|
ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$6,356.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$1,176.95 |
| Max. Negotiated Rate |
$6,356.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,228.88
|
| Rate for Payer: Aetna of WY Medicare |
$1,384.65
|
| Rate for Payer: Beech Street Commercial |
$6,038.20
|
| Rate for Payer: Cash Price |
$4,449.20
|
| Rate for Payer: Cash Price |
$4,449.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,165.32
|
| Rate for Payer: Cigna of WY Commercial |
$6,228.88
|
| Rate for Payer: First Choice Health Commercial |
$5,720.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,038.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,384.65
|
| Rate for Payer: HealthUtah PPO |
$6,356.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,165.32
|
| Rate for Payer: Multiplan Medicare/VA |
$1,176.95
|
| Rate for Payer: One Health Plan of WY PPO |
$6,228.88
|
| Rate for Payer: PacificSource Commercial |
$5,720.40
|
| Rate for Payer: PHCS PPO |
$6,038.20
|
| Rate for Payer: Three Rivers PPO |
$4,767.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,384.65
|
| Rate for Payer: United Healthcare Commercial |
$6,038.20
|
| Rate for Payer: WINHealth Partners Commercial |
$5,402.60
|
|
|
ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$6,356.00
|
|
|
Service Code
|
HCPCS 23472 AS
|
| Min. Negotiated Rate |
$1,176.95 |
| Max. Negotiated Rate |
$6,356.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,228.88
|
| Rate for Payer: Beech Street Commercial |
$6,038.20
|
| Rate for Payer: Cash Price |
$4,449.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,165.32
|
| Rate for Payer: Cigna of WY Commercial |
$6,228.88
|
| Rate for Payer: First Choice Health Commercial |
$5,720.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,038.20
|
| Rate for Payer: HealthUtah PPO |
$6,356.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,165.32
|
| Rate for Payer: One Health Plan of WY PPO |
$6,228.88
|
| Rate for Payer: PacificSource Commercial |
$5,720.40
|
| Rate for Payer: PHCS PPO |
$6,038.20
|
| Rate for Payer: Three Rivers PPO |
$4,767.00
|
| Rate for Payer: United Healthcare Commercial |
$6,038.20
|
| Rate for Payer: WINHealth Partners Commercial |
$5,402.60
|
|
|
ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$6,356.00
|
|
|
Service Code
|
HCPCS 23472 80
|
| Min. Negotiated Rate |
$1,176.95 |
| Max. Negotiated Rate |
$6,356.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,228.88
|
| Rate for Payer: Beech Street Commercial |
$6,038.20
|
| Rate for Payer: Cash Price |
$4,449.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,165.32
|
| Rate for Payer: Cigna of WY Commercial |
$6,228.88
|
| Rate for Payer: First Choice Health Commercial |
$5,720.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,038.20
|
| Rate for Payer: HealthUtah PPO |
$6,356.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,165.32
|
| Rate for Payer: One Health Plan of WY PPO |
$6,228.88
|
| Rate for Payer: PacificSource Commercial |
$5,720.40
|
| Rate for Payer: PHCS PPO |
$6,038.20
|
| Rate for Payer: Three Rivers PPO |
$4,767.00
|
| Rate for Payer: United Healthcare Commercial |
$6,038.20
|
| Rate for Payer: WINHealth Partners Commercial |
$5,402.60
|
|
|
ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$5,260.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$978.97 |
| Max. Negotiated Rate |
$5,260.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,154.80
|
| Rate for Payer: Aetna of WY Medicare |
$1,151.73
|
| Rate for Payer: Beech Street Commercial |
$4,997.00
|
| Rate for Payer: Cash Price |
$3,682.00
|
| Rate for Payer: Cash Price |
$3,682.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,102.20
|
| Rate for Payer: Cigna of WY Commercial |
$5,154.80
|
| Rate for Payer: First Choice Health Commercial |
$4,734.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,997.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,151.73
|
| Rate for Payer: HealthUtah PPO |
$5,260.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,102.20
|
| Rate for Payer: Multiplan Medicare/VA |
$978.97
|
| Rate for Payer: One Health Plan of WY PPO |
$5,154.80
|
| Rate for Payer: PacificSource Commercial |
$4,734.00
|
| Rate for Payer: PHCS PPO |
$4,997.00
|
| Rate for Payer: Three Rivers PPO |
$3,945.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,151.73
|
| Rate for Payer: United Healthcare Commercial |
$4,997.00
|
| Rate for Payer: WINHealth Partners Commercial |
$4,471.00
|
|
|
ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$5,260.00
|
|
|
Service Code
|
HCPCS 23470 80
|
| Min. Negotiated Rate |
$978.97 |
| Max. Negotiated Rate |
$5,260.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,154.80
|
| Rate for Payer: Beech Street Commercial |
$4,997.00
|
| Rate for Payer: Cash Price |
$3,682.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,102.20
|
| Rate for Payer: Cigna of WY Commercial |
$5,154.80
|
| Rate for Payer: First Choice Health Commercial |
$4,734.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,997.00
|
| Rate for Payer: HealthUtah PPO |
$5,260.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,102.20
|
| Rate for Payer: One Health Plan of WY PPO |
$5,154.80
|
| Rate for Payer: PacificSource Commercial |
$4,734.00
|
| Rate for Payer: PHCS PPO |
$4,997.00
|
| Rate for Payer: Three Rivers PPO |
$3,945.00
|
| Rate for Payer: United Healthcare Commercial |
$4,997.00
|
| Rate for Payer: WINHealth Partners Commercial |
$4,471.00
|
|
|
ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$8,348.00
|
|
|
Service Code
|
HCPCS 26535
|
| Min. Negotiated Rate |
$367.51 |
| Max. Negotiated Rate |
$8,348.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,181.04
|
| Rate for Payer: Aetna of WY Medicare |
$432.36
|
| Rate for Payer: Beech Street Commercial |
$7,930.60
|
| Rate for Payer: Cash Price |
$5,843.60
|
| Rate for Payer: Cash Price |
$5,843.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$8,097.56
|
| Rate for Payer: Cigna of WY Commercial |
$8,181.04
|
| Rate for Payer: First Choice Health Commercial |
$7,513.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,930.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$432.36
|
| Rate for Payer: HealthUtah PPO |
$8,348.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,097.56
|
| Rate for Payer: Multiplan Medicare/VA |
$367.51
|
| Rate for Payer: One Health Plan of WY PPO |
$8,181.04
|
| Rate for Payer: PacificSource Commercial |
$7,513.20
|
| Rate for Payer: PHCS PPO |
$7,930.60
|
| Rate for Payer: Three Rivers PPO |
$6,261.00
|
| Rate for Payer: TriWest Veterans Administration |
$432.36
|
| Rate for Payer: United Healthcare Commercial |
$7,930.60
|
| Rate for Payer: WINHealth Partners Commercial |
$7,095.80
|
|
|
ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$9,627.00
|
|
|
Service Code
|
HCPCS 26536
|
| Min. Negotiated Rate |
$625.37 |
| Max. Negotiated Rate |
$9,627.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,434.46
|
| Rate for Payer: Aetna of WY Medicare |
$735.73
|
| Rate for Payer: Beech Street Commercial |
$9,145.65
|
| Rate for Payer: Cash Price |
$6,738.90
|
| Rate for Payer: Cash Price |
$6,738.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,338.19
|
| Rate for Payer: Cigna of WY Commercial |
$9,434.46
|
| Rate for Payer: First Choice Health Commercial |
$8,664.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9,145.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$735.73
|
| Rate for Payer: HealthUtah PPO |
$9,627.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,338.19
|
| Rate for Payer: Multiplan Medicare/VA |
$625.37
|
| Rate for Payer: One Health Plan of WY PPO |
$9,434.46
|
| Rate for Payer: PacificSource Commercial |
$8,664.30
|
| Rate for Payer: PHCS PPO |
$9,145.65
|
| Rate for Payer: Three Rivers PPO |
$7,220.25
|
| Rate for Payer: TriWest Veterans Administration |
$735.73
|
| Rate for Payer: United Healthcare Commercial |
$9,145.65
|
| Rate for Payer: WINHealth Partners Commercial |
$8,182.95
|
|
|
ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$9,627.00
|
|
|
Service Code
|
HCPCS 26536 AS
|
| Min. Negotiated Rate |
$625.37 |
| Max. Negotiated Rate |
$9,627.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,434.46
|
| Rate for Payer: Beech Street Commercial |
$9,145.65
|
| Rate for Payer: Cash Price |
$6,738.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,338.19
|
| Rate for Payer: Cigna of WY Commercial |
$9,434.46
|
| Rate for Payer: First Choice Health Commercial |
$8,664.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9,145.65
|
| Rate for Payer: HealthUtah PPO |
$9,627.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,338.19
|
| Rate for Payer: One Health Plan of WY PPO |
$9,434.46
|
| Rate for Payer: PacificSource Commercial |
$8,664.30
|
| Rate for Payer: PHCS PPO |
$9,145.65
|
| Rate for Payer: Three Rivers PPO |
$7,220.25
|
| Rate for Payer: United Healthcare Commercial |
$9,145.65
|
| Rate for Payer: WINHealth Partners Commercial |
$8,182.95
|
|
|
ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 26530
|
| Min. Negotiated Rate |
$452.93 |
| Max. Negotiated Rate |
$2,329.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,282.42
|
| Rate for Payer: Aetna of WY Medicare |
$532.86
|
| Rate for Payer: Beech Street Commercial |
$2,212.55
|
| Rate for Payer: Cash Price |
$1,630.30
|
| Rate for Payer: Cash Price |
$1,630.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,259.13
|
| Rate for Payer: Cigna of WY Commercial |
$2,282.42
|
| Rate for Payer: First Choice Health Commercial |
$2,096.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,212.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$532.86
|
| Rate for Payer: HealthUtah PPO |
$2,329.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,259.13
|
| Rate for Payer: Multiplan Medicare/VA |
$452.93
|
| Rate for Payer: One Health Plan of WY PPO |
$2,282.42
|
| Rate for Payer: PacificSource Commercial |
$2,096.10
|
| Rate for Payer: PHCS PPO |
$2,212.55
|
| Rate for Payer: Three Rivers PPO |
$1,746.75
|
| Rate for Payer: TriWest Veterans Administration |
$532.86
|
| Rate for Payer: United Healthcare Commercial |
$2,212.55
|
| Rate for Payer: WINHealth Partners Commercial |
$1,979.65
|
|
|
ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 26530 AS
|
| Min. Negotiated Rate |
$452.93 |
| Max. Negotiated Rate |
$2,329.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,282.42
|
| Rate for Payer: Beech Street Commercial |
$2,212.55
|
| Rate for Payer: Cash Price |
$1,630.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,259.13
|
| Rate for Payer: Cigna of WY Commercial |
$2,282.42
|
| Rate for Payer: First Choice Health Commercial |
$2,096.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,212.55
|
| Rate for Payer: HealthUtah PPO |
$2,329.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,259.13
|
| Rate for Payer: One Health Plan of WY PPO |
$2,282.42
|
| Rate for Payer: PacificSource Commercial |
$2,096.10
|
| Rate for Payer: PHCS PPO |
$2,212.55
|
| Rate for Payer: Three Rivers PPO |
$1,746.75
|
| Rate for Payer: United Healthcare Commercial |
$2,212.55
|
| Rate for Payer: WINHealth Partners Commercial |
$1,979.65
|
|
|
ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 27437 80
|
| Min. Negotiated Rate |
$1,788.75 |
| Max. Negotiated Rate |
$2,385.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,337.30
|
| Rate for Payer: Beech Street Commercial |
$2,265.75
|
| Rate for Payer: Cash Price |
$1,669.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,313.45
|
| Rate for Payer: Cigna of WY Commercial |
$2,337.30
|
| Rate for Payer: First Choice Health Commercial |
$2,146.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,265.75
|
| Rate for Payer: HealthUtah PPO |
$2,385.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,313.45
|
| Rate for Payer: One Health Plan of WY PPO |
$2,337.30
|
| Rate for Payer: PacificSource Commercial |
$2,146.50
|
| Rate for Payer: PHCS PPO |
$2,265.75
|
| Rate for Payer: Three Rivers PPO |
$1,788.75
|
| Rate for Payer: United Healthcare Commercial |
$2,265.75
|
| Rate for Payer: WINHealth Partners Commercial |
$2,027.25
|
|
|
ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$2,907.00
|
|
|
Service Code
|
HCPCS 27437
|
| Min. Negotiated Rate |
$547.88 |
| Max. Negotiated Rate |
$2,907.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,848.86
|
| Rate for Payer: Aetna of WY Medicare |
$644.57
|
| Rate for Payer: Beech Street Commercial |
$2,761.65
|
| Rate for Payer: Cash Price |
$2,034.90
|
| Rate for Payer: Cash Price |
$2,034.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,819.79
|
| Rate for Payer: Cigna of WY Commercial |
$2,848.86
|
| Rate for Payer: First Choice Health Commercial |
$2,616.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,761.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$644.57
|
| Rate for Payer: HealthUtah PPO |
$2,907.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,819.79
|
| Rate for Payer: Multiplan Medicare/VA |
$547.88
|
| Rate for Payer: One Health Plan of WY PPO |
$2,848.86
|
| Rate for Payer: PacificSource Commercial |
$2,616.30
|
| Rate for Payer: PHCS PPO |
$2,761.65
|
| Rate for Payer: Three Rivers PPO |
$2,180.25
|
| Rate for Payer: TriWest Veterans Administration |
$644.57
|
| Rate for Payer: United Healthcare Commercial |
$2,761.65
|
| Rate for Payer: WINHealth Partners Commercial |
$2,470.95
|
|
|
ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$3,713.00
|
|
|
Service Code
|
HCPCS 27438 AS
|
| Min. Negotiated Rate |
$692.22 |
| Max. Negotiated Rate |
$3,713.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,638.74
|
| Rate for Payer: Beech Street Commercial |
$3,527.35
|
| Rate for Payer: Cash Price |
$2,599.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,601.61
|
| Rate for Payer: Cigna of WY Commercial |
$3,638.74
|
| Rate for Payer: First Choice Health Commercial |
$3,341.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,527.35
|
| Rate for Payer: HealthUtah PPO |
$3,713.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,601.61
|
| Rate for Payer: One Health Plan of WY PPO |
$3,638.74
|
| Rate for Payer: PacificSource Commercial |
$3,341.70
|
| Rate for Payer: PHCS PPO |
$3,527.35
|
| Rate for Payer: Three Rivers PPO |
$2,784.75
|
| Rate for Payer: United Healthcare Commercial |
$3,527.35
|
| Rate for Payer: WINHealth Partners Commercial |
$3,156.05
|
|
|
ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$3,713.00
|
|
|
Service Code
|
HCPCS 27438
|
| Min. Negotiated Rate |
$692.22 |
| Max. Negotiated Rate |
$3,713.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,638.74
|
| Rate for Payer: Aetna of WY Medicare |
$814.38
|
| Rate for Payer: Beech Street Commercial |
$3,527.35
|
| Rate for Payer: Cash Price |
$2,599.10
|
| Rate for Payer: Cash Price |
$2,599.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,601.61
|
| Rate for Payer: Cigna of WY Commercial |
$3,638.74
|
| Rate for Payer: First Choice Health Commercial |
$3,341.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,527.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$814.38
|
| Rate for Payer: HealthUtah PPO |
$3,713.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,601.61
|
| Rate for Payer: Multiplan Medicare/VA |
$692.22
|
| Rate for Payer: One Health Plan of WY PPO |
$3,638.74
|
| Rate for Payer: PacificSource Commercial |
$3,341.70
|
| Rate for Payer: PHCS PPO |
$3,527.35
|
| Rate for Payer: Three Rivers PPO |
$2,784.75
|
| Rate for Payer: TriWest Veterans Administration |
$814.38
|
| Rate for Payer: United Healthcare Commercial |
$3,527.35
|
| Rate for Payer: WINHealth Partners Commercial |
$3,156.05
|
|
|
ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$3,713.00
|
|
|
Service Code
|
HCPCS 27438 80
|
| Min. Negotiated Rate |
$692.22 |
| Max. Negotiated Rate |
$3,713.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,638.74
|
| Rate for Payer: Beech Street Commercial |
$3,527.35
|
| Rate for Payer: Cash Price |
$2,599.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,601.61
|
| Rate for Payer: Cigna of WY Commercial |
$3,638.74
|
| Rate for Payer: First Choice Health Commercial |
$3,341.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,527.35
|
| Rate for Payer: HealthUtah PPO |
$3,713.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,601.61
|
| Rate for Payer: One Health Plan of WY PPO |
$3,638.74
|
| Rate for Payer: PacificSource Commercial |
$3,341.70
|
| Rate for Payer: PHCS PPO |
$3,527.35
|
| Rate for Payer: Three Rivers PPO |
$2,784.75
|
| Rate for Payer: United Healthcare Commercial |
$3,527.35
|
| Rate for Payer: WINHealth Partners Commercial |
$3,156.05
|
|
|
ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$8,694.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$562.99 |
| Max. Negotiated Rate |
$8,694.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,520.12
|
| Rate for Payer: Aetna of WY Medicare |
$662.34
|
| Rate for Payer: Beech Street Commercial |
$8,259.30
|
| Rate for Payer: Cash Price |
$6,085.80
|
| Rate for Payer: Cash Price |
$6,085.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$8,433.18
|
| Rate for Payer: Cigna of WY Commercial |
$8,520.12
|
| Rate for Payer: First Choice Health Commercial |
$7,824.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,259.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$662.34
|
| Rate for Payer: HealthUtah PPO |
$8,694.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,433.18
|
| Rate for Payer: Multiplan Medicare/VA |
$562.99
|
| Rate for Payer: One Health Plan of WY PPO |
$8,520.12
|
| Rate for Payer: PacificSource Commercial |
$7,824.60
|
| Rate for Payer: PHCS PPO |
$8,259.30
|
| Rate for Payer: Three Rivers PPO |
$6,520.50
|
| Rate for Payer: TriWest Veterans Administration |
$662.34
|
| Rate for Payer: United Healthcare Commercial |
$8,259.30
|
| Rate for Payer: WINHealth Partners Commercial |
$7,389.90
|
|
|
ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$8,694.00
|
|
|
Service Code
|
HCPCS 24366 AS
|
| Min. Negotiated Rate |
$562.99 |
| Max. Negotiated Rate |
$8,694.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8,520.12
|
| Rate for Payer: Beech Street Commercial |
$8,259.30
|
| Rate for Payer: Cash Price |
$6,085.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$8,433.18
|
| Rate for Payer: Cigna of WY Commercial |
$8,520.12
|
| Rate for Payer: First Choice Health Commercial |
$7,824.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,259.30
|
| Rate for Payer: HealthUtah PPO |
$8,694.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,433.18
|
| Rate for Payer: One Health Plan of WY PPO |
$8,520.12
|
| Rate for Payer: PacificSource Commercial |
$7,824.60
|
| Rate for Payer: PHCS PPO |
$8,259.30
|
| Rate for Payer: Three Rivers PPO |
$6,520.50
|
| Rate for Payer: United Healthcare Commercial |
$8,259.30
|
| Rate for Payer: WINHealth Partners Commercial |
$7,389.90
|
|
|
ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$807.00
|
|
|
Service Code
|
HCPCS 24366 80
|
| Min. Negotiated Rate |
$605.25 |
| Max. Negotiated Rate |
$807.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$790.86
|
| Rate for Payer: Beech Street Commercial |
$766.65
|
| Rate for Payer: Cash Price |
$564.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$782.79
|
| Rate for Payer: Cigna of WY Commercial |
$790.86
|
| Rate for Payer: First Choice Health Commercial |
$726.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$766.65
|
| Rate for Payer: HealthUtah PPO |
$807.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$782.79
|
| Rate for Payer: One Health Plan of WY PPO |
$790.86
|
| Rate for Payer: PacificSource Commercial |
$726.30
|
| Rate for Payer: PHCS PPO |
$766.65
|
| Rate for Payer: Three Rivers PPO |
$605.25
|
| Rate for Payer: United Healthcare Commercial |
$766.65
|
| Rate for Payer: WINHealth Partners Commercial |
$685.95
|
|
|
ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$4,103.00
|
|
|
Service Code
|
HCPCS 29851 80
|
| Min. Negotiated Rate |
$763.38 |
| Max. Negotiated Rate |
$4,103.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,020.94
|
| Rate for Payer: Beech Street Commercial |
$3,897.85
|
| Rate for Payer: Cash Price |
$2,872.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,979.91
|
| Rate for Payer: Cigna of WY Commercial |
$4,020.94
|
| Rate for Payer: First Choice Health Commercial |
$3,692.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,897.85
|
| Rate for Payer: HealthUtah PPO |
$4,103.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,979.91
|
| Rate for Payer: One Health Plan of WY PPO |
$4,020.94
|
| Rate for Payer: PacificSource Commercial |
$3,692.70
|
| Rate for Payer: PHCS PPO |
$3,897.85
|
| Rate for Payer: Three Rivers PPO |
$3,077.25
|
| Rate for Payer: United Healthcare Commercial |
$3,897.85
|
| Rate for Payer: WINHealth Partners Commercial |
$3,487.55
|
|
|
ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$4,103.00
|
|
|
Service Code
|
HCPCS 29851 AS
|
| Min. Negotiated Rate |
$763.38 |
| Max. Negotiated Rate |
$4,103.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,020.94
|
| Rate for Payer: Beech Street Commercial |
$3,897.85
|
| Rate for Payer: Cash Price |
$2,872.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,979.91
|
| Rate for Payer: Cigna of WY Commercial |
$4,020.94
|
| Rate for Payer: First Choice Health Commercial |
$3,692.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,897.85
|
| Rate for Payer: HealthUtah PPO |
$4,103.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,979.91
|
| Rate for Payer: One Health Plan of WY PPO |
$4,020.94
|
| Rate for Payer: PacificSource Commercial |
$3,692.70
|
| Rate for Payer: PHCS PPO |
$3,897.85
|
| Rate for Payer: Three Rivers PPO |
$3,077.25
|
| Rate for Payer: United Healthcare Commercial |
$3,897.85
|
| Rate for Payer: WINHealth Partners Commercial |
$3,487.55
|
|
|
ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$4,103.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$763.38 |
| Max. Negotiated Rate |
$4,103.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,020.94
|
| Rate for Payer: Aetna of WY Medicare |
$898.09
|
| Rate for Payer: Beech Street Commercial |
$3,897.85
|
| Rate for Payer: Cash Price |
$2,872.10
|
| Rate for Payer: Cash Price |
$2,872.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,979.91
|
| Rate for Payer: Cigna of WY Commercial |
$4,020.94
|
| Rate for Payer: First Choice Health Commercial |
$3,692.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,897.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$898.09
|
| Rate for Payer: HealthUtah PPO |
$4,103.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,979.91
|
| Rate for Payer: Multiplan Medicare/VA |
$763.38
|
| Rate for Payer: One Health Plan of WY PPO |
$4,020.94
|
| Rate for Payer: PacificSource Commercial |
$3,692.70
|
| Rate for Payer: PHCS PPO |
$3,897.85
|
| Rate for Payer: Three Rivers PPO |
$3,077.25
|
| Rate for Payer: TriWest Veterans Administration |
$898.09
|
| Rate for Payer: United Healthcare Commercial |
$3,897.85
|
| Rate for Payer: WINHealth Partners Commercial |
$3,487.55
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$6,726.00
|
|
|
Service Code
|
HCPCS 29898 AS
|
| Min. Negotiated Rate |
$463.03 |
| Max. Negotiated Rate |
$6,726.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,591.48
|
| Rate for Payer: Beech Street Commercial |
$6,389.70
|
| Rate for Payer: Cash Price |
$4,708.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,524.22
|
| Rate for Payer: Cigna of WY Commercial |
$6,591.48
|
| Rate for Payer: First Choice Health Commercial |
$6,053.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,389.70
|
| Rate for Payer: HealthUtah PPO |
$6,726.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,524.22
|
| Rate for Payer: One Health Plan of WY PPO |
$6,591.48
|
| Rate for Payer: PacificSource Commercial |
$6,053.40
|
| Rate for Payer: PHCS PPO |
$6,389.70
|
| Rate for Payer: Three Rivers PPO |
$5,044.50
|
| Rate for Payer: United Healthcare Commercial |
$6,389.70
|
| Rate for Payer: WINHealth Partners Commercial |
$5,717.10
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$6,726.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$463.03 |
| Max. Negotiated Rate |
$6,726.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,591.48
|
| Rate for Payer: Aetna of WY Medicare |
$544.74
|
| Rate for Payer: Beech Street Commercial |
$6,389.70
|
| Rate for Payer: Cash Price |
$4,708.20
|
| Rate for Payer: Cash Price |
$4,708.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,524.22
|
| Rate for Payer: Cigna of WY Commercial |
$6,591.48
|
| Rate for Payer: First Choice Health Commercial |
$6,053.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,389.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$544.74
|
| Rate for Payer: HealthUtah PPO |
$6,726.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,524.22
|
| Rate for Payer: Multiplan Medicare/VA |
$463.03
|
| Rate for Payer: One Health Plan of WY PPO |
$6,591.48
|
| Rate for Payer: PacificSource Commercial |
$6,053.40
|
| Rate for Payer: PHCS PPO |
$6,389.70
|
| Rate for Payer: Three Rivers PPO |
$5,044.50
|
| Rate for Payer: TriWest Veterans Administration |
$544.74
|
| Rate for Payer: United Healthcare Commercial |
$6,389.70
|
| Rate for Payer: WINHealth Partners Commercial |
$5,717.10
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 29898 80
|
| Min. Negotiated Rate |
$1,009.50 |
| Max. Negotiated Rate |
$1,346.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,319.08
|
| Rate for Payer: Beech Street Commercial |
$1,278.70
|
| Rate for Payer: Cash Price |
$942.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,305.62
|
| Rate for Payer: Cigna of WY Commercial |
$1,319.08
|
| Rate for Payer: First Choice Health Commercial |
$1,211.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,278.70
|
| Rate for Payer: HealthUtah PPO |
$1,346.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,305.62
|
| Rate for Payer: One Health Plan of WY PPO |
$1,319.08
|
| Rate for Payer: PacificSource Commercial |
$1,211.40
|
| Rate for Payer: PHCS PPO |
$1,278.70
|
| Rate for Payer: Three Rivers PPO |
$1,009.50
|
| Rate for Payer: United Healthcare Commercial |
$1,278.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,144.10
|
|
|
ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$2,054.00
|
|
|
Service Code
|
HCPCS 29897 AS
|
| Min. Negotiated Rate |
$409.55 |
| Max. Negotiated Rate |
$2,054.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,012.92
|
| Rate for Payer: Beech Street Commercial |
$1,951.30
|
| Rate for Payer: Cash Price |
$1,437.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,992.38
|
| Rate for Payer: Cigna of WY Commercial |
$2,012.92
|
| Rate for Payer: First Choice Health Commercial |
$1,848.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,951.30
|
| Rate for Payer: HealthUtah PPO |
$2,054.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,992.38
|
| Rate for Payer: One Health Plan of WY PPO |
$2,012.92
|
| Rate for Payer: PacificSource Commercial |
$1,848.60
|
| Rate for Payer: PHCS PPO |
$1,951.30
|
| Rate for Payer: Three Rivers PPO |
$1,540.50
|
| Rate for Payer: United Healthcare Commercial |
$1,951.30
|
| Rate for Payer: WINHealth Partners Commercial |
$1,745.90
|
|
