|
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
|
|
|
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$3,614.00
|
|
|
Service Code
|
HCPCS 29870 50
|
| Min. Negotiated Rate |
$2,710.50 |
| Max. Negotiated Rate |
$3,614.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,541.72
|
| Rate for Payer: Beech Street Commercial |
$3,433.30
|
| Rate for Payer: Cash Price |
$2,529.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,505.58
|
| Rate for Payer: Cigna of WY Commercial |
$3,541.72
|
| Rate for Payer: First Choice Health Commercial |
$3,252.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,433.30
|
| Rate for Payer: HealthUtah PPO |
$3,614.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,505.58
|
| Rate for Payer: One Health Plan of WY PPO |
$3,541.72
|
| Rate for Payer: PacificSource Commercial |
$3,252.60
|
| Rate for Payer: PHCS PPO |
$3,433.30
|
| Rate for Payer: Three Rivers PPO |
$2,710.50
|
| Rate for Payer: United Healthcare Commercial |
$3,433.30
|
| Rate for Payer: WINHealth Partners Commercial |
$3,071.90
|
|
|
ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$3,214.00
|
|
|
Service Code
|
HCPCS 29871 AS
|
| Min. Negotiated Rate |
$2,410.50 |
| Max. Negotiated Rate |
$3,214.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,149.72
|
| Rate for Payer: Beech Street Commercial |
$3,053.30
|
| Rate for Payer: Cash Price |
$2,249.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,117.58
|
| Rate for Payer: Cigna of WY Commercial |
$3,149.72
|
| Rate for Payer: First Choice Health Commercial |
$2,892.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,053.30
|
| Rate for Payer: HealthUtah PPO |
$3,214.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,117.58
|
| Rate for Payer: One Health Plan of WY PPO |
$3,149.72
|
| Rate for Payer: PacificSource Commercial |
$2,892.60
|
| Rate for Payer: PHCS PPO |
$3,053.30
|
| Rate for Payer: Three Rivers PPO |
$2,410.50
|
| Rate for Payer: United Healthcare Commercial |
$3,053.30
|
| Rate for Payer: WINHealth Partners Commercial |
$2,731.90
|
|
|
ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$2,264.00
|
|
|
Service Code
|
HCPCS 29871
|
| Min. Negotiated Rate |
$427.72 |
| Max. Negotiated Rate |
$2,264.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,218.72
|
| Rate for Payer: Aetna of WY Medicare |
$503.20
|
| Rate for Payer: Beech Street Commercial |
$2,150.80
|
| Rate for Payer: Cash Price |
$1,584.80
|
| Rate for Payer: Cash Price |
$1,584.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,196.08
|
| Rate for Payer: Cigna of WY Commercial |
$2,218.72
|
| Rate for Payer: First Choice Health Commercial |
$2,037.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,150.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$503.20
|
| Rate for Payer: HealthUtah PPO |
$2,264.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,196.08
|
| Rate for Payer: Multiplan Medicare/VA |
$427.72
|
| Rate for Payer: One Health Plan of WY PPO |
$2,218.72
|
| Rate for Payer: PacificSource Commercial |
$2,037.60
|
| Rate for Payer: PHCS PPO |
$2,150.80
|
| Rate for Payer: Three Rivers PPO |
$1,698.00
|
| Rate for Payer: TriWest Veterans Administration |
$503.20
|
| Rate for Payer: United Healthcare Commercial |
$2,150.80
|
| Rate for Payer: WINHealth Partners Commercial |
$1,924.40
|
|
|
ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$1,846.00
|
|
|
Service Code
|
HCPCS 29871 80
|
| Min. Negotiated Rate |
$1,384.50 |
| Max. Negotiated Rate |
$1,846.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,809.08
|
| Rate for Payer: Beech Street Commercial |
$1,753.70
|
| Rate for Payer: Cash Price |
$1,292.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,790.62
|
| Rate for Payer: Cigna of WY Commercial |
$1,809.08
|
| Rate for Payer: First Choice Health Commercial |
$1,661.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,753.70
|
| Rate for Payer: HealthUtah PPO |
$1,846.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,790.62
|
| Rate for Payer: One Health Plan of WY PPO |
$1,809.08
|
| Rate for Payer: PacificSource Commercial |
$1,661.40
|
| Rate for Payer: PHCS PPO |
$1,753.70
|
| Rate for Payer: Three Rivers PPO |
$1,384.50
|
| Rate for Payer: United Healthcare Commercial |
$1,753.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,569.10
|
|
|
ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$4,016.00
|
|
|
Service Code
|
HCPCS 29873 AS
|
| Min. Negotiated Rate |
$3,012.00 |
| Max. Negotiated Rate |
$4,016.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,935.68
|
| Rate for Payer: Beech Street Commercial |
$3,815.20
|
| Rate for Payer: Cash Price |
$2,811.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,895.52
|
| Rate for Payer: Cigna of WY Commercial |
$3,935.68
|
| Rate for Payer: First Choice Health Commercial |
$3,614.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,815.20
|
| Rate for Payer: HealthUtah PPO |
$4,016.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,895.52
|
| Rate for Payer: One Health Plan of WY PPO |
$3,935.68
|
| Rate for Payer: PacificSource Commercial |
$3,614.40
|
| Rate for Payer: PHCS PPO |
$3,815.20
|
| Rate for Payer: Three Rivers PPO |
$3,012.00
|
| Rate for Payer: United Healthcare Commercial |
$3,815.20
|
| Rate for Payer: WINHealth Partners Commercial |
$3,413.60
|
|
|
ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 29873
|
| Min. Negotiated Rate |
$448.42 |
| Max. Negotiated Rate |
$2,333.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,286.34
|
| Rate for Payer: Aetna of WY Medicare |
$527.55
|
| Rate for Payer: Beech Street Commercial |
$2,216.35
|
| Rate for Payer: Cash Price |
$1,633.10
|
| Rate for Payer: Cash Price |
$1,633.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,263.01
|
| Rate for Payer: Cigna of WY Commercial |
$2,286.34
|
| Rate for Payer: First Choice Health Commercial |
$2,099.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,216.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$527.55
|
| Rate for Payer: HealthUtah PPO |
$2,333.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,263.01
|
| Rate for Payer: Multiplan Medicare/VA |
$448.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,286.34
|
| Rate for Payer: PacificSource Commercial |
$2,099.70
|
| Rate for Payer: PHCS PPO |
$2,216.35
|
| Rate for Payer: Three Rivers PPO |
$1,749.75
|
| Rate for Payer: TriWest Veterans Administration |
$527.55
|
| Rate for Payer: United Healthcare Commercial |
$2,216.35
|
| Rate for Payer: WINHealth Partners Commercial |
$1,983.05
|
|
|
ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$4,666.00
|
|
|
Service Code
|
HCPCS 29873 50
|
| Min. Negotiated Rate |
$3,499.50 |
| Max. Negotiated Rate |
$4,666.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,572.68
|
| Rate for Payer: Beech Street Commercial |
$4,432.70
|
| Rate for Payer: Cash Price |
$3,266.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,526.02
|
| Rate for Payer: Cigna of WY Commercial |
$4,572.68
|
| Rate for Payer: First Choice Health Commercial |
$4,199.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,432.70
|
| Rate for Payer: HealthUtah PPO |
$4,666.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,526.02
|
| Rate for Payer: One Health Plan of WY PPO |
$4,572.68
|
| Rate for Payer: PacificSource Commercial |
$4,199.40
|
| Rate for Payer: PHCS PPO |
$4,432.70
|
| Rate for Payer: Three Rivers PPO |
$3,499.50
|
| Rate for Payer: United Healthcare Commercial |
$4,432.70
|
| Rate for Payer: WINHealth Partners Commercial |
$3,966.10
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$4,631.00
|
|
|
Service Code
|
HCPCS 29866 80
|
| Min. Negotiated Rate |
$865.09 |
| Max. Negotiated Rate |
$4,631.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,538.38
|
| Rate for Payer: Beech Street Commercial |
$4,399.45
|
| Rate for Payer: Cash Price |
$3,241.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,492.07
|
| Rate for Payer: Cigna of WY Commercial |
$4,538.38
|
| Rate for Payer: First Choice Health Commercial |
$4,167.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,399.45
|
| Rate for Payer: HealthUtah PPO |
$4,631.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,492.07
|
| Rate for Payer: One Health Plan of WY PPO |
$4,538.38
|
| Rate for Payer: PacificSource Commercial |
$4,167.90
|
| Rate for Payer: PHCS PPO |
$4,399.45
|
| Rate for Payer: Three Rivers PPO |
$3,473.25
|
| Rate for Payer: United Healthcare Commercial |
$4,399.45
|
| Rate for Payer: WINHealth Partners Commercial |
$3,936.35
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$4,631.00
|
|
|
Service Code
|
HCPCS 29866 AS
|
| Min. Negotiated Rate |
$865.09 |
| Max. Negotiated Rate |
$4,631.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,538.38
|
| Rate for Payer: Beech Street Commercial |
$4,399.45
|
| Rate for Payer: Cash Price |
$3,241.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,492.07
|
| Rate for Payer: Cigna of WY Commercial |
$4,538.38
|
| Rate for Payer: First Choice Health Commercial |
$4,167.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,399.45
|
| Rate for Payer: HealthUtah PPO |
$4,631.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,492.07
|
| Rate for Payer: One Health Plan of WY PPO |
$4,538.38
|
| Rate for Payer: PacificSource Commercial |
$4,167.90
|
| Rate for Payer: PHCS PPO |
$4,399.45
|
| Rate for Payer: Three Rivers PPO |
$3,473.25
|
| Rate for Payer: United Healthcare Commercial |
$4,399.45
|
| Rate for Payer: WINHealth Partners Commercial |
$3,936.35
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$4,631.00
|
|
|
Service Code
|
HCPCS 29866
|
| Min. Negotiated Rate |
$865.09 |
| Max. Negotiated Rate |
$4,631.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,538.38
|
| Rate for Payer: Aetna of WY Medicare |
$1,017.75
|
| Rate for Payer: Beech Street Commercial |
$4,399.45
|
| Rate for Payer: Cash Price |
$3,241.70
|
| Rate for Payer: Cash Price |
$3,241.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,492.07
|
| Rate for Payer: Cigna of WY Commercial |
$4,538.38
|
| Rate for Payer: First Choice Health Commercial |
$4,167.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,399.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,017.75
|
| Rate for Payer: HealthUtah PPO |
$4,631.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,492.07
|
| Rate for Payer: Multiplan Medicare/VA |
$865.09
|
| Rate for Payer: One Health Plan of WY PPO |
$4,538.38
|
| Rate for Payer: PacificSource Commercial |
$4,167.90
|
| Rate for Payer: PHCS PPO |
$4,399.45
|
| Rate for Payer: Three Rivers PPO |
$3,473.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,017.75
|
| Rate for Payer: United Healthcare Commercial |
$4,399.45
|
| Rate for Payer: WINHealth Partners Commercial |
$3,936.35
|
|
|
ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT
|
Professional
|
Both
|
$5,636.00
|
|
|
Service Code
|
HCPCS 29867
|
| Min. Negotiated Rate |
$1,047.36 |
| Max. Negotiated Rate |
$5,636.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,523.28
|
| Rate for Payer: Aetna of WY Medicare |
$1,232.19
|
| Rate for Payer: Beech Street Commercial |
$5,354.20
|
| Rate for Payer: Cash Price |
$3,945.20
|
| Rate for Payer: Cash Price |
$3,945.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,466.92
|
| Rate for Payer: Cigna of WY Commercial |
$5,523.28
|
| Rate for Payer: First Choice Health Commercial |
$5,072.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,354.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,232.19
|
| Rate for Payer: HealthUtah PPO |
$5,636.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,466.92
|
| Rate for Payer: Multiplan Medicare/VA |
$1,047.36
|
| Rate for Payer: One Health Plan of WY PPO |
$5,523.28
|
| Rate for Payer: PacificSource Commercial |
$5,072.40
|
| Rate for Payer: PHCS PPO |
$5,354.20
|
| Rate for Payer: Three Rivers PPO |
$4,227.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,232.19
|
| Rate for Payer: United Healthcare Commercial |
$5,354.20
|
| Rate for Payer: WINHealth Partners Commercial |
$4,790.60
|
|
|
ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,370.00
|
|
|
Service Code
|
HCPCS 29874
|
| Min. Negotiated Rate |
$445.92 |
| Max. Negotiated Rate |
$2,370.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,322.60
|
| Rate for Payer: Aetna of WY Medicare |
$524.61
|
| Rate for Payer: Beech Street Commercial |
$2,251.50
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,298.90
|
| Rate for Payer: Cigna of WY Commercial |
$2,322.60
|
| Rate for Payer: First Choice Health Commercial |
$2,133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,251.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$524.61
|
| Rate for Payer: HealthUtah PPO |
$2,370.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,298.90
|
| Rate for Payer: Multiplan Medicare/VA |
$445.92
|
| Rate for Payer: One Health Plan of WY PPO |
$2,322.60
|
| Rate for Payer: PacificSource Commercial |
$2,133.00
|
| Rate for Payer: PHCS PPO |
$2,251.50
|
| Rate for Payer: Three Rivers PPO |
$1,777.50
|
| Rate for Payer: TriWest Veterans Administration |
$524.61
|
| Rate for Payer: United Healthcare Commercial |
$2,251.50
|
| Rate for Payer: WINHealth Partners Commercial |
$2,014.50
|
|
|
ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,370.00
|
|
|
Service Code
|
HCPCS 29874 80
|
| Min. Negotiated Rate |
$445.92 |
| Max. Negotiated Rate |
$2,370.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,322.60
|
| Rate for Payer: Beech Street Commercial |
$2,251.50
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,298.90
|
| Rate for Payer: Cigna of WY Commercial |
$2,322.60
|
| Rate for Payer: First Choice Health Commercial |
$2,133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,251.50
|
| Rate for Payer: HealthUtah PPO |
$2,370.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,298.90
|
| Rate for Payer: One Health Plan of WY PPO |
$2,322.60
|
| Rate for Payer: PacificSource Commercial |
$2,133.00
|
| Rate for Payer: PHCS PPO |
$2,251.50
|
| Rate for Payer: Three Rivers PPO |
$1,777.50
|
| Rate for Payer: United Healthcare Commercial |
$2,251.50
|
| Rate for Payer: WINHealth Partners Commercial |
$2,014.50
|
|
|
ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,370.00
|
|
|
Service Code
|
HCPCS 29874 AS
|
| Min. Negotiated Rate |
$445.92 |
| Max. Negotiated Rate |
$2,370.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,322.60
|
| Rate for Payer: Beech Street Commercial |
$2,251.50
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,298.90
|
| Rate for Payer: Cigna of WY Commercial |
$2,322.60
|
| Rate for Payer: First Choice Health Commercial |
$2,133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,251.50
|
| Rate for Payer: HealthUtah PPO |
$2,370.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,298.90
|
| Rate for Payer: One Health Plan of WY PPO |
$2,322.60
|
| Rate for Payer: PacificSource Commercial |
$2,133.00
|
| Rate for Payer: PHCS PPO |
$2,251.50
|
| Rate for Payer: Three Rivers PPO |
$1,777.50
|
| Rate for Payer: United Healthcare Commercial |
$2,251.50
|
| Rate for Payer: WINHealth Partners Commercial |
$2,014.50
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 29876 80
|
| Min. Negotiated Rate |
$603.00 |
| Max. Negotiated Rate |
$804.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$787.92
|
| Rate for Payer: Beech Street Commercial |
$763.80
|
| Rate for Payer: Cash Price |
$562.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$779.88
|
| Rate for Payer: Cigna of WY Commercial |
$787.92
|
| Rate for Payer: First Choice Health Commercial |
$723.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$763.80
|
| Rate for Payer: HealthUtah PPO |
$804.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$779.88
|
| Rate for Payer: One Health Plan of WY PPO |
$787.92
|
| Rate for Payer: PacificSource Commercial |
$723.60
|
| Rate for Payer: PHCS PPO |
$763.80
|
| Rate for Payer: Three Rivers PPO |
$603.00
|
| Rate for Payer: United Healthcare Commercial |
$763.80
|
| Rate for Payer: WINHealth Partners Commercial |
$683.40
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$5,763.00
|
|
|
Service Code
|
HCPCS 29876 50
|
| Min. Negotiated Rate |
$4,322.25 |
| Max. Negotiated Rate |
$5,763.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,647.74
|
| Rate for Payer: Beech Street Commercial |
$5,474.85
|
| Rate for Payer: Cash Price |
$4,034.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,590.11
|
| Rate for Payer: Cigna of WY Commercial |
$5,647.74
|
| Rate for Payer: First Choice Health Commercial |
$5,186.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,474.85
|
| Rate for Payer: HealthUtah PPO |
$5,763.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,590.11
|
| Rate for Payer: One Health Plan of WY PPO |
$5,647.74
|
| Rate for Payer: PacificSource Commercial |
$5,186.70
|
| Rate for Payer: PHCS PPO |
$5,474.85
|
| Rate for Payer: Three Rivers PPO |
$4,322.25
|
| Rate for Payer: United Healthcare Commercial |
$5,474.85
|
| Rate for Payer: WINHealth Partners Commercial |
$4,898.55
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$2,881.00
|
|
|
Service Code
|
HCPCS 29876
|
| Min. Negotiated Rate |
$539.62 |
| Max. Negotiated Rate |
$2,881.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,823.38
|
| Rate for Payer: Aetna of WY Medicare |
$634.85
|
| Rate for Payer: Beech Street Commercial |
$2,736.95
|
| Rate for Payer: Cash Price |
$2,016.70
|
| Rate for Payer: Cash Price |
$2,016.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,794.57
|
| Rate for Payer: Cigna of WY Commercial |
$2,823.38
|
| Rate for Payer: First Choice Health Commercial |
$2,592.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,736.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$634.85
|
| Rate for Payer: HealthUtah PPO |
$2,881.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,794.57
|
| Rate for Payer: Multiplan Medicare/VA |
$539.62
|
| Rate for Payer: One Health Plan of WY PPO |
$2,823.38
|
| Rate for Payer: PacificSource Commercial |
$2,592.90
|
| Rate for Payer: PHCS PPO |
$2,736.95
|
| Rate for Payer: Three Rivers PPO |
$2,160.75
|
| Rate for Payer: TriWest Veterans Administration |
$634.85
|
| Rate for Payer: United Healthcare Commercial |
$2,736.95
|
| Rate for Payer: WINHealth Partners Commercial |
$2,448.85
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 29876 AS
|
| Min. Negotiated Rate |
$685.50 |
| Max. Negotiated Rate |
$914.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$895.72
|
| Rate for Payer: Beech Street Commercial |
$868.30
|
| Rate for Payer: Cash Price |
$639.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$886.58
|
| Rate for Payer: Cigna of WY Commercial |
$895.72
|
| Rate for Payer: First Choice Health Commercial |
$822.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$868.30
|
| Rate for Payer: HealthUtah PPO |
$914.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$886.58
|
| Rate for Payer: One Health Plan of WY PPO |
$895.72
|
| Rate for Payer: PacificSource Commercial |
$822.60
|
| Rate for Payer: PHCS PPO |
$868.30
|
| Rate for Payer: Three Rivers PPO |
$685.50
|
| Rate for Payer: United Healthcare Commercial |
$868.30
|
| Rate for Payer: WINHealth Partners Commercial |
$776.90
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 29875 AS
|
| Min. Negotiated Rate |
$412.22 |
| Max. Negotiated Rate |
$2,188.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,144.24
|
| Rate for Payer: Beech Street Commercial |
$2,078.60
|
| Rate for Payer: Cash Price |
$1,531.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,122.36
|
| Rate for Payer: Cigna of WY Commercial |
$2,144.24
|
| Rate for Payer: First Choice Health Commercial |
$1,969.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,078.60
|
| Rate for Payer: HealthUtah PPO |
$2,188.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,122.36
|
| Rate for Payer: One Health Plan of WY PPO |
$2,144.24
|
| Rate for Payer: PacificSource Commercial |
$1,969.20
|
| Rate for Payer: PHCS PPO |
$2,078.60
|
| Rate for Payer: Three Rivers PPO |
$1,641.00
|
| Rate for Payer: United Healthcare Commercial |
$2,078.60
|
| Rate for Payer: WINHealth Partners Commercial |
$1,859.80
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 29875 80
|
| Min. Negotiated Rate |
$412.22 |
| Max. Negotiated Rate |
$2,188.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,144.24
|
| Rate for Payer: Beech Street Commercial |
$2,078.60
|
| Rate for Payer: Cash Price |
$1,531.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,122.36
|
| Rate for Payer: Cigna of WY Commercial |
$2,144.24
|
| Rate for Payer: First Choice Health Commercial |
$1,969.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,078.60
|
| Rate for Payer: HealthUtah PPO |
$2,188.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,122.36
|
| Rate for Payer: One Health Plan of WY PPO |
$2,144.24
|
| Rate for Payer: PacificSource Commercial |
$1,969.20
|
| Rate for Payer: PHCS PPO |
$2,078.60
|
| Rate for Payer: Three Rivers PPO |
$1,641.00
|
| Rate for Payer: United Healthcare Commercial |
$2,078.60
|
| Rate for Payer: WINHealth Partners Commercial |
$1,859.80
|
|
|
ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 29875
|
| Min. Negotiated Rate |
$412.22 |
| Max. Negotiated Rate |
$2,188.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,144.24
|
| Rate for Payer: Aetna of WY Medicare |
$484.96
|
| Rate for Payer: Beech Street Commercial |
$2,078.60
|
| Rate for Payer: Cash Price |
$1,531.60
|
| Rate for Payer: Cash Price |
$1,531.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,122.36
|
| Rate for Payer: Cigna of WY Commercial |
$2,144.24
|
| Rate for Payer: First Choice Health Commercial |
$1,969.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,078.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$484.96
|
| Rate for Payer: HealthUtah PPO |
$2,188.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,122.36
|
| Rate for Payer: Multiplan Medicare/VA |
$412.22
|
| Rate for Payer: One Health Plan of WY PPO |
$2,144.24
|
| Rate for Payer: PacificSource Commercial |
$1,969.20
|
| Rate for Payer: PHCS PPO |
$2,078.60
|
| Rate for Payer: Three Rivers PPO |
$1,641.00
|
| Rate for Payer: TriWest Veterans Administration |
$484.96
|
| Rate for Payer: United Healthcare Commercial |
$2,078.60
|
| Rate for Payer: WINHealth Partners Commercial |
$1,859.80
|
|
|
ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,728.00
|
|
|
Service Code
|
HCPCS 29884 80
|
| Min. Negotiated Rate |
$512.86 |
| Max. Negotiated Rate |
$2,728.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,673.44
|
| Rate for Payer: Beech Street Commercial |
$2,591.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,646.16
|
| Rate for Payer: Cigna of WY Commercial |
$2,673.44
|
| Rate for Payer: First Choice Health Commercial |
$2,455.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,591.60
|
| Rate for Payer: HealthUtah PPO |
$2,728.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,646.16
|
| Rate for Payer: One Health Plan of WY PPO |
$2,673.44
|
| Rate for Payer: PacificSource Commercial |
$2,455.20
|
| Rate for Payer: PHCS PPO |
$2,591.60
|
| Rate for Payer: Three Rivers PPO |
$2,046.00
|
| Rate for Payer: United Healthcare Commercial |
$2,591.60
|
| Rate for Payer: WINHealth Partners Commercial |
$2,318.80
|
|
|
ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,728.00
|
|
|
Service Code
|
HCPCS 29884
|
| Min. Negotiated Rate |
$512.86 |
| Max. Negotiated Rate |
$2,728.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,673.44
|
| Rate for Payer: Aetna of WY Medicare |
$603.37
|
| Rate for Payer: Beech Street Commercial |
$2,591.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,646.16
|
| Rate for Payer: Cigna of WY Commercial |
$2,673.44
|
| Rate for Payer: First Choice Health Commercial |
$2,455.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,591.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.37
|
| Rate for Payer: HealthUtah PPO |
$2,728.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,646.16
|
| Rate for Payer: Multiplan Medicare/VA |
$512.86
|
| Rate for Payer: One Health Plan of WY PPO |
$2,673.44
|
| Rate for Payer: PacificSource Commercial |
$2,455.20
|
| Rate for Payer: PHCS PPO |
$2,591.60
|
| Rate for Payer: Three Rivers PPO |
$2,046.00
|
| Rate for Payer: TriWest Veterans Administration |
$603.37
|
| Rate for Payer: United Healthcare Commercial |
$2,591.60
|
| Rate for Payer: WINHealth Partners Commercial |
$2,318.80
|
|
|
ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,728.00
|
|
|
Service Code
|
HCPCS 29884 AS
|
| Min. Negotiated Rate |
$512.86 |
| Max. Negotiated Rate |
$2,728.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,673.44
|
| Rate for Payer: Beech Street Commercial |
$2,591.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,646.16
|
| Rate for Payer: Cigna of WY Commercial |
$2,673.44
|
| Rate for Payer: First Choice Health Commercial |
$2,455.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,591.60
|
| Rate for Payer: HealthUtah PPO |
$2,728.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,646.16
|
| Rate for Payer: One Health Plan of WY PPO |
$2,673.44
|
| Rate for Payer: PacificSource Commercial |
$2,455.20
|
| Rate for Payer: PHCS PPO |
$2,591.60
|
| Rate for Payer: Three Rivers PPO |
$2,046.00
|
| Rate for Payer: United Healthcare Commercial |
$2,591.60
|
| Rate for Payer: WINHealth Partners Commercial |
$2,318.80
|
|
