ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,239.00
|
|
Service Code
|
HCPCS 27610
|
Hospital Charge Code |
27610
|
Min. Negotiated Rate |
$533.12 |
Max. Negotiated Rate |
$2,239.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,194.22
|
Rate for Payer: Aetna of WY Medicare |
$627.20
|
Rate for Payer: Beech Street Commercial |
$2,127.05
|
Rate for Payer: Cash Price |
$1,567.30
|
Rate for Payer: Cash Price |
$1,567.30
|
Rate for Payer: ChoiceCare Network Commercial |
$2,171.83
|
Rate for Payer: Cigna of WY Commercial |
$2,194.22
|
Rate for Payer: First Choice Health Commercial |
$2,015.10
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,127.05
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$627.20
|
Rate for Payer: HealthUtah PPO |
$2,239.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,171.83
|
Rate for Payer: Multiplan Medicare/VA |
$533.12
|
Rate for Payer: One Health Plan of WY PPO |
$2,194.22
|
Rate for Payer: PacificSource Commercial |
$2,015.10
|
Rate for Payer: PHCS PPO |
$2,127.05
|
Rate for Payer: Three Rivers PPO |
$1,679.25
|
Rate for Payer: TriWest Veterans Administration |
$627.20
|
Rate for Payer: United Healthcare Commercial |
$1,947.93
|
Rate for Payer: United Healthcare Medicare |
$627.20
|
Rate for Payer: WINHealth Partners Commercial |
$1,903.15
|
|
ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,239.00
|
|
Service Code
|
HCPCS 27610 AS
|
Hospital Charge Code |
27610
|
Min. Negotiated Rate |
$533.12 |
Max. Negotiated Rate |
$2,239.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,194.22
|
Rate for Payer: Aetna of WY Medicare |
$627.20
|
Rate for Payer: Beech Street Commercial |
$2,127.05
|
Rate for Payer: Cash Price |
$1,567.30
|
Rate for Payer: Cash Price |
$1,567.30
|
Rate for Payer: ChoiceCare Network Commercial |
$2,171.83
|
Rate for Payer: Cigna of WY Commercial |
$2,194.22
|
Rate for Payer: First Choice Health Commercial |
$2,015.10
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,127.05
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$627.20
|
Rate for Payer: HealthUtah PPO |
$2,239.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,171.83
|
Rate for Payer: Multiplan Medicare/VA |
$533.12
|
Rate for Payer: One Health Plan of WY PPO |
$2,194.22
|
Rate for Payer: PacificSource Commercial |
$2,015.10
|
Rate for Payer: PHCS PPO |
$2,127.05
|
Rate for Payer: Three Rivers PPO |
$1,679.25
|
Rate for Payer: TriWest Veterans Administration |
$627.20
|
Rate for Payer: United Healthcare Commercial |
$1,947.93
|
Rate for Payer: United Healthcare Medicare |
$627.20
|
Rate for Payer: WINHealth Partners Commercial |
$1,903.15
|
|
ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,665.00
|
|
Service Code
|
HCPCS 26110
|
Hospital Charge Code |
26110
|
Min. Negotiated Rate |
$274.35 |
Max. Negotiated Rate |
$1,665.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,631.70
|
Rate for Payer: Aetna of WY Medicare |
$322.77
|
Rate for Payer: Beech Street Commercial |
$1,581.75
|
Rate for Payer: Cash Price |
$1,165.50
|
Rate for Payer: Cash Price |
$1,165.50
|
Rate for Payer: ChoiceCare Network Commercial |
$1,615.05
|
Rate for Payer: Cigna of WY Commercial |
$1,631.70
|
Rate for Payer: First Choice Health Commercial |
$1,498.50
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,581.75
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$322.77
|
Rate for Payer: HealthUtah PPO |
$1,665.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,615.05
|
Rate for Payer: Multiplan Medicare/VA |
$274.35
|
Rate for Payer: One Health Plan of WY PPO |
$1,631.70
|
Rate for Payer: PacificSource Commercial |
$1,498.50
|
Rate for Payer: PHCS PPO |
$1,581.75
|
Rate for Payer: Three Rivers PPO |
$1,248.75
|
Rate for Payer: TriWest Veterans Administration |
$322.77
|
Rate for Payer: United Healthcare Commercial |
$1,448.55
|
Rate for Payer: United Healthcare Medicare |
$322.77
|
Rate for Payer: WINHealth Partners Commercial |
$1,415.25
|
|
ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$3,174.00
|
|
Service Code
|
HCPCS 25107 AS
|
Hospital Charge Code |
25107
|
Min. Negotiated Rate |
$516.13 |
Max. Negotiated Rate |
$3,174.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,110.52
|
Rate for Payer: Aetna of WY Medicare |
$607.21
|
Rate for Payer: Beech Street Commercial |
$3,015.30
|
Rate for Payer: Cash Price |
$2,221.80
|
Rate for Payer: Cash Price |
$2,221.80
|
Rate for Payer: ChoiceCare Network Commercial |
$3,078.78
|
Rate for Payer: Cigna of WY Commercial |
$3,110.52
|
Rate for Payer: First Choice Health Commercial |
$2,856.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,015.30
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$607.21
|
Rate for Payer: HealthUtah PPO |
$3,174.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,078.78
|
Rate for Payer: Multiplan Medicare/VA |
$516.13
|
Rate for Payer: One Health Plan of WY PPO |
$3,110.52
|
Rate for Payer: PacificSource Commercial |
$2,856.60
|
Rate for Payer: PHCS PPO |
$3,015.30
|
Rate for Payer: Three Rivers PPO |
$2,380.50
|
Rate for Payer: TriWest Veterans Administration |
$607.21
|
Rate for Payer: United Healthcare Commercial |
$2,761.38
|
Rate for Payer: United Healthcare Medicare |
$607.21
|
Rate for Payer: WINHealth Partners Commercial |
$2,697.90
|
|
ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$3,174.00
|
|
Service Code
|
HCPCS 25107
|
Hospital Charge Code |
25107
|
Min. Negotiated Rate |
$516.13 |
Max. Negotiated Rate |
$3,174.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,110.52
|
Rate for Payer: Aetna of WY Medicare |
$607.21
|
Rate for Payer: Beech Street Commercial |
$3,015.30
|
Rate for Payer: Cash Price |
$2,221.80
|
Rate for Payer: Cash Price |
$2,221.80
|
Rate for Payer: ChoiceCare Network Commercial |
$3,078.78
|
Rate for Payer: Cigna of WY Commercial |
$3,110.52
|
Rate for Payer: First Choice Health Commercial |
$2,856.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,015.30
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$607.21
|
Rate for Payer: HealthUtah PPO |
$3,174.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,078.78
|
Rate for Payer: Multiplan Medicare/VA |
$516.13
|
Rate for Payer: One Health Plan of WY PPO |
$3,110.52
|
Rate for Payer: PacificSource Commercial |
$2,856.60
|
Rate for Payer: PHCS PPO |
$3,015.30
|
Rate for Payer: Three Rivers PPO |
$2,380.50
|
Rate for Payer: TriWest Veterans Administration |
$607.21
|
Rate for Payer: United Healthcare Commercial |
$2,761.38
|
Rate for Payer: United Healthcare Medicare |
$607.21
|
Rate for Payer: WINHealth Partners Commercial |
$2,697.90
|
|
ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$2,153.00
|
|
Service Code
|
HCPCS 24102
|
Hospital Charge Code |
24102
|
Min. Negotiated Rate |
$512.75 |
Max. Negotiated Rate |
$2,153.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,109.94
|
Rate for Payer: Aetna of WY Medicare |
$603.23
|
Rate for Payer: Beech Street Commercial |
$2,045.35
|
Rate for Payer: Cash Price |
$1,507.10
|
Rate for Payer: Cash Price |
$1,507.10
|
Rate for Payer: ChoiceCare Network Commercial |
$2,088.41
|
Rate for Payer: Cigna of WY Commercial |
$2,109.94
|
Rate for Payer: First Choice Health Commercial |
$1,937.70
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,045.35
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.23
|
Rate for Payer: HealthUtah PPO |
$2,153.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,088.41
|
Rate for Payer: Multiplan Medicare/VA |
$512.75
|
Rate for Payer: One Health Plan of WY PPO |
$2,109.94
|
Rate for Payer: PacificSource Commercial |
$1,937.70
|
Rate for Payer: PHCS PPO |
$2,045.35
|
Rate for Payer: Three Rivers PPO |
$1,614.75
|
Rate for Payer: TriWest Veterans Administration |
$603.23
|
Rate for Payer: United Healthcare Commercial |
$1,873.11
|
Rate for Payer: United Healthcare Medicare |
$603.23
|
Rate for Payer: WINHealth Partners Commercial |
$1,830.05
|
|
ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$2,153.00
|
|
Service Code
|
HCPCS 24102 AS
|
Hospital Charge Code |
24102
|
Min. Negotiated Rate |
$512.75 |
Max. Negotiated Rate |
$2,153.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,109.94
|
Rate for Payer: Aetna of WY Medicare |
$603.23
|
Rate for Payer: Beech Street Commercial |
$2,045.35
|
Rate for Payer: Cash Price |
$1,507.10
|
Rate for Payer: Cash Price |
$1,507.10
|
Rate for Payer: ChoiceCare Network Commercial |
$2,088.41
|
Rate for Payer: Cigna of WY Commercial |
$2,109.94
|
Rate for Payer: First Choice Health Commercial |
$1,937.70
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,045.35
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.23
|
Rate for Payer: HealthUtah PPO |
$2,153.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,088.41
|
Rate for Payer: Multiplan Medicare/VA |
$512.75
|
Rate for Payer: One Health Plan of WY PPO |
$2,109.94
|
Rate for Payer: PacificSource Commercial |
$1,937.70
|
Rate for Payer: PHCS PPO |
$2,045.35
|
Rate for Payer: Three Rivers PPO |
$1,614.75
|
Rate for Payer: TriWest Veterans Administration |
$603.23
|
Rate for Payer: United Healthcare Commercial |
$1,873.11
|
Rate for Payer: United Healthcare Medicare |
$603.23
|
Rate for Payer: WINHealth Partners Commercial |
$1,830.05
|
|
ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$3,678.00
|
|
Service Code
|
HCPCS 23040
|
Hospital Charge Code |
23040
|
Min. Negotiated Rate |
$592.87 |
Max. Negotiated Rate |
$3,678.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,604.44
|
Rate for Payer: Aetna of WY Medicare |
$697.49
|
Rate for Payer: Beech Street Commercial |
$3,494.10
|
Rate for Payer: Cash Price |
$2,574.60
|
Rate for Payer: Cash Price |
$2,574.60
|
Rate for Payer: ChoiceCare Network Commercial |
$3,567.66
|
Rate for Payer: Cigna of WY Commercial |
$3,604.44
|
Rate for Payer: First Choice Health Commercial |
$3,310.20
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,494.10
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$697.49
|
Rate for Payer: HealthUtah PPO |
$3,678.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,567.66
|
Rate for Payer: Multiplan Medicare/VA |
$592.87
|
Rate for Payer: One Health Plan of WY PPO |
$3,604.44
|
Rate for Payer: PacificSource Commercial |
$3,310.20
|
Rate for Payer: PHCS PPO |
$3,494.10
|
Rate for Payer: Three Rivers PPO |
$2,758.50
|
Rate for Payer: TriWest Veterans Administration |
$697.49
|
Rate for Payer: United Healthcare Commercial |
$3,199.86
|
Rate for Payer: United Healthcare Medicare |
$697.49
|
Rate for Payer: WINHealth Partners Commercial |
$3,126.30
|
|
ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$4,844.00
|
|
Service Code
|
HCPCS 27030 AS
|
Hospital Charge Code |
27030
|
Min. Negotiated Rate |
$767.40 |
Max. Negotiated Rate |
$4,844.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,747.12
|
Rate for Payer: Aetna of WY Medicare |
$902.82
|
Rate for Payer: Beech Street Commercial |
$4,601.80
|
Rate for Payer: Cash Price |
$3,390.80
|
Rate for Payer: Cash Price |
$3,390.80
|
Rate for Payer: ChoiceCare Network Commercial |
$4,698.68
|
Rate for Payer: Cigna of WY Commercial |
$4,747.12
|
Rate for Payer: First Choice Health Commercial |
$4,359.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,601.80
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$902.82
|
Rate for Payer: HealthUtah PPO |
$4,844.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,698.68
|
Rate for Payer: Multiplan Medicare/VA |
$767.40
|
Rate for Payer: One Health Plan of WY PPO |
$4,747.12
|
Rate for Payer: PacificSource Commercial |
$4,359.60
|
Rate for Payer: PHCS PPO |
$4,601.80
|
Rate for Payer: Three Rivers PPO |
$3,633.00
|
Rate for Payer: TriWest Veterans Administration |
$902.82
|
Rate for Payer: United Healthcare Commercial |
$4,214.28
|
Rate for Payer: United Healthcare Medicare |
$902.82
|
Rate for Payer: WINHealth Partners Commercial |
$4,117.40
|
|
ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$4,844.00
|
|
Service Code
|
HCPCS 27030
|
Hospital Charge Code |
27030
|
Min. Negotiated Rate |
$767.40 |
Max. Negotiated Rate |
$4,844.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,747.12
|
Rate for Payer: Aetna of WY Medicare |
$902.82
|
Rate for Payer: Beech Street Commercial |
$4,601.80
|
Rate for Payer: Cash Price |
$3,390.80
|
Rate for Payer: Cash Price |
$3,390.80
|
Rate for Payer: ChoiceCare Network Commercial |
$4,698.68
|
Rate for Payer: Cigna of WY Commercial |
$4,747.12
|
Rate for Payer: First Choice Health Commercial |
$4,359.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,601.80
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$902.82
|
Rate for Payer: HealthUtah PPO |
$4,844.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,698.68
|
Rate for Payer: Multiplan Medicare/VA |
$767.40
|
Rate for Payer: One Health Plan of WY PPO |
$4,747.12
|
Rate for Payer: PacificSource Commercial |
$4,359.60
|
Rate for Payer: PHCS PPO |
$4,601.80
|
Rate for Payer: Three Rivers PPO |
$3,633.00
|
Rate for Payer: TriWest Veterans Administration |
$902.82
|
Rate for Payer: United Healthcare Commercial |
$4,214.28
|
Rate for Payer: United Healthcare Medicare |
$902.82
|
Rate for Payer: WINHealth Partners Commercial |
$4,117.40
|
|
ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$6,107.00
|
|
Service Code
|
HCPCS 27330
|
Hospital Charge Code |
27330
|
Min. Negotiated Rate |
$354.05 |
Max. Negotiated Rate |
$6,107.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,984.86
|
Rate for Payer: Aetna of WY Medicare |
$416.53
|
Rate for Payer: Beech Street Commercial |
$5,801.65
|
Rate for Payer: Cash Price |
$4,274.90
|
Rate for Payer: Cash Price |
$4,274.90
|
Rate for Payer: ChoiceCare Network Commercial |
$5,923.79
|
Rate for Payer: Cigna of WY Commercial |
$5,984.86
|
Rate for Payer: First Choice Health Commercial |
$5,496.30
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,801.65
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$416.53
|
Rate for Payer: HealthUtah PPO |
$6,107.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,923.79
|
Rate for Payer: Multiplan Medicare/VA |
$354.05
|
Rate for Payer: One Health Plan of WY PPO |
$5,984.86
|
Rate for Payer: PacificSource Commercial |
$5,496.30
|
Rate for Payer: PHCS PPO |
$5,801.65
|
Rate for Payer: Three Rivers PPO |
$4,580.25
|
Rate for Payer: TriWest Veterans Administration |
$416.53
|
Rate for Payer: United Healthcare Commercial |
$5,313.09
|
Rate for Payer: United Healthcare Medicare |
$416.53
|
Rate for Payer: WINHealth Partners Commercial |
$5,190.95
|
|
ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,246.00
|
|
Service Code
|
HCPCS 27403 80
|
Hospital Charge Code |
27403
|
Min. Negotiated Rate |
$534.96 |
Max. Negotiated Rate |
$2,246.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,201.08
|
Rate for Payer: Aetna of WY Medicare |
$629.36
|
Rate for Payer: Beech Street Commercial |
$2,133.70
|
Rate for Payer: Cash Price |
$1,572.20
|
Rate for Payer: Cash Price |
$1,572.20
|
Rate for Payer: ChoiceCare Network Commercial |
$2,178.62
|
Rate for Payer: Cigna of WY Commercial |
$2,201.08
|
Rate for Payer: First Choice Health Commercial |
$2,021.40
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,133.70
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$629.36
|
Rate for Payer: HealthUtah PPO |
$2,246.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,178.62
|
Rate for Payer: Multiplan Medicare/VA |
$534.96
|
Rate for Payer: One Health Plan of WY PPO |
$2,201.08
|
Rate for Payer: PacificSource Commercial |
$2,021.40
|
Rate for Payer: PHCS PPO |
$2,133.70
|
Rate for Payer: Three Rivers PPO |
$1,684.50
|
Rate for Payer: TriWest Veterans Administration |
$629.36
|
Rate for Payer: United Healthcare Commercial |
$1,954.02
|
Rate for Payer: United Healthcare Medicare |
$629.36
|
Rate for Payer: WINHealth Partners Commercial |
$1,909.10
|
|
ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,246.00
|
|
Service Code
|
HCPCS 27403
|
Hospital Charge Code |
27403
|
Min. Negotiated Rate |
$534.96 |
Max. Negotiated Rate |
$2,246.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,201.08
|
Rate for Payer: Aetna of WY Medicare |
$629.36
|
Rate for Payer: Beech Street Commercial |
$2,133.70
|
Rate for Payer: Cash Price |
$1,572.20
|
Rate for Payer: Cash Price |
$1,572.20
|
Rate for Payer: ChoiceCare Network Commercial |
$2,178.62
|
Rate for Payer: Cigna of WY Commercial |
$2,201.08
|
Rate for Payer: First Choice Health Commercial |
$2,021.40
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,133.70
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$629.36
|
Rate for Payer: HealthUtah PPO |
$2,246.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,178.62
|
Rate for Payer: Multiplan Medicare/VA |
$534.96
|
Rate for Payer: One Health Plan of WY PPO |
$2,201.08
|
Rate for Payer: PacificSource Commercial |
$2,021.40
|
Rate for Payer: PHCS PPO |
$2,133.70
|
Rate for Payer: Three Rivers PPO |
$1,684.50
|
Rate for Payer: TriWest Veterans Administration |
$629.36
|
Rate for Payer: United Healthcare Commercial |
$1,954.02
|
Rate for Payer: United Healthcare Medicare |
$629.36
|
Rate for Payer: WINHealth Partners Commercial |
$1,909.10
|
|
ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,246.00
|
|
Service Code
|
HCPCS 27403 AS
|
Hospital Charge Code |
27403
|
Min. Negotiated Rate |
$534.96 |
Max. Negotiated Rate |
$2,246.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,201.08
|
Rate for Payer: Aetna of WY Medicare |
$629.36
|
Rate for Payer: Beech Street Commercial |
$2,133.70
|
Rate for Payer: Cash Price |
$1,572.20
|
Rate for Payer: Cash Price |
$1,572.20
|
Rate for Payer: ChoiceCare Network Commercial |
$2,178.62
|
Rate for Payer: Cigna of WY Commercial |
$2,201.08
|
Rate for Payer: First Choice Health Commercial |
$2,021.40
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,133.70
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$629.36
|
Rate for Payer: HealthUtah PPO |
$2,246.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,178.62
|
Rate for Payer: Multiplan Medicare/VA |
$534.96
|
Rate for Payer: One Health Plan of WY PPO |
$2,201.08
|
Rate for Payer: PacificSource Commercial |
$2,021.40
|
Rate for Payer: PHCS PPO |
$2,133.70
|
Rate for Payer: Three Rivers PPO |
$1,684.50
|
Rate for Payer: TriWest Veterans Administration |
$629.36
|
Rate for Payer: United Healthcare Commercial |
$1,954.02
|
Rate for Payer: United Healthcare Medicare |
$629.36
|
Rate for Payer: WINHealth Partners Commercial |
$1,909.10
|
|
ARTHROTOMY WRIST JOINT WITH BIOPSY
|
Professional
|
Both
|
$1,792.00
|
|
Service Code
|
HCPCS 25100
|
Hospital Charge Code |
25100
|
Min. Negotiated Rate |
$294.36 |
Max. Negotiated Rate |
$1,792.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,756.16
|
Rate for Payer: Aetna of WY Medicare |
$346.30
|
Rate for Payer: Beech Street Commercial |
$1,702.40
|
Rate for Payer: Cash Price |
$1,254.40
|
Rate for Payer: Cash Price |
$1,254.40
|
Rate for Payer: ChoiceCare Network Commercial |
$1,738.24
|
Rate for Payer: Cigna of WY Commercial |
$1,756.16
|
Rate for Payer: First Choice Health Commercial |
$1,612.80
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,702.40
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$346.30
|
Rate for Payer: HealthUtah PPO |
$1,792.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,738.24
|
Rate for Payer: Multiplan Medicare/VA |
$294.36
|
Rate for Payer: One Health Plan of WY PPO |
$1,756.16
|
Rate for Payer: PacificSource Commercial |
$1,612.80
|
Rate for Payer: PHCS PPO |
$1,702.40
|
Rate for Payer: Three Rivers PPO |
$1,344.00
|
Rate for Payer: TriWest Veterans Administration |
$346.30
|
Rate for Payer: United Healthcare Commercial |
$1,559.04
|
Rate for Payer: United Healthcare Medicare |
$346.30
|
Rate for Payer: WINHealth Partners Commercial |
$1,523.20
|
|
ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY
|
Professional
|
Both
|
$2,504.00
|
|
Service Code
|
HCPCS 25105 AS
|
Hospital Charge Code |
25105
|
Min. Negotiated Rate |
$407.67 |
Max. Negotiated Rate |
$2,504.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,453.92
|
Rate for Payer: Aetna of WY Medicare |
$479.61
|
Rate for Payer: Beech Street Commercial |
$2,378.80
|
Rate for Payer: Cash Price |
$1,752.80
|
Rate for Payer: Cash Price |
$1,752.80
|
Rate for Payer: ChoiceCare Network Commercial |
$2,428.88
|
Rate for Payer: Cigna of WY Commercial |
$2,453.92
|
Rate for Payer: First Choice Health Commercial |
$2,253.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,378.80
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$479.61
|
Rate for Payer: HealthUtah PPO |
$2,504.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,428.88
|
Rate for Payer: Multiplan Medicare/VA |
$407.67
|
Rate for Payer: One Health Plan of WY PPO |
$2,453.92
|
Rate for Payer: PacificSource Commercial |
$2,253.60
|
Rate for Payer: PHCS PPO |
$2,378.80
|
Rate for Payer: Three Rivers PPO |
$1,878.00
|
Rate for Payer: TriWest Veterans Administration |
$479.61
|
Rate for Payer: United Healthcare Commercial |
$2,178.48
|
Rate for Payer: United Healthcare Medicare |
$479.61
|
Rate for Payer: WINHealth Partners Commercial |
$2,128.40
|
|
ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY
|
Professional
|
Both
|
$2,504.00
|
|
Service Code
|
HCPCS 25105
|
Hospital Charge Code |
25105
|
Min. Negotiated Rate |
$407.67 |
Max. Negotiated Rate |
$2,504.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,453.92
|
Rate for Payer: Aetna of WY Medicare |
$479.61
|
Rate for Payer: Beech Street Commercial |
$2,378.80
|
Rate for Payer: Cash Price |
$1,752.80
|
Rate for Payer: Cash Price |
$1,752.80
|
Rate for Payer: ChoiceCare Network Commercial |
$2,428.88
|
Rate for Payer: Cigna of WY Commercial |
$2,453.92
|
Rate for Payer: First Choice Health Commercial |
$2,253.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,378.80
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$479.61
|
Rate for Payer: HealthUtah PPO |
$2,504.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,428.88
|
Rate for Payer: Multiplan Medicare/VA |
$407.67
|
Rate for Payer: One Health Plan of WY PPO |
$2,453.92
|
Rate for Payer: PacificSource Commercial |
$2,253.60
|
Rate for Payer: PHCS PPO |
$2,378.80
|
Rate for Payer: Three Rivers PPO |
$1,878.00
|
Rate for Payer: TriWest Veterans Administration |
$479.61
|
Rate for Payer: United Healthcare Commercial |
$2,178.48
|
Rate for Payer: United Healthcare Medicare |
$479.61
|
Rate for Payer: WINHealth Partners Commercial |
$2,128.40
|
|
ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY
|
Professional
|
Both
|
$2,152.00
|
|
Service Code
|
HCPCS 27626 AS
|
Hospital Charge Code |
27626
|
Min. Negotiated Rate |
$512.37 |
Max. Negotiated Rate |
$2,152.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,108.96
|
Rate for Payer: Aetna of WY Medicare |
$602.79
|
Rate for Payer: Beech Street Commercial |
$2,044.40
|
Rate for Payer: Cash Price |
$1,506.40
|
Rate for Payer: Cash Price |
$1,506.40
|
Rate for Payer: ChoiceCare Network Commercial |
$2,087.44
|
Rate for Payer: Cigna of WY Commercial |
$2,108.96
|
Rate for Payer: First Choice Health Commercial |
$1,936.80
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,044.40
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$602.79
|
Rate for Payer: HealthUtah PPO |
$2,152.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,087.44
|
Rate for Payer: Multiplan Medicare/VA |
$512.37
|
Rate for Payer: One Health Plan of WY PPO |
$2,108.96
|
Rate for Payer: PacificSource Commercial |
$1,936.80
|
Rate for Payer: PHCS PPO |
$2,044.40
|
Rate for Payer: Three Rivers PPO |
$1,614.00
|
Rate for Payer: TriWest Veterans Administration |
$602.79
|
Rate for Payer: United Healthcare Commercial |
$1,872.24
|
Rate for Payer: United Healthcare Medicare |
$602.79
|
Rate for Payer: WINHealth Partners Commercial |
$1,829.20
|
|
ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY
|
Professional
|
Both
|
$2,152.00
|
|
Service Code
|
HCPCS 27626 80
|
Hospital Charge Code |
27626
|
Min. Negotiated Rate |
$512.37 |
Max. Negotiated Rate |
$2,152.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,108.96
|
Rate for Payer: Aetna of WY Medicare |
$602.79
|
Rate for Payer: Beech Street Commercial |
$2,044.40
|
Rate for Payer: Cash Price |
$1,506.40
|
Rate for Payer: Cash Price |
$1,506.40
|
Rate for Payer: ChoiceCare Network Commercial |
$2,087.44
|
Rate for Payer: Cigna of WY Commercial |
$2,108.96
|
Rate for Payer: First Choice Health Commercial |
$1,936.80
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,044.40
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$602.79
|
Rate for Payer: HealthUtah PPO |
$2,152.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,087.44
|
Rate for Payer: Multiplan Medicare/VA |
$512.37
|
Rate for Payer: One Health Plan of WY PPO |
$2,108.96
|
Rate for Payer: PacificSource Commercial |
$1,936.80
|
Rate for Payer: PHCS PPO |
$2,044.40
|
Rate for Payer: Three Rivers PPO |
$1,614.00
|
Rate for Payer: TriWest Veterans Administration |
$602.79
|
Rate for Payer: United Healthcare Commercial |
$1,872.24
|
Rate for Payer: United Healthcare Medicare |
$602.79
|
Rate for Payer: WINHealth Partners Commercial |
$1,829.20
|
|
ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY
|
Professional
|
Both
|
$2,152.00
|
|
Service Code
|
HCPCS 27626
|
Hospital Charge Code |
27626
|
Min. Negotiated Rate |
$512.37 |
Max. Negotiated Rate |
$2,152.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,108.96
|
Rate for Payer: Aetna of WY Medicare |
$602.79
|
Rate for Payer: Beech Street Commercial |
$2,044.40
|
Rate for Payer: Cash Price |
$1,506.40
|
Rate for Payer: Cash Price |
$1,506.40
|
Rate for Payer: ChoiceCare Network Commercial |
$2,087.44
|
Rate for Payer: Cigna of WY Commercial |
$2,108.96
|
Rate for Payer: First Choice Health Commercial |
$1,936.80
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,044.40
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$602.79
|
Rate for Payer: HealthUtah PPO |
$2,152.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,087.44
|
Rate for Payer: Multiplan Medicare/VA |
$512.37
|
Rate for Payer: One Health Plan of WY PPO |
$2,108.96
|
Rate for Payer: PacificSource Commercial |
$1,936.80
|
Rate for Payer: PHCS PPO |
$2,044.40
|
Rate for Payer: Three Rivers PPO |
$1,614.00
|
Rate for Payer: TriWest Veterans Administration |
$602.79
|
Rate for Payer: United Healthcare Commercial |
$1,872.24
|
Rate for Payer: United Healthcare Medicare |
$602.79
|
Rate for Payer: WINHealth Partners Commercial |
$1,829.20
|
|
ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$8,419.00
|
|
Service Code
|
HCPCS 27334 80
|
Hospital Charge Code |
27334
|
Min. Negotiated Rate |
$568.40 |
Max. Negotiated Rate |
$8,419.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,250.62
|
Rate for Payer: Aetna of WY Medicare |
$668.70
|
Rate for Payer: Beech Street Commercial |
$7,998.05
|
Rate for Payer: Cash Price |
$5,893.30
|
Rate for Payer: Cash Price |
$5,893.30
|
Rate for Payer: ChoiceCare Network Commercial |
$8,166.43
|
Rate for Payer: Cigna of WY Commercial |
$8,250.62
|
Rate for Payer: First Choice Health Commercial |
$7,577.10
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,998.05
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.70
|
Rate for Payer: HealthUtah PPO |
$8,419.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,166.43
|
Rate for Payer: Multiplan Medicare/VA |
$568.40
|
Rate for Payer: One Health Plan of WY PPO |
$8,250.62
|
Rate for Payer: PacificSource Commercial |
$7,577.10
|
Rate for Payer: PHCS PPO |
$7,998.05
|
Rate for Payer: Three Rivers PPO |
$6,314.25
|
Rate for Payer: TriWest Veterans Administration |
$668.70
|
Rate for Payer: United Healthcare Commercial |
$7,324.53
|
Rate for Payer: United Healthcare Medicare |
$668.70
|
Rate for Payer: WINHealth Partners Commercial |
$7,156.15
|
|
ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$8,419.00
|
|
Service Code
|
HCPCS 27334 AS
|
Hospital Charge Code |
27334
|
Min. Negotiated Rate |
$568.40 |
Max. Negotiated Rate |
$8,419.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,250.62
|
Rate for Payer: Aetna of WY Medicare |
$668.70
|
Rate for Payer: Beech Street Commercial |
$7,998.05
|
Rate for Payer: Cash Price |
$5,893.30
|
Rate for Payer: Cash Price |
$5,893.30
|
Rate for Payer: ChoiceCare Network Commercial |
$8,166.43
|
Rate for Payer: Cigna of WY Commercial |
$8,250.62
|
Rate for Payer: First Choice Health Commercial |
$7,577.10
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,998.05
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.70
|
Rate for Payer: HealthUtah PPO |
$8,419.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,166.43
|
Rate for Payer: Multiplan Medicare/VA |
$568.40
|
Rate for Payer: One Health Plan of WY PPO |
$8,250.62
|
Rate for Payer: PacificSource Commercial |
$7,577.10
|
Rate for Payer: PHCS PPO |
$7,998.05
|
Rate for Payer: Three Rivers PPO |
$6,314.25
|
Rate for Payer: TriWest Veterans Administration |
$668.70
|
Rate for Payer: United Healthcare Commercial |
$7,324.53
|
Rate for Payer: United Healthcare Medicare |
$668.70
|
Rate for Payer: WINHealth Partners Commercial |
$7,156.15
|
|
ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$8,419.00
|
|
Service Code
|
HCPCS 27334
|
Hospital Charge Code |
27334
|
Min. Negotiated Rate |
$568.40 |
Max. Negotiated Rate |
$8,419.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,250.62
|
Rate for Payer: Aetna of WY Medicare |
$668.70
|
Rate for Payer: Beech Street Commercial |
$7,998.05
|
Rate for Payer: Cash Price |
$5,893.30
|
Rate for Payer: Cash Price |
$5,893.30
|
Rate for Payer: ChoiceCare Network Commercial |
$8,166.43
|
Rate for Payer: Cigna of WY Commercial |
$8,250.62
|
Rate for Payer: First Choice Health Commercial |
$7,577.10
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,998.05
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.70
|
Rate for Payer: HealthUtah PPO |
$8,419.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,166.43
|
Rate for Payer: Multiplan Medicare/VA |
$568.40
|
Rate for Payer: One Health Plan of WY PPO |
$8,250.62
|
Rate for Payer: PacificSource Commercial |
$7,577.10
|
Rate for Payer: PHCS PPO |
$7,998.05
|
Rate for Payer: Three Rivers PPO |
$6,314.25
|
Rate for Payer: TriWest Veterans Administration |
$668.70
|
Rate for Payer: United Healthcare Commercial |
$7,324.53
|
Rate for Payer: United Healthcare Medicare |
$668.70
|
Rate for Payer: WINHealth Partners Commercial |
$7,156.15
|
|
ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$6,998.00
|
|
Service Code
|
HCPCS 27130 AS
|
Hospital Charge Code |
27130
|
Min. Negotiated Rate |
$1,045.90 |
Max. Negotiated Rate |
$6,998.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,858.04
|
Rate for Payer: Aetna of WY Medicare |
$1,230.47
|
Rate for Payer: Beech Street Commercial |
$6,648.10
|
Rate for Payer: Cash Price |
$4,898.60
|
Rate for Payer: Cash Price |
$4,898.60
|
Rate for Payer: ChoiceCare Network Commercial |
$6,788.06
|
Rate for Payer: Cigna of WY Commercial |
$6,858.04
|
Rate for Payer: First Choice Health Commercial |
$6,298.20
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,648.10
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,230.47
|
Rate for Payer: HealthUtah PPO |
$6,998.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,788.06
|
Rate for Payer: Multiplan Medicare/VA |
$1,045.90
|
Rate for Payer: One Health Plan of WY PPO |
$6,858.04
|
Rate for Payer: PacificSource Commercial |
$6,298.20
|
Rate for Payer: PHCS PPO |
$6,648.10
|
Rate for Payer: Three Rivers PPO |
$5,248.50
|
Rate for Payer: TriWest Veterans Administration |
$1,230.47
|
Rate for Payer: United Healthcare Commercial |
$6,088.26
|
Rate for Payer: United Healthcare Medicare |
$1,230.47
|
Rate for Payer: WINHealth Partners Commercial |
$5,948.30
|
|
ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$6,998.00
|
|
Service Code
|
HCPCS 27130
|
Hospital Charge Code |
27130
|
Min. Negotiated Rate |
$1,045.90 |
Max. Negotiated Rate |
$6,998.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,858.04
|
Rate for Payer: Aetna of WY Medicare |
$1,230.47
|
Rate for Payer: Beech Street Commercial |
$6,648.10
|
Rate for Payer: Cash Price |
$4,898.60
|
Rate for Payer: Cash Price |
$4,898.60
|
Rate for Payer: ChoiceCare Network Commercial |
$6,788.06
|
Rate for Payer: Cigna of WY Commercial |
$6,858.04
|
Rate for Payer: First Choice Health Commercial |
$6,298.20
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,648.10
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,230.47
|
Rate for Payer: HealthUtah PPO |
$6,998.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,788.06
|
Rate for Payer: Multiplan Medicare/VA |
$1,045.90
|
Rate for Payer: One Health Plan of WY PPO |
$6,858.04
|
Rate for Payer: PacificSource Commercial |
$6,298.20
|
Rate for Payer: PHCS PPO |
$6,648.10
|
Rate for Payer: Three Rivers PPO |
$5,248.50
|
Rate for Payer: TriWest Veterans Administration |
$1,230.47
|
Rate for Payer: United Healthcare Commercial |
$6,088.26
|
Rate for Payer: United Healthcare Medicare |
$1,230.47
|
Rate for Payer: WINHealth Partners Commercial |
$5,948.30
|
|