|
HC EXCISION THROMBOSED HEMORRHOID, EXTERNAL
|
Facility
|
OP
|
$576.00
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
5104632001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$317.38 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$564.48
|
| Rate for Payer: Aetna of WY Medicare |
$380.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$552.96
|
| Rate for Payer: Altius Commercial |
$552.96
|
| Rate for Payer: Beech Street Commercial |
$564.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$472.90
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$558.72
|
| Rate for Payer: Cigna of WY Commercial |
$564.48
|
| Rate for Payer: Entrust Commercial |
$547.20
|
| Rate for Payer: First Choice Health Commercial |
$547.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$547.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$334.08
|
| Rate for Payer: HealthUtah PPO |
$576.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$558.72
|
| Rate for Payer: Multiplan Medicare/VA |
$317.38
|
| Rate for Payer: One Health Plan of WY PPO |
$564.48
|
| Rate for Payer: PacificSource Commercial |
$518.40
|
| Rate for Payer: PHCS PPO |
$564.48
|
| Rate for Payer: Three Rivers PPO |
$432.00
|
| Rate for Payer: TriWest Veterans Administration |
$334.08
|
| Rate for Payer: United Healthcare Commercial |
$501.12
|
| Rate for Payer: United Healthcare Medicare |
$334.08
|
| Rate for Payer: WINHealth Partners Commercial |
$564.48
|
| Rate for Payer: Wise Provider Network Commercial |
$547.20
|
|
|
HC EXCISION THROMBOSED HEMORRHOID, EXTERNAL
|
Facility
|
IP
|
$576.00
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
5104632001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$361.15 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$564.48
|
| Rate for Payer: Altius Auto/Workers Compensation |
$552.96
|
| Rate for Payer: Altius Commercial |
$552.96
|
| Rate for Payer: Beech Street Commercial |
$564.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$472.90
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$558.72
|
| Rate for Payer: Cigna of WY Commercial |
$564.48
|
| Rate for Payer: Entrust Commercial |
$547.20
|
| Rate for Payer: First Choice Health Commercial |
$547.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$547.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$380.16
|
| Rate for Payer: HealthUtah PPO |
$576.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$558.72
|
| Rate for Payer: Multiplan Medicare/VA |
$361.15
|
| Rate for Payer: One Health Plan of WY PPO |
$564.48
|
| Rate for Payer: PacificSource Commercial |
$518.40
|
| Rate for Payer: PHCS PPO |
$564.48
|
| Rate for Payer: Three Rivers PPO |
$432.00
|
| Rate for Payer: TriWest Veterans Administration |
$380.16
|
| Rate for Payer: United Healthcare Commercial |
$501.12
|
| Rate for Payer: United Healthcare Medicare |
$380.16
|
| Rate for Payer: WINHealth Partners Commercial |
$547.20
|
| Rate for Payer: Wise Provider Network Commercial |
$547.20
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>
|
Facility
|
IP
|
$431.00
|
|
|
Service Code
|
HCPCS 23071
|
| Hospital Charge Code |
5102307101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$270.24 |
| Max. Negotiated Rate |
$431.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$422.38
|
| Rate for Payer: Altius Auto/Workers Compensation |
$413.76
|
| Rate for Payer: Altius Commercial |
$413.76
|
| Rate for Payer: Beech Street Commercial |
$422.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$353.85
|
| Rate for Payer: Cash Price |
$301.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$418.07
|
| Rate for Payer: Cigna of WY Commercial |
$422.38
|
| Rate for Payer: Entrust Commercial |
$409.45
|
| Rate for Payer: First Choice Health Commercial |
$409.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$409.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$284.46
|
| Rate for Payer: HealthUtah PPO |
$431.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$418.07
|
| Rate for Payer: Multiplan Medicare/VA |
$270.24
|
| Rate for Payer: One Health Plan of WY PPO |
$422.38
|
| Rate for Payer: PacificSource Commercial |
$387.90
|
| Rate for Payer: PHCS PPO |
$422.38
|
| Rate for Payer: Three Rivers PPO |
$323.25
|
| Rate for Payer: TriWest Veterans Administration |
$284.46
|
| Rate for Payer: United Healthcare Commercial |
$374.97
|
| Rate for Payer: United Healthcare Medicare |
$284.46
|
| Rate for Payer: WINHealth Partners Commercial |
$409.45
|
| Rate for Payer: Wise Provider Network Commercial |
$409.45
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>
|
Facility
|
OP
|
$431.00
|
|
|
Service Code
|
HCPCS 23071
|
| Hospital Charge Code |
5102307101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$237.48 |
| Max. Negotiated Rate |
$431.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$422.38
|
| Rate for Payer: Aetna of WY Medicare |
$284.46
|
| Rate for Payer: Altius Auto/Workers Compensation |
$413.76
|
| Rate for Payer: Altius Commercial |
$413.76
|
| Rate for Payer: Beech Street Commercial |
$422.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$353.85
|
| Rate for Payer: Cash Price |
$301.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$418.07
|
| Rate for Payer: Cigna of WY Commercial |
$422.38
|
| Rate for Payer: Entrust Commercial |
$409.45
|
| Rate for Payer: First Choice Health Commercial |
$409.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$409.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$249.98
|
| Rate for Payer: HealthUtah PPO |
$431.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$418.07
|
| Rate for Payer: Multiplan Medicare/VA |
$237.48
|
| Rate for Payer: One Health Plan of WY PPO |
$422.38
|
| Rate for Payer: PacificSource Commercial |
$387.90
|
| Rate for Payer: PHCS PPO |
$422.38
|
| Rate for Payer: Three Rivers PPO |
$323.25
|
| Rate for Payer: TriWest Veterans Administration |
$249.98
|
| Rate for Payer: United Healthcare Commercial |
$374.97
|
| Rate for Payer: United Healthcare Medicare |
$249.98
|
| Rate for Payer: WINHealth Partners Commercial |
$422.38
|
| Rate for Payer: Wise Provider Network Commercial |
$409.45
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
OP
|
$335.00
|
|
|
Service Code
|
HCPCS 23075
|
| Hospital Charge Code |
5102307501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$184.58 |
| Max. Negotiated Rate |
$335.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$328.30
|
| Rate for Payer: Aetna of WY Medicare |
$221.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$321.60
|
| Rate for Payer: Altius Commercial |
$321.60
|
| Rate for Payer: Beech Street Commercial |
$328.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$275.04
|
| Rate for Payer: Cash Price |
$234.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$324.95
|
| Rate for Payer: Cigna of WY Commercial |
$328.30
|
| Rate for Payer: Entrust Commercial |
$318.25
|
| Rate for Payer: First Choice Health Commercial |
$318.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$318.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$194.30
|
| Rate for Payer: HealthUtah PPO |
$335.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$324.95
|
| Rate for Payer: Multiplan Medicare/VA |
$184.58
|
| Rate for Payer: One Health Plan of WY PPO |
$328.30
|
| Rate for Payer: PacificSource Commercial |
$301.50
|
| Rate for Payer: PHCS PPO |
$328.30
|
| Rate for Payer: Three Rivers PPO |
$251.25
|
| Rate for Payer: TriWest Veterans Administration |
$194.30
|
| Rate for Payer: United Healthcare Commercial |
$291.45
|
| Rate for Payer: United Healthcare Medicare |
$194.30
|
| Rate for Payer: WINHealth Partners Commercial |
$328.30
|
| Rate for Payer: Wise Provider Network Commercial |
$318.25
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
IP
|
$335.00
|
|
|
Service Code
|
HCPCS 23075
|
| Hospital Charge Code |
5102307501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$210.04 |
| Max. Negotiated Rate |
$335.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$328.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$321.60
|
| Rate for Payer: Altius Commercial |
$321.60
|
| Rate for Payer: Beech Street Commercial |
$328.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$275.04
|
| Rate for Payer: Cash Price |
$234.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$324.95
|
| Rate for Payer: Cigna of WY Commercial |
$328.30
|
| Rate for Payer: Entrust Commercial |
$318.25
|
| Rate for Payer: First Choice Health Commercial |
$318.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$318.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$221.10
|
| Rate for Payer: HealthUtah PPO |
$335.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$324.95
|
| Rate for Payer: Multiplan Medicare/VA |
$210.04
|
| Rate for Payer: One Health Plan of WY PPO |
$328.30
|
| Rate for Payer: PacificSource Commercial |
$301.50
|
| Rate for Payer: PHCS PPO |
$328.30
|
| Rate for Payer: Three Rivers PPO |
$251.25
|
| Rate for Payer: TriWest Veterans Administration |
$221.10
|
| Rate for Payer: United Healthcare Commercial |
$291.45
|
| Rate for Payer: United Healthcare Medicare |
$221.10
|
| Rate for Payer: WINHealth Partners Commercial |
$318.25
|
| Rate for Payer: Wise Provider Network Commercial |
$318.25
|
|
|
HC EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Facility
|
IP
|
$1,741.00
|
|
|
Service Code
|
HCPCS 27327
|
| Hospital Charge Code |
5102732701
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,091.61 |
| Max. Negotiated Rate |
$1,741.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,706.18
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,671.36
|
| Rate for Payer: Altius Commercial |
$1,671.36
|
| Rate for Payer: Beech Street Commercial |
$1,706.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,429.36
|
| Rate for Payer: Cash Price |
$1,218.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,688.77
|
| Rate for Payer: Cigna of WY Commercial |
$1,706.18
|
| Rate for Payer: Entrust Commercial |
$1,653.95
|
| Rate for Payer: First Choice Health Commercial |
$1,653.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,653.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,149.06
|
| Rate for Payer: HealthUtah PPO |
$1,741.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,688.77
|
| Rate for Payer: Multiplan Medicare/VA |
$1,091.61
|
| Rate for Payer: One Health Plan of WY PPO |
$1,706.18
|
| Rate for Payer: PacificSource Commercial |
$1,566.90
|
| Rate for Payer: PHCS PPO |
$1,706.18
|
| Rate for Payer: Three Rivers PPO |
$1,305.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,149.06
|
| Rate for Payer: United Healthcare Commercial |
$1,514.67
|
| Rate for Payer: United Healthcare Medicare |
$1,149.06
|
| Rate for Payer: WINHealth Partners Commercial |
$1,653.95
|
| Rate for Payer: Wise Provider Network Commercial |
$1,653.95
|
|
|
HC EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Facility
|
OP
|
$1,741.00
|
|
|
Service Code
|
HCPCS 27327
|
| Hospital Charge Code |
5102732701
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$959.29 |
| Max. Negotiated Rate |
$1,741.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,706.18
|
| Rate for Payer: Aetna of WY Medicare |
$1,149.06
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,671.36
|
| Rate for Payer: Altius Commercial |
$1,671.36
|
| Rate for Payer: Beech Street Commercial |
$1,706.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,429.36
|
| Rate for Payer: Cash Price |
$1,218.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,688.77
|
| Rate for Payer: Cigna of WY Commercial |
$1,706.18
|
| Rate for Payer: Entrust Commercial |
$1,653.95
|
| Rate for Payer: First Choice Health Commercial |
$1,653.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,653.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,009.78
|
| Rate for Payer: HealthUtah PPO |
$1,741.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,688.77
|
| Rate for Payer: Multiplan Medicare/VA |
$959.29
|
| Rate for Payer: One Health Plan of WY PPO |
$1,706.18
|
| Rate for Payer: PacificSource Commercial |
$1,566.90
|
| Rate for Payer: PHCS PPO |
$1,706.18
|
| Rate for Payer: Three Rivers PPO |
$1,305.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,009.78
|
| Rate for Payer: United Healthcare Commercial |
$1,514.67
|
| Rate for Payer: United Healthcare Medicare |
$1,009.78
|
| Rate for Payer: WINHealth Partners Commercial |
$1,706.18
|
| Rate for Payer: Wise Provider Network Commercial |
$1,653.95
|
|
|
HC EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Facility
|
IP
|
$3,482.00
|
|
|
Service Code
|
HCPCS 27327 50
|
| Hospital Charge Code |
5102732701
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,183.21 |
| Max. Negotiated Rate |
$3,482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,412.36
|
| Rate for Payer: Altius Auto/Workers Compensation |
$3,342.72
|
| Rate for Payer: Altius Commercial |
$3,342.72
|
| Rate for Payer: Beech Street Commercial |
$3,412.36
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,858.72
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,377.54
|
| Rate for Payer: Cigna of WY Commercial |
$3,412.36
|
| Rate for Payer: Entrust Commercial |
$3,307.90
|
| Rate for Payer: First Choice Health Commercial |
$3,307.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,307.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,298.12
|
| Rate for Payer: HealthUtah PPO |
$3,482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,377.54
|
| Rate for Payer: Multiplan Medicare/VA |
$2,183.21
|
| Rate for Payer: One Health Plan of WY PPO |
$3,412.36
|
| Rate for Payer: PacificSource Commercial |
$3,133.80
|
| Rate for Payer: PHCS PPO |
$3,412.36
|
| Rate for Payer: Three Rivers PPO |
$2,611.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,298.12
|
| Rate for Payer: United Healthcare Commercial |
$3,029.34
|
| Rate for Payer: United Healthcare Medicare |
$2,298.12
|
| Rate for Payer: WINHealth Partners Commercial |
$3,307.90
|
| Rate for Payer: Wise Provider Network Commercial |
$3,307.90
|
|
|
HC EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Facility
|
OP
|
$3,482.00
|
|
|
Service Code
|
HCPCS 27327 50
|
| Hospital Charge Code |
5102732701
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,918.58 |
| Max. Negotiated Rate |
$3,482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,412.36
|
| Rate for Payer: Aetna of WY Medicare |
$2,298.12
|
| Rate for Payer: Altius Auto/Workers Compensation |
$3,342.72
|
| Rate for Payer: Altius Commercial |
$3,342.72
|
| Rate for Payer: Beech Street Commercial |
$3,412.36
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,858.72
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,377.54
|
| Rate for Payer: Cigna of WY Commercial |
$3,412.36
|
| Rate for Payer: Entrust Commercial |
$3,307.90
|
| Rate for Payer: First Choice Health Commercial |
$3,307.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,307.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,019.56
|
| Rate for Payer: HealthUtah PPO |
$3,482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,377.54
|
| Rate for Payer: Multiplan Medicare/VA |
$1,918.58
|
| Rate for Payer: One Health Plan of WY PPO |
$3,412.36
|
| Rate for Payer: PacificSource Commercial |
$3,133.80
|
| Rate for Payer: PHCS PPO |
$3,412.36
|
| Rate for Payer: Three Rivers PPO |
$2,611.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,019.56
|
| Rate for Payer: United Healthcare Commercial |
$3,029.34
|
| Rate for Payer: United Healthcare Medicare |
$2,019.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,412.36
|
| Rate for Payer: Wise Provider Network Commercial |
$3,307.90
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
OP
|
$238.00
|
|
|
Service Code
|
HCPCS 57135
|
| Hospital Charge Code |
5105713501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$131.14 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$233.24
|
| Rate for Payer: Aetna of WY Medicare |
$157.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$228.48
|
| Rate for Payer: Altius Commercial |
$228.48
|
| Rate for Payer: Beech Street Commercial |
$233.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$195.40
|
| Rate for Payer: Cash Price |
$166.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$230.86
|
| Rate for Payer: Cigna of WY Commercial |
$233.24
|
| Rate for Payer: Entrust Commercial |
$226.10
|
| Rate for Payer: First Choice Health Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$138.04
|
| Rate for Payer: HealthUtah PPO |
$238.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$230.86
|
| Rate for Payer: Multiplan Medicare/VA |
$131.14
|
| Rate for Payer: One Health Plan of WY PPO |
$233.24
|
| Rate for Payer: PacificSource Commercial |
$214.20
|
| Rate for Payer: PHCS PPO |
$233.24
|
| Rate for Payer: Three Rivers PPO |
$178.50
|
| Rate for Payer: TriWest Veterans Administration |
$138.04
|
| Rate for Payer: United Healthcare Commercial |
$207.06
|
| Rate for Payer: United Healthcare Medicare |
$138.04
|
| Rate for Payer: WINHealth Partners Commercial |
$233.24
|
| Rate for Payer: Wise Provider Network Commercial |
$226.10
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
HCPCS 57135
|
| Hospital Charge Code |
5105713501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$149.23 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$233.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$228.48
|
| Rate for Payer: Altius Commercial |
$228.48
|
| Rate for Payer: Beech Street Commercial |
$233.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$195.40
|
| Rate for Payer: Cash Price |
$166.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$230.86
|
| Rate for Payer: Cigna of WY Commercial |
$233.24
|
| Rate for Payer: Entrust Commercial |
$226.10
|
| Rate for Payer: First Choice Health Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$157.08
|
| Rate for Payer: HealthUtah PPO |
$238.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$230.86
|
| Rate for Payer: Multiplan Medicare/VA |
$149.23
|
| Rate for Payer: One Health Plan of WY PPO |
$233.24
|
| Rate for Payer: PacificSource Commercial |
$214.20
|
| Rate for Payer: PHCS PPO |
$233.24
|
| Rate for Payer: Three Rivers PPO |
$178.50
|
| Rate for Payer: TriWest Veterans Administration |
$157.08
|
| Rate for Payer: United Healthcare Commercial |
$207.06
|
| Rate for Payer: United Healthcare Medicare |
$157.08
|
| Rate for Payer: WINHealth Partners Commercial |
$226.10
|
| Rate for Payer: Wise Provider Network Commercial |
$226.10
|
|
|
HC EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
HCPCS 67840
|
| Hospital Charge Code |
5106784001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$181.83 |
| Max. Negotiated Rate |
$290.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$284.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$278.40
|
| Rate for Payer: Altius Commercial |
$278.40
|
| Rate for Payer: Beech Street Commercial |
$284.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$238.09
|
| Rate for Payer: Cash Price |
$203.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$281.30
|
| Rate for Payer: Cigna of WY Commercial |
$284.20
|
| Rate for Payer: Entrust Commercial |
$275.50
|
| Rate for Payer: First Choice Health Commercial |
$275.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$275.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$191.40
|
| Rate for Payer: HealthUtah PPO |
$290.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$281.30
|
| Rate for Payer: Multiplan Medicare/VA |
$181.83
|
| Rate for Payer: One Health Plan of WY PPO |
$284.20
|
| Rate for Payer: PacificSource Commercial |
$261.00
|
| Rate for Payer: PHCS PPO |
$284.20
|
| Rate for Payer: Three Rivers PPO |
$217.50
|
| Rate for Payer: TriWest Veterans Administration |
$191.40
|
| Rate for Payer: United Healthcare Commercial |
$252.30
|
| Rate for Payer: United Healthcare Medicare |
$191.40
|
| Rate for Payer: WINHealth Partners Commercial |
$275.50
|
| Rate for Payer: Wise Provider Network Commercial |
$275.50
|
|
|
HC EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
HCPCS 67840
|
| Hospital Charge Code |
5106784001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.79 |
| Max. Negotiated Rate |
$290.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$284.20
|
| Rate for Payer: Aetna of WY Medicare |
$191.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$278.40
|
| Rate for Payer: Altius Commercial |
$278.40
|
| Rate for Payer: Beech Street Commercial |
$284.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$238.09
|
| Rate for Payer: Cash Price |
$203.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$281.30
|
| Rate for Payer: Cigna of WY Commercial |
$284.20
|
| Rate for Payer: Entrust Commercial |
$275.50
|
| Rate for Payer: First Choice Health Commercial |
$275.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$275.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$168.20
|
| Rate for Payer: HealthUtah PPO |
$290.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$281.30
|
| Rate for Payer: Multiplan Medicare/VA |
$159.79
|
| Rate for Payer: One Health Plan of WY PPO |
$284.20
|
| Rate for Payer: PacificSource Commercial |
$261.00
|
| Rate for Payer: PHCS PPO |
$284.20
|
| Rate for Payer: Three Rivers PPO |
$217.50
|
| Rate for Payer: TriWest Veterans Administration |
$168.20
|
| Rate for Payer: United Healthcare Commercial |
$252.30
|
| Rate for Payer: United Healthcare Medicare |
$168.20
|
| Rate for Payer: WINHealth Partners Commercial |
$284.20
|
| Rate for Payer: Wise Provider Network Commercial |
$275.50
|
|
|
HC EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR
|
Facility
|
OP
|
$384.00
|
|
|
Service Code
|
HCPCS 40814
|
| Hospital Charge Code |
5104081401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$211.58 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$376.32
|
| Rate for Payer: Aetna of WY Medicare |
$253.44
|
| Rate for Payer: Altius Auto/Workers Compensation |
$368.64
|
| Rate for Payer: Altius Commercial |
$368.64
|
| Rate for Payer: Beech Street Commercial |
$376.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$315.26
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$372.48
|
| Rate for Payer: Cigna of WY Commercial |
$376.32
|
| Rate for Payer: Entrust Commercial |
$364.80
|
| Rate for Payer: First Choice Health Commercial |
$364.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$364.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$222.72
|
| Rate for Payer: HealthUtah PPO |
$384.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$372.48
|
| Rate for Payer: Multiplan Medicare/VA |
$211.58
|
| Rate for Payer: One Health Plan of WY PPO |
$376.32
|
| Rate for Payer: PacificSource Commercial |
$345.60
|
| Rate for Payer: PHCS PPO |
$376.32
|
| Rate for Payer: Three Rivers PPO |
$288.00
|
| Rate for Payer: TriWest Veterans Administration |
$222.72
|
| Rate for Payer: United Healthcare Commercial |
$334.08
|
| Rate for Payer: United Healthcare Medicare |
$222.72
|
| Rate for Payer: WINHealth Partners Commercial |
$376.32
|
| Rate for Payer: Wise Provider Network Commercial |
$364.80
|
|
|
HC EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR
|
Facility
|
IP
|
$384.00
|
|
|
Service Code
|
HCPCS 40814
|
| Hospital Charge Code |
5104081401
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$240.77 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$376.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$368.64
|
| Rate for Payer: Altius Commercial |
$368.64
|
| Rate for Payer: Beech Street Commercial |
$376.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$315.26
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$372.48
|
| Rate for Payer: Cigna of WY Commercial |
$376.32
|
| Rate for Payer: Entrust Commercial |
$364.80
|
| Rate for Payer: First Choice Health Commercial |
$364.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$364.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$253.44
|
| Rate for Payer: HealthUtah PPO |
$384.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$372.48
|
| Rate for Payer: Multiplan Medicare/VA |
$240.77
|
| Rate for Payer: One Health Plan of WY PPO |
$376.32
|
| Rate for Payer: PacificSource Commercial |
$345.60
|
| Rate for Payer: PHCS PPO |
$376.32
|
| Rate for Payer: Three Rivers PPO |
$288.00
|
| Rate for Payer: TriWest Veterans Administration |
$253.44
|
| Rate for Payer: United Healthcare Commercial |
$334.08
|
| Rate for Payer: United Healthcare Medicare |
$253.44
|
| Rate for Payer: WINHealth Partners Commercial |
$364.80
|
| Rate for Payer: Wise Provider Network Commercial |
$364.80
|
|
|
HC EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
HCPCS 40812
|
| Hospital Charge Code |
5104081201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$122.89 |
| Max. Negotiated Rate |
$196.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$192.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$188.16
|
| Rate for Payer: Altius Commercial |
$188.16
|
| Rate for Payer: Beech Street Commercial |
$192.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$160.92
|
| Rate for Payer: Cash Price |
$137.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$190.12
|
| Rate for Payer: Cigna of WY Commercial |
$192.08
|
| Rate for Payer: Entrust Commercial |
$186.20
|
| Rate for Payer: First Choice Health Commercial |
$186.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$186.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$129.36
|
| Rate for Payer: HealthUtah PPO |
$196.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$190.12
|
| Rate for Payer: Multiplan Medicare/VA |
$122.89
|
| Rate for Payer: One Health Plan of WY PPO |
$192.08
|
| Rate for Payer: PacificSource Commercial |
$176.40
|
| Rate for Payer: PHCS PPO |
$192.08
|
| Rate for Payer: Three Rivers PPO |
$147.00
|
| Rate for Payer: TriWest Veterans Administration |
$129.36
|
| Rate for Payer: United Healthcare Commercial |
$170.52
|
| Rate for Payer: United Healthcare Medicare |
$129.36
|
| Rate for Payer: WINHealth Partners Commercial |
$186.20
|
| Rate for Payer: Wise Provider Network Commercial |
$186.20
|
|
|
HC EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
HCPCS 40812
|
| Hospital Charge Code |
5104081201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$196.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$192.08
|
| Rate for Payer: Aetna of WY Medicare |
$129.36
|
| Rate for Payer: Altius Auto/Workers Compensation |
$188.16
|
| Rate for Payer: Altius Commercial |
$188.16
|
| Rate for Payer: Beech Street Commercial |
$192.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$160.92
|
| Rate for Payer: Cash Price |
$137.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$190.12
|
| Rate for Payer: Cigna of WY Commercial |
$192.08
|
| Rate for Payer: Entrust Commercial |
$186.20
|
| Rate for Payer: First Choice Health Commercial |
$186.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$186.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$113.68
|
| Rate for Payer: HealthUtah PPO |
$196.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$190.12
|
| Rate for Payer: Multiplan Medicare/VA |
$108.00
|
| Rate for Payer: One Health Plan of WY PPO |
$192.08
|
| Rate for Payer: PacificSource Commercial |
$176.40
|
| Rate for Payer: PHCS PPO |
$192.08
|
| Rate for Payer: Three Rivers PPO |
$147.00
|
| Rate for Payer: TriWest Veterans Administration |
$113.68
|
| Rate for Payer: United Healthcare Commercial |
$170.52
|
| Rate for Payer: United Healthcare Medicare |
$113.68
|
| Rate for Payer: WINHealth Partners Commercial |
$192.08
|
| Rate for Payer: Wise Provider Network Commercial |
$186.20
|
|
|
HC EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
HCPCS 40810
|
| Hospital Charge Code |
5104081001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$79.63 |
| Max. Negotiated Rate |
$127.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$124.46
|
| Rate for Payer: Altius Auto/Workers Compensation |
$121.92
|
| Rate for Payer: Altius Commercial |
$121.92
|
| Rate for Payer: Beech Street Commercial |
$124.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.27
|
| Rate for Payer: Cash Price |
$88.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$123.19
|
| Rate for Payer: Cigna of WY Commercial |
$124.46
|
| Rate for Payer: Entrust Commercial |
$120.65
|
| Rate for Payer: First Choice Health Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.82
|
| Rate for Payer: HealthUtah PPO |
$127.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$123.19
|
| Rate for Payer: Multiplan Medicare/VA |
$79.63
|
| Rate for Payer: One Health Plan of WY PPO |
$124.46
|
| Rate for Payer: PacificSource Commercial |
$114.30
|
| Rate for Payer: PHCS PPO |
$124.46
|
| Rate for Payer: Three Rivers PPO |
$95.25
|
| Rate for Payer: TriWest Veterans Administration |
$83.82
|
| Rate for Payer: United Healthcare Commercial |
$110.49
|
| Rate for Payer: United Healthcare Medicare |
$83.82
|
| Rate for Payer: WINHealth Partners Commercial |
$120.65
|
| Rate for Payer: Wise Provider Network Commercial |
$120.65
|
|
|
HC EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
HCPCS 40810
|
| Hospital Charge Code |
5104081001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.98 |
| Max. Negotiated Rate |
$127.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$124.46
|
| Rate for Payer: Aetna of WY Medicare |
$83.82
|
| Rate for Payer: Altius Auto/Workers Compensation |
$121.92
|
| Rate for Payer: Altius Commercial |
$121.92
|
| Rate for Payer: Beech Street Commercial |
$124.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.27
|
| Rate for Payer: Cash Price |
$88.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$123.19
|
| Rate for Payer: Cigna of WY Commercial |
$124.46
|
| Rate for Payer: Entrust Commercial |
$120.65
|
| Rate for Payer: First Choice Health Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$73.66
|
| Rate for Payer: HealthUtah PPO |
$127.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$123.19
|
| Rate for Payer: Multiplan Medicare/VA |
$69.98
|
| Rate for Payer: One Health Plan of WY PPO |
$124.46
|
| Rate for Payer: PacificSource Commercial |
$114.30
|
| Rate for Payer: PHCS PPO |
$124.46
|
| Rate for Payer: Three Rivers PPO |
$95.25
|
| Rate for Payer: TriWest Veterans Administration |
$73.66
|
| Rate for Payer: United Healthcare Commercial |
$110.49
|
| Rate for Payer: United Healthcare Medicare |
$73.66
|
| Rate for Payer: WINHealth Partners Commercial |
$124.46
|
| Rate for Payer: Wise Provider Network Commercial |
$120.65
|
|
|
HC EXC MAL LESION TRUNK, ARM, LEG <0.5 CM
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
5101160001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$66.12 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$117.60
|
| Rate for Payer: Aetna of WY Medicare |
$79.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$115.20
|
| Rate for Payer: Altius Commercial |
$115.20
|
| Rate for Payer: Beech Street Commercial |
$117.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$98.52
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$116.40
|
| Rate for Payer: Cigna of WY Commercial |
$117.60
|
| Rate for Payer: Entrust Commercial |
$114.00
|
| Rate for Payer: First Choice Health Commercial |
$114.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$114.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$69.60
|
| Rate for Payer: HealthUtah PPO |
$120.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$116.40
|
| Rate for Payer: Multiplan Medicare/VA |
$66.12
|
| Rate for Payer: One Health Plan of WY PPO |
$117.60
|
| Rate for Payer: PacificSource Commercial |
$108.00
|
| Rate for Payer: PHCS PPO |
$117.60
|
| Rate for Payer: Three Rivers PPO |
$90.00
|
| Rate for Payer: TriWest Veterans Administration |
$69.60
|
| Rate for Payer: United Healthcare Commercial |
$104.40
|
| Rate for Payer: United Healthcare Medicare |
$69.60
|
| Rate for Payer: WINHealth Partners Commercial |
$117.60
|
| Rate for Payer: Wise Provider Network Commercial |
$114.00
|
|
|
HC EXC MAL LESION TRUNK, ARM, LEG <0.5 CM
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
5101160001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$75.24 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$117.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$115.20
|
| Rate for Payer: Altius Commercial |
$115.20
|
| Rate for Payer: Beech Street Commercial |
$117.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$98.52
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$116.40
|
| Rate for Payer: Cigna of WY Commercial |
$117.60
|
| Rate for Payer: Entrust Commercial |
$114.00
|
| Rate for Payer: First Choice Health Commercial |
$114.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$114.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$79.20
|
| Rate for Payer: HealthUtah PPO |
$120.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$116.40
|
| Rate for Payer: Multiplan Medicare/VA |
$75.24
|
| Rate for Payer: One Health Plan of WY PPO |
$117.60
|
| Rate for Payer: PacificSource Commercial |
$108.00
|
| Rate for Payer: PHCS PPO |
$117.60
|
| Rate for Payer: Three Rivers PPO |
$90.00
|
| Rate for Payer: TriWest Veterans Administration |
$79.20
|
| Rate for Payer: United Healthcare Commercial |
$104.40
|
| Rate for Payer: United Healthcare Medicare |
$79.20
|
| Rate for Payer: WINHealth Partners Commercial |
$114.00
|
| Rate for Payer: Wise Provider Network Commercial |
$114.00
|
|
|
HC EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT
|
Facility
|
IP
|
$2,044.00
|
|
|
Service Code
|
HCPCS 44800
|
| Hospital Charge Code |
9834480001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,281.59 |
| Max. Negotiated Rate |
$2,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,003.12
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,962.24
|
| Rate for Payer: Altius Commercial |
$1,962.24
|
| Rate for Payer: Beech Street Commercial |
$2,003.12
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,678.12
|
| Rate for Payer: Cash Price |
$1,430.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,982.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,003.12
|
| Rate for Payer: Entrust Commercial |
$1,941.80
|
| Rate for Payer: First Choice Health Commercial |
$1,941.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,941.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,349.04
|
| Rate for Payer: HealthUtah PPO |
$2,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,982.68
|
| Rate for Payer: Multiplan Medicare/VA |
$1,281.59
|
| Rate for Payer: One Health Plan of WY PPO |
$2,003.12
|
| Rate for Payer: PacificSource Commercial |
$1,839.60
|
| Rate for Payer: PHCS PPO |
$2,003.12
|
| Rate for Payer: Three Rivers PPO |
$1,533.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,349.04
|
| Rate for Payer: United Healthcare Commercial |
$1,778.28
|
| Rate for Payer: United Healthcare Medicare |
$1,349.04
|
| Rate for Payer: WINHealth Partners Commercial |
$1,941.80
|
| Rate for Payer: Wise Provider Network Commercial |
$1,941.80
|
|
|
HC EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT
|
Facility
|
OP
|
$2,044.00
|
|
|
Service Code
|
HCPCS 44800
|
| Hospital Charge Code |
9834480001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,126.24 |
| Max. Negotiated Rate |
$2,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,003.12
|
| Rate for Payer: Aetna of WY Medicare |
$1,349.04
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,962.24
|
| Rate for Payer: Altius Commercial |
$1,962.24
|
| Rate for Payer: Beech Street Commercial |
$2,003.12
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,678.12
|
| Rate for Payer: Cash Price |
$1,430.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,982.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,003.12
|
| Rate for Payer: Entrust Commercial |
$1,941.80
|
| Rate for Payer: First Choice Health Commercial |
$1,941.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,941.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,185.52
|
| Rate for Payer: HealthUtah PPO |
$2,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,982.68
|
| Rate for Payer: Multiplan Medicare/VA |
$1,126.24
|
| Rate for Payer: One Health Plan of WY PPO |
$2,003.12
|
| Rate for Payer: PacificSource Commercial |
$1,839.60
|
| Rate for Payer: PHCS PPO |
$2,003.12
|
| Rate for Payer: Three Rivers PPO |
$1,533.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,185.52
|
| Rate for Payer: United Healthcare Commercial |
$1,778.28
|
| Rate for Payer: United Healthcare Medicare |
$1,185.52
|
| Rate for Payer: WINHealth Partners Commercial |
$2,003.12
|
| Rate for Payer: Wise Provider Network Commercial |
$1,941.80
|
|
|
HC EXC SKIN BENIG <0.5 CM FACE,FACIAL
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 11440
|
| Hospital Charge Code |
5101144001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$64.58 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$100.94
|
| Rate for Payer: Altius Auto/Workers Compensation |
$98.88
|
| Rate for Payer: Altius Commercial |
$98.88
|
| Rate for Payer: Beech Street Commercial |
$100.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$84.56
|
| Rate for Payer: Cash Price |
$72.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$99.91
|
| Rate for Payer: Cigna of WY Commercial |
$100.94
|
| Rate for Payer: Entrust Commercial |
$97.85
|
| Rate for Payer: First Choice Health Commercial |
$97.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$97.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$67.98
|
| Rate for Payer: HealthUtah PPO |
$103.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$99.91
|
| Rate for Payer: Multiplan Medicare/VA |
$64.58
|
| Rate for Payer: One Health Plan of WY PPO |
$100.94
|
| Rate for Payer: PacificSource Commercial |
$92.70
|
| Rate for Payer: PHCS PPO |
$100.94
|
| Rate for Payer: Three Rivers PPO |
$77.25
|
| Rate for Payer: TriWest Veterans Administration |
$67.98
|
| Rate for Payer: United Healthcare Commercial |
$89.61
|
| Rate for Payer: United Healthcare Medicare |
$67.98
|
| Rate for Payer: WINHealth Partners Commercial |
$97.85
|
| Rate for Payer: Wise Provider Network Commercial |
$97.85
|
|
