|
ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$4,194.00
|
|
|
Service Code
|
HCPCS 29862
|
| Hospital Charge Code |
29862
|
| Min. Negotiated Rate |
$672.17 |
| Max. Negotiated Rate |
$4,194.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,110.12
|
| Rate for Payer: Aetna of WY Medicare |
$790.79
|
| Rate for Payer: Beech Street Commercial |
$3,984.30
|
| Rate for Payer: Cash Price |
$2,935.80
|
| Rate for Payer: Cash Price |
$2,935.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,068.18
|
| Rate for Payer: Cigna of WY Commercial |
$4,110.12
|
| Rate for Payer: First Choice Health Commercial |
$3,774.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,984.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$790.79
|
| Rate for Payer: HealthUtah PPO |
$4,194.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,068.18
|
| Rate for Payer: Multiplan Medicare/VA |
$672.17
|
| Rate for Payer: One Health Plan of WY PPO |
$4,110.12
|
| Rate for Payer: PacificSource Commercial |
$3,774.60
|
| Rate for Payer: PHCS PPO |
$3,984.30
|
| Rate for Payer: Three Rivers PPO |
$3,145.50
|
| Rate for Payer: TriWest Veterans Administration |
$790.79
|
| Rate for Payer: United Healthcare Commercial |
$3,648.78
|
| Rate for Payer: United Healthcare Medicare |
$790.79
|
| Rate for Payer: WINHealth Partners Commercial |
$3,564.90
|
|
|
ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$4,194.00
|
|
|
Service Code
|
HCPCS 29862 AS
|
| Hospital Charge Code |
29862
|
| Min. Negotiated Rate |
$672.17 |
| Max. Negotiated Rate |
$4,194.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,110.12
|
| Rate for Payer: Aetna of WY Medicare |
$790.79
|
| Rate for Payer: Beech Street Commercial |
$3,984.30
|
| Rate for Payer: Cash Price |
$2,935.80
|
| Rate for Payer: Cash Price |
$2,935.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,068.18
|
| Rate for Payer: Cigna of WY Commercial |
$4,110.12
|
| Rate for Payer: First Choice Health Commercial |
$3,774.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,984.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$790.79
|
| Rate for Payer: HealthUtah PPO |
$4,194.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,068.18
|
| Rate for Payer: Multiplan Medicare/VA |
$672.17
|
| Rate for Payer: One Health Plan of WY PPO |
$4,110.12
|
| Rate for Payer: PacificSource Commercial |
$3,774.60
|
| Rate for Payer: PHCS PPO |
$3,984.30
|
| Rate for Payer: Three Rivers PPO |
$3,145.50
|
| Rate for Payer: TriWest Veterans Administration |
$790.79
|
| Rate for Payer: United Healthcare Commercial |
$3,648.78
|
| Rate for Payer: United Healthcare Medicare |
$790.79
|
| Rate for Payer: WINHealth Partners Commercial |
$3,564.90
|
|
|
ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$4,194.00
|
|
|
Service Code
|
HCPCS 29862 80
|
| Hospital Charge Code |
29862
|
| Min. Negotiated Rate |
$672.17 |
| Max. Negotiated Rate |
$4,194.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,110.12
|
| Rate for Payer: Aetna of WY Medicare |
$790.79
|
| Rate for Payer: Beech Street Commercial |
$3,984.30
|
| Rate for Payer: Cash Price |
$2,935.80
|
| Rate for Payer: Cash Price |
$2,935.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,068.18
|
| Rate for Payer: Cigna of WY Commercial |
$4,110.12
|
| Rate for Payer: First Choice Health Commercial |
$3,774.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,984.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$790.79
|
| Rate for Payer: HealthUtah PPO |
$4,194.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,068.18
|
| Rate for Payer: Multiplan Medicare/VA |
$672.17
|
| Rate for Payer: One Health Plan of WY PPO |
$4,110.12
|
| Rate for Payer: PacificSource Commercial |
$3,774.60
|
| Rate for Payer: PHCS PPO |
$3,984.30
|
| Rate for Payer: Three Rivers PPO |
$3,145.50
|
| Rate for Payer: TriWest Veterans Administration |
$790.79
|
| Rate for Payer: United Healthcare Commercial |
$3,648.78
|
| Rate for Payer: United Healthcare Medicare |
$790.79
|
| Rate for Payer: WINHealth Partners Commercial |
$3,564.90
|
|
|
ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 29879 AS
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$546.84 |
| Max. Negotiated Rate |
$3,414.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,345.72
|
| Rate for Payer: Aetna of WY Medicare |
$643.34
|
| Rate for Payer: Beech Street Commercial |
$3,243.30
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,311.58
|
| Rate for Payer: Cigna of WY Commercial |
$3,345.72
|
| Rate for Payer: First Choice Health Commercial |
$3,072.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,243.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$643.34
|
| Rate for Payer: HealthUtah PPO |
$3,414.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,311.58
|
| Rate for Payer: Multiplan Medicare/VA |
$546.84
|
| Rate for Payer: One Health Plan of WY PPO |
$3,345.72
|
| Rate for Payer: PacificSource Commercial |
$3,072.60
|
| Rate for Payer: PHCS PPO |
$3,243.30
|
| Rate for Payer: Three Rivers PPO |
$2,560.50
|
| Rate for Payer: TriWest Veterans Administration |
$643.34
|
| Rate for Payer: United Healthcare Commercial |
$2,970.18
|
| Rate for Payer: United Healthcare Medicare |
$643.34
|
| Rate for Payer: WINHealth Partners Commercial |
$2,901.90
|
|
|
ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 29879 80
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$546.84 |
| Max. Negotiated Rate |
$3,414.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,345.72
|
| Rate for Payer: Aetna of WY Medicare |
$643.34
|
| Rate for Payer: Beech Street Commercial |
$3,243.30
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,311.58
|
| Rate for Payer: Cigna of WY Commercial |
$3,345.72
|
| Rate for Payer: First Choice Health Commercial |
$3,072.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,243.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$643.34
|
| Rate for Payer: HealthUtah PPO |
$3,414.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,311.58
|
| Rate for Payer: Multiplan Medicare/VA |
$546.84
|
| Rate for Payer: One Health Plan of WY PPO |
$3,345.72
|
| Rate for Payer: PacificSource Commercial |
$3,072.60
|
| Rate for Payer: PHCS PPO |
$3,243.30
|
| Rate for Payer: Three Rivers PPO |
$2,560.50
|
| Rate for Payer: TriWest Veterans Administration |
$643.34
|
| Rate for Payer: United Healthcare Commercial |
$2,970.18
|
| Rate for Payer: United Healthcare Medicare |
$643.34
|
| Rate for Payer: WINHealth Partners Commercial |
$2,901.90
|
|
|
ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$546.84 |
| Max. Negotiated Rate |
$3,414.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,345.72
|
| Rate for Payer: Aetna of WY Medicare |
$643.34
|
| Rate for Payer: Beech Street Commercial |
$3,243.30
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,311.58
|
| Rate for Payer: Cigna of WY Commercial |
$3,345.72
|
| Rate for Payer: First Choice Health Commercial |
$3,072.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,243.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$643.34
|
| Rate for Payer: HealthUtah PPO |
$3,414.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,311.58
|
| Rate for Payer: Multiplan Medicare/VA |
$546.84
|
| Rate for Payer: One Health Plan of WY PPO |
$3,345.72
|
| Rate for Payer: PacificSource Commercial |
$3,072.60
|
| Rate for Payer: PHCS PPO |
$3,243.30
|
| Rate for Payer: Three Rivers PPO |
$2,560.50
|
| Rate for Payer: TriWest Veterans Administration |
$643.34
|
| Rate for Payer: United Healthcare Commercial |
$2,970.18
|
| Rate for Payer: United Healthcare Medicare |
$643.34
|
| Rate for Payer: WINHealth Partners Commercial |
$2,901.90
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$3,203.00
|
|
|
Service Code
|
HCPCS 29877 80
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$513.70 |
| Max. Negotiated Rate |
$3,203.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,138.94
|
| Rate for Payer: Aetna of WY Medicare |
$604.35
|
| Rate for Payer: Beech Street Commercial |
$3,042.85
|
| Rate for Payer: Cash Price |
$2,242.10
|
| Rate for Payer: Cash Price |
$2,242.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,106.91
|
| Rate for Payer: Cigna of WY Commercial |
$3,138.94
|
| Rate for Payer: First Choice Health Commercial |
$2,882.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,042.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$604.35
|
| Rate for Payer: HealthUtah PPO |
$3,203.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,106.91
|
| Rate for Payer: Multiplan Medicare/VA |
$513.70
|
| Rate for Payer: One Health Plan of WY PPO |
$3,138.94
|
| Rate for Payer: PacificSource Commercial |
$2,882.70
|
| Rate for Payer: PHCS PPO |
$3,042.85
|
| Rate for Payer: Three Rivers PPO |
$2,402.25
|
| Rate for Payer: TriWest Veterans Administration |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$2,786.61
|
| Rate for Payer: United Healthcare Medicare |
$604.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2,722.55
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$3,203.00
|
|
|
Service Code
|
HCPCS 29877 AS
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$513.70 |
| Max. Negotiated Rate |
$3,203.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,138.94
|
| Rate for Payer: Aetna of WY Medicare |
$604.35
|
| Rate for Payer: Beech Street Commercial |
$3,042.85
|
| Rate for Payer: Cash Price |
$2,242.10
|
| Rate for Payer: Cash Price |
$2,242.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,106.91
|
| Rate for Payer: Cigna of WY Commercial |
$3,138.94
|
| Rate for Payer: First Choice Health Commercial |
$2,882.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,042.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$604.35
|
| Rate for Payer: HealthUtah PPO |
$3,203.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,106.91
|
| Rate for Payer: Multiplan Medicare/VA |
$513.70
|
| Rate for Payer: One Health Plan of WY PPO |
$3,138.94
|
| Rate for Payer: PacificSource Commercial |
$2,882.70
|
| Rate for Payer: PHCS PPO |
$3,042.85
|
| Rate for Payer: Three Rivers PPO |
$2,402.25
|
| Rate for Payer: TriWest Veterans Administration |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$2,786.61
|
| Rate for Payer: United Healthcare Medicare |
$604.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2,722.55
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$6,407.00
|
|
|
Service Code
|
HCPCS 29877 50
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$513.70 |
| Max. Negotiated Rate |
$6,407.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,278.86
|
| Rate for Payer: Aetna of WY Medicare |
$604.35
|
| Rate for Payer: Beech Street Commercial |
$6,086.65
|
| Rate for Payer: Cash Price |
$4,484.90
|
| Rate for Payer: Cash Price |
$4,484.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,214.79
|
| Rate for Payer: Cigna of WY Commercial |
$6,278.86
|
| Rate for Payer: First Choice Health Commercial |
$5,766.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,086.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$604.35
|
| Rate for Payer: HealthUtah PPO |
$6,407.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,214.79
|
| Rate for Payer: Multiplan Medicare/VA |
$513.70
|
| Rate for Payer: One Health Plan of WY PPO |
$6,278.86
|
| Rate for Payer: PacificSource Commercial |
$5,766.30
|
| Rate for Payer: PHCS PPO |
$6,086.65
|
| Rate for Payer: Three Rivers PPO |
$4,805.25
|
| Rate for Payer: TriWest Veterans Administration |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$5,574.09
|
| Rate for Payer: United Healthcare Medicare |
$604.35
|
| Rate for Payer: WINHealth Partners Commercial |
$5,445.95
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$3,203.00
|
|
|
Service Code
|
HCPCS 29877
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$513.70 |
| Max. Negotiated Rate |
$3,203.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,138.94
|
| Rate for Payer: Aetna of WY Medicare |
$604.35
|
| Rate for Payer: Beech Street Commercial |
$3,042.85
|
| Rate for Payer: Cash Price |
$2,242.10
|
| Rate for Payer: Cash Price |
$2,242.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,106.91
|
| Rate for Payer: Cigna of WY Commercial |
$3,138.94
|
| Rate for Payer: First Choice Health Commercial |
$2,882.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,042.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$604.35
|
| Rate for Payer: HealthUtah PPO |
$3,203.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,106.91
|
| Rate for Payer: Multiplan Medicare/VA |
$513.70
|
| Rate for Payer: One Health Plan of WY PPO |
$3,138.94
|
| Rate for Payer: PacificSource Commercial |
$2,882.70
|
| Rate for Payer: PHCS PPO |
$3,042.85
|
| Rate for Payer: Three Rivers PPO |
$2,402.25
|
| Rate for Payer: TriWest Veterans Administration |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$2,786.61
|
| Rate for Payer: United Healthcare Medicare |
$604.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2,722.55
|
|
|
ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ
|
Professional
|
Both
|
$3,875.00
|
|
|
Service Code
|
HCPCS 29887
|
| Hospital Charge Code |
29887
|
| Min. Negotiated Rate |
$622.67 |
| Max. Negotiated Rate |
$3,875.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,797.50
|
| Rate for Payer: Aetna of WY Medicare |
$732.55
|
| Rate for Payer: Beech Street Commercial |
$3,681.25
|
| Rate for Payer: Cash Price |
$2,712.50
|
| Rate for Payer: Cash Price |
$2,712.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,758.75
|
| Rate for Payer: Cigna of WY Commercial |
$3,797.50
|
| Rate for Payer: First Choice Health Commercial |
$3,487.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,681.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$732.55
|
| Rate for Payer: HealthUtah PPO |
$3,875.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,758.75
|
| Rate for Payer: Multiplan Medicare/VA |
$622.67
|
| Rate for Payer: One Health Plan of WY PPO |
$3,797.50
|
| Rate for Payer: PacificSource Commercial |
$3,487.50
|
| Rate for Payer: PHCS PPO |
$3,681.25
|
| Rate for Payer: Three Rivers PPO |
$2,906.25
|
| Rate for Payer: TriWest Veterans Administration |
$732.55
|
| Rate for Payer: United Healthcare Commercial |
$3,371.25
|
| Rate for Payer: United Healthcare Medicare |
$732.55
|
| Rate for Payer: WINHealth Partners Commercial |
$3,293.75
|
|
|
ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,897.00
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$465.74 |
| Max. Negotiated Rate |
$2,897.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,839.06
|
| Rate for Payer: Aetna of WY Medicare |
$547.93
|
| Rate for Payer: Beech Street Commercial |
$2,752.15
|
| Rate for Payer: Cash Price |
$2,027.90
|
| Rate for Payer: Cash Price |
$2,027.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,810.09
|
| Rate for Payer: Cigna of WY Commercial |
$2,839.06
|
| Rate for Payer: First Choice Health Commercial |
$2,607.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,752.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$547.93
|
| Rate for Payer: HealthUtah PPO |
$2,897.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,810.09
|
| Rate for Payer: Multiplan Medicare/VA |
$465.74
|
| Rate for Payer: One Health Plan of WY PPO |
$2,839.06
|
| Rate for Payer: PacificSource Commercial |
$2,607.30
|
| Rate for Payer: PHCS PPO |
$2,752.15
|
| Rate for Payer: Three Rivers PPO |
$2,172.75
|
| Rate for Payer: TriWest Veterans Administration |
$547.93
|
| Rate for Payer: United Healthcare Commercial |
$2,520.39
|
| Rate for Payer: United Healthcare Medicare |
$547.93
|
| Rate for Payer: WINHealth Partners Commercial |
$2,462.45
|
|
|
ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,897.00
|
|
|
Service Code
|
HCPCS 29880 AS
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$465.74 |
| Max. Negotiated Rate |
$2,897.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,839.06
|
| Rate for Payer: Aetna of WY Medicare |
$547.93
|
| Rate for Payer: Beech Street Commercial |
$2,752.15
|
| Rate for Payer: Cash Price |
$2,027.90
|
| Rate for Payer: Cash Price |
$2,027.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,810.09
|
| Rate for Payer: Cigna of WY Commercial |
$2,839.06
|
| Rate for Payer: First Choice Health Commercial |
$2,607.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,752.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$547.93
|
| Rate for Payer: HealthUtah PPO |
$2,897.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,810.09
|
| Rate for Payer: Multiplan Medicare/VA |
$465.74
|
| Rate for Payer: One Health Plan of WY PPO |
$2,839.06
|
| Rate for Payer: PacificSource Commercial |
$2,607.30
|
| Rate for Payer: PHCS PPO |
$2,752.15
|
| Rate for Payer: Three Rivers PPO |
$2,172.75
|
| Rate for Payer: TriWest Veterans Administration |
$547.93
|
| Rate for Payer: United Healthcare Commercial |
$2,520.39
|
| Rate for Payer: United Healthcare Medicare |
$547.93
|
| Rate for Payer: WINHealth Partners Commercial |
$2,462.45
|
|
|
ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,897.00
|
|
|
Service Code
|
HCPCS 29880 80
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$465.74 |
| Max. Negotiated Rate |
$2,897.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,839.06
|
| Rate for Payer: Aetna of WY Medicare |
$547.93
|
| Rate for Payer: Beech Street Commercial |
$2,752.15
|
| Rate for Payer: Cash Price |
$2,027.90
|
| Rate for Payer: Cash Price |
$2,027.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,810.09
|
| Rate for Payer: Cigna of WY Commercial |
$2,839.06
|
| Rate for Payer: First Choice Health Commercial |
$2,607.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,752.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$547.93
|
| Rate for Payer: HealthUtah PPO |
$2,897.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,810.09
|
| Rate for Payer: Multiplan Medicare/VA |
$465.74
|
| Rate for Payer: One Health Plan of WY PPO |
$2,839.06
|
| Rate for Payer: PacificSource Commercial |
$2,607.30
|
| Rate for Payer: PHCS PPO |
$2,752.15
|
| Rate for Payer: Three Rivers PPO |
$2,172.75
|
| Rate for Payer: TriWest Veterans Administration |
$547.93
|
| Rate for Payer: United Healthcare Commercial |
$2,520.39
|
| Rate for Payer: United Healthcare Medicare |
$547.93
|
| Rate for Payer: WINHealth Partners Commercial |
$2,462.45
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 29881 AS
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,792.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,736.16
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,652.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,708.24
|
| Rate for Payer: Cigna of WY Commercial |
$2,736.16
|
| Rate for Payer: First Choice Health Commercial |
$2,512.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,652.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,792.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,708.24
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,736.16
|
| Rate for Payer: PacificSource Commercial |
$2,512.80
|
| Rate for Payer: PHCS PPO |
$2,652.40
|
| Rate for Payer: Three Rivers PPO |
$2,094.00
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,429.04
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,373.20
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,792.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,736.16
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,652.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,708.24
|
| Rate for Payer: Cigna of WY Commercial |
$2,736.16
|
| Rate for Payer: First Choice Health Commercial |
$2,512.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,652.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,792.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,708.24
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,736.16
|
| Rate for Payer: PacificSource Commercial |
$2,512.80
|
| Rate for Payer: PHCS PPO |
$2,652.40
|
| Rate for Payer: Three Rivers PPO |
$2,094.00
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,429.04
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,373.20
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$5,583.00
|
|
|
Service Code
|
HCPCS 29881 50
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$5,583.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,471.34
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$5,303.85
|
| Rate for Payer: Cash Price |
$3,908.10
|
| Rate for Payer: Cash Price |
$3,908.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,415.51
|
| Rate for Payer: Cigna of WY Commercial |
$5,471.34
|
| Rate for Payer: First Choice Health Commercial |
$5,024.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,303.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$5,583.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,415.51
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$5,471.34
|
| Rate for Payer: PacificSource Commercial |
$5,024.70
|
| Rate for Payer: PHCS PPO |
$5,303.85
|
| Rate for Payer: Three Rivers PPO |
$4,187.25
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$4,857.21
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$4,745.55
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 29881 80
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,792.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,736.16
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,652.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,708.24
|
| Rate for Payer: Cigna of WY Commercial |
$2,736.16
|
| Rate for Payer: First Choice Health Commercial |
$2,512.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,652.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,792.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,708.24
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,736.16
|
| Rate for Payer: PacificSource Commercial |
$2,512.80
|
| Rate for Payer: PHCS PPO |
$2,652.40
|
| Rate for Payer: Three Rivers PPO |
$2,094.00
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,429.04
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,373.20
|
|
|
ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 29800
|
| Hospital Charge Code |
29800
|
| Min. Negotiated Rate |
$440.85 |
| Max. Negotiated Rate |
$2,725.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,670.50
|
| Rate for Payer: Aetna of WY Medicare |
$518.65
|
| Rate for Payer: Beech Street Commercial |
$2,588.75
|
| Rate for Payer: Cash Price |
$1,907.50
|
| Rate for Payer: Cash Price |
$1,907.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,643.25
|
| Rate for Payer: Cigna of WY Commercial |
$2,670.50
|
| Rate for Payer: First Choice Health Commercial |
$2,452.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,588.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$518.65
|
| Rate for Payer: HealthUtah PPO |
$2,725.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,643.25
|
| Rate for Payer: Multiplan Medicare/VA |
$440.85
|
| Rate for Payer: One Health Plan of WY PPO |
$2,670.50
|
| Rate for Payer: PacificSource Commercial |
$2,452.50
|
| Rate for Payer: PHCS PPO |
$2,588.75
|
| Rate for Payer: Three Rivers PPO |
$2,043.75
|
| Rate for Payer: TriWest Veterans Administration |
$518.65
|
| Rate for Payer: United Healthcare Commercial |
$2,370.75
|
| Rate for Payer: United Healthcare Medicare |
$518.65
|
| Rate for Payer: WINHealth Partners Commercial |
$2,316.25
|
|
|
ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$2,142.00
|
|
|
Service Code
|
HCPCS 29846
|
| Hospital Charge Code |
29846
|
| Min. Negotiated Rate |
$434.21 |
| Max. Negotiated Rate |
$2,142.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,099.16
|
| Rate for Payer: Aetna of WY Medicare |
$510.83
|
| Rate for Payer: Beech Street Commercial |
$2,034.90
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,077.74
|
| Rate for Payer: Cigna of WY Commercial |
$2,099.16
|
| Rate for Payer: First Choice Health Commercial |
$1,927.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,034.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$510.83
|
| Rate for Payer: HealthUtah PPO |
$2,142.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,077.74
|
| Rate for Payer: Multiplan Medicare/VA |
$434.21
|
| Rate for Payer: One Health Plan of WY PPO |
$2,099.16
|
| Rate for Payer: PacificSource Commercial |
$1,927.80
|
| Rate for Payer: PHCS PPO |
$2,034.90
|
| Rate for Payer: Three Rivers PPO |
$1,606.50
|
| Rate for Payer: TriWest Veterans Administration |
$510.83
|
| Rate for Payer: United Healthcare Commercial |
$1,863.54
|
| Rate for Payer: United Healthcare Medicare |
$510.83
|
| Rate for Payer: WINHealth Partners Commercial |
$1,820.70
|
|
|
ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$2,142.00
|
|
|
Service Code
|
HCPCS 29846 AS
|
| Hospital Charge Code |
29846
|
| Min. Negotiated Rate |
$434.21 |
| Max. Negotiated Rate |
$2,142.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,099.16
|
| Rate for Payer: Aetna of WY Medicare |
$510.83
|
| Rate for Payer: Beech Street Commercial |
$2,034.90
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,077.74
|
| Rate for Payer: Cigna of WY Commercial |
$2,099.16
|
| Rate for Payer: First Choice Health Commercial |
$1,927.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,034.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$510.83
|
| Rate for Payer: HealthUtah PPO |
$2,142.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,077.74
|
| Rate for Payer: Multiplan Medicare/VA |
$434.21
|
| Rate for Payer: One Health Plan of WY PPO |
$2,099.16
|
| Rate for Payer: PacificSource Commercial |
$1,927.80
|
| Rate for Payer: PHCS PPO |
$2,034.90
|
| Rate for Payer: Three Rivers PPO |
$1,606.50
|
| Rate for Payer: TriWest Veterans Administration |
$510.83
|
| Rate for Payer: United Healthcare Commercial |
$1,863.54
|
| Rate for Payer: United Healthcare Medicare |
$510.83
|
| Rate for Payer: WINHealth Partners Commercial |
$1,820.70
|
|
|
ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$2,142.00
|
|
|
Service Code
|
HCPCS 29846 80
|
| Hospital Charge Code |
29846
|
| Min. Negotiated Rate |
$434.21 |
| Max. Negotiated Rate |
$2,142.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,099.16
|
| Rate for Payer: Aetna of WY Medicare |
$510.83
|
| Rate for Payer: Beech Street Commercial |
$2,034.90
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,077.74
|
| Rate for Payer: Cigna of WY Commercial |
$2,099.16
|
| Rate for Payer: First Choice Health Commercial |
$1,927.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,034.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$510.83
|
| Rate for Payer: HealthUtah PPO |
$2,142.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,077.74
|
| Rate for Payer: Multiplan Medicare/VA |
$434.21
|
| Rate for Payer: One Health Plan of WY PPO |
$2,099.16
|
| Rate for Payer: PacificSource Commercial |
$1,927.80
|
| Rate for Payer: PHCS PPO |
$2,034.90
|
| Rate for Payer: Three Rivers PPO |
$1,606.50
|
| Rate for Payer: TriWest Veterans Administration |
$510.83
|
| Rate for Payer: United Healthcare Commercial |
$1,863.54
|
| Rate for Payer: United Healthcare Medicare |
$510.83
|
| Rate for Payer: WINHealth Partners Commercial |
$1,820.70
|
|
|
ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,933.00
|
|
|
Service Code
|
HCPCS 23044
|
| Hospital Charge Code |
23044
|
| Min. Negotiated Rate |
$467.93 |
| Max. Negotiated Rate |
$1,933.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,894.34
|
| Rate for Payer: Aetna of WY Medicare |
$550.51
|
| Rate for Payer: Beech Street Commercial |
$1,836.35
|
| Rate for Payer: Cash Price |
$1,353.10
|
| Rate for Payer: Cash Price |
$1,353.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,875.01
|
| Rate for Payer: Cigna of WY Commercial |
$1,894.34
|
| Rate for Payer: First Choice Health Commercial |
$1,739.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,836.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$550.51
|
| Rate for Payer: HealthUtah PPO |
$1,933.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,875.01
|
| Rate for Payer: Multiplan Medicare/VA |
$467.93
|
| Rate for Payer: One Health Plan of WY PPO |
$1,894.34
|
| Rate for Payer: PacificSource Commercial |
$1,739.70
|
| Rate for Payer: PHCS PPO |
$1,836.35
|
| Rate for Payer: Three Rivers PPO |
$1,449.75
|
| Rate for Payer: TriWest Veterans Administration |
$550.51
|
| Rate for Payer: United Healthcare Commercial |
$1,681.71
|
| Rate for Payer: United Healthcare Medicare |
$550.51
|
| Rate for Payer: WINHealth Partners Commercial |
$1,643.05
|
|
|
ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 27620 AS
|
| Hospital Charge Code |
27620
|
| Min. Negotiated Rate |
$372.81 |
| Max. Negotiated Rate |
$2,313.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,266.74
|
| Rate for Payer: Aetna of WY Medicare |
$438.60
|
| Rate for Payer: Beech Street Commercial |
$2,197.35
|
| Rate for Payer: Cash Price |
$1,619.10
|
| Rate for Payer: Cash Price |
$1,619.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,243.61
|
| Rate for Payer: Cigna of WY Commercial |
$2,266.74
|
| Rate for Payer: First Choice Health Commercial |
$2,081.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,197.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$438.60
|
| Rate for Payer: HealthUtah PPO |
$2,313.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,243.61
|
| Rate for Payer: Multiplan Medicare/VA |
$372.81
|
| Rate for Payer: One Health Plan of WY PPO |
$2,266.74
|
| Rate for Payer: PacificSource Commercial |
$2,081.70
|
| Rate for Payer: PHCS PPO |
$2,197.35
|
| Rate for Payer: Three Rivers PPO |
$1,734.75
|
| Rate for Payer: TriWest Veterans Administration |
$438.60
|
| Rate for Payer: United Healthcare Commercial |
$2,012.31
|
| Rate for Payer: United Healthcare Medicare |
$438.60
|
| Rate for Payer: WINHealth Partners Commercial |
$1,966.05
|
|
|
ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 27620
|
| Hospital Charge Code |
27620
|
| Min. Negotiated Rate |
$372.81 |
| Max. Negotiated Rate |
$2,313.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,266.74
|
| Rate for Payer: Aetna of WY Medicare |
$438.60
|
| Rate for Payer: Beech Street Commercial |
$2,197.35
|
| Rate for Payer: Cash Price |
$1,619.10
|
| Rate for Payer: Cash Price |
$1,619.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,243.61
|
| Rate for Payer: Cigna of WY Commercial |
$2,266.74
|
| Rate for Payer: First Choice Health Commercial |
$2,081.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,197.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$438.60
|
| Rate for Payer: HealthUtah PPO |
$2,313.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,243.61
|
| Rate for Payer: Multiplan Medicare/VA |
$372.81
|
| Rate for Payer: One Health Plan of WY PPO |
$2,266.74
|
| Rate for Payer: PacificSource Commercial |
$2,081.70
|
| Rate for Payer: PHCS PPO |
$2,197.35
|
| Rate for Payer: Three Rivers PPO |
$1,734.75
|
| Rate for Payer: TriWest Veterans Administration |
$438.60
|
| Rate for Payer: United Healthcare Commercial |
$2,012.31
|
| Rate for Payer: United Healthcare Medicare |
$438.60
|
| Rate for Payer: WINHealth Partners Commercial |
$1,966.05
|
|
