for Payer: WINHealth Partners Commercial |
$2,176.00
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$2,560.00
|
|
|
Service Code
|
HCPCS 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$412.22 |
| 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 |
$484.96
|
| 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 |
$484.96
|
| Rate for Payer: HealthUtah PPO |
$2,560.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,483.20
|
| Rate for Payer: Multiplan Medicare/VA |
$412.22
|
| 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 |
$484.96
|
| Rate for Payer: United Healthcare Commercial |
$2,227.20
|
| Rate for Payer: United Healthcare Medicare |
$484.96
|
| Rate for Payer: WINHealth Partners Commercial |
$2,176.00
|
|
|
ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 29884 80
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$512.86 |
| Max. Negotiated Rate |
$3,192.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,128.16
|
| Rate for Payer: Aetna of WY Medicare |
$603.37
|
| Rate for Payer: Beech Street Commercial |
$3,032.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,096.24
|
| Rate for Payer: Cigna of WY Commercial |
$3,128.16
|
| Rate for Payer: First Choice Health Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,032.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.37
|
| Rate for Payer: HealthUtah PPO |
$3,192.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,096.24
|
| Rate for Payer: Multiplan Medicare/VA |
$512.86
|
| Rate for Payer: One Health Plan of WY PPO |
$3,128.16
|
| Rate for Payer: PacificSource Commercial |
$2,872.80
|
| Rate for Payer: PHCS PPO |
$3,032.40
|
| Rate for Payer: Three Rivers PPO |
$2,394.00
|
| Rate for Payer: TriWest Veterans Administration |
$603.37
|
| Rate for Payer: United Healthcare Commercial |
$2,777.04
|
| Rate for Payer: United Healthcare Medicare |
$603.37
|
| Rate for Payer: WINHealth Partners Commercial |
$2,713.20
|
|
|
ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$512.86 |
| Max. Negotiated Rate |
$3,192.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,128.16
|
| Rate for Payer: Aetna of WY Medicare |
$603.37
|
| Rate for Payer: Beech Street Commercial |
$3,032.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,096.24
|
| Rate for Payer: Cigna of WY Commercial |
$3,128.16
|
| Rate for Payer: First Choice Health Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,032.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.37
|
| Rate for Payer: HealthUtah PPO |
$3,192.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,096.24
|
| Rate for Payer: Multiplan Medicare/VA |
$512.86
|
| Rate for Payer: One Health Plan of WY PPO |
$3,128.16
|
| Rate for Payer: PacificSource Commercial |
$2,872.80
|
| Rate for Payer: PHCS PPO |
$3,032.40
|
| Rate for Payer: Three Rivers PPO |
$2,394.00
|
| Rate for Payer: TriWest Veterans Administration |
$603.37
|
| Rate for Payer: United Healthcare Commercial |
$2,777.04
|
| Rate for Payer: United Healthcare Medicare |
$603.37
|
| Rate for Payer: WINHealth Partners Commercial |
$2,713.20
|
|
|
ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 29884 AS
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$512.86 |
| Max. Negotiated Rate |
$3,192.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,128.16
|
| Rate for Payer: Aetna of WY Medicare |
$603.37
|
| Rate for Payer: Beech Street Commercial |
$3,032.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,096.24
|
| Rate for Payer: Cigna of WY Commercial |
$3,128.16
|
| Rate for Payer: First Choice Health Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,032.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.37
|
| Rate for Payer: HealthUtah PPO |
$3,192.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,096.24
|
| Rate for Payer: Multiplan Medicare/VA |
$512.86
|
| Rate for Payer: One Health Plan of WY PPO |
$3,128.16
|
| Rate for Payer: PacificSource Commercial |
$2,872.80
|
| Rate for Payer: PHCS PPO |
$3,032.40
|
| Rate for Payer: Three Rivers PPO |
$2,394.00
|
| Rate for Payer: TriWest Veterans Administration |
$603.37
|
| Rate for Payer: United Healthcare Commercial |
$2,777.04
|
| Rate for Payer: United Healthcare Medicare |
$603.37
|
| Rate for Payer: WINHealth Partners Commercial |
$2,713.20
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$4,341.00
|
|
|
Service Code
|
HCPCS 29883 AS
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$693.90 |
| Max. Negotiated Rate |
$4,341.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,254.18
|
| Rate for Payer: Aetna of WY Medicare |
$816.35
|
| Rate for Payer: Beech Street Commercial |
$4,123.95
|
| Rate for Payer: Cash Price |
$3,038.70
|
| Rate for Payer: Cash Price |
$3,038.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,210.77
|
| Rate for Payer: Cigna of WY Commercial |
$4,254.18
|
| Rate for Payer: First Choice Health Commercial |
$3,906.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,123.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$816.35
|
| Rate for Payer: HealthUtah PPO |
$4,341.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,210.77
|
| Rate for Payer: Multiplan Medicare/VA |
$693.90
|
| Rate for Payer: One Health Plan of WY PPO |
$4,254.18
|
| Rate for Payer: PacificSource Commercial |
$3,906.90
|
| Rate for Payer: PHCS PPO |
$4,123.95
|
| Rate for Payer: Three Rivers PPO |
$3,255.75
|
| Rate for Payer: TriWest Veterans Administration |
$816.35
|
| Rate for Payer: United Healthcare Commercial |
$3,776.67
|
| Rate for Payer: United Healthcare Medicare |
$816.35
|
| Rate for Payer: WINHealth Partners Commercial |
$3,689.85
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$4,341.00
|
|
|
Service Code
|
HCPCS 29883 80
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$693.90 |
| Max. Negotiated Rate |
$4,341.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,254.18
|
| Rate for Payer: Aetna of WY Medicare |
$816.35
|
| Rate for Payer: Beech Street Commercial |
$4,123.95
|
| Rate for Payer: Cash Price |
$3,038.70
|
| Rate for Payer: Cash Price |
$3,038.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,210.77
|
| Rate for Payer: Cigna of WY Commercial |
$4,254.18
|
| Rate for Payer: First Choice Health Commercial |
$3,906.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,123.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$816.35
|
| Rate for Payer: HealthUtah PPO |
$4,341.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,210.77
|
| Rate for Payer: Multiplan Medicare/VA |
$693.90
|
| Rate for Payer: One Health Plan of WY PPO |
$4,254.18
|
| Rate for Payer: PacificSource Commercial |
$3,906.90
|
| Rate for Payer: PHCS PPO |
$4,123.95
|
| Rate for Payer: Three Rivers PPO |
$3,255.75
|
| Rate for Payer: TriWest Veterans Administration |
$816.35
|
| Rate for Payer: United Healthcare Commercial |
$3,776.67
|
| Rate for Payer: United Healthcare Medicare |
$816.35
|
| Rate for Payer: WINHealth Partners Commercial |
$3,689.85
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$4,341.00
|
|
|
Service Code
|
HCPCS 29883
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$693.90 |
| Max. Negotiated Rate |
$4,341.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,254.18
|
| Rate for Payer: Aetna of WY Medicare |
$816.35
|
| Rate for Payer: Beech Street Commercial |
$4,123.95
|
| Rate for Payer: Cash Price |
$3,038.70
|
| Rate for Payer: Cash Price |
$3,038.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,210.77
|
| Rate for Payer: Cigna of WY Commercial |
$4,254.18
|
| Rate for Payer: First Choice Health Commercial |
$3,906.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,123.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$816.35
|
| Rate for Payer: HealthUtah PPO |
$4,341.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,210.77
|
| Rate for Payer: Multiplan Medicare/VA |
$693.90
|
| Rate for Payer: One Health Plan of WY PPO |
$4,254.18
|
| Rate for Payer: PacificSource Commercial |
$3,906.90
|
| Rate for Payer: PHCS PPO |
$4,123.95
|
| Rate for Payer: Three Rivers PPO |
$3,255.75
|
| Rate for Payer: TriWest Veterans Administration |
$816.35
|
| Rate for Payer: United Healthcare Commercial |
$3,776.67
|
| Rate for Payer: United Healthcare Medicare |
$816.35
|
| Rate for Payer: WINHealth Partners Commercial |
$3,689.85
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$3,576.00
|
|
|
Service Code
|
HCPCS 29882 80
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$568.19 |
| Max. Negotiated Rate |
$3,576.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,504.48
|
| Rate for Payer: Aetna of WY Medicare |
$668.46
|
| Rate for Payer: Beech Street Commercial |
$3,397.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,468.72
|
| Rate for Payer: Cigna of WY Commercial |
$3,504.48
|
| Rate for Payer: First Choice Health Commercial |
$3,218.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,397.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.46
|
| Rate for Payer: HealthUtah PPO |
$3,576.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,468.72
|
| Rate for Payer: Multiplan Medicare/VA |
$568.19
|
| Rate for Payer: One Health Plan of WY PPO |
$3,504.48
|
| Rate for Payer: PacificSource Commercial |
$3,218.40
|
| Rate for Payer: PHCS PPO |
$3,397.20
|
| Rate for Payer: Three Rivers PPO |
$2,682.00
|
| Rate for Payer: TriWest Veterans Administration |
$668.46
|
| Rate for Payer: United Healthcare Commercial |
$3,111.12
|
| Rate for Payer: United Healthcare Medicare |
$668.46
|
| Rate for Payer: WINHealth Partners Commercial |
$3,039.60
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$3,576.00
|
|
|
Service Code
|
HCPCS 29882
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$568.19 |
| Max. Negotiated Rate |
$3,576.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,504.48
|
| Rate for Payer: Aetna of WY Medicare |
$668.46
|
| Rate for Payer: Beech Street Commercial |
$3,397.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,468.72
|
| Rate for Payer: Cigna of WY Commercial |
$3,504.48
|
| Rate for Payer: First Choice Health Commercial |
$3,218.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,397.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.46
|
| Rate for Payer: HealthUtah PPO |
$3,576.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,468.72
|
| Rate for Payer: Multiplan Medicare/VA |
$568.19
|
| Rate for Payer: One Health Plan of WY PPO |
$3,504.48
|
| Rate for Payer: PacificSource Commercial |
$3,218.40
|
| Rate for Payer: PHCS PPO |
$3,397.20
|
| Rate for Payer: Three Rivers PPO |
$2,682.00
|
| Rate for Payer: TriWest Veterans Administration |
$668.46
|
| Rate for Payer: United Healthcare Commercial |
$3,111.12
|
| Rate for Payer: United Healthcare Medicare |
$668.46
|
| Rate for Payer: WINHealth Partners Commercial |
$3,039.60
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$3,576.00
|
|
|
Service Code
|
HCPCS 29882 AS
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$568.19 |
| Max. Negotiated Rate |
$3,576.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,504.48
|
| Rate for Payer: Aetna of WY Medicare |
$668.46
|
| Rate for Payer: Beech Street Commercial |
$3,397.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,468.72
|
| Rate for Payer: Cigna of WY Commercial |
$3,504.48
|
| Rate for Payer: First Choice Health Commercial |
$3,218.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,397.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.46
|
| Rate for Payer: HealthUtah PPO |
$3,576.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,468.72
|
| Rate for Payer: Multiplan Medicare/VA |
$568.19
|
| Rate for Payer: One Health Plan of WY PPO |
$3,504.48
|
| Rate for Payer: PacificSource Commercial |
$3,218.40
|
| Rate for Payer: PHCS PPO |
$3,397.20
|
| Rate for Payer: Three Rivers PPO |
$2,682.00
|
| Rate for Payer: TriWest Veterans Administration |
$668.46
|
| Rate for Payer: United Healthcare Commercial |
$3,111.12
|
| Rate for Payer: United Healthcare Medicare |
$668.46
|
| Rate for Payer: WINHealth Partners Commercial |
$3,039.60
|
|
|
ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX
|
Professional
|
Both
|
$9,386.00
|
|
|
Service Code
|
HCPCS 29840
|
| Hospital Charge Code |
29840
|
| Min. Negotiated Rate |
$375.62 |
| Max. Negotiated Rate |
$9,386.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,198.28
|
| Rate for Payer: Aetna of WY Medicare |
$441.91
|
| Rate for Payer: Beech Street Commercial |
$8,916.70
|
| Rate for Payer: Cash Price |
$6,570.20
|
| Rate for Payer: Cash Price |
$6,570.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,104.42
|
| Rate for Payer: Cigna of WY Commercial |
$9,198.28
|
| Rate for Payer: First Choice Health Commercial |
$8,447.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,916.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$441.91
|
| Rate for Payer: HealthUtah PPO |
$9,386.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,104.42
|
| Rate for Payer: Multiplan Medicare/VA |
$375.62
|
| Rate for Payer: One Health Plan of WY PPO |
$9,198.28
|
| Rate for Payer: PacificSource Commercial |
$8,447.40
|
| Rate for Payer: PHCS PPO |
$8,916.70
|
| Rate for Payer: Three Rivers PPO |
$7,039.50
|
| Rate for Payer: TriWest Veterans Administration |
$441.91
|
| Rate for Payer: United Healthcare Commercial |
$8,165.82
|
| Rate for Payer: United Healthcare Medicare |
$441.91
|
| Rate for Payer: WINHealth Partners Commercial |
$7,978.10
|
|
|
ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$2,505.00
|
|
|
Service Code
|
HCPCS 29843
|
| Hospital Charge Code |
29843
|
| Min. Negotiated Rate |
$405.20 |
| Max. Negotiated Rate |
$2,505.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,454.90
|
| Rate for Payer: Aetna of WY Medicare |
$476.71
|
| Rate for Payer: Beech Street Commercial |
$2,379.75
|
| Rate for Payer: Cash Price |
$1,753.50
|
| Rate for Payer: Cash Price |
$1,753.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,429.85
|
| Rate for Payer: Cigna of WY Commercial |
$2,454.90
|
| Rate for Payer: First Choice Health Commercial |
$2,254.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,379.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$476.71
|
| Rate for Payer: HealthUtah PPO |
$2,505.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,429.85
|
| Rate for Payer: Multiplan Medicare/VA |
$405.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2,454.90
|
| Rate for Payer: PacificSource Commercial |
$2,254.50
|
| Rate for Payer: PHCS PPO |
$2,379.75
|
| Rate for Payer: Three Rivers PPO |
$1,878.75
|
| Rate for Payer: TriWest Veterans Administration |
$476.71
|
| Rate for Payer: United Healthcare Commercial |
$2,179.35
|
| Rate for Payer: United Healthcare Medicare |
$476.71
|
| Rate for Payer: WINHealth Partners Commercial |
$2,129.25
|
|
|
ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$2,505.00
|
|
|
Service Code
|
HCPCS 29843 80
|
| Hospital Charge Code |
29843
|
| Min. Negotiated Rate |
$405.20 |
| Max. Negotiated Rate |
$2,505.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,454.90
|
| Rate for Payer: Aetna of WY Medicare |
$476.71
|
| Rate for Payer: Beech Street Commercial |
$2,379.75
|
| Rate for Payer: Cash Price |
$1,753.50
|
| Rate for Payer: Cash Price |
$1,753.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,429.85
|
| Rate for Payer: Cigna of WY Commercial |
$2,454.90
|
| Rate for Payer: First Choice Health Commercial |
$2,254.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,379.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$476.71
|
| Rate for Payer: HealthUtah PPO |
$2,505.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,429.85
|
| Rate for Payer: Multiplan Medicare/VA |
$405.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2,454.90
|
| Rate for Payer: PacificSource Commercial |
$2,254.50
|
| Rate for Payer: PHCS PPO |
$2,379.75
|
| Rate for Payer: Three Rivers PPO |
$1,878.75
|
| Rate for Payer: TriWest Veterans Administration |
$476.71
|
| Rate for Payer: United Healthcare Commercial |
$2,179.35
|
| Rate for Payer: United Healthcare Medicare |
$476.71
|
| Rate for Payer: WINHealth Partners Commercial |
$2,129.25
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$6,692.00
|
|
|
Service Code
|
HCPCS 29845 80
|
| Hospital Charge Code |
29845
|
| Min. Negotiated Rate |
$486.75 |
| Max. Negotiated Rate |
$6,692.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,558.16
|
| Rate for Payer: Aetna of WY Medicare |
$572.65
|
| Rate for Payer: Beech Street Commercial |
$6,357.40
|
| Rate for Payer: Cash Price |
$4,684.40
|
| Rate for Payer: Cash Price |
$4,684.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,491.24
|
| Rate for Payer: Cigna of WY Commercial |
$6,558.16
|
| Rate for Payer: First Choice Health Commercial |
$6,022.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,357.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$572.65
|
| Rate for Payer: HealthUtah PPO |
$6,692.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,491.24
|
| Rate for Payer: Multiplan Medicare/VA |
$486.75
|
| Rate for Payer: One Health Plan of WY PPO |
$6,558.16
|
| Rate for Payer: PacificSource Commercial |
$6,022.80
|
| Rate for Payer: PHCS PPO |
$6,357.40
|
| Rate for Payer: Three Rivers PPO |
$5,019.00
|
| Rate for Payer: TriWest Veterans Administration |
$572.65
|
| Rate for Payer: United Healthcare Commercial |
$5,822.04
|
| Rate for Payer: United Healthcare Medicare |
$572.65
|
| Rate for Payer: WINHealth Partners Commercial |
$5,688.20
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$6,692.00
|
|
|
Service Code
|
HCPCS 29845
|
| Hospital Charge Code |
29845
|
| Min. Negotiated Rate |
$486.75 |
| Max. Negotiated Rate |
$6,692.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,558.16
|
| Rate for Payer: Aetna of WY Medicare |
$572.65
|
| Rate for Payer: Beech Street Commercial |
$6,357.40
|
| Rate for Payer: Cash Price |
$4,684.40
|
| Rate for Payer: Cash Price |
$4,684.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,491.24
|
| Rate for Payer: Cigna of WY Commercial |
$6,558.16
|
| Rate for Payer: First Choice Health Commercial |
$6,022.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,357.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$572.65
|
| Rate for Payer: HealthUtah PPO |
$6,692.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,491.24
|
| Rate for Payer: Multiplan Medicare/VA |
$486.75
|
| Rate for Payer: One Health Plan of WY PPO |
$6,558.16
|
| Rate for Payer: PacificSource Commercial |
$6,022.80
|
| Rate for Payer: PHCS PPO |
$6,357.40
|
| Rate for Payer: Three Rivers PPO |
$5,019.00
|
| Rate for Payer: TriWest Veterans Administration |
$572.65
|
| Rate for Payer: United Healthcare Commercial |
$5,822.04
|
| Rate for Payer: United Healthcare Medicare |
$572.65
|
| Rate for Payer: WINHealth Partners Commercial |
$5,688.20
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$6,692.00
|
|
|
Service Code
|
HCPCS 29845 AS
|
| Hospital Charge Code |
29845
|
| Min. Negotiated Rate |
$486.75 |
| Max. Negotiated Rate |
$6,692.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,558.16
|
| Rate for Payer: Aetna of WY Medicare |
$572.65
|
| Rate for Payer: Beech Street Commercial |
$6,357.40
|
| Rate for Payer: Cash Price |
$4,684.40
|
| Rate for Payer: Cash Price |
$4,684.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,491.24
|
| Rate for Payer: Cigna of WY Commercial |
$6,558.16
|
| Rate for Payer: First Choice Health Commercial |
$6,022.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,357.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$572.65
|
| Rate for Payer: HealthUtah PPO |
$6,692.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,491.24
|
| Rate for Payer: Multiplan Medicare/VA |
$486.75
|
| Rate for Payer: One Health Plan of WY PPO |
$6,558.16
|
| Rate for Payer: PacificSource Commercial |
$6,022.80
|
| Rate for Payer: PHCS PPO |
$6,357.40
|
| Rate for Payer: Three Rivers PPO |
$5,019.00
|
| Rate for Payer: TriWest Veterans Administration |
$572.65
|
| Rate for Payer: United Healthcare Commercial |
$5,822.04
|
| Rate for Payer: United Healthcare Medicare |
$572.65
|
| Rate for Payer: WINHealth Partners Commercial |
$5,688.20
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$6,496.00
|
|
|
Service Code
|
HCPCS 29844 AS
|
| Hospital Charge Code |
29844
|
| Min. Negotiated Rate |
$4,872.00 |
| Max. Negotiated Rate |
$6,496.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,366.08
|
| Rate for Payer: Beech Street Commercial |
$6,171.20
|
| Rate for Payer: Cash Price |
$4,547.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,301.12
|
| Rate for Payer: Cigna of WY Commercial |
$6,366.08
|
| Rate for Payer: First Choice Health Commercial |
$5,846.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,171.20
|
| Rate for Payer: HealthUtah PPO |
$6,496.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,301.12
|
| Rate for Payer: One Health Plan of WY PPO |
$6,366.08
|
| Rate for Payer: PacificSource Commercial |
$5,846.40
|
| Rate for Payer: PHCS PPO |
$6,171.20
|
| Rate for Payer: Three Rivers PPO |
$4,872.00
|
| Rate for Payer: United Healthcare Commercial |
$5,651.52
|
| Rate for Payer: WINHealth Partners Commercial |
$5,521.60
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$6,496.00
|
|
|
Service Code
|
HCPCS 29844
|
| Hospital Charge Code |
29844
|
| Min. Negotiated Rate |
$4,872.00 |
| Max. Negotiated Rate |
$6,496.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,366.08
|
| Rate for Payer: Beech Street Commercial |
$6,171.20
|
| Rate for Payer: Cash Price |
$4,547.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,301.12
|
| Rate for Payer: Cigna of WY Commercial |
$6,366.08
|
| Rate for Payer: First Choice Health Commercial |
$5,846.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,171.20
|
| Rate for Payer: HealthUtah PPO |
$6,496.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,301.12
|
| Rate for Payer: One Health Plan of WY PPO |
$6,366.08
|
| Rate for Payer: PacificSource Commercial |
$5,846.40
|
| Rate for Payer: PHCS PPO |
$6,171.20
|
| Rate for Payer: Three Rivers PPO |
$4,872.00
|
| Rate for Payer: United Healthcare Commercial |
$5,651.52
|
| Rate for Payer: WINHealth Partners Commercial |
$5,521.60
|
|
