HC PRO ANESTHESIA PARTIAL RIB RESECTION THORACOPLASTY
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00472
|
Hospital Charge Code |
9640047201
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA PERINEAL PROSTATECTOMY
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00908
|
Hospital Charge Code |
9640090801
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA RADICAL/MODIFIED RADICAL BREAST
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00404
|
Hospital Charge Code |
9640040401
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA RADICAL PERINEAL PROCEDURE
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00904
|
Hospital Charge Code |
9640090401
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA RECONSTRUCTION BREAST
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00402
|
Hospital Charge Code |
9640040201
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA SALIVARY GLANDS WITH BIOPSY
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00100
|
Hospital Charge Code |
9640010001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA TENOPLASTY ELBOW TO SHOULDER
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01714
|
Hospital Charge Code |
9640171401
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA THER IVNTL RADIOLOGICAL ARTERIAL
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01924
|
Hospital Charge Code |
9640192401
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA THORACIC SPINE & CORD NOS
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00620
|
Hospital Charge Code |
9640062001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA TRACHEOBRONCHIAL RECONSTRUCTION
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00539
|
Hospital Charge Code |
9640053901
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA TRANSURETHRAL RESECTION OF PROSTATE
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00914
|
Hospital Charge Code |
9640091401
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA UPPER 2/3 FEMUR AMPUTATION
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01232
|
Hospital Charge Code |
9640123201
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA UPPER ANTERIOR ABDOMINAL WALL NOS
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00700
|
Hospital Charge Code |
9640070001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA UPPER GI ENDOSCOPIC PX ERCP
|
Professional
|
Both
|
$212.00
|
|
Service Code
|
HCPCS 00732
|
Hospital Charge Code |
9640073201
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$159.00 |
Max. Negotiated Rate |
$212.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$207.76
|
Rate for Payer: Beech Street Commercial |
$201.40
|
Rate for Payer: Cash Price |
$148.40
|
Rate for Payer: ChoiceCare Network Commercial |
$205.64
|
Rate for Payer: Cigna of WY Commercial |
$207.76
|
Rate for Payer: First Choice Health Commercial |
$190.80
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$201.40
|
Rate for Payer: HealthUtah PPO |
$212.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$205.64
|
Rate for Payer: One Health Plan of WY PPO |
$207.76
|
Rate for Payer: PacificSource Commercial |
$190.80
|
Rate for Payer: PHCS PPO |
$201.40
|
Rate for Payer: Three Rivers PPO |
$159.00
|
Rate for Payer: United Healthcare Commercial |
$184.44
|
Rate for Payer: WINHealth Partners Commercial |
$201.40
|
|
HC PRO ANESTHESIA UPPER GI ENDOSCOPIC PX NOS
|
Professional
|
Both
|
$212.00
|
|
Service Code
|
HCPCS 00731
|
Hospital Charge Code |
9640073101
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$159.00 |
Max. Negotiated Rate |
$212.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$207.76
|
Rate for Payer: Beech Street Commercial |
$201.40
|
Rate for Payer: Cash Price |
$148.40
|
Rate for Payer: ChoiceCare Network Commercial |
$205.64
|
Rate for Payer: Cigna of WY Commercial |
$207.76
|
Rate for Payer: First Choice Health Commercial |
$190.80
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$201.40
|
Rate for Payer: HealthUtah PPO |
$212.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$205.64
|
Rate for Payer: One Health Plan of WY PPO |
$207.76
|
Rate for Payer: PacificSource Commercial |
$190.80
|
Rate for Payer: PHCS PPO |
$201.40
|
Rate for Payer: Three Rivers PPO |
$159.00
|
Rate for Payer: United Healthcare Commercial |
$184.44
|
Rate for Payer: WINHealth Partners Commercial |
$201.40
|
|
HC PRO ANESTHESIA UPPER POSTERIOR ABDOMINAL WALL
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00730
|
Hospital Charge Code |
9640073001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VAGINAL DELIVERY ONLY
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01960
|
Hospital Charge Code |
9640196001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VAGINAL HYSTERECTOMY INCL BIOPSY
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00944
|
Hospital Charge Code |
9640094401
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VAGINAL PROCEDURE W/BIOPSY NOS
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 00940
|
Hospital Charge Code |
9640094001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VASCULAR SHUNT/SHUNT REVISION
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01844
|
Hospital Charge Code |
9640184401
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VEINS FOREARM WRIST & HAND NOS
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01850
|
Hospital Charge Code |
9640185001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VEINS KNEE & POPLITEAL AREA NOS
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01430
|
Hospital Charge Code |
9640143001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VEINS OF LOWER LEG NOS
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01520
|
Hospital Charge Code |
9640152001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VEINS SHOULDER & AXILLA
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01670
|
Hospital Charge Code |
9640167001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|
HC PRO ANESTHESIA VEINS UPPER ARM & ELBOW NOS
|
Professional
|
Both
|
$314.00
|
|
Service Code
|
HCPCS 01780
|
Hospital Charge Code |
9640178001
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$235.50 |
Max. Negotiated Rate |
$314.00 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
Rate for Payer: Beech Street Commercial |
$298.30
|
Rate for Payer: Cash Price |
$219.80
|
Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
Rate for Payer: Cigna of WY Commercial |
$307.72
|
Rate for Payer: First Choice Health Commercial |
$282.60
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
Rate for Payer: HealthUtah PPO |
$314.00
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
Rate for Payer: One Health Plan of WY PPO |
$307.72
|
Rate for Payer: PacificSource Commercial |
$282.60
|
Rate for Payer: PHCS PPO |
$298.30
|
Rate for Payer: Three Rivers PPO |
$235.50
|
Rate for Payer: United Healthcare Commercial |
$273.18
|
Rate for Payer: WINHealth Partners Commercial |
$298.30
|
|