|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$3,710.00
|
|
|
Service Code
|
HCPCS 29883
|
| Min. Negotiated Rate |
$693.90 |
| Max. Negotiated Rate |
$3,710.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,635.80
|
| Rate for Payer: Aetna of WY Medicare |
$816.35
|
| Rate for Payer: Beech Street Commercial |
$3,524.50
|
| Rate for Payer: Cash Price |
$2,597.00
|
| Rate for Payer: Cash Price |
$2,597.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,598.70
|
| Rate for Payer: Cigna of WY Commercial |
$3,635.80
|
| Rate for Payer: First Choice Health Commercial |
$3,339.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,524.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$816.35
|
| Rate for Payer: HealthUtah PPO |
$3,710.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,598.70
|
| Rate for Payer: Multiplan Medicare/VA |
$693.90
|
| Rate for Payer: One Health Plan of WY PPO |
$3,635.80
|
| Rate for Payer: PacificSource Commercial |
$3,339.00
|
| Rate for Payer: PHCS PPO |
$3,524.50
|
| Rate for Payer: Three Rivers PPO |
$2,782.50
|
| Rate for Payer: TriWest Veterans Administration |
$816.35
|
| Rate for Payer: United Healthcare Commercial |
$3,524.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,153.50
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$3,710.00
|
|
|
Service Code
|
HCPCS 29883 AS
|
| Min. Negotiated Rate |
$693.90 |
| Max. Negotiated Rate |
$3,710.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,635.80
|
| Rate for Payer: Beech Street Commercial |
$3,524.50
|
| Rate for Payer: Cash Price |
$2,597.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,598.70
|
| Rate for Payer: Cigna of WY Commercial |
$3,635.80
|
| Rate for Payer: First Choice Health Commercial |
$3,339.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,524.50
|
| Rate for Payer: HealthUtah PPO |
$3,710.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,598.70
|
| Rate for Payer: One Health Plan of WY PPO |
$3,635.80
|
| Rate for Payer: PacificSource Commercial |
$3,339.00
|
| Rate for Payer: PHCS PPO |
$3,524.50
|
| Rate for Payer: Three Rivers PPO |
$2,782.50
|
| Rate for Payer: United Healthcare Commercial |
$3,524.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,153.50
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$3,710.00
|
|
|
Service Code
|
HCPCS 29883 80
|
| Min. Negotiated Rate |
$693.90 |
| Max. Negotiated Rate |
$3,710.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,635.80
|
| Rate for Payer: Beech Street Commercial |
$3,524.50
|
| Rate for Payer: Cash Price |
$2,597.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,598.70
|
| Rate for Payer: Cigna of WY Commercial |
$3,635.80
|
| Rate for Payer: First Choice Health Commercial |
$3,339.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,524.50
|
| Rate for Payer: HealthUtah PPO |
$3,710.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,598.70
|
| Rate for Payer: One Health Plan of WY PPO |
$3,635.80
|
| Rate for Payer: PacificSource Commercial |
$3,339.00
|
| Rate for Payer: PHCS PPO |
$3,524.50
|
| Rate for Payer: Three Rivers PPO |
$2,782.50
|
| Rate for Payer: United Healthcare Commercial |
$3,524.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,153.50
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$3,056.00
|
|
|
Service Code
|
HCPCS 29882
|
| Min. Negotiated Rate |
$568.19 |
| Max. Negotiated Rate |
$3,056.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,994.88
|
| Rate for Payer: Aetna of WY Medicare |
$668.46
|
| Rate for Payer: Beech Street Commercial |
$2,903.20
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,964.32
|
| Rate for Payer: Cigna of WY Commercial |
$2,994.88
|
| Rate for Payer: First Choice Health Commercial |
$2,750.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,903.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.46
|
| Rate for Payer: HealthUtah PPO |
$3,056.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,964.32
|
| Rate for Payer: Multiplan Medicare/VA |
$568.19
|
| Rate for Payer: One Health Plan of WY PPO |
$2,994.88
|
| Rate for Payer: PacificSource Commercial |
$2,750.40
|
| Rate for Payer: PHCS PPO |
$2,903.20
|
| Rate for Payer: Three Rivers PPO |
$2,292.00
|
| Rate for Payer: TriWest Veterans Administration |
$668.46
|
| Rate for Payer: United Healthcare Commercial |
$2,903.20
|
| Rate for Payer: WINHealth Partners Commercial |
$2,597.60
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$2,506.00
|
|
|
Service Code
|
HCPCS 29882 AS
|
| Min. Negotiated Rate |
$1,879.50 |
| Max. Negotiated Rate |
$2,506.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,455.88
|
| Rate for Payer: Beech Street Commercial |
$2,380.70
|
| Rate for Payer: Cash Price |
$1,754.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,430.82
|
| Rate for Payer: Cigna of WY Commercial |
$2,455.88
|
| Rate for Payer: First Choice Health Commercial |
$2,255.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,380.70
|
| Rate for Payer: HealthUtah PPO |
$2,506.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,430.82
|
| Rate for Payer: One Health Plan of WY PPO |
$2,455.88
|
| Rate for Payer: PacificSource Commercial |
$2,255.40
|
| Rate for Payer: PHCS PPO |
$2,380.70
|
| Rate for Payer: Three Rivers PPO |
$1,879.50
|
| Rate for Payer: United Healthcare Commercial |
$2,380.70
|
| Rate for Payer: WINHealth Partners Commercial |
$2,130.10
|
|
|
ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 29882 80
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$884.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$866.32
|
| Rate for Payer: Beech Street Commercial |
$839.80
|
| Rate for Payer: Cash Price |
$618.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$857.48
|
| Rate for Payer: Cigna of WY Commercial |
$866.32
|
| Rate for Payer: First Choice Health Commercial |
$795.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$839.80
|
| Rate for Payer: HealthUtah PPO |
$884.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$857.48
|
| Rate for Payer: One Health Plan of WY PPO |
$866.32
|
| Rate for Payer: PacificSource Commercial |
$795.60
|
| Rate for Payer: PHCS PPO |
$839.80
|
| Rate for Payer: Three Rivers PPO |
$663.00
|
| Rate for Payer: United Healthcare Commercial |
$839.80
|
| Rate for Payer: WINHealth Partners Commercial |
$751.40
|
|
|
ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX
|
Professional
|
Both
|
$8,022.00
|
|
|
Service Code
|
HCPCS 29840
|
| Min. Negotiated Rate |
$375.62 |
| Max. Negotiated Rate |
$8,022.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,861.56
|
| Rate for Payer: Aetna of WY Medicare |
$441.91
|
| Rate for Payer: Beech Street Commercial |
$7,620.90
|
| Rate for Payer: Cash Price |
$5,615.40
|
| Rate for Payer: Cash Price |
$5,615.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,781.34
|
| Rate for Payer: Cigna of WY Commercial |
$7,861.56
|
| Rate for Payer: First Choice Health Commercial |
$7,219.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,620.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$441.91
|
| Rate for Payer: HealthUtah PPO |
$8,022.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,781.34
|
| Rate for Payer: Multiplan Medicare/VA |
$375.62
|
| Rate for Payer: One Health Plan of WY PPO |
$7,861.56
|
| Rate for Payer: PacificSource Commercial |
$7,219.80
|
| Rate for Payer: PHCS PPO |
$7,620.90
|
| Rate for Payer: Three Rivers PPO |
$6,016.50
|
| Rate for Payer: TriWest Veterans Administration |
$441.91
|
| Rate for Payer: United Healthcare Commercial |
$7,620.90
|
| Rate for Payer: WINHealth Partners Commercial |
$6,818.70
|
|
|
ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$2,141.00
|
|
|
Service Code
|
HCPCS 29843 80
|
| Min. Negotiated Rate |
$405.20 |
| Max. Negotiated Rate |
$2,141.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,098.18
|
| Rate for Payer: Beech Street Commercial |
$2,033.95
|
| Rate for Payer: Cash Price |
$1,498.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,076.77
|
| Rate for Payer: Cigna of WY Commercial |
$2,098.18
|
| Rate for Payer: First Choice Health Commercial |
$1,926.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,033.95
|
| Rate for Payer: HealthUtah PPO |
$2,141.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,076.77
|
| Rate for Payer: One Health Plan of WY PPO |
$2,098.18
|
| Rate for Payer: PacificSource Commercial |
$1,926.90
|
| Rate for Payer: PHCS PPO |
$2,033.95
|
| Rate for Payer: Three Rivers PPO |
$1,605.75
|
| Rate for Payer: United Healthcare Commercial |
$2,033.95
|
| Rate for Payer: WINHealth Partners Commercial |
$1,819.85
|
|
|
ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$2,141.00
|
|
|
Service Code
|
HCPCS 29843
|
| Min. Negotiated Rate |
$405.20 |
| Max. Negotiated Rate |
$2,141.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,098.18
|
| Rate for Payer: Aetna of WY Medicare |
$476.71
|
| Rate for Payer: Beech Street Commercial |
$2,033.95
|
| Rate for Payer: Cash Price |
$1,498.70
|
| Rate for Payer: Cash Price |
$1,498.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,076.77
|
| Rate for Payer: Cigna of WY Commercial |
$2,098.18
|
| Rate for Payer: First Choice Health Commercial |
$1,926.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,033.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$476.71
|
| Rate for Payer: HealthUtah PPO |
$2,141.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,076.77
|
| Rate for Payer: Multiplan Medicare/VA |
$405.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2,098.18
|
| Rate for Payer: PacificSource Commercial |
$1,926.90
|
| Rate for Payer: PHCS PPO |
$2,033.95
|
| Rate for Payer: Three Rivers PPO |
$1,605.75
|
| Rate for Payer: TriWest Veterans Administration |
$476.71
|
| Rate for Payer: United Healthcare Commercial |
$2,033.95
|
| Rate for Payer: WINHealth Partners Commercial |
$1,819.85
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$5,720.00
|
|
|
Service Code
|
HCPCS 29845
|
| Min. Negotiated Rate |
$486.75 |
| Max. Negotiated Rate |
$5,720.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,605.60
|
| Rate for Payer: Aetna of WY Medicare |
$572.65
|
| Rate for Payer: Beech Street Commercial |
$5,434.00
|
| Rate for Payer: Cash Price |
$4,004.00
|
| Rate for Payer: Cash Price |
$4,004.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,548.40
|
| Rate for Payer: Cigna of WY Commercial |
$5,605.60
|
| Rate for Payer: First Choice Health Commercial |
$5,148.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,434.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$572.65
|
| Rate for Payer: HealthUtah PPO |
$5,720.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,548.40
|
| Rate for Payer: Multiplan Medicare/VA |
$486.75
|
| Rate for Payer: One Health Plan of WY PPO |
$5,605.60
|
| Rate for Payer: PacificSource Commercial |
$5,148.00
|
| Rate for Payer: PHCS PPO |
$5,434.00
|
| Rate for Payer: Three Rivers PPO |
$4,290.00
|
| Rate for Payer: TriWest Veterans Administration |
$572.65
|
| Rate for Payer: United Healthcare Commercial |
$5,434.00
|
| Rate for Payer: WINHealth Partners Commercial |
$4,862.00
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$5,720.00
|
|
|
Service Code
|
HCPCS 29845 AS
|
| Min. Negotiated Rate |
$486.75 |
| Max. Negotiated Rate |
$5,720.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,605.60
|
| Rate for Payer: Beech Street Commercial |
$5,434.00
|
| Rate for Payer: Cash Price |
$4,004.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,548.40
|
| Rate for Payer: Cigna of WY Commercial |
$5,605.60
|
| Rate for Payer: First Choice Health Commercial |
$5,148.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,434.00
|
| Rate for Payer: HealthUtah PPO |
$5,720.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,548.40
|
| Rate for Payer: One Health Plan of WY PPO |
$5,605.60
|
| Rate for Payer: PacificSource Commercial |
$5,148.00
|
| Rate for Payer: PHCS PPO |
$5,434.00
|
| Rate for Payer: Three Rivers PPO |
$4,290.00
|
| Rate for Payer: United Healthcare Commercial |
$5,434.00
|
| Rate for Payer: WINHealth Partners Commercial |
$4,862.00
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 29845 80
|
| Min. Negotiated Rate |
$1,017.75 |
| Max. Negotiated Rate |
$1,357.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,329.86
|
| Rate for Payer: Beech Street Commercial |
$1,289.15
|
| Rate for Payer: Cash Price |
$949.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,316.29
|
| Rate for Payer: Cigna of WY Commercial |
$1,329.86
|
| Rate for Payer: First Choice Health Commercial |
$1,221.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,289.15
|
| Rate for Payer: HealthUtah PPO |
$1,357.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,316.29
|
| Rate for Payer: One Health Plan of WY PPO |
$1,329.86
|
| Rate for Payer: PacificSource Commercial |
$1,221.30
|
| Rate for Payer: PHCS PPO |
$1,289.15
|
| Rate for Payer: Three Rivers PPO |
$1,017.75
|
| Rate for Payer: United Healthcare Commercial |
$1,289.15
|
| Rate for Payer: WINHealth Partners Commercial |
$1,153.45
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$5,552.00
|
|
|
Service Code
|
HCPCS 29844 AS
|
| Min. Negotiated Rate |
$4,164.00 |
| Max. Negotiated Rate |
$5,552.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,440.96
|
| Rate for Payer: Beech Street Commercial |
$5,274.40
|
| Rate for Payer: Cash Price |
$3,886.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,385.44
|
| Rate for Payer: Cigna of WY Commercial |
$5,440.96
|
| Rate for Payer: First Choice Health Commercial |
$4,996.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,274.40
|
| Rate for Payer: HealthUtah PPO |
$5,552.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,385.44
|
| Rate for Payer: One Health Plan of WY PPO |
$5,440.96
|
| Rate for Payer: PacificSource Commercial |
$4,996.80
|
| Rate for Payer: PHCS PPO |
$5,274.40
|
| Rate for Payer: Three Rivers PPO |
$4,164.00
|
| Rate for Payer: United Healthcare Commercial |
$5,274.40
|
| Rate for Payer: WINHealth Partners Commercial |
$4,719.20
|
|
|
ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$5,552.00
|
|
|
Service Code
|
HCPCS 29844
|
| Min. Negotiated Rate |
$4,164.00 |
| Max. Negotiated Rate |
$5,552.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,440.96
|
| Rate for Payer: Beech Street Commercial |
$5,274.40
|
| Rate for Payer: Cash Price |
$3,886.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,385.44
|
| Rate for Payer: Cigna of WY Commercial |
$5,440.96
|
| Rate for Payer: First Choice Health Commercial |
$4,996.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,274.40
|
| Rate for Payer: HealthUtah PPO |
$5,552.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,385.44
|
| Rate for Payer: One Health Plan of WY PPO |
$5,440.96
|
| Rate for Payer: PacificSource Commercial |
$4,996.80
|
| Rate for Payer: PHCS PPO |
$5,274.40
|
| Rate for Payer: Three Rivers PPO |
$4,164.00
|
| Rate for Payer: United Healthcare Commercial |
$5,274.40
|
| Rate for Payer: WINHealth Partners Commercial |
$4,719.20
|
|
|
ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$4,838.00
|
|
|
Service Code
|
HCPCS 27610 AS
|
| Min. Negotiated Rate |
$3,628.50 |
| Max. Negotiated Rate |
$4,838.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,741.24
|
| Rate for Payer: Beech Street Commercial |
$4,596.10
|
| Rate for Payer: Cash Price |
$3,386.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,692.86
|
| Rate for Payer: Cigna of WY Commercial |
$4,741.24
|
| Rate for Payer: First Choice Health Commercial |
$4,354.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,596.10
|
| Rate for Payer: HealthUtah PPO |
$4,838.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,692.86
|
| Rate for Payer: One Health Plan of WY PPO |
$4,741.24
|
| Rate for Payer: PacificSource Commercial |
$4,354.20
|
| Rate for Payer: PHCS PPO |
$4,596.10
|
| Rate for Payer: Three Rivers PPO |
$3,628.50
|
| Rate for Payer: United Healthcare Commercial |
$4,596.10
|
| Rate for Payer: WINHealth Partners Commercial |
$4,112.30
|
|
|
ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$5,897.00
|
|
|
Service Code
|
HCPCS 27610
|
| Min. Negotiated Rate |
$533.12 |
| Max. Negotiated Rate |
$5,897.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,779.06
|
| Rate for Payer: Aetna of WY Medicare |
$627.20
|
| Rate for Payer: Beech Street Commercial |
$5,602.15
|
| Rate for Payer: Cash Price |
$4,127.90
|
| Rate for Payer: Cash Price |
$4,127.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,720.09
|
| Rate for Payer: Cigna of WY Commercial |
$5,779.06
|
| Rate for Payer: First Choice Health Commercial |
$5,307.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,602.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$627.20
|
| Rate for Payer: HealthUtah PPO |
$5,897.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,720.09
|
| Rate for Payer: Multiplan Medicare/VA |
$533.12
|
| Rate for Payer: One Health Plan of WY PPO |
$5,779.06
|
| Rate for Payer: PacificSource Commercial |
$5,307.30
|
| Rate for Payer: PHCS PPO |
$5,602.15
|
| Rate for Payer: Three Rivers PPO |
$4,422.75
|
| Rate for Payer: TriWest Veterans Administration |
$627.20
|
| Rate for Payer: United Healthcare Commercial |
$5,602.15
|
| Rate for Payer: WINHealth Partners Commercial |
$5,012.45
|
|
|
ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 26110
|
| Min. Negotiated Rate |
$274.35 |
| Max. Negotiated Rate |
$1,423.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,394.54
|
| Rate for Payer: Aetna of WY Medicare |
$322.77
|
| Rate for Payer: Beech Street Commercial |
$1,351.85
|
| Rate for Payer: Cash Price |
$996.10
|
| Rate for Payer: Cash Price |
$996.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,380.31
|
| Rate for Payer: Cigna of WY Commercial |
$1,394.54
|
| Rate for Payer: First Choice Health Commercial |
$1,280.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,351.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$322.77
|
| Rate for Payer: HealthUtah PPO |
$1,423.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,380.31
|
| Rate for Payer: Multiplan Medicare/VA |
$274.35
|
| Rate for Payer: One Health Plan of WY PPO |
$1,394.54
|
| Rate for Payer: PacificSource Commercial |
$1,280.70
|
| Rate for Payer: PHCS PPO |
$1,351.85
|
| Rate for Payer: Three Rivers PPO |
$1,067.25
|
| Rate for Payer: TriWest Veterans Administration |
$322.77
|
| Rate for Payer: United Healthcare Commercial |
$1,351.85
|
| Rate for Payer: WINHealth Partners Commercial |
$1,209.55
|
|
|
ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$2,713.00
|
|
|
Service Code
|
HCPCS 25107 AS
|
| Min. Negotiated Rate |
$516.13 |
| Max. Negotiated Rate |
$2,713.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,658.74
|
| Rate for Payer: Beech Street Commercial |
$2,577.35
|
| Rate for Payer: Cash Price |
$1,899.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,631.61
|
| Rate for Payer: Cigna of WY Commercial |
$2,658.74
|
| Rate for Payer: First Choice Health Commercial |
$2,441.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,577.35
|
| Rate for Payer: HealthUtah PPO |
$2,713.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,631.61
|
| Rate for Payer: One Health Plan of WY PPO |
$2,658.74
|
| Rate for Payer: PacificSource Commercial |
$2,441.70
|
| Rate for Payer: PHCS PPO |
$2,577.35
|
| Rate for Payer: Three Rivers PPO |
$2,034.75
|
| Rate for Payer: United Healthcare Commercial |
$2,577.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2,306.05
|
|
|
ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$2,713.00
|
|
|
Service Code
|
HCPCS 25107
|
| Min. Negotiated Rate |
$516.13 |
| Max. Negotiated Rate |
$2,713.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,658.74
|
| Rate for Payer: Aetna of WY Medicare |
$607.21
|
| Rate for Payer: Beech Street Commercial |
$2,577.35
|
| Rate for Payer: Cash Price |
$1,899.10
|
| Rate for Payer: Cash Price |
$1,899.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,631.61
|
| Rate for Payer: Cigna of WY Commercial |
$2,658.74
|
| Rate for Payer: First Choice Health Commercial |
$2,441.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,577.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$607.21
|
| Rate for Payer: HealthUtah PPO |
$2,713.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,631.61
|
| Rate for Payer: Multiplan Medicare/VA |
$516.13
|
| Rate for Payer: One Health Plan of WY PPO |
$2,658.74
|
| Rate for Payer: PacificSource Commercial |
$2,441.70
|
| Rate for Payer: PHCS PPO |
$2,577.35
|
| Rate for Payer: Three Rivers PPO |
$2,034.75
|
| Rate for Payer: TriWest Veterans Administration |
$607.21
|
| Rate for Payer: United Healthcare Commercial |
$2,577.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2,306.05
|
|
|
ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$6,552.00
|
|
|
Service Code
|
HCPCS 24102 AS
|
| Min. Negotiated Rate |
$512.75 |
| Max. Negotiated Rate |
$6,552.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,420.96
|
| Rate for Payer: Beech Street Commercial |
$6,224.40
|
| Rate for Payer: Cash Price |
$4,586.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,355.44
|
| Rate for Payer: Cigna of WY Commercial |
$6,420.96
|
| Rate for Payer: First Choice Health Commercial |
$5,896.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,224.40
|
| Rate for Payer: HealthUtah PPO |
$6,552.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,355.44
|
| Rate for Payer: One Health Plan of WY PPO |
$6,420.96
|
| Rate for Payer: PacificSource Commercial |
$5,896.80
|
| Rate for Payer: PHCS PPO |
$6,224.40
|
| Rate for Payer: Three Rivers PPO |
$4,914.00
|
| Rate for Payer: United Healthcare Commercial |
$6,224.40
|
| Rate for Payer: WINHealth Partners Commercial |
$5,569.20
|
|
|
ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$6,552.00
|
|
|
Service Code
|
HCPCS 24102
|
| Min. Negotiated Rate |
$512.75 |
| Max. Negotiated Rate |
$6,552.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,420.96
|
| Rate for Payer: Aetna of WY Medicare |
$603.23
|
| Rate for Payer: Beech Street Commercial |
$6,224.40
|
| Rate for Payer: Cash Price |
$4,586.40
|
| Rate for Payer: Cash Price |
$4,586.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,355.44
|
| Rate for Payer: Cigna of WY Commercial |
$6,420.96
|
| Rate for Payer: First Choice Health Commercial |
$5,896.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,224.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.23
|
| Rate for Payer: HealthUtah PPO |
$6,552.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,355.44
|
| Rate for Payer: Multiplan Medicare/VA |
$512.75
|
| Rate for Payer: One Health Plan of WY PPO |
$6,420.96
|
| Rate for Payer: PacificSource Commercial |
$5,896.80
|
| Rate for Payer: PHCS PPO |
$6,224.40
|
| Rate for Payer: Three Rivers PPO |
$4,914.00
|
| Rate for Payer: TriWest Veterans Administration |
$603.23
|
| Rate for Payer: United Healthcare Commercial |
$6,224.40
|
| Rate for Payer: WINHealth Partners Commercial |
$5,569.20
|
|
|
ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$3,144.00
|
|
|
Service Code
|
HCPCS 23040
|
| Min. Negotiated Rate |
$592.87 |
| Max. Negotiated Rate |
$3,144.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,081.12
|
| Rate for Payer: Aetna of WY Medicare |
$697.49
|
| Rate for Payer: Beech Street Commercial |
$2,986.80
|
| Rate for Payer: Cash Price |
$2,200.80
|
| Rate for Payer: Cash Price |
$2,200.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,049.68
|
| Rate for Payer: Cigna of WY Commercial |
$3,081.12
|
| Rate for Payer: First Choice Health Commercial |
$2,829.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,986.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$697.49
|
| Rate for Payer: HealthUtah PPO |
$3,144.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,049.68
|
| Rate for Payer: Multiplan Medicare/VA |
$592.87
|
| Rate for Payer: One Health Plan of WY PPO |
$3,081.12
|
| Rate for Payer: PacificSource Commercial |
$2,829.60
|
| Rate for Payer: PHCS PPO |
$2,986.80
|
| Rate for Payer: Three Rivers PPO |
$2,358.00
|
| Rate for Payer: TriWest Veterans Administration |
$697.49
|
| Rate for Payer: United Healthcare Commercial |
$2,986.80
|
| Rate for Payer: WINHealth Partners Commercial |
$2,672.40
|
|
|
ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$4,140.00
|
|
|
Service Code
|
HCPCS 27030 AS
|
| Min. Negotiated Rate |
$767.40 |
| Max. Negotiated Rate |
$4,140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,057.20
|
| Rate for Payer: Beech Street Commercial |
$3,933.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,015.80
|
| Rate for Payer: Cigna of WY Commercial |
$4,057.20
|
| Rate for Payer: First Choice Health Commercial |
$3,726.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,933.00
|
| Rate for Payer: HealthUtah PPO |
$4,140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,015.80
|
| Rate for Payer: One Health Plan of WY PPO |
$4,057.20
|
| Rate for Payer: PacificSource Commercial |
$3,726.00
|
| Rate for Payer: PHCS PPO |
$3,933.00
|
| Rate for Payer: Three Rivers PPO |
$3,105.00
|
| Rate for Payer: United Healthcare Commercial |
$3,933.00
|
| Rate for Payer: WINHealth Partners Commercial |
$3,519.00
|
|
|
ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$4,140.00
|
|
|
Service Code
|
HCPCS 27030
|
| Min. Negotiated Rate |
$767.40 |
| Max. Negotiated Rate |
$4,140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,057.20
|
| Rate for Payer: Aetna of WY Medicare |
$902.82
|
| Rate for Payer: Beech Street Commercial |
$3,933.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,015.80
|
| Rate for Payer: Cigna of WY Commercial |
$4,057.20
|
| Rate for Payer: First Choice Health Commercial |
$3,726.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,933.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$902.82
|
| Rate for Payer: HealthUtah PPO |
$4,140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,015.80
|
| Rate for Payer: Multiplan Medicare/VA |
$767.40
|
| Rate for Payer: One Health Plan of WY PPO |
$4,057.20
|
| Rate for Payer: PacificSource Commercial |
$3,726.00
|
| Rate for Payer: PHCS PPO |
$3,933.00
|
| Rate for Payer: Three Rivers PPO |
$3,105.00
|
| Rate for Payer: TriWest Veterans Administration |
$902.82
|
| Rate for Payer: United Healthcare Commercial |
$3,933.00
|
| Rate for Payer: WINHealth Partners Commercial |
$3,519.00
|
|
|
ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$5,220.00
|
|
|
Service Code
|
HCPCS 27330
|
| Min. Negotiated Rate |
$354.05 |
| Max. Negotiated Rate |
$5,220.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,115.60
|
| Rate for Payer: Aetna of WY Medicare |
$416.53
|
| Rate for Payer: Beech Street Commercial |
$4,959.00
|
| Rate for Payer: Cash Price |
$3,654.00
|
| Rate for Payer: Cash Price |
$3,654.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,063.40
|
| Rate for Payer: Cigna of WY Commercial |
$5,115.60
|
| Rate for Payer: First Choice Health Commercial |
$4,698.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,959.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$416.53
|
| Rate for Payer: HealthUtah PPO |
$5,220.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,063.40
|
| Rate for Payer: Multiplan Medicare/VA |
$354.05
|
| Rate for Payer: One Health Plan of WY PPO |
$5,115.60
|
| Rate for Payer: PacificSource Commercial |
$4,698.00
|
| Rate for Payer: PHCS PPO |
$4,959.00
|
| Rate for Payer: Three Rivers PPO |
$3,915.00
|
| Rate for Payer: TriWest Veterans Administration |
$416.53
|
| Rate for Payer: United Healthcare Commercial |
$4,959.00
|
| Rate for Payer: WINHealth Partners Commercial |
$4,437.00
|
|
