|
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
|
|
|
ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$6,771.00
|
|
|
Service Code
|
HCPCS 29895 80
|
| Min. Negotiated Rate |
$383.08 |
| Max. Negotiated Rate |
$6,771.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,635.58
|
| Rate for Payer: Beech Street Commercial |
$6,432.45
|
| Rate for Payer: Cash Price |
$4,739.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,567.87
|
| Rate for Payer: Cigna of WY Commercial |
$6,635.58
|
| Rate for Payer: First Choice Health Commercial |
$6,093.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,432.45
|
| Rate for Payer: HealthUtah PPO |
$6,771.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,567.87
|
| Rate for Payer: One Health Plan of WY PPO |
$6,635.58
|
| Rate for Payer: PacificSource Commercial |
$6,093.90
|
| Rate for Payer: PHCS PPO |
$6,432.45
|
| Rate for Payer: Three Rivers PPO |
$5,078.25
|
| Rate for Payer: United Healthcare Commercial |
$6,432.45
|
| Rate for Payer: WINHealth Partners Commercial |
$5,755.35
|
|
|
ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$6,771.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$383.08 |
| Max. Negotiated Rate |
$6,771.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,635.58
|
| Rate for Payer: Aetna of WY Medicare |
$450.68
|
| Rate for Payer: Beech Street Commercial |
$6,432.45
|
| Rate for Payer: Cash Price |
$4,739.70
|
| Rate for Payer: Cash Price |
$4,739.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,567.87
|
| Rate for Payer: Cigna of WY Commercial |
$6,635.58
|
| Rate for Payer: First Choice Health Commercial |
$6,093.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,432.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$450.68
|
| Rate for Payer: HealthUtah PPO |
$6,771.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,567.87
|
| Rate for Payer: Multiplan Medicare/VA |
$383.08
|
| Rate for Payer: One Health Plan of WY PPO |
$6,635.58
|
| Rate for Payer: PacificSource Commercial |
$6,093.90
|
| Rate for Payer: PHCS PPO |
$6,432.45
|
| Rate for Payer: Three Rivers PPO |
$5,078.25
|
| Rate for Payer: TriWest Veterans Administration |
$450.68
|
| Rate for Payer: United Healthcare Commercial |
$6,432.45
|
| Rate for Payer: WINHealth Partners Commercial |
$5,755.35
|
|
|
ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$5,155.00
|
|
|
Service Code
|
HCPCS 29894 AS
|
| Min. Negotiated Rate |
$417.12 |
| Max. Negotiated Rate |
$5,155.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,051.90
|
| Rate for Payer: Beech Street Commercial |
$4,897.25
|
| Rate for Payer: Cash Price |
$3,608.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,000.35
|
| Rate for Payer: Cigna of WY Commercial |
$5,051.90
|
| Rate for Payer: First Choice Health Commercial |
$4,639.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,897.25
|
| Rate for Payer: HealthUtah PPO |
$5,155.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,000.35
|
| Rate for Payer: One Health Plan of WY PPO |
$5,051.90
|
| Rate for Payer: PacificSource Commercial |
$4,639.50
|
| Rate for Payer: PHCS PPO |
$4,897.25
|
| Rate for Payer: Three Rivers PPO |
$3,866.25
|
| Rate for Payer: United Healthcare Commercial |
$4,897.25
|
| Rate for Payer: WINHealth Partners Commercial |
$4,381.75
|
|
|
ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$5,155.00
|
|
|
Service Code
|
HCPCS 29894
|
| Min. Negotiated Rate |
$417.12 |
| Max. Negotiated Rate |
$5,155.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,051.90
|
| Rate for Payer: Aetna of WY Medicare |
$490.73
|
| Rate for Payer: Beech Street Commercial |
$4,897.25
|
| Rate for Payer: Cash Price |
$3,608.50
|
| Rate for Payer: Cash Price |
$3,608.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,000.35
|
| Rate for Payer: Cigna of WY Commercial |
$5,051.90
|
| Rate for Payer: First Choice Health Commercial |
$4,639.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,897.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$490.73
|
| Rate for Payer: HealthUtah PPO |
$5,155.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,000.35
|
| Rate for Payer: Multiplan Medicare/VA |
$417.12
|
| Rate for Payer: One Health Plan of WY PPO |
$5,051.90
|
| Rate for Payer: PacificSource Commercial |
$4,639.50
|
| Rate for Payer: PHCS PPO |
$4,897.25
|
| Rate for Payer: Three Rivers PPO |
$3,866.25
|
| Rate for Payer: TriWest Veterans Administration |
$490.73
|
| Rate for Payer: United Healthcare Commercial |
$4,897.25
|
| Rate for Payer: WINHealth Partners Commercial |
$4,381.75
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,612.00
|
|
|
Service Code
|
HCPCS 29838
|
| Min. Negotiated Rate |
$493.35 |
| Max. Negotiated Rate |
$2,612.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,559.76
|
| Rate for Payer: Aetna of WY Medicare |
$580.41
|
| Rate for Payer: Beech Street Commercial |
$2,481.40
|
| Rate for Payer: Cash Price |
$1,828.40
|
| Rate for Payer: Cash Price |
$1,828.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,533.64
|
| Rate for Payer: Cigna of WY Commercial |
$2,559.76
|
| Rate for Payer: First Choice Health Commercial |
$2,350.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,481.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$580.41
|
| Rate for Payer: HealthUtah PPO |
$2,612.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,533.64
|
| Rate for Payer: Multiplan Medicare/VA |
$493.35
|
| Rate for Payer: One Health Plan of WY PPO |
$2,559.76
|
| Rate for Payer: PacificSource Commercial |
$2,350.80
|
| Rate for Payer: PHCS PPO |
$2,481.40
|
| Rate for Payer: Three Rivers PPO |
$1,959.00
|
| Rate for Payer: TriWest Veterans Administration |
$580.41
|
| Rate for Payer: United Healthcare Commercial |
$2,481.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2,220.20
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$4,859.00
|
|
|
Service Code
|
HCPCS 29837
|
| Min. Negotiated Rate |
$435.37 |
| Max. Negotiated Rate |
$4,859.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,761.82
|
| Rate for Payer: Aetna of WY Medicare |
$512.20
|
| Rate for Payer: Beech Street Commercial |
$4,616.05
|
| Rate for Payer: Cash Price |
$3,401.30
|
| Rate for Payer: Cash Price |
$3,401.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,713.23
|
| Rate for Payer: Cigna of WY Commercial |
$4,761.82
|
| Rate for Payer: First Choice Health Commercial |
$4,373.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,616.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$512.20
|
| Rate for Payer: HealthUtah PPO |
$4,859.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,713.23
|
| Rate for Payer: Multiplan Medicare/VA |
$435.37
|
| Rate for Payer: One Health Plan of WY PPO |
$4,761.82
|
| Rate for Payer: PacificSource Commercial |
$4,373.10
|
| Rate for Payer: PHCS PPO |
$4,616.05
|
| Rate for Payer: Three Rivers PPO |
$3,644.25
|
| Rate for Payer: TriWest Veterans Administration |
$512.20
|
| Rate for Payer: United Healthcare Commercial |
$4,616.05
|
| Rate for Payer: WINHealth Partners Commercial |
$4,130.15
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$976.00
|
|
|
Service Code
|
HCPCS 29837 80
|
| Min. Negotiated Rate |
$732.00 |
| Max. Negotiated Rate |
$976.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$956.48
|
| Rate for Payer: Beech Street Commercial |
$927.20
|
| Rate for Payer: Cash Price |
$683.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$946.72
|
| Rate for Payer: Cigna of WY Commercial |
$956.48
|
| Rate for Payer: First Choice Health Commercial |
$878.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$927.20
|
| Rate for Payer: HealthUtah PPO |
$976.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$946.72
|
| Rate for Payer: One Health Plan of WY PPO |
$956.48
|
| Rate for Payer: PacificSource Commercial |
$878.40
|
| Rate for Payer: PHCS PPO |
$927.20
|
| Rate for Payer: Three Rivers PPO |
$732.00
|
| Rate for Payer: United Healthcare Commercial |
$927.20
|
| Rate for Payer: WINHealth Partners Commercial |
$829.60
|
|
|
ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$4,859.00
|
|
|
Service Code
|
HCPCS 29837 AS
|
| Min. Negotiated Rate |
$435.37 |
| Max. Negotiated Rate |
$4,859.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,761.82
|
| Rate for Payer: Beech Street Commercial |
$4,616.05
|
| Rate for Payer: Cash Price |
$3,401.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,713.23
|
| Rate for Payer: Cigna of WY Commercial |
$4,761.82
|
| Rate for Payer: First Choice Health Commercial |
$4,373.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,616.05
|
| Rate for Payer: HealthUtah PPO |
$4,859.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,713.23
|
| Rate for Payer: One Health Plan of WY PPO |
$4,761.82
|
| Rate for Payer: PacificSource Commercial |
$4,373.10
|
| Rate for Payer: PHCS PPO |
$4,616.05
|
| Rate for Payer: Three Rivers PPO |
$3,644.25
|
| Rate for Payer: United Healthcare Commercial |
$4,616.05
|
| Rate for Payer: WINHealth Partners Commercial |
$4,130.15
|
|
|
ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 29835 80
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$2,243.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,198.14
|
| Rate for Payer: Beech Street Commercial |
$2,130.85
|
| Rate for Payer: Cash Price |
$1,570.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,175.71
|
| Rate for Payer: Cigna of WY Commercial |
$2,198.14
|
| Rate for Payer: First Choice Health Commercial |
$2,018.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,130.85
|
| Rate for Payer: HealthUtah PPO |
$2,243.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,175.71
|
| Rate for Payer: One Health Plan of WY PPO |
$2,198.14
|
| Rate for Payer: PacificSource Commercial |
$2,018.70
|
| Rate for Payer: PHCS PPO |
$2,130.85
|
| Rate for Payer: Three Rivers PPO |
$1,682.25
|
| Rate for Payer: United Healthcare Commercial |
$2,130.85
|
| Rate for Payer: WINHealth Partners Commercial |
$1,906.55
|
|
|
ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 29835
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$2,243.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,198.14
|
| Rate for Payer: Aetna of WY Medicare |
$497.88
|
| Rate for Payer: Beech Street Commercial |
$2,130.85
|
| Rate for Payer: Cash Price |
$1,570.10
|
| Rate for Payer: Cash Price |
$1,570.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,175.71
|
| Rate for Payer: Cigna of WY Commercial |
$2,198.14
|
| Rate for Payer: First Choice Health Commercial |
$2,018.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,130.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$497.88
|
| Rate for Payer: HealthUtah PPO |
$2,243.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,175.71
|
| Rate for Payer: Multiplan Medicare/VA |
$423.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2,198.14
|
| Rate for Payer: PacificSource Commercial |
$2,018.70
|
| Rate for Payer: PHCS PPO |
$2,130.85
|
| Rate for Payer: Three Rivers PPO |
$1,682.25
|
| Rate for Payer: TriWest Veterans Administration |
$497.88
|
| Rate for Payer: United Healthcare Commercial |
$2,130.85
|
| Rate for Payer: WINHealth Partners Commercial |
$1,906.55
|
|
|
ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$976.00
|
|
|
Service Code
|
HCPCS 29834 80
|
| Min. Negotiated Rate |
$732.00 |
| Max. Negotiated Rate |
$976.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$956.48
|
| Rate for Payer: Beech Street Commercial |
$927.20
|
| Rate for Payer: Cash Price |
$683.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$946.72
|
| Rate for Payer: Cigna of WY Commercial |
$956.48
|
| Rate for Payer: First Choice Health Commercial |
$878.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$927.20
|
| Rate for Payer: HealthUtah PPO |
$976.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$946.72
|
| Rate for Payer: One Health Plan of WY PPO |
$956.48
|
| Rate for Payer: PacificSource Commercial |
$878.40
|
| Rate for Payer: PHCS PPO |
$927.20
|
| Rate for Payer: Three Rivers PPO |
$732.00
|
| Rate for Payer: United Healthcare Commercial |
$927.20
|
| Rate for Payer: WINHealth Partners Commercial |
$829.60
|
|
|
ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$4,859.00
|
|
|
Service Code
|
HCPCS 29834 AS
|
| Min. Negotiated Rate |
$408.13 |
| Max. Negotiated Rate |
$4,859.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,761.82
|
| Rate for Payer: Beech Street Commercial |
$4,616.05
|
| Rate for Payer: Cash Price |
$3,401.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,713.23
|
| Rate for Payer: Cigna of WY Commercial |
$4,761.82
|
| Rate for Payer: First Choice Health Commercial |
$4,373.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,616.05
|
| Rate for Payer: HealthUtah PPO |
$4,859.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,713.23
|
| Rate for Payer: One Health Plan of WY PPO |
$4,761.82
|
| Rate for Payer: PacificSource Commercial |
$4,373.10
|
| Rate for Payer: PHCS PPO |
$4,616.05
|
| Rate for Payer: Three Rivers PPO |
$3,644.25
|
| Rate for Payer: United Healthcare Commercial |
$4,616.05
|
| Rate for Payer: WINHealth Partners Commercial |
$4,130.15
|
|
|
ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$4,859.00
|
|
|
Service Code
|
HCPCS 29834
|
| Min. Negotiated Rate |
$408.13 |
| Max. Negotiated Rate |
$4,859.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,761.82
|
| Rate for Payer: Aetna of WY Medicare |
$480.15
|
| Rate for Payer: Beech Street Commercial |
$4,616.05
|
| Rate for Payer: Cash Price |
$3,401.30
|
| Rate for Payer: Cash Price |
$3,401.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,713.23
|
| Rate for Payer: Cigna of WY Commercial |
$4,761.82
|
| Rate for Payer: First Choice Health Commercial |
$4,373.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,616.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$480.15
|
| Rate for Payer: HealthUtah PPO |
$4,859.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,713.23
|
| Rate for Payer: Multiplan Medicare/VA |
$408.13
|
| Rate for Payer: One Health Plan of WY PPO |
$4,761.82
|
| Rate for Payer: PacificSource Commercial |
$4,373.10
|
| Rate for Payer: PHCS PPO |
$4,616.05
|
| Rate for Payer: Three Rivers PPO |
$3,644.25
|
| Rate for Payer: TriWest Veterans Administration |
$480.15
|
| Rate for Payer: United Healthcare Commercial |
$4,616.05
|
| Rate for Payer: WINHealth Partners Commercial |
$4,130.15
|
|
|
ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$1,546.00
|
|
|
Service Code
|
HCPCS 29915 80
|
| Min. Negotiated Rate |
$1,159.50 |
| Max. Negotiated Rate |
$1,546.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,515.08
|
| Rate for Payer: Beech Street Commercial |
$1,468.70
|
| Rate for Payer: Cash Price |
$1,082.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,499.62
|
| Rate for Payer: Cigna of WY Commercial |
$1,515.08
|
| Rate for Payer: First Choice Health Commercial |
$1,391.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,468.70
|
| Rate for Payer: HealthUtah PPO |
$1,546.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,499.62
|
| Rate for Payer: One Health Plan of WY PPO |
$1,515.08
|
| Rate for Payer: PacificSource Commercial |
$1,391.40
|
| Rate for Payer: PHCS PPO |
$1,468.70
|
| Rate for Payer: Three Rivers PPO |
$1,159.50
|
| Rate for Payer: United Healthcare Commercial |
$1,468.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,314.10
|
|
|
ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$7,741.00
|
|
|
Service Code
|
HCPCS 29915
|
| Min. Negotiated Rate |
$834.01 |
| Max. Negotiated Rate |
$7,741.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,586.18
|
| Rate for Payer: Aetna of WY Medicare |
$981.19
|
| Rate for Payer: Beech Street Commercial |
$7,353.95
|
| Rate for Payer: Cash Price |
$5,418.70
|
| Rate for Payer: Cash Price |
$5,418.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,508.77
|
| Rate for Payer: Cigna of WY Commercial |
$7,586.18
|
| Rate for Payer: First Choice Health Commercial |
$6,966.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,353.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$981.19
|
| Rate for Payer: HealthUtah PPO |
$7,741.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,508.77
|
| Rate for Payer: Multiplan Medicare/VA |
$834.01
|
| Rate for Payer: One Health Plan of WY PPO |
$7,586.18
|
| Rate for Payer: PacificSource Commercial |
$6,966.90
|
| Rate for Payer: PHCS PPO |
$7,353.95
|
| Rate for Payer: Three Rivers PPO |
$5,805.75
|
| Rate for Payer: TriWest Veterans Administration |
$981.19
|
| Rate for Payer: United Healthcare Commercial |
$7,353.95
|
| Rate for Payer: WINHealth Partners Commercial |
$6,579.85
|
|
|
ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$7,741.00
|
|
|
Service Code
|
HCPCS 29915 AS
|
| Min. Negotiated Rate |
$834.01 |
| Max. Negotiated Rate |
$7,741.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,586.18
|
| Rate for Payer: Beech Street Commercial |
$7,353.95
|
| Rate for Payer: Cash Price |
$5,418.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,508.77
|
| Rate for Payer: Cigna of WY Commercial |
$7,586.18
|
| Rate for Payer: First Choice Health Commercial |
$6,966.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,353.95
|
| Rate for Payer: HealthUtah PPO |
$7,741.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,508.77
|
| Rate for Payer: One Health Plan of WY PPO |
$7,586.18
|
| Rate for Payer: PacificSource Commercial |
$6,966.90
|
| Rate for Payer: PHCS PPO |
$7,353.95
|
| Rate for Payer: Three Rivers PPO |
$5,805.75
|
| Rate for Payer: United Healthcare Commercial |
$7,353.95
|
| Rate for Payer: WINHealth Partners Commercial |
$6,579.85
|
|
|
ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$1,842.00
|
|
|
Service Code
|
HCPCS 29914 80
|
| Min. Negotiated Rate |
$1,381.50 |
| Max. Negotiated Rate |
$1,842.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,805.16
|
| Rate for Payer: Beech Street Commercial |
$1,749.90
|
| Rate for Payer: Cash Price |
$1,289.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,786.74
|
| Rate for Payer: Cigna of WY Commercial |
$1,805.16
|
| Rate for Payer: First Choice Health Commercial |
$1,657.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,749.90
|
| Rate for Payer: HealthUtah PPO |
$1,842.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,786.74
|
| Rate for Payer: One Health Plan of WY PPO |
$1,805.16
|
| Rate for Payer: PacificSource Commercial |
$1,657.80
|
| Rate for Payer: PHCS PPO |
$1,749.90
|
| Rate for Payer: Three Rivers PPO |
$1,381.50
|
| Rate for Payer: United Healthcare Commercial |
$1,749.90
|
| Rate for Payer: WINHealth Partners Commercial |
$1,565.70
|
|
|
ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$9,213.00
|
|
|
Service Code
|
HCPCS 29914
|
| Min. Negotiated Rate |
$813.93 |
| Max. Negotiated Rate |
$9,213.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,028.74
|
| Rate for Payer: Aetna of WY Medicare |
$957.57
|
| Rate for Payer: Beech Street Commercial |
$8,752.35
|
| Rate for Payer: Cash Price |
$6,449.10
|
| Rate for Payer: Cash Price |
$6,449.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$8,936.61
|
| Rate for Payer: Cigna of WY Commercial |
$9,028.74
|
| Rate for Payer: First Choice Health Commercial |
$8,291.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,752.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$957.57
|
| Rate for Payer: HealthUtah PPO |
$9,213.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,936.61
|
| Rate for Payer: Multiplan Medicare/VA |
$813.93
|
| Rate for Payer: One Health Plan of WY PPO |
$9,028.74
|
| Rate for Payer: PacificSource Commercial |
$8,291.70
|
| Rate for Payer: PHCS PPO |
$8,752.35
|
| Rate for Payer: Three Rivers PPO |
$6,909.75
|
| Rate for Payer: TriWest Veterans Administration |
$957.57
|
| Rate for Payer: United Healthcare Commercial |
$8,752.35
|
| Rate for Payer: WINHealth Partners Commercial |
$7,831.05
|
|
|
ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$9,213.00
|
|
|
Service Code
|
HCPCS 29914 AS
|
| Min. Negotiated Rate |
$813.93 |
| Max. Negotiated Rate |
$9,213.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,028.74
|
| Rate for Payer: Beech Street Commercial |
$8,752.35
|
| Rate for Payer: Cash Price |
$6,449.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$8,936.61
|
| Rate for Payer: Cigna of WY Commercial |
$9,028.74
|
| Rate for Payer: First Choice Health Commercial |
$8,291.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,752.35
|
| Rate for Payer: HealthUtah PPO |
$9,213.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8,936.61
|
| Rate for Payer: One Health Plan of WY PPO |
$9,028.74
|
| Rate for Payer: PacificSource Commercial |
$8,291.70
|
| Rate for Payer: PHCS PPO |
$8,752.35
|
| Rate for Payer: Three Rivers PPO |
$6,909.75
|
| Rate for Payer: United Healthcare Commercial |
$8,752.35
|
| Rate for Payer: WINHealth Partners Commercial |
$7,831.05
|
|
|
ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$7,858.00
|
|
|
Service Code
|
HCPCS 29916 AS
|
| Min. Negotiated Rate |
$830.61 |
| Max. Negotiated Rate |
$7,858.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,700.84
|
| Rate for Payer: Beech Street Commercial |
$7,465.10
|
| Rate for Payer: Cash Price |
$5,500.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,622.26
|
| Rate for Payer: Cigna of WY Commercial |
$7,700.84
|
| Rate for Payer: First Choice Health Commercial |
$7,072.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,465.10
|
| Rate for Payer: HealthUtah PPO |
$7,858.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,622.26
|
| Rate for Payer: One Health Plan of WY PPO |
$7,700.84
|
| Rate for Payer: PacificSource Commercial |
$7,072.20
|
| Rate for Payer: PHCS PPO |
$7,465.10
|
| Rate for Payer: Three Rivers PPO |
$5,893.50
|
| Rate for Payer: United Healthcare Commercial |
$7,465.10
|
| Rate for Payer: WINHealth Partners Commercial |
$6,679.30
|
|
|
ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS 29916 80
|
| Min. Negotiated Rate |
$1,178.25 |
| Max. Negotiated Rate |
$1,571.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,539.58
|
| Rate for Payer: Beech Street Commercial |
$1,492.45
|
| Rate for Payer: Cash Price |
$1,099.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,523.87
|
| Rate for Payer: Cigna of WY Commercial |
$1,539.58
|
| Rate for Payer: First Choice Health Commercial |
$1,413.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,492.45
|
| Rate for Payer: HealthUtah PPO |
$1,571.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,523.87
|
| Rate for Payer: One Health Plan of WY PPO |
$1,539.58
|
| Rate for Payer: PacificSource Commercial |
$1,413.90
|
| Rate for Payer: PHCS PPO |
$1,492.45
|
| Rate for Payer: Three Rivers PPO |
$1,178.25
|
| Rate for Payer: United Healthcare Commercial |
$1,492.45
|
| Rate for Payer: WINHealth Partners Commercial |
$1,335.35
|
|
|
ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$7,858.00
|
|
|
Service Code
|
HCPCS 29916
|
| Min. Negotiated Rate |
$830.61 |
| Max. Negotiated Rate |
$7,858.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,700.84
|
| Rate for Payer: Aetna of WY Medicare |
$977.19
|
| Rate for Payer: Beech Street Commercial |
$7,465.10
|
| Rate for Payer: Cash Price |
$5,500.60
|
| Rate for Payer: Cash Price |
$5,500.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,622.26
|
| Rate for Payer: Cigna of WY Commercial |
$7,700.84
|
| Rate for Payer: First Choice Health Commercial |
$7,072.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,465.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$977.19
|
| Rate for Payer: HealthUtah PPO |
$7,858.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,622.26
|
| Rate for Payer: Multiplan Medicare/VA |
$830.61
|
| Rate for Payer: One Health Plan of WY PPO |
$7,700.84
|
| Rate for Payer: PacificSource Commercial |
$7,072.20
|
| Rate for Payer: PHCS PPO |
$7,465.10
|
| Rate for Payer: Three Rivers PPO |
$5,893.50
|
| Rate for Payer: TriWest Veterans Administration |
$977.19
|
| Rate for Payer: United Healthcare Commercial |
$7,465.10
|
| Rate for Payer: WINHealth Partners Commercial |
$6,679.30
|
|
|
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,807.00
|
|
|
Service Code
|
HCPCS 29870
|
| Min. Negotiated Rate |
$341.54 |
| Max. Negotiated Rate |
$1,807.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,770.86
|
| Rate for Payer: Aetna of WY Medicare |
$401.81
|
| Rate for Payer: Beech Street Commercial |
$1,716.65
|
| Rate for Payer: Cash Price |
$1,264.90
|
| Rate for Payer: Cash Price |
$1,264.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,752.79
|
| Rate for Payer: Cigna of WY Commercial |
$1,770.86
|
| Rate for Payer: First Choice Health Commercial |
$1,626.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,716.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$401.81
|
| Rate for Payer: HealthUtah PPO |
$1,807.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,752.79
|
| Rate for Payer: Multiplan Medicare/VA |
$341.54
|
| Rate for Payer: One Health Plan of WY PPO |
$1,770.86
|
| Rate for Payer: PacificSource Commercial |
$1,626.30
|
| Rate for Payer: PHCS PPO |
$1,716.65
|
| Rate for Payer: Three Rivers PPO |
$1,355.25
|
| Rate for Payer: TriWest Veterans Administration |
$401.81
|
| Rate for Payer: United Healthcare Commercial |
$1,716.65
|
| Rate for Payer: WINHealth Partners Commercial |
$1,535.95
|
|
|
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 29870 80
|
| Min. Negotiated Rate |
$1,111.50 |
| Max. Negotiated Rate |
$1,482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,452.36
|
| Rate for Payer: Beech Street Commercial |
$1,407.90
|
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,437.54
|
| Rate for Payer: Cigna of WY Commercial |
$1,452.36
|
| Rate for Payer: First Choice Health Commercial |
$1,333.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,407.90
|
| Rate for Payer: HealthUtah PPO |
$1,482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,437.54
|
| Rate for Payer: One Health Plan of WY PPO |
$1,452.36
|
| Rate for Payer: PacificSource Commercial |
$1,333.80
|
| Rate for Payer: PHCS PPO |
$1,407.90
|
| Rate for Payer: Three Rivers PPO |
$1,111.50
|
| Rate for Payer: United Healthcare Commercial |
$1,407.90
|
| Rate for Payer: WINHealth Partners Commercial |
$1,259.70
|
|
