|
HC PRO DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS 17261 NONPBBPAYER
|
| Hospital Charge Code |
9831726101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$71.98 |
| Max. Negotiated Rate |
$434.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$425.32
|
| Rate for Payer: Aetna of WY Medicare |
$84.68
|
| Rate for Payer: Beech Street Commercial |
$412.30
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$420.98
|
| Rate for Payer: Cigna of WY Commercial |
$425.32
|
| Rate for Payer: First Choice Health Commercial |
$390.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$412.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$84.68
|
| Rate for Payer: HealthUtah PPO |
$434.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$420.98
|
| Rate for Payer: Multiplan Medicare/VA |
$71.98
|
| Rate for Payer: One Health Plan of WY PPO |
$425.32
|
| Rate for Payer: PacificSource Commercial |
$390.60
|
| Rate for Payer: PHCS PPO |
$412.30
|
| Rate for Payer: Three Rivers PPO |
$325.50
|
| Rate for Payer: TriWest Veterans Administration |
$84.68
|
| Rate for Payer: United Healthcare Commercial |
$377.58
|
| Rate for Payer: United Healthcare Medicare |
$84.68
|
| Rate for Payer: WINHealth Partners Commercial |
$368.90
|
|
|
HC PRO DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 17262
|
| Hospital Charge Code |
9831726201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$90.89 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$437.08
|
| Rate for Payer: Aetna of WY Medicare |
$106.93
|
| Rate for Payer: Beech Street Commercial |
$423.70
|
| Rate for Payer: Cash Price |
$312.20
|
| Rate for Payer: Cash Price |
$312.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$432.62
|
| Rate for Payer: Cigna of WY Commercial |
$437.08
|
| Rate for Payer: First Choice Health Commercial |
$401.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$423.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$106.93
|
| Rate for Payer: HealthUtah PPO |
$446.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$432.62
|
| Rate for Payer: Multiplan Medicare/VA |
$90.89
|
| Rate for Payer: One Health Plan of WY PPO |
$437.08
|
| Rate for Payer: PacificSource Commercial |
$401.40
|
| Rate for Payer: PHCS PPO |
$423.70
|
| Rate for Payer: Three Rivers PPO |
$334.50
|
| Rate for Payer: TriWest Veterans Administration |
$106.93
|
| Rate for Payer: United Healthcare Commercial |
$388.02
|
| Rate for Payer: United Healthcare Medicare |
$106.93
|
| Rate for Payer: WINHealth Partners Commercial |
$379.10
|
|
|
HC PRO DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 17262 NONPBBPAYER
|
| Hospital Charge Code |
9831726201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$90.89 |
| Max. Negotiated Rate |
$558.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$546.84
|
| Rate for Payer: Aetna of WY Medicare |
$106.93
|
| Rate for Payer: Beech Street Commercial |
$530.10
|
| Rate for Payer: Cash Price |
$390.60
|
| Rate for Payer: Cash Price |
$390.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$541.26
|
| Rate for Payer: Cigna of WY Commercial |
$546.84
|
| Rate for Payer: First Choice Health Commercial |
$502.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$530.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$106.93
|
| Rate for Payer: HealthUtah PPO |
$558.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$541.26
|
| Rate for Payer: Multiplan Medicare/VA |
$90.89
|
| Rate for Payer: One Health Plan of WY PPO |
$546.84
|
| Rate for Payer: PacificSource Commercial |
$502.20
|
| Rate for Payer: PHCS PPO |
$530.10
|
| Rate for Payer: Three Rivers PPO |
$418.50
|
| Rate for Payer: TriWest Veterans Administration |
$106.93
|
| Rate for Payer: United Healthcare Commercial |
$485.46
|
| Rate for Payer: United Healthcare Medicare |
$106.93
|
| Rate for Payer: WINHealth Partners Commercial |
$474.30
|
|
|
HC PRO DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM
|
Professional
|
Both
|
$621.00
|
|
|
Service Code
|
HCPCS 17263 NONPBBPAYER
|
| Hospital Charge Code |
9831726301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$100.49 |
| Max. Negotiated Rate |
$621.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$608.58
|
| Rate for Payer: Aetna of WY Medicare |
$118.22
|
| Rate for Payer: Beech Street Commercial |
$589.95
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$602.37
|
| Rate for Payer: Cigna of WY Commercial |
$608.58
|
| Rate for Payer: First Choice Health Commercial |
$558.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$589.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$118.22
|
| Rate for Payer: HealthUtah PPO |
$621.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$602.37
|
| Rate for Payer: Multiplan Medicare/VA |
$100.49
|
| Rate for Payer: One Health Plan of WY PPO |
$608.58
|
| Rate for Payer: PacificSource Commercial |
$558.90
|
| Rate for Payer: PHCS PPO |
$589.95
|
| Rate for Payer: Three Rivers PPO |
$465.75
|
| Rate for Payer: TriWest Veterans Administration |
$118.22
|
| Rate for Payer: United Healthcare Commercial |
$540.27
|
| Rate for Payer: United Healthcare Medicare |
$118.22
|
| Rate for Payer: WINHealth Partners Commercial |
$527.85
|
|
|
HC PRO DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 17263
|
| Hospital Charge Code |
9831726301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$100.49 |
| Max. Negotiated Rate |
$497.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$487.06
|
| Rate for Payer: Aetna of WY Medicare |
$118.22
|
| Rate for Payer: Beech Street Commercial |
$472.15
|
| Rate for Payer: Cash Price |
$347.90
|
| Rate for Payer: Cash Price |
$347.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$482.09
|
| Rate for Payer: Cigna of WY Commercial |
$487.06
|
| Rate for Payer: First Choice Health Commercial |
$447.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$472.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$118.22
|
| Rate for Payer: HealthUtah PPO |
$497.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$482.09
|
| Rate for Payer: Multiplan Medicare/VA |
$100.49
|
| Rate for Payer: One Health Plan of WY PPO |
$487.06
|
| Rate for Payer: PacificSource Commercial |
$447.30
|
| Rate for Payer: PHCS PPO |
$472.15
|
| Rate for Payer: Three Rivers PPO |
$372.75
|
| Rate for Payer: TriWest Veterans Administration |
$118.22
|
| Rate for Payer: United Healthcare Commercial |
$432.39
|
| Rate for Payer: United Healthcare Medicare |
$118.22
|
| Rate for Payer: WINHealth Partners Commercial |
$422.45
|
|
|
HC PRO DESTRUCT,VAGINAL LESION(S),SIMPLE
|
Professional
|
Both
|
$2,856.00
|
|
|
Service Code
|
HCPCS 57061 NONPBBPAYER
|
| Hospital Charge Code |
9835706101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$95.81 |
| Max. Negotiated Rate |
$2,856.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,798.88
|
| Rate for Payer: Aetna of WY Medicare |
$112.72
|
| Rate for Payer: Beech Street Commercial |
$2,713.20
|
| Rate for Payer: Cash Price |
$1,999.20
|
| Rate for Payer: Cash Price |
$1,999.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,770.32
|
| Rate for Payer: Cigna of WY Commercial |
$2,798.88
|
| Rate for Payer: First Choice Health Commercial |
$2,570.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,713.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$112.72
|
| Rate for Payer: HealthUtah PPO |
$2,856.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,770.32
|
| Rate for Payer: Multiplan Medicare/VA |
$95.81
|
| Rate for Payer: One Health Plan of WY PPO |
$2,798.88
|
| Rate for Payer: PacificSource Commercial |
$2,570.40
|
| Rate for Payer: PHCS PPO |
$2,713.20
|
| Rate for Payer: Three Rivers PPO |
$2,142.00
|
| Rate for Payer: TriWest Veterans Administration |
$112.72
|
| Rate for Payer: United Healthcare Commercial |
$2,484.72
|
| Rate for Payer: United Healthcare Medicare |
$112.72
|
| Rate for Payer: WINHealth Partners Commercial |
$2,427.60
|
|
|
HC PRO DESTRUCT,VAGINAL LESION(S),SIMPLE
|
Professional
|
Both
|
$2,285.00
|
|
|
Service Code
|
HCPCS 57061
|
| Hospital Charge Code |
9835706101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$95.81 |
| Max. Negotiated Rate |
$2,285.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,239.30
|
| Rate for Payer: Aetna of WY Medicare |
$112.72
|
| Rate for Payer: Beech Street Commercial |
$2,170.75
|
| Rate for Payer: Cash Price |
$1,599.50
|
| Rate for Payer: Cash Price |
$1,599.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,216.45
|
| Rate for Payer: Cigna of WY Commercial |
$2,239.30
|
| Rate for Payer: First Choice Health Commercial |
$2,056.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,170.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$112.72
|
| Rate for Payer: HealthUtah PPO |
$2,285.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,216.45
|
| Rate for Payer: Multiplan Medicare/VA |
$95.81
|
| Rate for Payer: One Health Plan of WY PPO |
$2,239.30
|
| Rate for Payer: PacificSource Commercial |
$2,056.50
|
| Rate for Payer: PHCS PPO |
$2,170.75
|
| Rate for Payer: Three Rivers PPO |
$1,713.75
|
| Rate for Payer: TriWest Veterans Administration |
$112.72
|
| Rate for Payer: United Healthcare Commercial |
$1,987.95
|
| Rate for Payer: United Healthcare Medicare |
$112.72
|
| Rate for Payer: WINHealth Partners Commercial |
$1,942.25
|
|
|
HC PRO DIAGNOSTIC BONE MARROW ASPIRATIONS
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 38220
|
| Hospital Charge Code |
9833822001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$54.66 |
| Max. Negotiated Rate |
$942.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$923.16
|
| Rate for Payer: Aetna of WY Medicare |
$64.31
|
| Rate for Payer: Beech Street Commercial |
$894.90
|
| Rate for Payer: Cash Price |
$659.40
|
| Rate for Payer: Cash Price |
$659.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$913.74
|
| Rate for Payer: Cigna of WY Commercial |
$923.16
|
| Rate for Payer: First Choice Health Commercial |
$847.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$894.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$64.31
|
| Rate for Payer: HealthUtah PPO |
$942.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$913.74
|
| Rate for Payer: Multiplan Medicare/VA |
$54.66
|
| Rate for Payer: One Health Plan of WY PPO |
$923.16
|
| Rate for Payer: PacificSource Commercial |
$847.80
|
| Rate for Payer: PHCS PPO |
$894.90
|
| Rate for Payer: Three Rivers PPO |
$706.50
|
| Rate for Payer: TriWest Veterans Administration |
$64.31
|
| Rate for Payer: United Healthcare Commercial |
$819.54
|
| Rate for Payer: United Healthcare Medicare |
$64.31
|
| Rate for Payer: WINHealth Partners Commercial |
$800.70
|
|
|
HC PRO DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 57170 NONPBBPAYER
|
| Hospital Charge Code |
9835717001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$38.16 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$203.84
|
| Rate for Payer: Aetna of WY Medicare |
$44.89
|
| Rate for Payer: Beech Street Commercial |
$197.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$201.76
|
| Rate for Payer: Cigna of WY Commercial |
$203.84
|
| Rate for Payer: First Choice Health Commercial |
$187.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$197.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.89
|
| Rate for Payer: HealthUtah PPO |
$208.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$201.76
|
| Rate for Payer: Multiplan Medicare/VA |
$38.16
|
| Rate for Payer: One Health Plan of WY PPO |
$203.84
|
| Rate for Payer: PacificSource Commercial |
$187.20
|
| Rate for Payer: PHCS PPO |
$197.60
|
| Rate for Payer: Three Rivers PPO |
$156.00
|
| Rate for Payer: TriWest Veterans Administration |
$44.89
|
| Rate for Payer: United Healthcare Commercial |
$180.96
|
| Rate for Payer: United Healthcare Medicare |
$44.89
|
| Rate for Payer: WINHealth Partners Commercial |
$176.80
|
|
|
HC PRO DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 57170
|
| Hospital Charge Code |
9835717001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$38.16 |
| Max. Negotiated Rate |
$166.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$162.68
|
| Rate for Payer: Aetna of WY Medicare |
$44.89
|
| Rate for Payer: Beech Street Commercial |
$157.70
|
| Rate for Payer: Cash Price |
$116.20
|
| Rate for Payer: Cash Price |
$116.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$161.02
|
| Rate for Payer: Cigna of WY Commercial |
$162.68
|
| Rate for Payer: First Choice Health Commercial |
$149.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$157.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.89
|
| Rate for Payer: HealthUtah PPO |
$166.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$161.02
|
| Rate for Payer: Multiplan Medicare/VA |
$38.16
|
| Rate for Payer: One Health Plan of WY PPO |
$162.68
|
| Rate for Payer: PacificSource Commercial |
$149.40
|
| Rate for Payer: PHCS PPO |
$157.70
|
| Rate for Payer: Three Rivers PPO |
$124.50
|
| Rate for Payer: TriWest Veterans Administration |
$44.89
|
| Rate for Payer: United Healthcare Commercial |
$144.42
|
| Rate for Payer: United Healthcare Medicare |
$44.89
|
| Rate for Payer: WINHealth Partners Commercial |
$141.10
|
|
|
HC PRO DILATION CERVICAL CANAL
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 57800
|
| Hospital Charge Code |
9835780001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$455.70
|
| Rate for Payer: Aetna of WY Medicare |
$46.37
|
| Rate for Payer: Beech Street Commercial |
$441.75
|
| Rate for Payer: Cash Price |
$325.50
|
| Rate for Payer: Cash Price |
$325.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$451.05
|
| Rate for Payer: Cigna of WY Commercial |
$455.70
|
| Rate for Payer: First Choice Health Commercial |
$418.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$441.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.37
|
| Rate for Payer: HealthUtah PPO |
$465.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$451.05
|
| Rate for Payer: Multiplan Medicare/VA |
$39.41
|
| Rate for Payer: One Health Plan of WY PPO |
$455.70
|
| Rate for Payer: PacificSource Commercial |
$418.50
|
| Rate for Payer: PHCS PPO |
$441.75
|
| Rate for Payer: Three Rivers PPO |
$348.75
|
| Rate for Payer: TriWest Veterans Administration |
$46.37
|
| Rate for Payer: United Healthcare Commercial |
$404.55
|
| Rate for Payer: United Healthcare Medicare |
$46.37
|
| Rate for Payer: WINHealth Partners Commercial |
$395.25
|
|
|
HC PRO DILATION CERVICAL CANAL
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 57800 NONPBBPAYER
|
| Hospital Charge Code |
9835780001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$581.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$569.38
|
| Rate for Payer: Aetna of WY Medicare |
$46.37
|
| Rate for Payer: Beech Street Commercial |
$551.95
|
| Rate for Payer: Cash Price |
$406.70
|
| Rate for Payer: Cash Price |
$406.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$563.57
|
| Rate for Payer: Cigna of WY Commercial |
$569.38
|
| Rate for Payer: First Choice Health Commercial |
$522.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$551.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.37
|
| Rate for Payer: HealthUtah PPO |
$581.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$563.57
|
| Rate for Payer: Multiplan Medicare/VA |
$39.41
|
| Rate for Payer: One Health Plan of WY PPO |
$569.38
|
| Rate for Payer: PacificSource Commercial |
$522.90
|
| Rate for Payer: PHCS PPO |
$551.95
|
| Rate for Payer: Three Rivers PPO |
$435.75
|
| Rate for Payer: TriWest Veterans Administration |
$46.37
|
| Rate for Payer: United Healthcare Commercial |
$505.47
|
| Rate for Payer: United Healthcare Medicare |
$46.37
|
| Rate for Payer: WINHealth Partners Commercial |
$493.85
|
|
|
HC PRO DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 42975
|
| Hospital Charge Code |
9834297501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$79.32 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$326.34
|
| Rate for Payer: Aetna of WY Medicare |
$93.32
|
| Rate for Payer: Beech Street Commercial |
$316.35
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$323.01
|
| Rate for Payer: Cigna of WY Commercial |
$326.34
|
| Rate for Payer: First Choice Health Commercial |
$299.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$316.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$93.32
|
| Rate for Payer: HealthUtah PPO |
$333.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$323.01
|
| Rate for Payer: Multiplan Medicare/VA |
$79.32
|
| Rate for Payer: One Health Plan of WY PPO |
$326.34
|
| Rate for Payer: PacificSource Commercial |
$299.70
|
| Rate for Payer: PHCS PPO |
$316.35
|
| Rate for Payer: Three Rivers PPO |
$249.75
|
| Rate for Payer: TriWest Veterans Administration |
$93.32
|
| Rate for Payer: United Healthcare Commercial |
$289.71
|
| Rate for Payer: United Healthcare Medicare |
$93.32
|
| Rate for Payer: WINHealth Partners Commercial |
$283.05
|
|
|
HC PRO DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 99335
|
| Hospital Charge Code |
9839933501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$114.00 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Beech Street Commercial |
$144.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: First Choice Health Commercial |
$136.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$144.40
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: WINHealth Partners Commercial |
$144.40
|
|
|
HC PRO DRAINAGE OF FINGER ABSCESS COMPLICATED
|
Professional
|
Both
|
$1,663.00
|
|
|
Service Code
|
HCPCS 26011 NONPBBPAYER
|
| Hospital Charge Code |
9832601101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$153.72 |
| Max. Negotiated Rate |
$1,663.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,629.74
|
| Rate for Payer: Aetna of WY Medicare |
$180.85
|
| Rate for Payer: Beech Street Commercial |
$1,579.85
|
| Rate for Payer: Cash Price |
$1,164.10
|
| Rate for Payer: Cash Price |
$1,164.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,613.11
|
| Rate for Payer: Cigna of WY Commercial |
$1,629.74
|
| Rate for Payer: First Choice Health Commercial |
$1,496.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,579.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$180.85
|
| Rate for Payer: HealthUtah PPO |
$1,663.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,613.11
|
| Rate for Payer: Multiplan Medicare/VA |
$153.72
|
| Rate for Payer: One Health Plan of WY PPO |
$1,629.74
|
| Rate for Payer: PacificSource Commercial |
$1,496.70
|
| Rate for Payer: PHCS PPO |
$1,579.85
|
| Rate for Payer: Three Rivers PPO |
$1,247.25
|
| Rate for Payer: TriWest Veterans Administration |
$180.85
|
| Rate for Payer: United Healthcare Commercial |
$1,446.81
|
| Rate for Payer: United Healthcare Medicare |
$180.85
|
| Rate for Payer: WINHealth Partners Commercial |
$1,413.55
|
|
|
HC PRO DRAINAGE OF FINGER ABSCESS COMPLICATED
|
Professional
|
Both
|
$3,457.00
|
|
|
Service Code
|
HCPCS 26011
|
| Hospital Charge Code |
9832601101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$153.72 |
| Max. Negotiated Rate |
$3,457.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,387.86
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,303.40
|
| Rate for Payer: Aetna of WY Medicare |
$180.85
|
| Rate for Payer: Aetna of WY Medicare |
$180.85
|
| Rate for Payer: Beech Street Commercial |
$1,263.50
|
| Rate for Payer: Beech Street Commercial |
$3,284.15
|
| Rate for Payer: Cash Price |
$931.00
|
| Rate for Payer: Cash Price |
$931.00
|
| Rate for Payer: Cash Price |
$2,419.90
|
| Rate for Payer: Cash Price |
$2,419.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,353.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,290.10
|
| Rate for Payer: Cigna of WY Commercial |
$1,303.40
|
| Rate for Payer: Cigna of WY Commercial |
$3,387.86
|
| Rate for Payer: First Choice Health Commercial |
$1,197.00
|
| Rate for Payer: First Choice Health Commercial |
$3,111.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,284.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,263.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$180.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$180.85
|
| Rate for Payer: HealthUtah PPO |
$3,457.00
|
| Rate for Payer: HealthUtah PPO |
$1,330.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,353.29
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,290.10
|
| Rate for Payer: Multiplan Medicare/VA |
$153.72
|
| Rate for Payer: Multiplan Medicare/VA |
$153.72
|
| Rate for Payer: One Health Plan of WY PPO |
$3,387.86
|
| Rate for Payer: One Health Plan of WY PPO |
$1,303.40
|
| Rate for Payer: PacificSource Commercial |
$1,197.00
|
| Rate for Payer: PacificSource Commercial |
$3,111.30
|
| Rate for Payer: PHCS PPO |
$3,284.15
|
| Rate for Payer: PHCS PPO |
$1,263.50
|
| Rate for Payer: Three Rivers PPO |
$2,592.75
|
| Rate for Payer: Three Rivers PPO |
$997.50
|
| Rate for Payer: TriWest Veterans Administration |
$180.85
|
| Rate for Payer: TriWest Veterans Administration |
$180.85
|
| Rate for Payer: United Healthcare Commercial |
$1,157.10
|
| Rate for Payer: United Healthcare Commercial |
$3,007.59
|
| Rate for Payer: United Healthcare Medicare |
$180.85
|
| Rate for Payer: United Healthcare Medicare |
$180.85
|
| Rate for Payer: WINHealth Partners Commercial |
$2,938.45
|
| Rate for Payer: WINHealth Partners Commercial |
$1,130.50
|
|
|
HC PRO DRAINAGE OF GUM LESION
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 41800 NONPBBPAYER
|
| Hospital Charge Code |
9834180001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$128.10 |
| Max. Negotiated Rate |
$1,018.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$997.64
|
| Rate for Payer: Aetna of WY Medicare |
$150.71
|
| Rate for Payer: Beech Street Commercial |
$967.10
|
| Rate for Payer: Cash Price |
$712.60
|
| Rate for Payer: Cash Price |
$712.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$987.46
|
| Rate for Payer: Cigna of WY Commercial |
$997.64
|
| Rate for Payer: First Choice Health Commercial |
$916.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$967.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$150.71
|
| Rate for Payer: HealthUtah PPO |
$1,018.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$987.46
|
| Rate for Payer: Multiplan Medicare/VA |
$128.10
|
| Rate for Payer: One Health Plan of WY PPO |
$997.64
|
| Rate for Payer: PacificSource Commercial |
$916.20
|
| Rate for Payer: PHCS PPO |
$967.10
|
| Rate for Payer: Three Rivers PPO |
$763.50
|
| Rate for Payer: TriWest Veterans Administration |
$150.71
|
| Rate for Payer: United Healthcare Commercial |
$885.66
|
| Rate for Payer: United Healthcare Medicare |
$150.71
|
| Rate for Payer: WINHealth Partners Commercial |
$865.30
|
|
|
HC PRO DRAINAGE OF GUM LESION
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 41800
|
| Hospital Charge Code |
9834180001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$128.10 |
| Max. Negotiated Rate |
$814.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$797.72
|
| Rate for Payer: Aetna of WY Medicare |
$150.71
|
| Rate for Payer: Beech Street Commercial |
$773.30
|
| Rate for Payer: Cash Price |
$569.80
|
| Rate for Payer: Cash Price |
$569.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$789.58
|
| Rate for Payer: Cigna of WY Commercial |
$797.72
|
| Rate for Payer: First Choice Health Commercial |
$732.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$773.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$150.71
|
| Rate for Payer: HealthUtah PPO |
$814.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$789.58
|
| Rate for Payer: Multiplan Medicare/VA |
$128.10
|
| Rate for Payer: One Health Plan of WY PPO |
$797.72
|
| Rate for Payer: PacificSource Commercial |
$732.60
|
| Rate for Payer: PHCS PPO |
$773.30
|
| Rate for Payer: Three Rivers PPO |
$610.50
|
| Rate for Payer: TriWest Veterans Administration |
$150.71
|
| Rate for Payer: United Healthcare Commercial |
$708.18
|
| Rate for Payer: United Healthcare Medicare |
$150.71
|
| Rate for Payer: WINHealth Partners Commercial |
$691.90
|
|
|
HC PRO DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN
|
Professional
|
Both
|
$3,774.00
|
|
|
Service Code
|
HCPCS 49020
|
| Hospital Charge Code |
9834902001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,284.35 |
| Max. Negotiated Rate |
$3,774.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,698.52
|
| Rate for Payer: Aetna of WY Medicare |
$1,511.00
|
| Rate for Payer: Beech Street Commercial |
$3,585.30
|
| Rate for Payer: Cash Price |
$2,641.80
|
| Rate for Payer: Cash Price |
$2,641.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,660.78
|
| Rate for Payer: Cigna of WY Commercial |
$3,698.52
|
| Rate for Payer: First Choice Health Commercial |
$3,396.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,585.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,511.00
|
| Rate for Payer: HealthUtah PPO |
$3,774.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,660.78
|
| Rate for Payer: Multiplan Medicare/VA |
$1,284.35
|
| Rate for Payer: One Health Plan of WY PPO |
$3,698.52
|
| Rate for Payer: PacificSource Commercial |
$3,396.60
|
| Rate for Payer: PHCS PPO |
$3,585.30
|
| Rate for Payer: Three Rivers PPO |
$2,830.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,511.00
|
| Rate for Payer: United Healthcare Commercial |
$3,283.38
|
| Rate for Payer: United Healthcare Medicare |
$1,511.00
|
| Rate for Payer: WINHealth Partners Commercial |
$3,207.90
|
|
|
HC PRO DRAINAGE TENDON SHEATH DIGIT&/PALM EACH
|
Professional
|
Both
|
$1,558.00
|
|
|
Service Code
|
HCPCS 26020
|
| Hospital Charge Code |
9832602001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$463.91 |
| Max. Negotiated Rate |
$1,558.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,526.84
|
| Rate for Payer: Aetna of WY Medicare |
$545.78
|
| Rate for Payer: Beech Street Commercial |
$1,480.10
|
| Rate for Payer: Cash Price |
$1,090.60
|
| Rate for Payer: Cash Price |
$1,090.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,511.26
|
| Rate for Payer: Cigna of WY Commercial |
$1,526.84
|
| Rate for Payer: First Choice Health Commercial |
$1,402.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,480.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$545.78
|
| Rate for Payer: HealthUtah PPO |
$1,558.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,511.26
|
| Rate for Payer: Multiplan Medicare/VA |
$463.91
|
| Rate for Payer: One Health Plan of WY PPO |
$1,526.84
|
| Rate for Payer: PacificSource Commercial |
$1,402.20
|
| Rate for Payer: PHCS PPO |
$1,480.10
|
| Rate for Payer: Three Rivers PPO |
$1,168.50
|
| Rate for Payer: TriWest Veterans Administration |
$545.78
|
| Rate for Payer: United Healthcare Commercial |
$1,355.46
|
| Rate for Payer: United Healthcare Medicare |
$545.78
|
| Rate for Payer: WINHealth Partners Commercial |
$1,324.30
|
|
|
HC PRO DRAINAGE TENDON SHEATH DIGIT&/PALM EACH
|
Professional
|
Both
|
$1,948.00
|
|
|
Service Code
|
HCPCS 26020 NONPBBPAYER
|
| Hospital Charge Code |
9832602001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$463.91 |
| Max. Negotiated Rate |
$1,948.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,909.04
|
| Rate for Payer: Aetna of WY Medicare |
$545.78
|
| Rate for Payer: Beech Street Commercial |
$1,850.60
|
| Rate for Payer: Cash Price |
$1,363.60
|
| Rate for Payer: Cash Price |
$1,363.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,889.56
|
| Rate for Payer: Cigna of WY Commercial |
$1,909.04
|
| Rate for Payer: First Choice Health Commercial |
$1,753.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,850.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$545.78
|
| Rate for Payer: HealthUtah PPO |
$1,948.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,889.56
|
| Rate for Payer: Multiplan Medicare/VA |
$463.91
|
| Rate for Payer: One Health Plan of WY PPO |
$1,909.04
|
| Rate for Payer: PacificSource Commercial |
$1,753.20
|
| Rate for Payer: PHCS PPO |
$1,850.60
|
| Rate for Payer: Three Rivers PPO |
$1,461.00
|
| Rate for Payer: TriWest Veterans Administration |
$545.78
|
| Rate for Payer: United Healthcare Commercial |
$1,694.76
|
| Rate for Payer: United Healthcare Medicare |
$545.78
|
| Rate for Payer: WINHealth Partners Commercial |
$1,655.80
|
|
|
HC PRO DRAIN EXT AUDITORY CANAL ABSCESS
|
Professional
|
Both
|
$721.00
|
|
|
Service Code
|
HCPCS 69020 NONPBBPAYER
|
| Hospital Charge Code |
9836902001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$119.75 |
| Max. Negotiated Rate |
$721.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$706.58
|
| Rate for Payer: Aetna of WY Medicare |
$140.88
|
| Rate for Payer: Beech Street Commercial |
$684.95
|
| Rate for Payer: Cash Price |
$504.70
|
| Rate for Payer: Cash Price |
$504.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$699.37
|
| Rate for Payer: Cigna of WY Commercial |
$706.58
|
| Rate for Payer: First Choice Health Commercial |
$648.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$684.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$140.88
|
| Rate for Payer: HealthUtah PPO |
$721.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$699.37
|
| Rate for Payer: Multiplan Medicare/VA |
$119.75
|
| Rate for Payer: One Health Plan of WY PPO |
$706.58
|
| Rate for Payer: PacificSource Commercial |
$648.90
|
| Rate for Payer: PHCS PPO |
$684.95
|
| Rate for Payer: Three Rivers PPO |
$540.75
|
| Rate for Payer: TriWest Veterans Administration |
$140.88
|
| Rate for Payer: United Healthcare Commercial |
$627.27
|
| Rate for Payer: United Healthcare Medicare |
$140.88
|
| Rate for Payer: WINHealth Partners Commercial |
$612.85
|
|
|
HC PRO DRAIN EXT AUDITORY CANAL ABSCESS
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 69020
|
| Hospital Charge Code |
9836902001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$119.75 |
| Max. Negotiated Rate |
$577.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$565.46
|
| Rate for Payer: Aetna of WY Medicare |
$140.88
|
| Rate for Payer: Beech Street Commercial |
$548.15
|
| Rate for Payer: Cash Price |
$403.90
|
| Rate for Payer: Cash Price |
$403.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$559.69
|
| Rate for Payer: Cigna of WY Commercial |
$565.46
|
| Rate for Payer: First Choice Health Commercial |
$519.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$548.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$140.88
|
| Rate for Payer: HealthUtah PPO |
$577.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$559.69
|
| Rate for Payer: Multiplan Medicare/VA |
$119.75
|
| Rate for Payer: One Health Plan of WY PPO |
$565.46
|
| Rate for Payer: PacificSource Commercial |
$519.30
|
| Rate for Payer: PHCS PPO |
$548.15
|
| Rate for Payer: Three Rivers PPO |
$432.75
|
| Rate for Payer: TriWest Veterans Administration |
$140.88
|
| Rate for Payer: United Healthcare Commercial |
$501.99
|
| Rate for Payer: United Healthcare Medicare |
$140.88
|
| Rate for Payer: WINHealth Partners Commercial |
$490.45
|
|
|
HC PRO DRAIN EXT EAR ABSC/BLOOD,SIMPLE
|
Professional
|
Both
|
$621.00
|
|
|
Service Code
|
HCPCS 69000 NONPBBPAYER
|
| Hospital Charge Code |
9836900001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$104.09 |
| Max. Negotiated Rate |
$621.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$608.58
|
| Rate for Payer: Aetna of WY Medicare |
$122.46
|
| Rate for Payer: Beech Street Commercial |
$589.95
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$602.37
|
| Rate for Payer: Cigna of WY Commercial |
$608.58
|
| Rate for Payer: First Choice Health Commercial |
$558.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$589.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$122.46
|
| Rate for Payer: HealthUtah PPO |
$621.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$602.37
|
| Rate for Payer: Multiplan Medicare/VA |
$104.09
|
| Rate for Payer: One Health Plan of WY PPO |
$608.58
|
| Rate for Payer: PacificSource Commercial |
$558.90
|
| Rate for Payer: PHCS PPO |
$589.95
|
| Rate for Payer: Three Rivers PPO |
$465.75
|
| Rate for Payer: TriWest Veterans Administration |
$122.46
|
| Rate for Payer: United Healthcare Commercial |
$540.27
|
| Rate for Payer: United Healthcare Medicare |
$122.46
|
| Rate for Payer: WINHealth Partners Commercial |
$527.85
|
|
|
HC PRO DRAIN EXT EAR ABSC/BLOOD,SIMPLE
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 69000
|
| Hospital Charge Code |
9836900001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$104.09 |
| Max. Negotiated Rate |
$935.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$916.30
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$487.06
|
| Rate for Payer: Aetna of WY Medicare |
$122.46
|
| Rate for Payer: Aetna of WY Medicare |
$122.46
|
| Rate for Payer: Beech Street Commercial |
$472.15
|
| Rate for Payer: Beech Street Commercial |
$888.25
|
| Rate for Payer: Cash Price |
$347.90
|
| Rate for Payer: Cash Price |
$347.90
|
| Rate for Payer: Cash Price |
$654.50
|
| Rate for Payer: Cash Price |
$654.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$906.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$482.09
|
| Rate for Payer: Cigna of WY Commercial |
$487.06
|
| Rate for Payer: Cigna of WY Commercial |
$916.30
|
| Rate for Payer: First Choice Health Commercial |
$447.30
|
| Rate for Payer: First Choice Health Commercial |
$841.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$888.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$472.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$122.46
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$122.46
|
| Rate for Payer: HealthUtah PPO |
$935.00
|
| Rate for Payer: HealthUtah PPO |
$497.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$906.95
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$482.09
|
| Rate for Payer: Multiplan Medicare/VA |
$104.09
|
| Rate for Payer: Multiplan Medicare/VA |
$104.09
|
| Rate for Payer: One Health Plan of WY PPO |
$916.30
|
| Rate for Payer: One Health Plan of WY PPO |
$487.06
|
| Rate for Payer: PacificSource Commercial |
$447.30
|
| Rate for Payer: PacificSource Commercial |
$841.50
|
| Rate for Payer: PHCS PPO |
$888.25
|
| Rate for Payer: PHCS PPO |
$472.15
|
| Rate for Payer: Three Rivers PPO |
$701.25
|
| Rate for Payer: Three Rivers PPO |
$372.75
|
| Rate for Payer: TriWest Veterans Administration |
$122.46
|
| Rate for Payer: TriWest Veterans Administration |
$122.46
|
| Rate for Payer: United Healthcare Commercial |
$432.39
|
| Rate for Payer: United Healthcare Commercial |
$813.45
|
| Rate for Payer: United Healthcare Medicare |
$122.46
|
| Rate for Payer: United Healthcare Medicare |
$122.46
|
| Rate for Payer: WINHealth Partners Commercial |
$794.75
|
| Rate for Payer: WINHealth Partners Commercial |
$422.45
|
|
