|
HC PRO ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
9832061101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$47.90 |
| Max. Negotiated Rate |
$368.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$360.64
|
| Rate for Payer: Aetna of WY Medicare |
$56.35
|
| Rate for Payer: Beech Street Commercial |
$349.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$356.96
|
| Rate for Payer: Cigna of WY Commercial |
$360.64
|
| Rate for Payer: First Choice Health Commercial |
$331.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$349.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$56.35
|
| Rate for Payer: HealthUtah PPO |
$368.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$356.96
|
| Rate for Payer: Multiplan Medicare/VA |
$47.90
|
| Rate for Payer: One Health Plan of WY PPO |
$360.64
|
| Rate for Payer: PacificSource Commercial |
$331.20
|
| Rate for Payer: PHCS PPO |
$349.60
|
| Rate for Payer: Three Rivers PPO |
$276.00
|
| Rate for Payer: TriWest Veterans Administration |
$56.35
|
| Rate for Payer: United Healthcare Commercial |
$320.16
|
| Rate for Payer: United Healthcare Medicare |
$56.35
|
| Rate for Payer: WINHealth Partners Commercial |
$312.80
|
|
|
HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 20600 50,NONPBBPAYER
|
| Hospital Charge Code |
9832060001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$29.13 |
| Max. Negotiated Rate |
$356.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$348.88
|
| Rate for Payer: Aetna of WY Medicare |
$34.27
|
| Rate for Payer: Beech Street Commercial |
$338.20
|
| Rate for Payer: Cash Price |
$249.20
|
| Rate for Payer: Cash Price |
$249.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$345.32
|
| Rate for Payer: Cigna of WY Commercial |
$348.88
|
| Rate for Payer: First Choice Health Commercial |
$320.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$338.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$34.27
|
| Rate for Payer: HealthUtah PPO |
$356.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$345.32
|
| Rate for Payer: Multiplan Medicare/VA |
$29.13
|
| Rate for Payer: One Health Plan of WY PPO |
$348.88
|
| Rate for Payer: PacificSource Commercial |
$320.40
|
| Rate for Payer: PHCS PPO |
$338.20
|
| Rate for Payer: Three Rivers PPO |
$267.00
|
| Rate for Payer: TriWest Veterans Administration |
$34.27
|
| Rate for Payer: United Healthcare Commercial |
$309.72
|
| Rate for Payer: United Healthcare Medicare |
$34.27
|
| Rate for Payer: WINHealth Partners Commercial |
$302.60
|
|
|
HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 20600 50
|
| Hospital Charge Code |
9832060001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$29.13 |
| Max. Negotiated Rate |
$284.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$278.32
|
| Rate for Payer: Aetna of WY Medicare |
$34.27
|
| Rate for Payer: Beech Street Commercial |
$269.80
|
| Rate for Payer: Cash Price |
$198.80
|
| Rate for Payer: Cash Price |
$198.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$275.48
|
| Rate for Payer: Cigna of WY Commercial |
$278.32
|
| Rate for Payer: First Choice Health Commercial |
$255.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$269.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$34.27
|
| Rate for Payer: HealthUtah PPO |
$284.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$275.48
|
| Rate for Payer: Multiplan Medicare/VA |
$29.13
|
| Rate for Payer: One Health Plan of WY PPO |
$278.32
|
| Rate for Payer: PacificSource Commercial |
$255.60
|
| Rate for Payer: PHCS PPO |
$269.80
|
| Rate for Payer: Three Rivers PPO |
$213.00
|
| Rate for Payer: TriWest Veterans Administration |
$34.27
|
| Rate for Payer: United Healthcare Commercial |
$247.08
|
| Rate for Payer: United Healthcare Medicare |
$34.27
|
| Rate for Payer: WINHealth Partners Commercial |
$241.40
|
|
|
HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 20600 NONPBBPAYER
|
| Hospital Charge Code |
9832060001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$29.13 |
| Max. Negotiated Rate |
$178.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$174.44
|
| Rate for Payer: Aetna of WY Medicare |
$34.27
|
| Rate for Payer: Beech Street Commercial |
$169.10
|
| Rate for Payer: Cash Price |
$124.60
|
| Rate for Payer: Cash Price |
$124.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$172.66
|
| Rate for Payer: Cigna of WY Commercial |
$174.44
|
| Rate for Payer: First Choice Health Commercial |
$160.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$169.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$34.27
|
| Rate for Payer: HealthUtah PPO |
$178.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$172.66
|
| Rate for Payer: Multiplan Medicare/VA |
$29.13
|
| Rate for Payer: One Health Plan of WY PPO |
$174.44
|
| Rate for Payer: PacificSource Commercial |
$160.20
|
| Rate for Payer: PHCS PPO |
$169.10
|
| Rate for Payer: Three Rivers PPO |
$133.50
|
| Rate for Payer: TriWest Veterans Administration |
$34.27
|
| Rate for Payer: United Healthcare Commercial |
$154.86
|
| Rate for Payer: United Healthcare Medicare |
$34.27
|
| Rate for Payer: WINHealth Partners Commercial |
$151.30
|
|
|
HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
9832060001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$29.13 |
| Max. Negotiated Rate |
$269.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$263.62
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$139.16
|
| Rate for Payer: Aetna of WY Medicare |
$34.27
|
| Rate for Payer: Aetna of WY Medicare |
$34.27
|
| Rate for Payer: Beech Street Commercial |
$134.90
|
| Rate for Payer: Beech Street Commercial |
$255.55
|
| Rate for Payer: Cash Price |
$99.40
|
| Rate for Payer: Cash Price |
$99.40
|
| Rate for Payer: Cash Price |
$188.30
|
| Rate for Payer: Cash Price |
$188.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$260.93
|
| Rate for Payer: ChoiceCare Network Commercial |
$137.74
|
| Rate for Payer: Cigna of WY Commercial |
$139.16
|
| Rate for Payer: Cigna of WY Commercial |
$263.62
|
| Rate for Payer: First Choice Health Commercial |
$127.80
|
| Rate for Payer: First Choice Health Commercial |
$242.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$255.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$134.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$34.27
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$34.27
|
| Rate for Payer: HealthUtah PPO |
$269.00
|
| Rate for Payer: HealthUtah PPO |
$142.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$260.93
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$137.74
|
| Rate for Payer: Multiplan Medicare/VA |
$29.13
|
| Rate for Payer: Multiplan Medicare/VA |
$29.13
|
| Rate for Payer: One Health Plan of WY PPO |
$263.62
|
| Rate for Payer: One Health Plan of WY PPO |
$139.16
|
| Rate for Payer: PacificSource Commercial |
$127.80
|
| Rate for Payer: PacificSource Commercial |
$242.10
|
| Rate for Payer: PHCS PPO |
$255.55
|
| Rate for Payer: PHCS PPO |
$134.90
|
| Rate for Payer: Three Rivers PPO |
$201.75
|
| Rate for Payer: Three Rivers PPO |
$106.50
|
| Rate for Payer: TriWest Veterans Administration |
$34.27
|
| Rate for Payer: TriWest Veterans Administration |
$34.27
|
| Rate for Payer: United Healthcare Commercial |
$123.54
|
| Rate for Payer: United Healthcare Commercial |
$234.03
|
| Rate for Payer: United Healthcare Medicare |
$34.27
|
| Rate for Payer: United Healthcare Medicare |
$34.27
|
| Rate for Payer: WINHealth Partners Commercial |
$228.65
|
| Rate for Payer: WINHealth Partners Commercial |
$120.70
|
|
|
HC PRO ARTHROCNT ASPIR INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 20604
|
| Hospital Charge Code |
9832060401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$37.13 |
| Max. Negotiated Rate |
$304.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$297.92
|
| Rate for Payer: Aetna of WY Medicare |
$43.68
|
| Rate for Payer: Beech Street Commercial |
$288.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$294.88
|
| Rate for Payer: Cigna of WY Commercial |
$297.92
|
| Rate for Payer: First Choice Health Commercial |
$273.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$288.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.68
|
| Rate for Payer: HealthUtah PPO |
$304.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$294.88
|
| Rate for Payer: Multiplan Medicare/VA |
$37.13
|
| Rate for Payer: One Health Plan of WY PPO |
$297.92
|
| Rate for Payer: PacificSource Commercial |
$273.60
|
| Rate for Payer: PHCS PPO |
$288.80
|
| Rate for Payer: Three Rivers PPO |
$228.00
|
| Rate for Payer: TriWest Veterans Administration |
$43.68
|
| Rate for Payer: United Healthcare Commercial |
$264.48
|
| Rate for Payer: United Healthcare Medicare |
$43.68
|
| Rate for Payer: WINHealth Partners Commercial |
$258.40
|
|
|
HC PRO ARTHROCNT ASPIR INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 20604 NONPBBPAYER
|
| Hospital Charge Code |
9832060401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$37.13 |
| Max. Negotiated Rate |
$380.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$372.40
|
| Rate for Payer: Aetna of WY Medicare |
$43.68
|
| Rate for Payer: Beech Street Commercial |
$361.00
|
| Rate for Payer: Cash Price |
$266.00
|
| Rate for Payer: Cash Price |
$266.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$368.60
|
| Rate for Payer: Cigna of WY Commercial |
$372.40
|
| Rate for Payer: First Choice Health Commercial |
$342.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$361.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.68
|
| Rate for Payer: HealthUtah PPO |
$380.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$368.60
|
| Rate for Payer: Multiplan Medicare/VA |
$37.13
|
| Rate for Payer: One Health Plan of WY PPO |
$372.40
|
| Rate for Payer: PacificSource Commercial |
$342.00
|
| Rate for Payer: PHCS PPO |
$361.00
|
| Rate for Payer: Three Rivers PPO |
$285.00
|
| Rate for Payer: TriWest Veterans Administration |
$43.68
|
| Rate for Payer: United Healthcare Commercial |
$330.60
|
| Rate for Payer: United Healthcare Medicare |
$43.68
|
| Rate for Payer: WINHealth Partners Commercial |
$323.00
|
|
|
HC PRO ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2
|
Professional
|
Both
|
$5,763.00
|
|
|
Service Code
|
HCPCS 22551
|
| Hospital Charge Code |
9832255101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,372.87 |
| Max. Negotiated Rate |
$5,763.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,647.74
|
| Rate for Payer: Aetna of WY Medicare |
$1,615.14
|
| Rate for Payer: Beech Street Commercial |
$5,474.85
|
| Rate for Payer: Cash Price |
$4,034.10
|
| 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: Government Employees Health Association (GEHA) Medicare |
$1,615.14
|
| Rate for Payer: HealthUtah PPO |
$5,763.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,590.11
|
| Rate for Payer: Multiplan Medicare/VA |
$1,372.87
|
| 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: TriWest Veterans Administration |
$1,615.14
|
| Rate for Payer: United Healthcare Commercial |
$5,013.81
|
| Rate for Payer: United Healthcare Medicare |
$1,615.14
|
| Rate for Payer: WINHealth Partners Commercial |
$4,898.55
|
|
|
HC PRO ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 EA
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 22552
|
| Hospital Charge Code |
9832255201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$314.35 |
| Max. Negotiated Rate |
$1,320.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,293.60
|
| Rate for Payer: Aetna of WY Medicare |
$369.82
|
| Rate for Payer: Beech Street Commercial |
$1,254.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,280.40
|
| Rate for Payer: Cigna of WY Commercial |
$1,293.60
|
| Rate for Payer: First Choice Health Commercial |
$1,188.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,254.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$369.82
|
| Rate for Payer: HealthUtah PPO |
$1,320.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,280.40
|
| Rate for Payer: Multiplan Medicare/VA |
$314.35
|
| Rate for Payer: One Health Plan of WY PPO |
$1,293.60
|
| Rate for Payer: PacificSource Commercial |
$1,188.00
|
| Rate for Payer: PHCS PPO |
$1,254.00
|
| Rate for Payer: Three Rivers PPO |
$990.00
|
| Rate for Payer: TriWest Veterans Administration |
$369.82
|
| Rate for Payer: United Healthcare Commercial |
$1,148.40
|
| Rate for Payer: United Healthcare Medicare |
$369.82
|
| Rate for Payer: WINHealth Partners Commercial |
$1,122.00
|
|
|
HC PRO ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$3,015.00
|
|
|
Service Code
|
HCPCS 28750
|
| Hospital Charge Code |
9822875001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$476.70 |
| Max. Negotiated Rate |
$3,015.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,954.70
|
| Rate for Payer: Aetna of WY Medicare |
$560.82
|
| Rate for Payer: Beech Street Commercial |
$2,864.25
|
| Rate for Payer: Cash Price |
$2,110.50
|
| Rate for Payer: Cash Price |
$2,110.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,924.55
|
| Rate for Payer: Cigna of WY Commercial |
$2,954.70
|
| Rate for Payer: First Choice Health Commercial |
$2,713.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,864.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$560.82
|
| Rate for Payer: HealthUtah PPO |
$3,015.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,924.55
|
| Rate for Payer: Multiplan Medicare/VA |
$476.70
|
| Rate for Payer: One Health Plan of WY PPO |
$2,954.70
|
| Rate for Payer: PacificSource Commercial |
$2,713.50
|
| Rate for Payer: PHCS PPO |
$2,864.25
|
| Rate for Payer: Three Rivers PPO |
$2,261.25
|
| Rate for Payer: TriWest Veterans Administration |
$560.82
|
| Rate for Payer: United Healthcare Commercial |
$2,623.05
|
| Rate for Payer: United Healthcare Medicare |
$560.82
|
| Rate for Payer: WINHealth Partners Commercial |
$2,562.75
|
|
|
HC PRO ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,153.00
|
|
|
Service Code
|
HCPCS 26860
|
| Hospital Charge Code |
9832686001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$512.88 |
| Max. Negotiated Rate |
$2,153.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,109.94
|
| Rate for Payer: Aetna of WY Medicare |
$603.39
|
| Rate for Payer: Beech Street Commercial |
$2,045.35
|
| Rate for Payer: Cash Price |
$1,507.10
|
| Rate for Payer: Cash Price |
$1,507.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,088.41
|
| Rate for Payer: Cigna of WY Commercial |
$2,109.94
|
| Rate for Payer: First Choice Health Commercial |
$1,937.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,045.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$603.39
|
| Rate for Payer: HealthUtah PPO |
$2,153.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,088.41
|
| Rate for Payer: Multiplan Medicare/VA |
$512.88
|
| Rate for Payer: One Health Plan of WY PPO |
$2,109.94
|
| Rate for Payer: PacificSource Commercial |
$1,937.70
|
| Rate for Payer: PHCS PPO |
$2,045.35
|
| Rate for Payer: Three Rivers PPO |
$1,614.75
|
| Rate for Payer: TriWest Veterans Administration |
$603.39
|
| Rate for Payer: United Healthcare Commercial |
$1,873.11
|
| Rate for Payer: United Healthcare Medicare |
$603.39
|
| Rate for Payer: WINHealth Partners Commercial |
$1,830.05
|
|
|
HC PRO ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT
|
Professional
|
Both
|
$4,170.00
|
|
|
Service Code
|
HCPCS 26861
|
| Hospital Charge Code |
9822686101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$4,170.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,086.60
|
| Rate for Payer: Aetna of WY Medicare |
$96.39
|
| Rate for Payer: Beech Street Commercial |
$3,961.50
|
| Rate for Payer: Cash Price |
$2,919.00
|
| Rate for Payer: Cash Price |
$2,919.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,044.90
|
| Rate for Payer: Cigna of WY Commercial |
$4,086.60
|
| Rate for Payer: First Choice Health Commercial |
$3,753.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,961.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$96.39
|
| Rate for Payer: HealthUtah PPO |
$4,170.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,044.90
|
| Rate for Payer: Multiplan Medicare/VA |
$81.93
|
| Rate for Payer: One Health Plan of WY PPO |
$4,086.60
|
| Rate for Payer: PacificSource Commercial |
$3,753.00
|
| Rate for Payer: PHCS PPO |
$3,961.50
|
| Rate for Payer: Three Rivers PPO |
$3,127.50
|
| Rate for Payer: TriWest Veterans Administration |
$96.39
|
| Rate for Payer: United Healthcare Commercial |
$3,627.90
|
| Rate for Payer: United Healthcare Medicare |
$96.39
|
| Rate for Payer: WINHealth Partners Commercial |
$3,544.50
|
|
|
HC PRO ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,569.00
|
|
|
Service Code
|
HCPCS 26850
|
| Hospital Charge Code |
9822685001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$612.04 |
| Max. Negotiated Rate |
$2,569.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,517.62
|
| Rate for Payer: Aetna of WY Medicare |
$720.05
|
| Rate for Payer: Beech Street Commercial |
$2,440.55
|
| Rate for Payer: Cash Price |
$1,798.30
|
| Rate for Payer: Cash Price |
$1,798.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,491.93
|
| Rate for Payer: Cigna of WY Commercial |
$2,517.62
|
| Rate for Payer: First Choice Health Commercial |
$2,312.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,440.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$720.05
|
| Rate for Payer: HealthUtah PPO |
$2,569.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,491.93
|
| Rate for Payer: Multiplan Medicare/VA |
$612.04
|
| Rate for Payer: One Health Plan of WY PPO |
$2,517.62
|
| Rate for Payer: PacificSource Commercial |
$2,312.10
|
| Rate for Payer: PHCS PPO |
$2,440.55
|
| Rate for Payer: Three Rivers PPO |
$1,926.75
|
| Rate for Payer: TriWest Veterans Administration |
$720.05
|
| Rate for Payer: United Healthcare Commercial |
$2,235.03
|
| Rate for Payer: United Healthcare Medicare |
$720.05
|
| Rate for Payer: WINHealth Partners Commercial |
$2,183.65
|
|
|
HC PRO ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT
|
Professional
|
Both
|
$2,864.00
|
|
|
Service Code
|
HCPCS 28740
|
| Hospital Charge Code |
9832874001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$509.86 |
| Max. Negotiated Rate |
$2,864.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,806.72
|
| Rate for Payer: Aetna of WY Medicare |
$599.83
|
| Rate for Payer: Beech Street Commercial |
$2,720.80
|
| Rate for Payer: Cash Price |
$2,004.80
|
| Rate for Payer: Cash Price |
$2,004.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,778.08
|
| Rate for Payer: Cigna of WY Commercial |
$2,806.72
|
| Rate for Payer: First Choice Health Commercial |
$2,577.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,720.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$599.83
|
| Rate for Payer: HealthUtah PPO |
$2,864.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,778.08
|
| Rate for Payer: Multiplan Medicare/VA |
$509.86
|
| Rate for Payer: One Health Plan of WY PPO |
$2,806.72
|
| Rate for Payer: PacificSource Commercial |
$2,577.60
|
| Rate for Payer: PHCS PPO |
$2,720.80
|
| Rate for Payer: Three Rivers PPO |
$2,148.00
|
| Rate for Payer: TriWest Veterans Administration |
$599.83
|
| Rate for Payer: United Healthcare Commercial |
$2,491.68
|
| Rate for Payer: United Healthcare Medicare |
$599.83
|
| Rate for Payer: WINHealth Partners Commercial |
$2,434.40
|
|
|
HC PRO ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL
|
Professional
|
Both
|
$1,803.00
|
|
|
Service Code
|
HCPCS 22614
|
| Hospital Charge Code |
9832261401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$310.53 |
| Max. Negotiated Rate |
$1,803.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,766.94
|
| Rate for Payer: Aetna of WY Medicare |
$365.33
|
| Rate for Payer: Beech Street Commercial |
$1,712.85
|
| Rate for Payer: Cash Price |
$1,262.10
|
| Rate for Payer: Cash Price |
$1,262.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,748.91
|
| Rate for Payer: Cigna of WY Commercial |
$1,766.94
|
| Rate for Payer: First Choice Health Commercial |
$1,622.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,712.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$365.33
|
| Rate for Payer: HealthUtah PPO |
$1,803.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,748.91
|
| Rate for Payer: Multiplan Medicare/VA |
$310.53
|
| Rate for Payer: One Health Plan of WY PPO |
$1,766.94
|
| Rate for Payer: PacificSource Commercial |
$1,622.70
|
| Rate for Payer: PHCS PPO |
$1,712.85
|
| Rate for Payer: Three Rivers PPO |
$1,352.25
|
| Rate for Payer: TriWest Veterans Administration |
$365.33
|
| Rate for Payer: United Healthcare Commercial |
$1,568.61
|
| Rate for Payer: United Healthcare Medicare |
$365.33
|
| Rate for Payer: WINHealth Partners Commercial |
$1,532.55
|
|
|
HC PRO ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR
|
Professional
|
Both
|
$5,378.00
|
|
|
Service Code
|
HCPCS 22612
|
| Hospital Charge Code |
9832261201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,281.15 |
| Max. Negotiated Rate |
$5,378.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,270.44
|
| Rate for Payer: Aetna of WY Medicare |
$1,507.24
|
| Rate for Payer: Beech Street Commercial |
$5,109.10
|
| Rate for Payer: Cash Price |
$3,764.60
|
| Rate for Payer: Cash Price |
$3,764.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,216.66
|
| Rate for Payer: Cigna of WY Commercial |
$5,270.44
|
| Rate for Payer: First Choice Health Commercial |
$4,840.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,109.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,507.24
|
| Rate for Payer: HealthUtah PPO |
$5,378.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,216.66
|
| Rate for Payer: Multiplan Medicare/VA |
$1,281.15
|
| Rate for Payer: One Health Plan of WY PPO |
$5,270.44
|
| Rate for Payer: PacificSource Commercial |
$4,840.20
|
| Rate for Payer: PHCS PPO |
$5,109.10
|
| Rate for Payer: Three Rivers PPO |
$4,033.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,507.24
|
| Rate for Payer: United Healthcare Commercial |
$4,678.86
|
| Rate for Payer: United Healthcare Medicare |
$1,507.24
|
| Rate for Payer: WINHealth Partners Commercial |
$4,571.30
|
|
|
HC PRO ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT
|
Professional
|
Both
|
$5,446.00
|
|
|
Service Code
|
HCPCS 25800
|
| Hospital Charge Code |
9832580001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$604.92 |
| Max. Negotiated Rate |
$5,446.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,337.08
|
| Rate for Payer: Aetna of WY Medicare |
$711.67
|
| Rate for Payer: Beech Street Commercial |
$5,173.70
|
| Rate for Payer: Cash Price |
$3,812.20
|
| Rate for Payer: Cash Price |
$3,812.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,282.62
|
| Rate for Payer: Cigna of WY Commercial |
$5,337.08
|
| Rate for Payer: First Choice Health Commercial |
$4,901.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,173.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$711.67
|
| Rate for Payer: HealthUtah PPO |
$5,446.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,282.62
|
| Rate for Payer: Multiplan Medicare/VA |
$604.92
|
| Rate for Payer: One Health Plan of WY PPO |
$5,337.08
|
| Rate for Payer: PacificSource Commercial |
$4,901.40
|
| Rate for Payer: PHCS PPO |
$5,173.70
|
| Rate for Payer: Three Rivers PPO |
$4,084.50
|
| Rate for Payer: TriWest Veterans Administration |
$711.67
|
| Rate for Payer: United Healthcare Commercial |
$4,738.02
|
| Rate for Payer: United Healthcare Medicare |
$711.67
|
| Rate for Payer: WINHealth Partners Commercial |
$4,629.10
|
|
|
HC PRO ARTHRODESIS WRIST LIMITED W/AUTOGRAFT
|
Professional
|
Both
|
$4,000.00
|
|
|
Service Code
|
HCPCS 25825
|
| Hospital Charge Code |
9832582501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$658.66 |
| Max. Negotiated Rate |
$4,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,920.00
|
| Rate for Payer: Aetna of WY Medicare |
$774.89
|
| Rate for Payer: Beech Street Commercial |
$3,800.00
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,880.00
|
| Rate for Payer: Cigna of WY Commercial |
$3,920.00
|
| Rate for Payer: First Choice Health Commercial |
$3,600.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,800.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$774.89
|
| Rate for Payer: HealthUtah PPO |
$4,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,880.00
|
| Rate for Payer: Multiplan Medicare/VA |
$658.66
|
| Rate for Payer: One Health Plan of WY PPO |
$3,920.00
|
| Rate for Payer: PacificSource Commercial |
$3,600.00
|
| Rate for Payer: PHCS PPO |
$3,800.00
|
| Rate for Payer: Three Rivers PPO |
$3,000.00
|
| Rate for Payer: TriWest Veterans Administration |
$774.89
|
| Rate for Payer: United Healthcare Commercial |
$3,480.00
|
| Rate for Payer: United Healthcare Medicare |
$774.89
|
| Rate for Payer: WINHealth Partners Commercial |
$3,400.00
|
|
|
HC PRO ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT
|
Professional
|
Both
|
$4,066.00
|
|
|
Service Code
|
HCPCS 25810
|
| Hospital Charge Code |
9832581001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$716.69 |
| Max. Negotiated Rate |
$4,066.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,984.68
|
| Rate for Payer: Aetna of WY Medicare |
$843.17
|
| Rate for Payer: Beech Street Commercial |
$3,862.70
|
| Rate for Payer: Cash Price |
$2,846.20
|
| Rate for Payer: Cash Price |
$2,846.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,944.02
|
| Rate for Payer: Cigna of WY Commercial |
$3,984.68
|
| Rate for Payer: First Choice Health Commercial |
$3,659.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,862.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$843.17
|
| Rate for Payer: HealthUtah PPO |
$4,066.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,944.02
|
| Rate for Payer: Multiplan Medicare/VA |
$716.69
|
| Rate for Payer: One Health Plan of WY PPO |
$3,984.68
|
| Rate for Payer: PacificSource Commercial |
$3,659.40
|
| Rate for Payer: PHCS PPO |
$3,862.70
|
| Rate for Payer: Three Rivers PPO |
$3,049.50
|
| Rate for Payer: TriWest Veterans Administration |
$843.17
|
| Rate for Payer: United Healthcare Commercial |
$3,537.42
|
| Rate for Payer: United Healthcare Medicare |
$843.17
|
| Rate for Payer: WINHealth Partners Commercial |
$3,456.10
|
|
|
HC PRO ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT
|
Professional
|
Both
|
$11,219.00
|
|
|
Service Code
|
HCPCS 25810 LT
|
| Hospital Charge Code |
9832581001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$716.69 |
| Max. Negotiated Rate |
$11,219.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,994.62
|
| Rate for Payer: Aetna of WY Medicare |
$843.17
|
| Rate for Payer: Beech Street Commercial |
$10,658.05
|
| Rate for Payer: Cash Price |
$7,853.30
|
| Rate for Payer: Cash Price |
$7,853.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,882.43
|
| Rate for Payer: Cigna of WY Commercial |
$10,994.62
|
| Rate for Payer: First Choice Health Commercial |
$10,097.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,658.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$843.17
|
| Rate for Payer: HealthUtah PPO |
$11,219.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,882.43
|
| Rate for Payer: Multiplan Medicare/VA |
$716.69
|
| Rate for Payer: One Health Plan of WY PPO |
$10,994.62
|
| Rate for Payer: PacificSource Commercial |
$10,097.10
|
| Rate for Payer: PHCS PPO |
$10,658.05
|
| Rate for Payer: Three Rivers PPO |
$8,414.25
|
| Rate for Payer: TriWest Veterans Administration |
$843.17
|
| Rate for Payer: United Healthcare Commercial |
$9,760.53
|
| Rate for Payer: United Healthcare Medicare |
$843.17
|
| Rate for Payer: WINHealth Partners Commercial |
$9,536.15
|
|
|
HC PRO ARTHROPLASTY GLENOHUMERAL JOINT; TOTAL SHOULDER
|
Professional
|
Both
|
$4,941.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
9832347201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,176.95 |
| Max. Negotiated Rate |
$4,941.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,842.18
|
| Rate for Payer: Aetna of WY Medicare |
$1,384.65
|
| Rate for Payer: Beech Street Commercial |
$4,693.95
|
| Rate for Payer: Cash Price |
$3,458.70
|
| Rate for Payer: Cash Price |
$3,458.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,792.77
|
| Rate for Payer: Cigna of WY Commercial |
$4,842.18
|
| Rate for Payer: First Choice Health Commercial |
$4,446.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,693.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,384.65
|
| Rate for Payer: HealthUtah PPO |
$4,941.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,792.77
|
| Rate for Payer: Multiplan Medicare/VA |
$1,176.95
|
| Rate for Payer: One Health Plan of WY PPO |
$4,842.18
|
| Rate for Payer: PacificSource Commercial |
$4,446.90
|
| Rate for Payer: PHCS PPO |
$4,693.95
|
| Rate for Payer: Three Rivers PPO |
$3,705.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,384.65
|
| Rate for Payer: United Healthcare Commercial |
$4,298.67
|
| Rate for Payer: United Healthcare Medicare |
$1,384.65
|
| Rate for Payer: WINHealth Partners Commercial |
$4,199.85
|
|
|
HC PRO ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,543.00
|
|
|
Service Code
|
HCPCS 26535
|
| Hospital Charge Code |
9832653501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$367.51 |
| Max. Negotiated Rate |
$1,543.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,512.14
|
| Rate for Payer: Aetna of WY Medicare |
$432.36
|
| Rate for Payer: Beech Street Commercial |
$1,465.85
|
| Rate for Payer: Cash Price |
$1,080.10
|
| Rate for Payer: Cash Price |
$1,080.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,496.71
|
| Rate for Payer: Cigna of WY Commercial |
$1,512.14
|
| Rate for Payer: First Choice Health Commercial |
$1,388.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,465.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$432.36
|
| Rate for Payer: HealthUtah PPO |
$1,543.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,496.71
|
| Rate for Payer: Multiplan Medicare/VA |
$367.51
|
| Rate for Payer: One Health Plan of WY PPO |
$1,512.14
|
| Rate for Payer: PacificSource Commercial |
$1,388.70
|
| Rate for Payer: PHCS PPO |
$1,465.85
|
| Rate for Payer: Three Rivers PPO |
$1,157.25
|
| Rate for Payer: TriWest Veterans Administration |
$432.36
|
| Rate for Payer: United Healthcare Commercial |
$1,342.41
|
| Rate for Payer: United Healthcare Medicare |
$432.36
|
| Rate for Payer: WINHealth Partners Commercial |
$1,311.55
|
|
|
HC PRO ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$2,625.00
|
|
|
Service Code
|
HCPCS 26536
|
| Hospital Charge Code |
9832653601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$625.37 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,572.50
|
| Rate for Payer: Aetna of WY Medicare |
$735.73
|
| Rate for Payer: Beech Street Commercial |
$2,493.75
|
| Rate for Payer: Cash Price |
$1,837.50
|
| Rate for Payer: Cash Price |
$1,837.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,546.25
|
| Rate for Payer: Cigna of WY Commercial |
$2,572.50
|
| Rate for Payer: First Choice Health Commercial |
$2,362.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,493.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$735.73
|
| Rate for Payer: HealthUtah PPO |
$2,625.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,546.25
|
| Rate for Payer: Multiplan Medicare/VA |
$625.37
|
| Rate for Payer: One Health Plan of WY PPO |
$2,572.50
|
| Rate for Payer: PacificSource Commercial |
$2,362.50
|
| Rate for Payer: PHCS PPO |
$2,493.75
|
| Rate for Payer: Three Rivers PPO |
$1,968.75
|
| Rate for Payer: TriWest Veterans Administration |
$735.73
|
| Rate for Payer: United Healthcare Commercial |
$2,283.75
|
| Rate for Payer: United Healthcare Medicare |
$735.73
|
| Rate for Payer: WINHealth Partners Commercial |
$2,231.25
|
|
|
HC PRO ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$3,056.00
|
|
|
Service Code
|
HCPCS 29838
|
| Hospital Charge Code |
9822983801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$493.35 |
| 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 |
$580.41
|
| 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 |
$580.41
|
| Rate for Payer: HealthUtah PPO |
$3,056.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,964.32
|
| Rate for Payer: Multiplan Medicare/VA |
$493.35
|
| 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 |
$580.41
|
| Rate for Payer: United Healthcare Commercial |
$2,658.72
|
| Rate for Payer: United Healthcare Medicare |
$580.41
|
| Rate for Payer: WINHealth Partners Commercial |
$2,597.60
|
|
|
HC PRO ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$5,685.00
|
|
|
Service Code
|
HCPCS 29834
|
| Hospital Charge Code |
9822983401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$408.13 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,571.30
|
| Rate for Payer: Aetna of WY Medicare |
$480.15
|
| Rate for Payer: Beech Street Commercial |
$5,400.75
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: Cash Price |
$3,979.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,514.45
|
| Rate for Payer: Cigna of WY Commercial |
$5,571.30
|
| Rate for Payer: First Choice Health Commercial |
$5,116.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,400.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$480.15
|
| Rate for Payer: HealthUtah PPO |
$5,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,514.45
|
| Rate for Payer: Multiplan Medicare/VA |
$408.13
|
| Rate for Payer: One Health Plan of WY PPO |
$5,571.30
|
| Rate for Payer: PacificSource Commercial |
$5,116.50
|
| Rate for Payer: PHCS PPO |
$5,400.75
|
| Rate for Payer: Three Rivers PPO |
$4,263.75
|
| Rate for Payer: TriWest Veterans Administration |
$480.15
|
| Rate for Payer: United Healthcare Commercial |
$4,945.95
|
| Rate for Payer: United Healthcare Medicare |
$480.15
|
| Rate for Payer: WINHealth Partners Commercial |
$4,832.25
|
|
