|
ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$5,111.00
|
|
|
Service Code
|
HCPCS 27446 80
|
| Min. Negotiated Rate |
$937.23 |
| Max. Negotiated Rate |
$5,111.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,008.78
|
| Rate for Payer: Beech Street Commercial |
$4,855.45
|
| Rate for Payer: Cash Price |
$3,577.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,957.67
|
| Rate for Payer: Cigna of WY Commercial |
$5,008.78
|
| Rate for Payer: First Choice Health Commercial |
$4,599.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,855.45
|
| Rate for Payer: HealthUtah PPO |
$5,111.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,957.67
|
| Rate for Payer: One Health Plan of WY PPO |
$5,008.78
|
| Rate for Payer: PacificSource Commercial |
$4,599.90
|
| Rate for Payer: PHCS PPO |
$4,855.45
|
| Rate for Payer: Three Rivers PPO |
$3,833.25
|
| Rate for Payer: United Healthcare Commercial |
$4,855.45
|
| Rate for Payer: WINHealth Partners Commercial |
$4,344.35
|
|
|
ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$5,111.00
|
|
|
Service Code
|
HCPCS 27446
|
| Min. Negotiated Rate |
$937.23 |
| Max. Negotiated Rate |
$5,111.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,008.78
|
| Rate for Payer: Aetna of WY Medicare |
$1,102.62
|
| Rate for Payer: Beech Street Commercial |
$4,855.45
|
| Rate for Payer: Cash Price |
$3,577.70
|
| Rate for Payer: Cash Price |
$3,577.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,957.67
|
| Rate for Payer: Cigna of WY Commercial |
$5,008.78
|
| Rate for Payer: First Choice Health Commercial |
$4,599.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,855.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,102.62
|
| Rate for Payer: HealthUtah PPO |
$5,111.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,957.67
|
| Rate for Payer: Multiplan Medicare/VA |
$937.23
|
| Rate for Payer: One Health Plan of WY PPO |
$5,008.78
|
| Rate for Payer: PacificSource Commercial |
$4,599.90
|
| Rate for Payer: PHCS PPO |
$4,855.45
|
| Rate for Payer: Three Rivers PPO |
$3,833.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,102.62
|
| Rate for Payer: United Healthcare Commercial |
$4,855.45
|
| Rate for Payer: WINHealth Partners Commercial |
$4,344.35
|
|
|
ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$5,111.00
|
|
|
Service Code
|
HCPCS 27446 AS
|
| Min. Negotiated Rate |
$937.23 |
| Max. Negotiated Rate |
$5,111.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,008.78
|
| Rate for Payer: Beech Street Commercial |
$4,855.45
|
| Rate for Payer: Cash Price |
$3,577.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,957.67
|
| Rate for Payer: Cigna of WY Commercial |
$5,008.78
|
| Rate for Payer: First Choice Health Commercial |
$4,599.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,855.45
|
| Rate for Payer: HealthUtah PPO |
$5,111.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,957.67
|
| Rate for Payer: One Health Plan of WY PPO |
$5,008.78
|
| Rate for Payer: PacificSource Commercial |
$4,599.90
|
| Rate for Payer: PHCS PPO |
$4,855.45
|
| Rate for Payer: Three Rivers PPO |
$3,833.25
|
| Rate for Payer: United Healthcare Commercial |
$4,855.45
|
| Rate for Payer: WINHealth Partners Commercial |
$4,344.35
|
|
|
ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT
|
Professional
|
Both
|
$7,912.00
|
|
|
Service Code
|
HCPCS 26531
|
| Min. Negotiated Rate |
$526.06 |
| Max. Negotiated Rate |
$7,912.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,753.76
|
| Rate for Payer: Aetna of WY Medicare |
$618.89
|
| Rate for Payer: Beech Street Commercial |
$7,516.40
|
| Rate for Payer: Cash Price |
$5,538.40
|
| Rate for Payer: Cash Price |
$5,538.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,674.64
|
| Rate for Payer: Cigna of WY Commercial |
$7,753.76
|
| Rate for Payer: First Choice Health Commercial |
$7,120.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,516.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$618.89
|
| Rate for Payer: HealthUtah PPO |
$7,912.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,674.64
|
| Rate for Payer: Multiplan Medicare/VA |
$526.06
|
| Rate for Payer: One Health Plan of WY PPO |
$7,753.76
|
| Rate for Payer: PacificSource Commercial |
$7,120.80
|
| Rate for Payer: PHCS PPO |
$7,516.40
|
| Rate for Payer: Three Rivers PPO |
$5,934.00
|
| Rate for Payer: TriWest Veterans Administration |
$618.89
|
| Rate for Payer: United Healthcare Commercial |
$7,516.40
|
| Rate for Payer: WINHealth Partners Commercial |
$6,725.20
|
|
|
ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT
|
Professional
|
Both
|
$7,912.00
|
|
|
Service Code
|
HCPCS 26531 AS
|
| Min. Negotiated Rate |
$526.06 |
| Max. Negotiated Rate |
$7,912.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,753.76
|
| Rate for Payer: Beech Street Commercial |
$7,516.40
|
| Rate for Payer: Cash Price |
$5,538.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,674.64
|
| Rate for Payer: Cigna of WY Commercial |
$7,753.76
|
| Rate for Payer: First Choice Health Commercial |
$7,120.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,516.40
|
| Rate for Payer: HealthUtah PPO |
$7,912.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,674.64
|
| Rate for Payer: One Health Plan of WY PPO |
$7,753.76
|
| Rate for Payer: PacificSource Commercial |
$7,120.80
|
| Rate for Payer: PHCS PPO |
$7,516.40
|
| Rate for Payer: Three Rivers PPO |
$5,934.00
|
| Rate for Payer: United Healthcare Commercial |
$7,516.40
|
| Rate for Payer: WINHealth Partners Commercial |
$6,725.20
|
|
|
ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 25446
|
| Min. Negotiated Rate |
$961.17 |
| Max. Negotiated Rate |
$3,190.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,126.20
|
| Rate for Payer: Aetna of WY Medicare |
$1,130.79
|
| Rate for Payer: Beech Street Commercial |
$3,030.50
|
| Rate for Payer: Cash Price |
$2,233.00
|
| Rate for Payer: Cash Price |
$2,233.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,094.30
|
| Rate for Payer: Cigna of WY Commercial |
$3,126.20
|
| Rate for Payer: First Choice Health Commercial |
$2,871.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,030.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,130.79
|
| Rate for Payer: HealthUtah PPO |
$3,190.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,094.30
|
| Rate for Payer: Multiplan Medicare/VA |
$961.17
|
| Rate for Payer: One Health Plan of WY PPO |
$3,126.20
|
| Rate for Payer: PacificSource Commercial |
$2,871.00
|
| Rate for Payer: PHCS PPO |
$3,030.50
|
| Rate for Payer: Three Rivers PPO |
$2,392.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,130.79
|
| Rate for Payer: United Healthcare Commercial |
$3,030.50
|
| Rate for Payer: WINHealth Partners Commercial |
$2,711.50
|
|
|
ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 25446 AS
|
| Min. Negotiated Rate |
$961.17 |
| Max. Negotiated Rate |
$3,190.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,126.20
|
| Rate for Payer: Beech Street Commercial |
$3,030.50
|
| Rate for Payer: Cash Price |
$2,233.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,094.30
|
| Rate for Payer: Cigna of WY Commercial |
$3,126.20
|
| Rate for Payer: First Choice Health Commercial |
$2,871.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,030.50
|
| Rate for Payer: HealthUtah PPO |
$3,190.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,094.30
|
| Rate for Payer: One Health Plan of WY PPO |
$3,126.20
|
| Rate for Payer: PacificSource Commercial |
$2,871.00
|
| Rate for Payer: PHCS PPO |
$3,030.50
|
| Rate for Payer: Three Rivers PPO |
$2,392.50
|
| Rate for Payer: United Healthcare Commercial |
$3,030.50
|
| Rate for Payer: WINHealth Partners Commercial |
$2,711.50
|
|
|
ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,326.00
|
|
|
Service Code
|
HCPCS 29888 80
|
| Min. Negotiated Rate |
$798.71 |
| Max. Negotiated Rate |
$4,326.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,239.48
|
| Rate for Payer: Beech Street Commercial |
$4,109.70
|
| Rate for Payer: Cash Price |
$3,028.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,196.22
|
| Rate for Payer: Cigna of WY Commercial |
$4,239.48
|
| Rate for Payer: First Choice Health Commercial |
$3,893.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,109.70
|
| Rate for Payer: HealthUtah PPO |
$4,326.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,196.22
|
| Rate for Payer: One Health Plan of WY PPO |
$4,239.48
|
| Rate for Payer: PacificSource Commercial |
$3,893.40
|
| Rate for Payer: PHCS PPO |
$4,109.70
|
| Rate for Payer: Three Rivers PPO |
$3,244.50
|
| Rate for Payer: United Healthcare Commercial |
$4,109.70
|
| Rate for Payer: WINHealth Partners Commercial |
$3,677.10
|
|
|
ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,326.00
|
|
|
Service Code
|
HCPCS 29888
|
| Min. Negotiated Rate |
$798.71 |
| Max. Negotiated Rate |
$4,326.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,239.48
|
| Rate for Payer: Aetna of WY Medicare |
$939.66
|
| Rate for Payer: Beech Street Commercial |
$4,109.70
|
| Rate for Payer: Cash Price |
$3,028.20
|
| Rate for Payer: Cash Price |
$3,028.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,196.22
|
| Rate for Payer: Cigna of WY Commercial |
$4,239.48
|
| Rate for Payer: First Choice Health Commercial |
$3,893.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,109.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$939.66
|
| Rate for Payer: HealthUtah PPO |
$4,326.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,196.22
|
| Rate for Payer: Multiplan Medicare/VA |
$798.71
|
| Rate for Payer: One Health Plan of WY PPO |
$4,239.48
|
| Rate for Payer: PacificSource Commercial |
$3,893.40
|
| Rate for Payer: PHCS PPO |
$4,109.70
|
| Rate for Payer: Three Rivers PPO |
$3,244.50
|
| Rate for Payer: TriWest Veterans Administration |
$939.66
|
| Rate for Payer: United Healthcare Commercial |
$4,109.70
|
| Rate for Payer: WINHealth Partners Commercial |
$3,677.10
|
|
|
ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,326.00
|
|
|
Service Code
|
HCPCS 29888 AS
|
| Min. Negotiated Rate |
$798.71 |
| Max. Negotiated Rate |
$4,326.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,239.48
|
| Rate for Payer: Beech Street Commercial |
$4,109.70
|
| Rate for Payer: Cash Price |
$3,028.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,196.22
|
| Rate for Payer: Cigna of WY Commercial |
$4,239.48
|
| Rate for Payer: First Choice Health Commercial |
$3,893.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,109.70
|
| Rate for Payer: HealthUtah PPO |
$4,326.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,196.22
|
| Rate for Payer: One Health Plan of WY PPO |
$4,239.48
|
| Rate for Payer: PacificSource Commercial |
$3,893.40
|
| Rate for Payer: PHCS PPO |
$4,109.70
|
| Rate for Payer: Three Rivers PPO |
$3,244.50
|
| Rate for Payer: United Healthcare Commercial |
$4,109.70
|
| Rate for Payer: WINHealth Partners Commercial |
$3,677.10
|
|
|
ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$5,394.00
|
|
|
Service Code
|
HCPCS 29889 80
|
| Min. Negotiated Rate |
$1,004.77 |
| Max. Negotiated Rate |
$5,394.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,286.12
|
| Rate for Payer: Beech Street Commercial |
$5,124.30
|
| Rate for Payer: Cash Price |
$3,775.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,232.18
|
| Rate for Payer: Cigna of WY Commercial |
$5,286.12
|
| Rate for Payer: First Choice Health Commercial |
$4,854.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,124.30
|
| Rate for Payer: HealthUtah PPO |
$5,394.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,232.18
|
| Rate for Payer: One Health Plan of WY PPO |
$5,286.12
|
| Rate for Payer: PacificSource Commercial |
$4,854.60
|
| Rate for Payer: PHCS PPO |
$5,124.30
|
| Rate for Payer: Three Rivers PPO |
$4,045.50
|
| Rate for Payer: United Healthcare Commercial |
$5,124.30
|
| Rate for Payer: WINHealth Partners Commercial |
$4,584.90
|
|
|
ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$5,394.00
|
|
|
Service Code
|
HCPCS 29889
|
| Min. Negotiated Rate |
$1,004.77 |
| Max. Negotiated Rate |
$5,394.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,286.12
|
| Rate for Payer: Aetna of WY Medicare |
$1,182.08
|
| Rate for Payer: Beech Street Commercial |
$5,124.30
|
| Rate for Payer: Cash Price |
$3,775.80
|
| Rate for Payer: Cash Price |
$3,775.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,232.18
|
| Rate for Payer: Cigna of WY Commercial |
$5,286.12
|
| Rate for Payer: First Choice Health Commercial |
$4,854.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,124.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,182.08
|
| Rate for Payer: HealthUtah PPO |
$5,394.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,232.18
|
| Rate for Payer: Multiplan Medicare/VA |
$1,004.77
|
| Rate for Payer: One Health Plan of WY PPO |
$5,286.12
|
| Rate for Payer: PacificSource Commercial |
$4,854.60
|
| Rate for Payer: PHCS PPO |
$5,124.30
|
| Rate for Payer: Three Rivers PPO |
$4,045.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,182.08
|
| Rate for Payer: United Healthcare Commercial |
$5,124.30
|
| Rate for Payer: WINHealth Partners Commercial |
$4,584.90
|
|
|
ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT
|
Professional
|
Both
|
$6,726.00
|
|
|
Service Code
|
HCPCS 29891
|
| Min. Negotiated Rate |
$557.42 |
| Max. Negotiated Rate |
$6,726.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,591.48
|
| Rate for Payer: Aetna of WY Medicare |
$655.79
|
| Rate for Payer: Beech Street Commercial |
$6,389.70
|
| Rate for Payer: Cash Price |
$4,708.20
|
| Rate for Payer: Cash Price |
$4,708.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,524.22
|
| Rate for Payer: Cigna of WY Commercial |
$6,591.48
|
| Rate for Payer: First Choice Health Commercial |
$6,053.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,389.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$655.79
|
| Rate for Payer: HealthUtah PPO |
$6,726.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,524.22
|
| Rate for Payer: Multiplan Medicare/VA |
$557.42
|
| Rate for Payer: One Health Plan of WY PPO |
$6,591.48
|
| Rate for Payer: PacificSource Commercial |
$6,053.40
|
| Rate for Payer: PHCS PPO |
$6,389.70
|
| Rate for Payer: Three Rivers PPO |
$5,044.50
|
| Rate for Payer: TriWest Veterans Administration |
$655.79
|
| Rate for Payer: United Healthcare Commercial |
$6,389.70
|
| Rate for Payer: WINHealth Partners Commercial |
$5,717.10
|
|
|
ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT
|
Professional
|
Both
|
$6,726.00
|
|
|
Service Code
|
HCPCS 29891 AS
|
| Min. Negotiated Rate |
$557.42 |
| Max. Negotiated Rate |
$6,726.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,591.48
|
| Rate for Payer: Beech Street Commercial |
$6,389.70
|
| Rate for Payer: Cash Price |
$4,708.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,524.22
|
| Rate for Payer: Cigna of WY Commercial |
$6,591.48
|
| Rate for Payer: First Choice Health Commercial |
$6,053.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,389.70
|
| Rate for Payer: HealthUtah PPO |
$6,726.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,524.22
|
| Rate for Payer: One Health Plan of WY PPO |
$6,591.48
|
| Rate for Payer: PacificSource Commercial |
$6,053.40
|
| Rate for Payer: PHCS PPO |
$6,389.70
|
| Rate for Payer: Three Rivers PPO |
$5,044.50
|
| Rate for Payer: United Healthcare Commercial |
$6,389.70
|
| Rate for Payer: WINHealth Partners Commercial |
$5,717.10
|
|
|
ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT
|
Professional
|
Both
|
$6,404.00
|
|
|
Service Code
|
HCPCS 29891 80
|
| Min. Negotiated Rate |
$4,803.00 |
| Max. Negotiated Rate |
$6,404.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,275.92
|
| Rate for Payer: Beech Street Commercial |
$6,083.80
|
| Rate for Payer: Cash Price |
$4,482.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,211.88
|
| Rate for Payer: Cigna of WY Commercial |
$6,275.92
|
| Rate for Payer: First Choice Health Commercial |
$5,763.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,083.80
|
| Rate for Payer: HealthUtah PPO |
$6,404.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,211.88
|
| Rate for Payer: One Health Plan of WY PPO |
$6,275.92
|
| Rate for Payer: PacificSource Commercial |
$5,763.60
|
| Rate for Payer: PHCS PPO |
$6,083.80
|
| Rate for Payer: Three Rivers PPO |
$4,803.00
|
| Rate for Payer: United Healthcare Commercial |
$6,083.80
|
| Rate for Payer: WINHealth Partners Commercial |
$5,443.40
|
|
|
ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$3,585.00
|
|
|
Service Code
|
HCPCS 29862 80
|
| Min. Negotiated Rate |
$672.17 |
| Max. Negotiated Rate |
$3,585.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,513.30
|
| Rate for Payer: Beech Street Commercial |
$3,405.75
|
| Rate for Payer: Cash Price |
$2,509.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,477.45
|
| Rate for Payer: Cigna of WY Commercial |
$3,513.30
|
| Rate for Payer: First Choice Health Commercial |
$3,226.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,405.75
|
| Rate for Payer: HealthUtah PPO |
$3,585.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,477.45
|
| Rate for Payer: One Health Plan of WY PPO |
$3,513.30
|
| Rate for Payer: PacificSource Commercial |
$3,226.50
|
| Rate for Payer: PHCS PPO |
$3,405.75
|
| Rate for Payer: Three Rivers PPO |
$2,688.75
|
| Rate for Payer: United Healthcare Commercial |
$3,405.75
|
| Rate for Payer: WINHealth Partners Commercial |
$3,047.25
|
|
|
ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$3,585.00
|
|
|
Service Code
|
HCPCS 29862
|
| Min. Negotiated Rate |
$672.17 |
| Max. Negotiated Rate |
$3,585.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,513.30
|
| Rate for Payer: Aetna of WY Medicare |
$790.79
|
| Rate for Payer: Beech Street Commercial |
$3,405.75
|
| Rate for Payer: Cash Price |
$2,509.50
|
| Rate for Payer: Cash Price |
$2,509.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,477.45
|
| Rate for Payer: Cigna of WY Commercial |
$3,513.30
|
| Rate for Payer: First Choice Health Commercial |
$3,226.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,405.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$790.79
|
| Rate for Payer: HealthUtah PPO |
$3,585.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,477.45
|
| Rate for Payer: Multiplan Medicare/VA |
$672.17
|
| Rate for Payer: One Health Plan of WY PPO |
$3,513.30
|
| Rate for Payer: PacificSource Commercial |
$3,226.50
|
| Rate for Payer: PHCS PPO |
$3,405.75
|
| Rate for Payer: Three Rivers PPO |
$2,688.75
|
| Rate for Payer: TriWest Veterans Administration |
$790.79
|
| Rate for Payer: United Healthcare Commercial |
$3,405.75
|
| Rate for Payer: WINHealth Partners Commercial |
$3,047.25
|
|
|
ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$3,585.00
|
|
|
Service Code
|
HCPCS 29862 AS
|
| Min. Negotiated Rate |
$672.17 |
| Max. Negotiated Rate |
$3,585.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,513.30
|
| Rate for Payer: Beech Street Commercial |
$3,405.75
|
| Rate for Payer: Cash Price |
$2,509.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,477.45
|
| Rate for Payer: Cigna of WY Commercial |
$3,513.30
|
| Rate for Payer: First Choice Health Commercial |
$3,226.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,405.75
|
| Rate for Payer: HealthUtah PPO |
$3,585.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,477.45
|
| Rate for Payer: One Health Plan of WY PPO |
$3,513.30
|
| Rate for Payer: PacificSource Commercial |
$3,226.50
|
| Rate for Payer: PHCS PPO |
$3,405.75
|
| Rate for Payer: Three Rivers PPO |
$2,688.75
|
| Rate for Payer: United Healthcare Commercial |
$3,405.75
|
| Rate for Payer: WINHealth Partners Commercial |
$3,047.25
|
|
|
ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,918.00
|
|
|
Service Code
|
HCPCS 29879
|
| Min. Negotiated Rate |
$546.84 |
| Max. Negotiated Rate |
$2,918.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,859.64
|
| Rate for Payer: Aetna of WY Medicare |
$643.34
|
| Rate for Payer: Beech Street Commercial |
$2,772.10
|
| Rate for Payer: Cash Price |
$2,042.60
|
| Rate for Payer: Cash Price |
$2,042.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,830.46
|
| Rate for Payer: Cigna of WY Commercial |
$2,859.64
|
| Rate for Payer: First Choice Health Commercial |
$2,626.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,772.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$643.34
|
| Rate for Payer: HealthUtah PPO |
$2,918.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,830.46
|
| Rate for Payer: Multiplan Medicare/VA |
$546.84
|
| Rate for Payer: One Health Plan of WY PPO |
$2,859.64
|
| Rate for Payer: PacificSource Commercial |
$2,626.20
|
| Rate for Payer: PHCS PPO |
$2,772.10
|
| Rate for Payer: Three Rivers PPO |
$2,188.50
|
| Rate for Payer: TriWest Veterans Administration |
$643.34
|
| Rate for Payer: United Healthcare Commercial |
$2,772.10
|
| Rate for Payer: WINHealth Partners Commercial |
$2,480.30
|
|
|
ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,918.00
|
|
|
Service Code
|
HCPCS 29879 80
|
| Min. Negotiated Rate |
$546.84 |
| Max. Negotiated Rate |
$2,918.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,859.64
|
| Rate for Payer: Beech Street Commercial |
$2,772.10
|
| Rate for Payer: Cash Price |
$2,042.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,830.46
|
| Rate for Payer: Cigna of WY Commercial |
$2,859.64
|
| Rate for Payer: First Choice Health Commercial |
$2,626.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,772.10
|
| Rate for Payer: HealthUtah PPO |
$2,918.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,830.46
|
| Rate for Payer: One Health Plan of WY PPO |
$2,859.64
|
| Rate for Payer: PacificSource Commercial |
$2,626.20
|
| Rate for Payer: PHCS PPO |
$2,772.10
|
| Rate for Payer: Three Rivers PPO |
$2,188.50
|
| Rate for Payer: United Healthcare Commercial |
$2,772.10
|
| Rate for Payer: WINHealth Partners Commercial |
$2,480.30
|
|
|
ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,918.00
|
|
|
Service Code
|
HCPCS 29879 AS
|
| Min. Negotiated Rate |
$546.84 |
| Max. Negotiated Rate |
$2,918.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,859.64
|
| Rate for Payer: Beech Street Commercial |
$2,772.10
|
| Rate for Payer: Cash Price |
$2,042.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,830.46
|
| Rate for Payer: Cigna of WY Commercial |
$2,859.64
|
| Rate for Payer: First Choice Health Commercial |
$2,626.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,772.10
|
| Rate for Payer: HealthUtah PPO |
$2,918.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,830.46
|
| Rate for Payer: One Health Plan of WY PPO |
$2,859.64
|
| Rate for Payer: PacificSource Commercial |
$2,626.20
|
| Rate for Payer: PHCS PPO |
$2,772.10
|
| Rate for Payer: Three Rivers PPO |
$2,188.50
|
| Rate for Payer: United Healthcare Commercial |
$2,772.10
|
| Rate for Payer: WINHealth Partners Commercial |
$2,480.30
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,738.00
|
|
|
Service Code
|
HCPCS 29877
|
| Min. Negotiated Rate |
$513.70 |
| Max. Negotiated Rate |
$2,738.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,683.24
|
| Rate for Payer: Aetna of WY Medicare |
$604.35
|
| Rate for Payer: Beech Street Commercial |
$2,601.10
|
| Rate for Payer: Cash Price |
$1,916.60
|
| Rate for Payer: Cash Price |
$1,916.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,655.86
|
| Rate for Payer: Cigna of WY Commercial |
$2,683.24
|
| Rate for Payer: First Choice Health Commercial |
$2,464.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,601.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$604.35
|
| Rate for Payer: HealthUtah PPO |
$2,738.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,655.86
|
| Rate for Payer: Multiplan Medicare/VA |
$513.70
|
| Rate for Payer: One Health Plan of WY PPO |
$2,683.24
|
| Rate for Payer: PacificSource Commercial |
$2,464.20
|
| Rate for Payer: PHCS PPO |
$2,601.10
|
| Rate for Payer: Three Rivers PPO |
$2,053.50
|
| Rate for Payer: TriWest Veterans Administration |
$604.35
|
| Rate for Payer: United Healthcare Commercial |
$2,601.10
|
| Rate for Payer: WINHealth Partners Commercial |
$2,327.30
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,738.00
|
|
|
Service Code
|
HCPCS 29877 AS
|
| Min. Negotiated Rate |
$513.70 |
| Max. Negotiated Rate |
$2,738.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,683.24
|
| Rate for Payer: Beech Street Commercial |
$2,601.10
|
| Rate for Payer: Cash Price |
$1,916.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,655.86
|
| Rate for Payer: Cigna of WY Commercial |
$2,683.24
|
| Rate for Payer: First Choice Health Commercial |
$2,464.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,601.10
|
| Rate for Payer: HealthUtah PPO |
$2,738.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,655.86
|
| Rate for Payer: One Health Plan of WY PPO |
$2,683.24
|
| Rate for Payer: PacificSource Commercial |
$2,464.20
|
| Rate for Payer: PHCS PPO |
$2,601.10
|
| Rate for Payer: Three Rivers PPO |
$2,053.50
|
| Rate for Payer: United Healthcare Commercial |
$2,601.10
|
| Rate for Payer: WINHealth Partners Commercial |
$2,327.30
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$5,475.00
|
|
|
Service Code
|
HCPCS 29877 50
|
| Min. Negotiated Rate |
$4,106.25 |
| Max. Negotiated Rate |
$5,475.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,365.50
|
| Rate for Payer: Beech Street Commercial |
$5,201.25
|
| Rate for Payer: Cash Price |
$3,832.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,310.75
|
| Rate for Payer: Cigna of WY Commercial |
$5,365.50
|
| Rate for Payer: First Choice Health Commercial |
$4,927.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,201.25
|
| Rate for Payer: HealthUtah PPO |
$5,475.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,310.75
|
| Rate for Payer: One Health Plan of WY PPO |
$5,365.50
|
| Rate for Payer: PacificSource Commercial |
$4,927.50
|
| Rate for Payer: PHCS PPO |
$5,201.25
|
| Rate for Payer: Three Rivers PPO |
$4,106.25
|
| Rate for Payer: United Healthcare Commercial |
$5,201.25
|
| Rate for Payer: WINHealth Partners Commercial |
$4,653.75
|
|
|
ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,738.00
|
|
|
Service Code
|
HCPCS 29877 80
|
| Min. Negotiated Rate |
$513.70 |
| Max. Negotiated Rate |
$2,738.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,683.24
|
| Rate for Payer: Beech Street Commercial |
$2,601.10
|
| Rate for Payer: Cash Price |
$1,916.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,655.86
|
| Rate for Payer: Cigna of WY Commercial |
$2,683.24
|
| Rate for Payer: First Choice Health Commercial |
$2,464.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,601.10
|
| Rate for Payer: HealthUtah PPO |
$2,738.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,655.86
|
| Rate for Payer: One Health Plan of WY PPO |
$2,683.24
|
| Rate for Payer: PacificSource Commercial |
$2,464.20
|
| Rate for Payer: PHCS PPO |
$2,601.10
|
| Rate for Payer: Three Rivers PPO |
$2,053.50
|
| Rate for Payer: United Healthcare Commercial |
$2,601.10
|
| Rate for Payer: WINHealth Partners Commercial |
$2,327.30
|
|
