|
ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ
|
Professional
|
Both
|
$3,312.00
|
|
|
Service Code
|
HCPCS 29887
|
| Min. Negotiated Rate |
$622.67 |
| Max. Negotiated Rate |
$3,312.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,245.76
|
| Rate for Payer: Aetna of WY Medicare |
$732.55
|
| Rate for Payer: Beech Street Commercial |
$3,146.40
|
| Rate for Payer: Cash Price |
$2,318.40
|
| Rate for Payer: Cash Price |
$2,318.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,212.64
|
| Rate for Payer: Cigna of WY Commercial |
$3,245.76
|
| Rate for Payer: First Choice Health Commercial |
$2,980.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,146.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$732.55
|
| Rate for Payer: HealthUtah PPO |
$3,312.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,212.64
|
| Rate for Payer: Multiplan Medicare/VA |
$622.67
|
| Rate for Payer: One Health Plan of WY PPO |
$3,245.76
|
| Rate for Payer: PacificSource Commercial |
$2,980.80
|
| Rate for Payer: PHCS PPO |
$3,146.40
|
| Rate for Payer: Three Rivers PPO |
$2,484.00
|
| Rate for Payer: TriWest Veterans Administration |
$732.55
|
| Rate for Payer: United Healthcare Commercial |
$3,146.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2,815.20
|
|
|
ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,476.00
|
|
|
Service Code
|
HCPCS 29880 80
|
| Min. Negotiated Rate |
$465.74 |
| Max. Negotiated Rate |
$2,476.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,426.48
|
| Rate for Payer: Beech Street Commercial |
$2,352.20
|
| Rate for Payer: Cash Price |
$1,733.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,401.72
|
| Rate for Payer: Cigna of WY Commercial |
$2,426.48
|
| Rate for Payer: First Choice Health Commercial |
$2,228.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,352.20
|
| Rate for Payer: HealthUtah PPO |
$2,476.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,401.72
|
| Rate for Payer: One Health Plan of WY PPO |
$2,426.48
|
| Rate for Payer: PacificSource Commercial |
$2,228.40
|
| Rate for Payer: PHCS PPO |
$2,352.20
|
| Rate for Payer: Three Rivers PPO |
$1,857.00
|
| Rate for Payer: United Healthcare Commercial |
$2,352.20
|
| Rate for Payer: WINHealth Partners Commercial |
$2,104.60
|
|
|
ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,476.00
|
|
|
Service Code
|
HCPCS 29880
|
| Min. Negotiated Rate |
$465.74 |
| Max. Negotiated Rate |
$2,476.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,426.48
|
| Rate for Payer: Aetna of WY Medicare |
$547.93
|
| Rate for Payer: Beech Street Commercial |
$2,352.20
|
| Rate for Payer: Cash Price |
$1,733.20
|
| Rate for Payer: Cash Price |
$1,733.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,401.72
|
| Rate for Payer: Cigna of WY Commercial |
$2,426.48
|
| Rate for Payer: First Choice Health Commercial |
$2,228.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,352.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$547.93
|
| Rate for Payer: HealthUtah PPO |
$2,476.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,401.72
|
| Rate for Payer: Multiplan Medicare/VA |
$465.74
|
| Rate for Payer: One Health Plan of WY PPO |
$2,426.48
|
| Rate for Payer: PacificSource Commercial |
$2,228.40
|
| Rate for Payer: PHCS PPO |
$2,352.20
|
| Rate for Payer: Three Rivers PPO |
$1,857.00
|
| Rate for Payer: TriWest Veterans Administration |
$547.93
|
| Rate for Payer: United Healthcare Commercial |
$2,352.20
|
| Rate for Payer: WINHealth Partners Commercial |
$2,104.60
|
|
|
ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,476.00
|
|
|
Service Code
|
HCPCS 29880 AS
|
| Min. Negotiated Rate |
$465.74 |
| Max. Negotiated Rate |
$2,476.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,426.48
|
| Rate for Payer: Beech Street Commercial |
$2,352.20
|
| Rate for Payer: Cash Price |
$1,733.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,401.72
|
| Rate for Payer: Cigna of WY Commercial |
$2,426.48
|
| Rate for Payer: First Choice Health Commercial |
$2,228.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,352.20
|
| Rate for Payer: HealthUtah PPO |
$2,476.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,401.72
|
| Rate for Payer: One Health Plan of WY PPO |
$2,426.48
|
| Rate for Payer: PacificSource Commercial |
$2,228.40
|
| Rate for Payer: PHCS PPO |
$2,352.20
|
| Rate for Payer: Three Rivers PPO |
$1,857.00
|
| Rate for Payer: United Healthcare Commercial |
$2,352.20
|
| Rate for Payer: WINHealth Partners Commercial |
$2,104.60
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,386.00
|
|
|
Service Code
|
HCPCS 29881 80
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,386.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,338.28
|
| Rate for Payer: Beech Street Commercial |
$2,266.70
|
| Rate for Payer: Cash Price |
$1,670.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,314.42
|
| Rate for Payer: Cigna of WY Commercial |
$2,338.28
|
| Rate for Payer: First Choice Health Commercial |
$2,147.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,266.70
|
| Rate for Payer: HealthUtah PPO |
$2,386.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,314.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,338.28
|
| Rate for Payer: PacificSource Commercial |
$2,147.40
|
| Rate for Payer: PHCS PPO |
$2,266.70
|
| Rate for Payer: Three Rivers PPO |
$1,789.50
|
| Rate for Payer: United Healthcare Commercial |
$2,266.70
|
| Rate for Payer: WINHealth Partners Commercial |
$2,028.10
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$4,771.00
|
|
|
Service Code
|
HCPCS 29881 50
|
| Min. Negotiated Rate |
$3,578.25 |
| Max. Negotiated Rate |
$4,771.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,675.58
|
| Rate for Payer: Beech Street Commercial |
$4,532.45
|
| Rate for Payer: Cash Price |
$3,339.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,627.87
|
| Rate for Payer: Cigna of WY Commercial |
$4,675.58
|
| Rate for Payer: First Choice Health Commercial |
$4,293.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,532.45
|
| Rate for Payer: HealthUtah PPO |
$4,771.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,627.87
|
| Rate for Payer: One Health Plan of WY PPO |
$4,675.58
|
| Rate for Payer: PacificSource Commercial |
$4,293.90
|
| Rate for Payer: PHCS PPO |
$4,532.45
|
| Rate for Payer: Three Rivers PPO |
$3,578.25
|
| Rate for Payer: United Healthcare Commercial |
$4,532.45
|
| Rate for Payer: WINHealth Partners Commercial |
$4,055.35
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,386.00
|
|
|
Service Code
|
HCPCS 29881 AS
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,386.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,338.28
|
| Rate for Payer: Beech Street Commercial |
$2,266.70
|
| Rate for Payer: Cash Price |
$1,670.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,314.42
|
| Rate for Payer: Cigna of WY Commercial |
$2,338.28
|
| Rate for Payer: First Choice Health Commercial |
$2,147.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,266.70
|
| Rate for Payer: HealthUtah PPO |
$2,386.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,314.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,338.28
|
| Rate for Payer: PacificSource Commercial |
$2,147.40
|
| Rate for Payer: PHCS PPO |
$2,266.70
|
| Rate for Payer: Three Rivers PPO |
$1,789.50
|
| Rate for Payer: United Healthcare Commercial |
$2,266.70
|
| Rate for Payer: WINHealth Partners Commercial |
$2,028.10
|
|
|
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,386.00
|
|
|
Service Code
|
HCPCS 29881
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,386.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,338.28
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,266.70
|
| Rate for Payer: Cash Price |
$1,670.20
|
| Rate for Payer: Cash Price |
$1,670.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,314.42
|
| Rate for Payer: Cigna of WY Commercial |
$2,338.28
|
| Rate for Payer: First Choice Health Commercial |
$2,147.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,266.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,386.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,314.42
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,338.28
|
| Rate for Payer: PacificSource Commercial |
$2,147.40
|
| Rate for Payer: PHCS PPO |
$2,266.70
|
| Rate for Payer: Three Rivers PPO |
$1,789.50
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,266.70
|
| Rate for Payer: WINHealth Partners Commercial |
$2,028.10
|
|
|
ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 29800
|
| Min. Negotiated Rate |
$440.85 |
| Max. Negotiated Rate |
$2,329.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,282.42
|
| Rate for Payer: Aetna of WY Medicare |
$518.65
|
| Rate for Payer: Beech Street Commercial |
$2,212.55
|
| Rate for Payer: Cash Price |
$1,630.30
|
| Rate for Payer: Cash Price |
$1,630.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,259.13
|
| Rate for Payer: Cigna of WY Commercial |
$2,282.42
|
| Rate for Payer: First Choice Health Commercial |
$2,096.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,212.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$518.65
|
| Rate for Payer: HealthUtah PPO |
$2,329.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,259.13
|
| Rate for Payer: Multiplan Medicare/VA |
$440.85
|
| Rate for Payer: One Health Plan of WY PPO |
$2,282.42
|
| Rate for Payer: PacificSource Commercial |
$2,096.10
|
| Rate for Payer: PHCS PPO |
$2,212.55
|
| Rate for Payer: Three Rivers PPO |
$1,746.75
|
| Rate for Payer: TriWest Veterans Administration |
$518.65
|
| Rate for Payer: United Healthcare Commercial |
$2,212.55
|
| Rate for Payer: WINHealth Partners Commercial |
$1,979.65
|
|
|
ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$1,831.00
|
|
|
Service Code
|
HCPCS 29846 80
|
| Min. Negotiated Rate |
$434.21 |
| Max. Negotiated Rate |
$1,831.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,794.38
|
| Rate for Payer: Beech Street Commercial |
$1,739.45
|
| Rate for Payer: Cash Price |
$1,281.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,776.07
|
| Rate for Payer: Cigna of WY Commercial |
$1,794.38
|
| Rate for Payer: First Choice Health Commercial |
$1,647.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,739.45
|
| Rate for Payer: HealthUtah PPO |
$1,831.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,776.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1,794.38
|
| Rate for Payer: PacificSource Commercial |
$1,647.90
|
| Rate for Payer: PHCS PPO |
$1,739.45
|
| Rate for Payer: Three Rivers PPO |
$1,373.25
|
| Rate for Payer: United Healthcare Commercial |
$1,739.45
|
| Rate for Payer: WINHealth Partners Commercial |
$1,556.35
|
|
|
ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$1,831.00
|
|
|
Service Code
|
HCPCS 29846 AS
|
| Min. Negotiated Rate |
$434.21 |
| Max. Negotiated Rate |
$1,831.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,794.38
|
| Rate for Payer: Beech Street Commercial |
$1,739.45
|
| Rate for Payer: Cash Price |
$1,281.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,776.07
|
| Rate for Payer: Cigna of WY Commercial |
$1,794.38
|
| Rate for Payer: First Choice Health Commercial |
$1,647.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,739.45
|
| Rate for Payer: HealthUtah PPO |
$1,831.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,776.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1,794.38
|
| Rate for Payer: PacificSource Commercial |
$1,647.90
|
| Rate for Payer: PHCS PPO |
$1,739.45
|
| Rate for Payer: Three Rivers PPO |
$1,373.25
|
| Rate for Payer: United Healthcare Commercial |
$1,739.45
|
| Rate for Payer: WINHealth Partners Commercial |
$1,556.35
|
|
|
ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$1,831.00
|
|
|
Service Code
|
HCPCS 29846
|
| Min. Negotiated Rate |
$434.21 |
| Max. Negotiated Rate |
$1,831.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,794.38
|
| Rate for Payer: Aetna of WY Medicare |
$510.83
|
| Rate for Payer: Beech Street Commercial |
$1,739.45
|
| Rate for Payer: Cash Price |
$1,281.70
|
| Rate for Payer: Cash Price |
$1,281.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,776.07
|
| Rate for Payer: Cigna of WY Commercial |
$1,794.38
|
| Rate for Payer: First Choice Health Commercial |
$1,647.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,739.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$510.83
|
| Rate for Payer: HealthUtah PPO |
$1,831.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,776.07
|
| Rate for Payer: Multiplan Medicare/VA |
$434.21
|
| Rate for Payer: One Health Plan of WY PPO |
$1,794.38
|
| Rate for Payer: PacificSource Commercial |
$1,647.90
|
| Rate for Payer: PHCS PPO |
$1,739.45
|
| Rate for Payer: Three Rivers PPO |
$1,373.25
|
| Rate for Payer: TriWest Veterans Administration |
$510.83
|
| Rate for Payer: United Healthcare Commercial |
$1,739.45
|
| Rate for Payer: WINHealth Partners Commercial |
$1,556.35
|
|
|
ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,652.00
|
|
|
Service Code
|
HCPCS 23044
|
| Min. Negotiated Rate |
$467.93 |
| Max. Negotiated Rate |
$1,652.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,618.96
|
| Rate for Payer: Aetna of WY Medicare |
$550.51
|
| Rate for Payer: Beech Street Commercial |
$1,569.40
|
| Rate for Payer: Cash Price |
$1,156.40
|
| Rate for Payer: Cash Price |
$1,156.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,602.44
|
| Rate for Payer: Cigna of WY Commercial |
$1,618.96
|
| Rate for Payer: First Choice Health Commercial |
$1,486.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,569.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$550.51
|
| Rate for Payer: HealthUtah PPO |
$1,652.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,602.44
|
| Rate for Payer: Multiplan Medicare/VA |
$467.93
|
| Rate for Payer: One Health Plan of WY PPO |
$1,618.96
|
| Rate for Payer: PacificSource Commercial |
$1,486.80
|
| Rate for Payer: PHCS PPO |
$1,569.40
|
| Rate for Payer: Three Rivers PPO |
$1,239.00
|
| Rate for Payer: TriWest Veterans Administration |
$550.51
|
| Rate for Payer: United Healthcare Commercial |
$1,569.40
|
| Rate for Payer: WINHealth Partners Commercial |
$1,404.20
|
|
|
ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,977.00
|
|
|
Service Code
|
HCPCS 27620 AS
|
| Min. Negotiated Rate |
$372.81 |
| Max. Negotiated Rate |
$1,977.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,937.46
|
| Rate for Payer: Beech Street Commercial |
$1,878.15
|
| Rate for Payer: Cash Price |
$1,383.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,917.69
|
| Rate for Payer: Cigna of WY Commercial |
$1,937.46
|
| Rate for Payer: First Choice Health Commercial |
$1,779.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,878.15
|
| Rate for Payer: HealthUtah PPO |
$1,977.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,917.69
|
| Rate for Payer: One Health Plan of WY PPO |
$1,937.46
|
| Rate for Payer: PacificSource Commercial |
$1,779.30
|
| Rate for Payer: PHCS PPO |
$1,878.15
|
| Rate for Payer: Three Rivers PPO |
$1,482.75
|
| Rate for Payer: United Healthcare Commercial |
$1,878.15
|
| Rate for Payer: WINHealth Partners Commercial |
$1,680.45
|
|
|
ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,977.00
|
|
|
Service Code
|
HCPCS 27620
|
| Min. Negotiated Rate |
$372.81 |
| Max. Negotiated Rate |
$1,977.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,937.46
|
| Rate for Payer: Aetna of WY Medicare |
$438.60
|
| Rate for Payer: Beech Street Commercial |
$1,878.15
|
| Rate for Payer: Cash Price |
$1,383.90
|
| Rate for Payer: Cash Price |
$1,383.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,917.69
|
| Rate for Payer: Cigna of WY Commercial |
$1,937.46
|
| Rate for Payer: First Choice Health Commercial |
$1,779.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,878.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$438.60
|
| Rate for Payer: HealthUtah PPO |
$1,977.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,917.69
|
| Rate for Payer: Multiplan Medicare/VA |
$372.81
|
| Rate for Payer: One Health Plan of WY PPO |
$1,937.46
|
| Rate for Payer: PacificSource Commercial |
$1,779.30
|
| Rate for Payer: PHCS PPO |
$1,878.15
|
| Rate for Payer: Three Rivers PPO |
$1,482.75
|
| Rate for Payer: TriWest Veterans Administration |
$438.60
|
| Rate for Payer: United Healthcare Commercial |
$1,878.15
|
| Rate for Payer: WINHealth Partners Commercial |
$1,680.45
|
|
|
ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$8,101.00
|
|
|
Service Code
|
HCPCS 24006 AS
|
| Min. Negotiated Rate |
$591.28 |
| Max. Negotiated Rate |
$8,101.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,938.98
|
| Rate for Payer: Beech Street Commercial |
$7,695.95
|
| Rate for Payer: Cash Price |
$5,670.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,857.97
|
| Rate for Payer: Cigna of WY Commercial |
$7,938.98
|
| Rate for Payer: First Choice Health Commercial |
$7,290.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,695.95
|
| Rate for Payer: HealthUtah PPO |
$8,101.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,857.97
|
| Rate for Payer: One Health Plan of WY PPO |
$7,938.98
|
| Rate for Payer: PacificSource Commercial |
$7,290.90
|
| Rate for Payer: PHCS PPO |
$7,695.95
|
| Rate for Payer: Three Rivers PPO |
$6,075.75
|
| Rate for Payer: United Healthcare Commercial |
$7,695.95
|
| Rate for Payer: WINHealth Partners Commercial |
$6,885.85
|
|
|
ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$1,620.00
|
|
|
Service Code
|
HCPCS 24006 80
|
| Min. Negotiated Rate |
$1,215.00 |
| Max. Negotiated Rate |
$1,620.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,587.60
|
| Rate for Payer: Beech Street Commercial |
$1,539.00
|
| Rate for Payer: Cash Price |
$1,134.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,571.40
|
| Rate for Payer: Cigna of WY Commercial |
$1,587.60
|
| Rate for Payer: First Choice Health Commercial |
$1,458.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,539.00
|
| Rate for Payer: HealthUtah PPO |
$1,620.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,571.40
|
| Rate for Payer: One Health Plan of WY PPO |
$1,587.60
|
| Rate for Payer: PacificSource Commercial |
$1,458.00
|
| Rate for Payer: PHCS PPO |
$1,539.00
|
| Rate for Payer: Three Rivers PPO |
$1,215.00
|
| Rate for Payer: United Healthcare Commercial |
$1,539.00
|
| Rate for Payer: WINHealth Partners Commercial |
$1,377.00
|
|
|
ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$8,101.00
|
|
|
Service Code
|
HCPCS 24006
|
| Min. Negotiated Rate |
$591.28 |
| Max. Negotiated Rate |
$8,101.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,938.98
|
| Rate for Payer: Aetna of WY Medicare |
$695.62
|
| Rate for Payer: Beech Street Commercial |
$7,695.95
|
| Rate for Payer: Cash Price |
$5,670.70
|
| Rate for Payer: Cash Price |
$5,670.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,857.97
|
| Rate for Payer: Cigna of WY Commercial |
$7,938.98
|
| Rate for Payer: First Choice Health Commercial |
$7,290.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,695.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$695.62
|
| Rate for Payer: HealthUtah PPO |
$8,101.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,857.97
|
| Rate for Payer: Multiplan Medicare/VA |
$591.28
|
| Rate for Payer: One Health Plan of WY PPO |
$7,938.98
|
| Rate for Payer: PacificSource Commercial |
$7,290.90
|
| Rate for Payer: PHCS PPO |
$7,695.95
|
| Rate for Payer: Three Rivers PPO |
$6,075.75
|
| Rate for Payer: TriWest Veterans Administration |
$695.62
|
| Rate for Payer: United Healthcare Commercial |
$7,695.95
|
| Rate for Payer: WINHealth Partners Commercial |
$6,885.85
|
|
|
ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,046.00
|
|
|
Service Code
|
HCPCS 24000
|
| Min. Negotiated Rate |
$399.44 |
| Max. Negotiated Rate |
$2,046.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,005.08
|
| Rate for Payer: Aetna of WY Medicare |
$469.93
|
| Rate for Payer: Beech Street Commercial |
$1,943.70
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,984.62
|
| Rate for Payer: Cigna of WY Commercial |
$2,005.08
|
| Rate for Payer: First Choice Health Commercial |
$1,841.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,943.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$469.93
|
| Rate for Payer: HealthUtah PPO |
$2,046.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,984.62
|
| Rate for Payer: Multiplan Medicare/VA |
$399.44
|
| Rate for Payer: One Health Plan of WY PPO |
$2,005.08
|
| Rate for Payer: PacificSource Commercial |
$1,841.40
|
| Rate for Payer: PHCS PPO |
$1,943.70
|
| Rate for Payer: Three Rivers PPO |
$1,534.50
|
| Rate for Payer: TriWest Veterans Administration |
$469.93
|
| Rate for Payer: United Healthcare Commercial |
$1,943.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,739.10
|
|
|
ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,046.00
|
|
|
Service Code
|
HCPCS 24000 AS
|
| Min. Negotiated Rate |
$399.44 |
| Max. Negotiated Rate |
$2,046.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,005.08
|
| Rate for Payer: Beech Street Commercial |
$1,943.70
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,984.62
|
| Rate for Payer: Cigna of WY Commercial |
$2,005.08
|
| Rate for Payer: First Choice Health Commercial |
$1,841.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,943.70
|
| Rate for Payer: HealthUtah PPO |
$2,046.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,984.62
|
| Rate for Payer: One Health Plan of WY PPO |
$2,005.08
|
| Rate for Payer: PacificSource Commercial |
$1,841.40
|
| Rate for Payer: PHCS PPO |
$1,943.70
|
| Rate for Payer: Three Rivers PPO |
$1,534.50
|
| Rate for Payer: United Healthcare Commercial |
$1,943.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,739.10
|
|
|
ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$6,435.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$420.24 |
| Max. Negotiated Rate |
$6,435.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,306.30
|
| Rate for Payer: Aetna of WY Medicare |
$494.40
|
| Rate for Payer: Beech Street Commercial |
$6,113.25
|
| Rate for Payer: Cash Price |
$4,504.50
|
| Rate for Payer: Cash Price |
$4,504.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,241.95
|
| Rate for Payer: Cigna of WY Commercial |
$6,306.30
|
| Rate for Payer: First Choice Health Commercial |
$5,791.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,113.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$494.40
|
| Rate for Payer: HealthUtah PPO |
$6,435.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,241.95
|
| Rate for Payer: Multiplan Medicare/VA |
$420.24
|
| Rate for Payer: One Health Plan of WY PPO |
$6,306.30
|
| Rate for Payer: PacificSource Commercial |
$5,791.50
|
| Rate for Payer: PHCS PPO |
$6,113.25
|
| Rate for Payer: Three Rivers PPO |
$4,826.25
|
| Rate for Payer: TriWest Veterans Administration |
$494.40
|
| Rate for Payer: United Healthcare Commercial |
$6,113.25
|
| Rate for Payer: WINHealth Partners Commercial |
$5,469.75
|
|
|
ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$769.00
|
|
|
Service Code
|
HCPCS 26080 80
|
| Min. Negotiated Rate |
$576.75 |
| Max. Negotiated Rate |
$769.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$753.62
|
| Rate for Payer: Beech Street Commercial |
$730.55
|
| Rate for Payer: Cash Price |
$538.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$745.93
|
| Rate for Payer: Cigna of WY Commercial |
$753.62
|
| Rate for Payer: First Choice Health Commercial |
$692.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$730.55
|
| Rate for Payer: HealthUtah PPO |
$769.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$745.93
|
| Rate for Payer: One Health Plan of WY PPO |
$753.62
|
| Rate for Payer: PacificSource Commercial |
$692.10
|
| Rate for Payer: PHCS PPO |
$730.55
|
| Rate for Payer: Three Rivers PPO |
$576.75
|
| Rate for Payer: United Healthcare Commercial |
$730.55
|
| Rate for Payer: WINHealth Partners Commercial |
$653.65
|
|
|
ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$4,776.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$335.89 |
| Max. Negotiated Rate |
$4,776.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,680.48
|
| Rate for Payer: Aetna of WY Medicare |
$395.16
|
| Rate for Payer: Beech Street Commercial |
$4,537.20
|
| Rate for Payer: Cash Price |
$3,343.20
|
| Rate for Payer: Cash Price |
$3,343.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,632.72
|
| Rate for Payer: Cigna of WY Commercial |
$4,680.48
|
| Rate for Payer: First Choice Health Commercial |
$4,298.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,537.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$395.16
|
| Rate for Payer: HealthUtah PPO |
$4,776.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,632.72
|
| Rate for Payer: Multiplan Medicare/VA |
$335.89
|
| Rate for Payer: One Health Plan of WY PPO |
$4,680.48
|
| Rate for Payer: PacificSource Commercial |
$4,298.40
|
| Rate for Payer: PHCS PPO |
$4,537.20
|
| Rate for Payer: Three Rivers PPO |
$3,582.00
|
| Rate for Payer: TriWest Veterans Administration |
$395.16
|
| Rate for Payer: United Healthcare Commercial |
$4,537.20
|
| Rate for Payer: WINHealth Partners Commercial |
$4,059.60
|
|
|
ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$2,599.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$284.92 |
| Max. Negotiated Rate |
$2,599.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,547.02
|
| Rate for Payer: Aetna of WY Medicare |
$335.20
|
| Rate for Payer: Beech Street Commercial |
$2,469.05
|
| Rate for Payer: Cash Price |
$1,819.30
|
| Rate for Payer: Cash Price |
$1,819.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,521.03
|
| Rate for Payer: Cigna of WY Commercial |
$2,547.02
|
| Rate for Payer: First Choice Health Commercial |
$2,339.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,469.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$335.20
|
| Rate for Payer: HealthUtah PPO |
$2,599.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,521.03
|
| Rate for Payer: Multiplan Medicare/VA |
$284.92
|
| Rate for Payer: One Health Plan of WY PPO |
$2,547.02
|
| Rate for Payer: PacificSource Commercial |
$2,339.10
|
| Rate for Payer: PHCS PPO |
$2,469.05
|
| Rate for Payer: Three Rivers PPO |
$1,949.25
|
| Rate for Payer: TriWest Veterans Administration |
$335.20
|
| Rate for Payer: United Healthcare Commercial |
$2,469.05
|
| Rate for Payer: WINHealth Partners Commercial |
$2,209.15
|
|
|
ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 26075 80
|
| Min. Negotiated Rate |
$298.50 |
| Max. Negotiated Rate |
$398.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$390.04
|
| Rate for Payer: Beech Street Commercial |
$378.10
|
| Rate for Payer: Cash Price |
$278.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$386.06
|
| Rate for Payer: Cigna of WY Commercial |
$390.04
|
| Rate for Payer: First Choice Health Commercial |
$358.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$378.10
|
| Rate for Payer: HealthUtah PPO |
$398.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$386.06
|
| Rate for Payer: One Health Plan of WY PPO |
$390.04
|
| Rate for Payer: PacificSource Commercial |
$358.20
|
| Rate for Payer: PHCS PPO |
$378.10
|
| Rate for Payer: Three Rivers PPO |
$298.50
|
| Rate for Payer: United Healthcare Commercial |
$378.10
|
| Rate for Payer: WINHealth Partners Commercial |
$338.30
|
|
