|
HC PRO HYSTEROSCOPY WITH REMOVAL LEIOMYOMATA
|
Professional
|
Both
|
$1,506.00
|
|
|
Service Code
|
HCPCS 58561
|
| Hospital Charge Code |
9835856101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$289.60 |
| Max. Negotiated Rate |
$1,506.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,475.88
|
| Rate for Payer: Aetna of WY Medicare |
$340.71
|
| Rate for Payer: Beech Street Commercial |
$1,430.70
|
| Rate for Payer: Cash Price |
$1,054.20
|
| Rate for Payer: Cash Price |
$1,054.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,460.82
|
| Rate for Payer: Cigna of WY Commercial |
$1,475.88
|
| Rate for Payer: First Choice Health Commercial |
$1,355.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,430.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$340.71
|
| Rate for Payer: HealthUtah PPO |
$1,506.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,460.82
|
| Rate for Payer: Multiplan Medicare/VA |
$289.60
|
| Rate for Payer: One Health Plan of WY PPO |
$1,475.88
|
| Rate for Payer: PacificSource Commercial |
$1,355.40
|
| Rate for Payer: PHCS PPO |
$1,430.70
|
| Rate for Payer: Three Rivers PPO |
$1,129.50
|
| Rate for Payer: TriWest Veterans Administration |
$340.71
|
| Rate for Payer: United Healthcare Commercial |
$1,310.22
|
| Rate for Payer: United Healthcare Medicare |
$340.71
|
| Rate for Payer: WINHealth Partners Commercial |
$1,280.10
|
|
|
HC PRO I&D ABCESS PERITONSILLAR
|
Professional
|
Both
|
$992.00
|
|
|
Service Code
|
HCPCS 42700
|
| Hospital Charge Code |
9834270001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$112.85 |
| Max. Negotiated Rate |
$992.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$972.16
|
| Rate for Payer: Aetna of WY Medicare |
$132.77
|
| Rate for Payer: Beech Street Commercial |
$942.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$962.24
|
| Rate for Payer: Cigna of WY Commercial |
$972.16
|
| Rate for Payer: First Choice Health Commercial |
$892.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$942.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$132.77
|
| Rate for Payer: HealthUtah PPO |
$992.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$962.24
|
| Rate for Payer: Multiplan Medicare/VA |
$112.85
|
| Rate for Payer: One Health Plan of WY PPO |
$972.16
|
| Rate for Payer: PacificSource Commercial |
$892.80
|
| Rate for Payer: PHCS PPO |
$942.40
|
| Rate for Payer: Three Rivers PPO |
$744.00
|
| Rate for Payer: TriWest Veterans Administration |
$132.77
|
| Rate for Payer: United Healthcare Commercial |
$863.04
|
| Rate for Payer: United Healthcare Medicare |
$132.77
|
| Rate for Payer: WINHealth Partners Commercial |
$843.20
|
|
|
HC PRO I&D ARM/ELBOW INFECT BURSA
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
HCPCS 23931
|
| Hospital Charge Code |
9832393101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$134.39 |
| Max. Negotiated Rate |
$641.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$628.18
|
| Rate for Payer: Aetna of WY Medicare |
$158.11
|
| Rate for Payer: Beech Street Commercial |
$608.95
|
| Rate for Payer: Cash Price |
$448.70
|
| Rate for Payer: Cash Price |
$448.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$621.77
|
| Rate for Payer: Cigna of WY Commercial |
$628.18
|
| Rate for Payer: First Choice Health Commercial |
$576.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$608.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$158.11
|
| Rate for Payer: HealthUtah PPO |
$641.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$621.77
|
| Rate for Payer: Multiplan Medicare/VA |
$134.39
|
| Rate for Payer: One Health Plan of WY PPO |
$628.18
|
| Rate for Payer: PacificSource Commercial |
$576.90
|
| Rate for Payer: PHCS PPO |
$608.95
|
| Rate for Payer: Three Rivers PPO |
$480.75
|
| Rate for Payer: TriWest Veterans Administration |
$158.11
|
| Rate for Payer: United Healthcare Commercial |
$557.67
|
| Rate for Payer: United Healthcare Medicare |
$158.11
|
| Rate for Payer: WINHealth Partners Commercial |
$544.85
|
|
|
HC PRO I&D ARM/ELBOW INFECT BURSA
|
Professional
|
Both
|
$801.00
|
|
|
Service Code
|
HCPCS 23931 NONPBBPAYER
|
| Hospital Charge Code |
9832393101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$134.39 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$784.98
|
| Rate for Payer: Aetna of WY Medicare |
$158.11
|
| Rate for Payer: Beech Street Commercial |
$760.95
|
| Rate for Payer: Cash Price |
$560.70
|
| Rate for Payer: Cash Price |
$560.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$776.97
|
| Rate for Payer: Cigna of WY Commercial |
$784.98
|
| Rate for Payer: First Choice Health Commercial |
$720.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$760.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$158.11
|
| Rate for Payer: HealthUtah PPO |
$801.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$776.97
|
| Rate for Payer: Multiplan Medicare/VA |
$134.39
|
| Rate for Payer: One Health Plan of WY PPO |
$784.98
|
| Rate for Payer: PacificSource Commercial |
$720.90
|
| Rate for Payer: PHCS PPO |
$760.95
|
| Rate for Payer: Three Rivers PPO |
$600.75
|
| Rate for Payer: TriWest Veterans Administration |
$158.11
|
| Rate for Payer: United Healthcare Commercial |
$696.87
|
| Rate for Payer: United Healthcare Medicare |
$158.11
|
| Rate for Payer: WINHealth Partners Commercial |
$680.85
|
|
|
HC PRO I&D BARTHOLIN GLAND ABSCESS
|
Professional
|
Both
|
$663.00
|
|
|
Service Code
|
HCPCS 56420
|
| Hospital Charge Code |
9835642001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$91.49 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$649.74
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$519.40
|
| Rate for Payer: Aetna of WY Medicare |
$107.64
|
| Rate for Payer: Aetna of WY Medicare |
$107.64
|
| Rate for Payer: Beech Street Commercial |
$503.50
|
| Rate for Payer: Beech Street Commercial |
$629.85
|
| Rate for Payer: Cash Price |
$371.00
|
| Rate for Payer: Cash Price |
$371.00
|
| Rate for Payer: Cash Price |
$464.10
|
| Rate for Payer: Cash Price |
$464.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$643.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$514.10
|
| Rate for Payer: Cigna of WY Commercial |
$519.40
|
| Rate for Payer: Cigna of WY Commercial |
$649.74
|
| Rate for Payer: First Choice Health Commercial |
$477.00
|
| Rate for Payer: First Choice Health Commercial |
$596.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$629.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$503.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$107.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$107.64
|
| Rate for Payer: HealthUtah PPO |
$663.00
|
| Rate for Payer: HealthUtah PPO |
$530.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$643.11
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$514.10
|
| Rate for Payer: Multiplan Medicare/VA |
$91.49
|
| Rate for Payer: Multiplan Medicare/VA |
$91.49
|
| Rate for Payer: One Health Plan of WY PPO |
$649.74
|
| Rate for Payer: One Health Plan of WY PPO |
$519.40
|
| Rate for Payer: PacificSource Commercial |
$477.00
|
| Rate for Payer: PacificSource Commercial |
$596.70
|
| Rate for Payer: PHCS PPO |
$629.85
|
| Rate for Payer: PHCS PPO |
$503.50
|
| Rate for Payer: Three Rivers PPO |
$497.25
|
| Rate for Payer: Three Rivers PPO |
$397.50
|
| Rate for Payer: TriWest Veterans Administration |
$107.64
|
| Rate for Payer: TriWest Veterans Administration |
$107.64
|
| Rate for Payer: United Healthcare Commercial |
$461.10
|
| Rate for Payer: United Healthcare Commercial |
$576.81
|
| Rate for Payer: United Healthcare Medicare |
$107.64
|
| Rate for Payer: United Healthcare Medicare |
$107.64
|
| Rate for Payer: WINHealth Partners Commercial |
$563.55
|
| Rate for Payer: WINHealth Partners Commercial |
$450.50
|
|
|
HC PRO I&D BARTHOLIN GLAND ABSCESS
|
Professional
|
Both
|
$663.00
|
|
|
Service Code
|
HCPCS 56420 NONPBBPAYER
|
| Hospital Charge Code |
9835642001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$91.49 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$649.74
|
| Rate for Payer: Aetna of WY Medicare |
$107.64
|
| Rate for Payer: Beech Street Commercial |
$629.85
|
| Rate for Payer: Cash Price |
$464.10
|
| Rate for Payer: Cash Price |
$464.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$643.11
|
| Rate for Payer: Cigna of WY Commercial |
$649.74
|
| Rate for Payer: First Choice Health Commercial |
$596.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$629.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$107.64
|
| Rate for Payer: HealthUtah PPO |
$663.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$643.11
|
| Rate for Payer: Multiplan Medicare/VA |
$91.49
|
| Rate for Payer: One Health Plan of WY PPO |
$649.74
|
| Rate for Payer: PacificSource Commercial |
$596.70
|
| Rate for Payer: PHCS PPO |
$629.85
|
| Rate for Payer: Three Rivers PPO |
$497.25
|
| Rate for Payer: TriWest Veterans Administration |
$107.64
|
| Rate for Payer: United Healthcare Commercial |
$576.81
|
| Rate for Payer: United Healthcare Medicare |
$107.64
|
| Rate for Payer: WINHealth Partners Commercial |
$563.55
|
|
|
HC PRO I&D COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 10180
|
| Hospital Charge Code |
9831018001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$146.31 |
| Max. Negotiated Rate |
$710.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$695.80
|
| Rate for Payer: Aetna of WY Medicare |
$172.13
|
| Rate for Payer: Beech Street Commercial |
$674.50
|
| Rate for Payer: Cash Price |
$497.00
|
| Rate for Payer: Cash Price |
$497.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$688.70
|
| Rate for Payer: Cigna of WY Commercial |
$695.80
|
| Rate for Payer: First Choice Health Commercial |
$639.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$674.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$172.13
|
| Rate for Payer: HealthUtah PPO |
$710.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$688.70
|
| Rate for Payer: Multiplan Medicare/VA |
$146.31
|
| Rate for Payer: One Health Plan of WY PPO |
$695.80
|
| Rate for Payer: PacificSource Commercial |
$639.00
|
| Rate for Payer: PHCS PPO |
$674.50
|
| Rate for Payer: Three Rivers PPO |
$532.50
|
| Rate for Payer: TriWest Veterans Administration |
$172.13
|
| Rate for Payer: United Healthcare Commercial |
$617.70
|
| Rate for Payer: United Healthcare Medicare |
$172.13
|
| Rate for Payer: WINHealth Partners Commercial |
$603.50
|
|
|
HC PRO I&D COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 10180 NONPBBPAYER
|
| Hospital Charge Code |
9831018001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$146.31 |
| Max. Negotiated Rate |
$888.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$870.24
|
| Rate for Payer: Aetna of WY Medicare |
$172.13
|
| Rate for Payer: Beech Street Commercial |
$843.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$861.36
|
| Rate for Payer: Cigna of WY Commercial |
$870.24
|
| Rate for Payer: First Choice Health Commercial |
$799.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$843.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$172.13
|
| Rate for Payer: HealthUtah PPO |
$888.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$861.36
|
| Rate for Payer: Multiplan Medicare/VA |
$146.31
|
| Rate for Payer: One Health Plan of WY PPO |
$870.24
|
| Rate for Payer: PacificSource Commercial |
$799.20
|
| Rate for Payer: PHCS PPO |
$843.60
|
| Rate for Payer: Three Rivers PPO |
$666.00
|
| Rate for Payer: TriWest Veterans Administration |
$172.13
|
| Rate for Payer: United Healthcare Commercial |
$772.56
|
| Rate for Payer: United Healthcare Medicare |
$172.13
|
| Rate for Payer: WINHealth Partners Commercial |
$754.80
|
|
|
HC PRO I&D DEEP ABSC BURSA THIGH/KNEE PRO FEE
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 27301
|
| Hospital Charge Code |
9832730101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$420.60 |
| Max. Negotiated Rate |
$2,600.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,548.00
|
| Rate for Payer: Aetna of WY Medicare |
$494.82
|
| Rate for Payer: Beech Street Commercial |
$2,470.00
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,522.00
|
| Rate for Payer: Cigna of WY Commercial |
$2,548.00
|
| Rate for Payer: First Choice Health Commercial |
$2,340.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,470.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$494.82
|
| Rate for Payer: HealthUtah PPO |
$2,600.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,522.00
|
| Rate for Payer: Multiplan Medicare/VA |
$420.60
|
| Rate for Payer: One Health Plan of WY PPO |
$2,548.00
|
| Rate for Payer: PacificSource Commercial |
$2,340.00
|
| Rate for Payer: PHCS PPO |
$2,470.00
|
| Rate for Payer: Three Rivers PPO |
$1,950.00
|
| Rate for Payer: TriWest Veterans Administration |
$494.82
|
| Rate for Payer: United Healthcare Commercial |
$2,262.00
|
| Rate for Payer: United Healthcare Medicare |
$494.82
|
| Rate for Payer: WINHealth Partners Commercial |
$2,210.00
|
|
|
HC PRO I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC
|
Professional
|
Both
|
$3,869.00
|
|
|
Service Code
|
HCPCS 22015
|
| Hospital Charge Code |
9832201501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$776.41 |
| Max. Negotiated Rate |
$3,869.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,791.62
|
| Rate for Payer: Aetna of WY Medicare |
$913.42
|
| Rate for Payer: Beech Street Commercial |
$3,675.55
|
| Rate for Payer: Cash Price |
$2,708.30
|
| Rate for Payer: Cash Price |
$2,708.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,752.93
|
| Rate for Payer: Cigna of WY Commercial |
$3,791.62
|
| Rate for Payer: First Choice Health Commercial |
$3,482.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,675.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$913.42
|
| Rate for Payer: HealthUtah PPO |
$3,869.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,752.93
|
| Rate for Payer: Multiplan Medicare/VA |
$776.41
|
| Rate for Payer: One Health Plan of WY PPO |
$3,791.62
|
| Rate for Payer: PacificSource Commercial |
$3,482.10
|
| Rate for Payer: PHCS PPO |
$3,675.55
|
| Rate for Payer: Three Rivers PPO |
$2,901.75
|
| Rate for Payer: TriWest Veterans Administration |
$913.42
|
| Rate for Payer: United Healthcare Commercial |
$3,366.03
|
| Rate for Payer: United Healthcare Medicare |
$913.42
|
| Rate for Payer: WINHealth Partners Commercial |
$3,288.65
|
|
|
HC PRO I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$3,993.00
|
|
|
Service Code
|
HCPCS 25028
|
| Hospital Charge Code |
9832502801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$576.56 |
| Max. Negotiated Rate |
$3,993.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,913.14
|
| Rate for Payer: Aetna of WY Medicare |
$678.31
|
| Rate for Payer: Beech Street Commercial |
$3,793.35
|
| Rate for Payer: Cash Price |
$2,795.10
|
| Rate for Payer: Cash Price |
$2,795.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,873.21
|
| Rate for Payer: Cigna of WY Commercial |
$3,913.14
|
| Rate for Payer: First Choice Health Commercial |
$3,593.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,793.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$678.31
|
| Rate for Payer: HealthUtah PPO |
$3,993.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,873.21
|
| Rate for Payer: Multiplan Medicare/VA |
$576.56
|
| Rate for Payer: One Health Plan of WY PPO |
$3,913.14
|
| Rate for Payer: PacificSource Commercial |
$3,593.70
|
| Rate for Payer: PHCS PPO |
$3,793.35
|
| Rate for Payer: Three Rivers PPO |
$2,994.75
|
| Rate for Payer: TriWest Veterans Administration |
$678.31
|
| Rate for Payer: United Healthcare Commercial |
$3,473.91
|
| Rate for Payer: United Healthcare Medicare |
$678.31
|
| Rate for Payer: WINHealth Partners Commercial |
$3,394.05
|
|
|
HC PRO I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$4,486.00
|
|
|
Service Code
|
HCPCS 46060
|
| Hospital Charge Code |
9834606001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$401.05 |
| Max. Negotiated Rate |
$4,486.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,396.28
|
| Rate for Payer: Aetna of WY Medicare |
$471.82
|
| Rate for Payer: Beech Street Commercial |
$4,261.70
|
| Rate for Payer: Cash Price |
$3,140.20
|
| Rate for Payer: Cash Price |
$3,140.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,351.42
|
| Rate for Payer: Cigna of WY Commercial |
$4,396.28
|
| Rate for Payer: First Choice Health Commercial |
$4,037.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,261.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$471.82
|
| Rate for Payer: HealthUtah PPO |
$4,486.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,351.42
|
| Rate for Payer: Multiplan Medicare/VA |
$401.05
|
| Rate for Payer: One Health Plan of WY PPO |
$4,396.28
|
| Rate for Payer: PacificSource Commercial |
$4,037.40
|
| Rate for Payer: PHCS PPO |
$4,261.70
|
| Rate for Payer: Three Rivers PPO |
$3,364.50
|
| Rate for Payer: TriWest Veterans Administration |
$471.82
|
| Rate for Payer: United Healthcare Commercial |
$3,902.82
|
| Rate for Payer: United Healthcare Medicare |
$471.82
|
| Rate for Payer: WINHealth Partners Commercial |
$3,813.10
|
|
|
HC PRO I&D LEG/ANKLE;DEEP ABSCESS
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 27603
|
| Hospital Charge Code |
9832760301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$322.08 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,575.84
|
| Rate for Payer: Aetna of WY Medicare |
$378.92
|
| Rate for Payer: Beech Street Commercial |
$1,527.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,559.76
|
| Rate for Payer: Cigna of WY Commercial |
$1,575.84
|
| Rate for Payer: First Choice Health Commercial |
$1,447.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,527.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$378.92
|
| Rate for Payer: HealthUtah PPO |
$1,608.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,559.76
|
| Rate for Payer: Multiplan Medicare/VA |
$322.08
|
| Rate for Payer: One Health Plan of WY PPO |
$1,575.84
|
| Rate for Payer: PacificSource Commercial |
$1,447.20
|
| Rate for Payer: PHCS PPO |
$1,527.60
|
| Rate for Payer: Three Rivers PPO |
$1,206.00
|
| Rate for Payer: TriWest Veterans Administration |
$378.92
|
| Rate for Payer: United Healthcare Commercial |
$1,398.96
|
| Rate for Payer: United Healthcare Medicare |
$378.92
|
| Rate for Payer: WINHealth Partners Commercial |
$1,366.80
|
|
|
HC PRO I&D LEG/ANKLE;DEEP ABSCESS
|
Professional
|
Both
|
$2,010.00
|
|
|
Service Code
|
HCPCS 27603 NONPBBPAYER
|
| Hospital Charge Code |
9832760301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$322.08 |
| Max. Negotiated Rate |
$2,010.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,969.80
|
| Rate for Payer: Aetna of WY Medicare |
$378.92
|
| Rate for Payer: Beech Street Commercial |
$1,909.50
|
| Rate for Payer: Cash Price |
$1,407.00
|
| Rate for Payer: Cash Price |
$1,407.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,949.70
|
| Rate for Payer: Cigna of WY Commercial |
$1,969.80
|
| Rate for Payer: First Choice Health Commercial |
$1,809.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,909.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$378.92
|
| Rate for Payer: HealthUtah PPO |
$2,010.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,949.70
|
| Rate for Payer: Multiplan Medicare/VA |
$322.08
|
| Rate for Payer: One Health Plan of WY PPO |
$1,969.80
|
| Rate for Payer: PacificSource Commercial |
$1,809.00
|
| Rate for Payer: PHCS PPO |
$1,909.50
|
| Rate for Payer: Three Rivers PPO |
$1,507.50
|
| Rate for Payer: TriWest Veterans Administration |
$378.92
|
| Rate for Payer: United Healthcare Commercial |
$1,748.70
|
| Rate for Payer: United Healthcare Medicare |
$378.92
|
| Rate for Payer: WINHealth Partners Commercial |
$1,708.50
|
|
|
HC PRO I&D MOUTH INTRA,SUBMANDIBULAR
|
Professional
|
Both
|
$1,475.00
|
|
|
Service Code
|
HCPCS 41008
|
| Hospital Charge Code |
9834100801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$1,475.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,445.50
|
| Rate for Payer: Aetna of WY Medicare |
$250.83
|
| Rate for Payer: Beech Street Commercial |
$1,401.25
|
| Rate for Payer: Cash Price |
$1,032.50
|
| Rate for Payer: Cash Price |
$1,032.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,430.75
|
| Rate for Payer: Cigna of WY Commercial |
$1,445.50
|
| Rate for Payer: First Choice Health Commercial |
$1,327.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,401.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$250.83
|
| Rate for Payer: HealthUtah PPO |
$1,475.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,430.75
|
| Rate for Payer: Multiplan Medicare/VA |
$213.21
|
| Rate for Payer: One Health Plan of WY PPO |
$1,445.50
|
| Rate for Payer: PacificSource Commercial |
$1,327.50
|
| Rate for Payer: PHCS PPO |
$1,401.25
|
| Rate for Payer: Three Rivers PPO |
$1,106.25
|
| Rate for Payer: TriWest Veterans Administration |
$250.83
|
| Rate for Payer: United Healthcare Commercial |
$1,283.25
|
| Rate for Payer: United Healthcare Medicare |
$250.83
|
| Rate for Payer: WINHealth Partners Commercial |
$1,253.75
|
|
|
HC PRO I&D NECK/ CHEST LESION
|
Professional
|
Both
|
$1,342.00
|
|
|
Service Code
|
HCPCS 21501
|
| Hospital Charge Code |
9832150101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$279.33 |
| Max. Negotiated Rate |
$1,342.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,315.16
|
| Rate for Payer: Aetna of WY Medicare |
$328.62
|
| Rate for Payer: Beech Street Commercial |
$1,274.90
|
| Rate for Payer: Cash Price |
$939.40
|
| Rate for Payer: Cash Price |
$939.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,301.74
|
| Rate for Payer: Cigna of WY Commercial |
$1,315.16
|
| Rate for Payer: First Choice Health Commercial |
$1,207.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,274.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$328.62
|
| Rate for Payer: HealthUtah PPO |
$1,342.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,301.74
|
| Rate for Payer: Multiplan Medicare/VA |
$279.33
|
| Rate for Payer: One Health Plan of WY PPO |
$1,315.16
|
| Rate for Payer: PacificSource Commercial |
$1,207.80
|
| Rate for Payer: PHCS PPO |
$1,274.90
|
| Rate for Payer: Three Rivers PPO |
$1,006.50
|
| Rate for Payer: TriWest Veterans Administration |
$328.62
|
| Rate for Payer: United Healthcare Commercial |
$1,167.54
|
| Rate for Payer: United Healthcare Medicare |
$328.62
|
| Rate for Payer: WINHealth Partners Commercial |
$1,140.70
|
|
|
HC PRO I&D NECK/ CHEST LESION
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 21501 NONPBBPAYER
|
| Hospital Charge Code |
9832150101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$279.33 |
| Max. Negotiated Rate |
$1,678.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,644.44
|
| Rate for Payer: Aetna of WY Medicare |
$328.62
|
| Rate for Payer: Beech Street Commercial |
$1,594.10
|
| Rate for Payer: Cash Price |
$1,174.60
|
| Rate for Payer: Cash Price |
$1,174.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,627.66
|
| Rate for Payer: Cigna of WY Commercial |
$1,644.44
|
| Rate for Payer: First Choice Health Commercial |
$1,510.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,594.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$328.62
|
| Rate for Payer: HealthUtah PPO |
$1,678.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,627.66
|
| Rate for Payer: Multiplan Medicare/VA |
$279.33
|
| Rate for Payer: One Health Plan of WY PPO |
$1,644.44
|
| Rate for Payer: PacificSource Commercial |
$1,510.20
|
| Rate for Payer: PHCS PPO |
$1,594.10
|
| Rate for Payer: Three Rivers PPO |
$1,258.50
|
| Rate for Payer: TriWest Veterans Administration |
$328.62
|
| Rate for Payer: United Healthcare Commercial |
$1,459.86
|
| Rate for Payer: United Healthcare Medicare |
$328.62
|
| Rate for Payer: WINHealth Partners Commercial |
$1,426.30
|
|
|
HC PRO I&D PERIANAL ABSCESS,SUPERFICIAL
|
Professional
|
Both
|
$511.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
9834605001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$83.70 |
| Max. Negotiated Rate |
$511.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$500.78
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$659.54
|
| Rate for Payer: Aetna of WY Medicare |
$98.47
|
| Rate for Payer: Aetna of WY Medicare |
$98.47
|
| Rate for Payer: Beech Street Commercial |
$639.35
|
| Rate for Payer: Beech Street Commercial |
$485.45
|
| Rate for Payer: Cash Price |
$471.10
|
| Rate for Payer: Cash Price |
$357.70
|
| Rate for Payer: Cash Price |
$357.70
|
| Rate for Payer: Cash Price |
$471.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$652.81
|
| Rate for Payer: ChoiceCare Network Commercial |
$495.67
|
| Rate for Payer: Cigna of WY Commercial |
$500.78
|
| Rate for Payer: Cigna of WY Commercial |
$659.54
|
| Rate for Payer: First Choice Health Commercial |
$605.70
|
| Rate for Payer: First Choice Health Commercial |
$459.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$485.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$639.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$98.47
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$98.47
|
| Rate for Payer: HealthUtah PPO |
$511.00
|
| Rate for Payer: HealthUtah PPO |
$673.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$652.81
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$495.67
|
| Rate for Payer: Multiplan Medicare/VA |
$83.70
|
| Rate for Payer: Multiplan Medicare/VA |
$83.70
|
| Rate for Payer: One Health Plan of WY PPO |
$659.54
|
| Rate for Payer: One Health Plan of WY PPO |
$500.78
|
| Rate for Payer: PacificSource Commercial |
$459.90
|
| Rate for Payer: PacificSource Commercial |
$605.70
|
| Rate for Payer: PHCS PPO |
$485.45
|
| Rate for Payer: PHCS PPO |
$639.35
|
| Rate for Payer: Three Rivers PPO |
$383.25
|
| Rate for Payer: Three Rivers PPO |
$504.75
|
| Rate for Payer: TriWest Veterans Administration |
$98.47
|
| Rate for Payer: TriWest Veterans Administration |
$98.47
|
| Rate for Payer: United Healthcare Commercial |
$585.51
|
| Rate for Payer: United Healthcare Commercial |
$444.57
|
| Rate for Payer: United Healthcare Medicare |
$98.47
|
| Rate for Payer: United Healthcare Medicare |
$98.47
|
| Rate for Payer: WINHealth Partners Commercial |
$434.35
|
| Rate for Payer: WINHealth Partners Commercial |
$572.05
|
|
|
HC PRO I&D PERIRECTAL ABSCESS
|
Professional
|
Both
|
$2,174.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
9834604001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$350.54 |
| Max. Negotiated Rate |
$2,174.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,130.52
|
| Rate for Payer: Aetna of WY Medicare |
$412.40
|
| Rate for Payer: Beech Street Commercial |
$2,065.30
|
| Rate for Payer: Cash Price |
$1,521.80
|
| Rate for Payer: Cash Price |
$1,521.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,108.78
|
| Rate for Payer: Cigna of WY Commercial |
$2,130.52
|
| Rate for Payer: First Choice Health Commercial |
$1,956.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,065.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$412.40
|
| Rate for Payer: HealthUtah PPO |
$2,174.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,108.78
|
| Rate for Payer: Multiplan Medicare/VA |
$350.54
|
| Rate for Payer: One Health Plan of WY PPO |
$2,130.52
|
| Rate for Payer: PacificSource Commercial |
$1,956.60
|
| Rate for Payer: PHCS PPO |
$2,065.30
|
| Rate for Payer: Three Rivers PPO |
$1,630.50
|
| Rate for Payer: TriWest Veterans Administration |
$412.40
|
| Rate for Payer: United Healthcare Commercial |
$1,891.38
|
| Rate for Payer: United Healthcare Medicare |
$412.40
|
| Rate for Payer: WINHealth Partners Commercial |
$1,847.90
|
|
|
HC PRO I&D SHOULDER DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$2,237.00
|
|
|
Service Code
|
HCPCS 23030
|
| Hospital Charge Code |
9832303001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$2,237.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,192.26
|
| Rate for Payer: Aetna of WY Medicare |
$247.13
|
| Rate for Payer: Beech Street Commercial |
$2,125.15
|
| Rate for Payer: Cash Price |
$1,565.90
|
| Rate for Payer: Cash Price |
$1,565.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,169.89
|
| Rate for Payer: Cigna of WY Commercial |
$2,192.26
|
| Rate for Payer: First Choice Health Commercial |
$2,013.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,125.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$247.13
|
| Rate for Payer: HealthUtah PPO |
$2,237.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,169.89
|
| Rate for Payer: Multiplan Medicare/VA |
$210.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,192.26
|
| Rate for Payer: PacificSource Commercial |
$2,013.30
|
| Rate for Payer: PHCS PPO |
$2,125.15
|
| Rate for Payer: Three Rivers PPO |
$1,677.75
|
| Rate for Payer: TriWest Veterans Administration |
$247.13
|
| Rate for Payer: United Healthcare Commercial |
$1,946.19
|
| Rate for Payer: United Healthcare Medicare |
$247.13
|
| Rate for Payer: WINHealth Partners Commercial |
$1,901.45
|
|
|
HC PRO I&D SUBMUCOSAL ABSCESS RECTUM
|
Professional
|
Both
|
$5,267.00
|
|
|
Service Code
|
HCPCS 45005
|
| Hospital Charge Code |
9834500501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$135.46 |
| Max. Negotiated Rate |
$5,267.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,161.66
|
| Rate for Payer: Aetna of WY Medicare |
$159.36
|
| Rate for Payer: Beech Street Commercial |
$5,003.65
|
| Rate for Payer: Cash Price |
$3,686.90
|
| Rate for Payer: Cash Price |
$3,686.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,108.99
|
| Rate for Payer: Cigna of WY Commercial |
$5,161.66
|
| Rate for Payer: First Choice Health Commercial |
$4,740.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,003.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$159.36
|
| Rate for Payer: HealthUtah PPO |
$5,267.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,108.99
|
| Rate for Payer: Multiplan Medicare/VA |
$135.46
|
| Rate for Payer: One Health Plan of WY PPO |
$5,161.66
|
| Rate for Payer: PacificSource Commercial |
$4,740.30
|
| Rate for Payer: PHCS PPO |
$5,003.65
|
| Rate for Payer: Three Rivers PPO |
$3,950.25
|
| Rate for Payer: TriWest Veterans Administration |
$159.36
|
| Rate for Payer: United Healthcare Commercial |
$4,582.29
|
| Rate for Payer: United Healthcare Medicare |
$159.36
|
| Rate for Payer: WINHealth Partners Commercial |
$4,476.95
|
|
|
HC PRO I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$875.00
|
|
|
Service Code
|
HCPCS 23930
|
| Hospital Charge Code |
9832393001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$177.17 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$857.50
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,423.94
|
| Rate for Payer: Aetna of WY Medicare |
$208.44
|
| Rate for Payer: Aetna of WY Medicare |
$208.44
|
| Rate for Payer: Beech Street Commercial |
$1,380.35
|
| Rate for Payer: Beech Street Commercial |
$831.25
|
| Rate for Payer: Cash Price |
$1,017.10
|
| Rate for Payer: Cash Price |
$1,017.10
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$848.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,409.41
|
| Rate for Payer: Cigna of WY Commercial |
$1,423.94
|
| Rate for Payer: Cigna of WY Commercial |
$857.50
|
| Rate for Payer: First Choice Health Commercial |
$1,307.70
|
| Rate for Payer: First Choice Health Commercial |
$787.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$831.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,380.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$208.44
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$208.44
|
| Rate for Payer: HealthUtah PPO |
$875.00
|
| Rate for Payer: HealthUtah PPO |
$1,453.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$848.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,409.41
|
| Rate for Payer: Multiplan Medicare/VA |
$177.17
|
| Rate for Payer: Multiplan Medicare/VA |
$177.17
|
| Rate for Payer: One Health Plan of WY PPO |
$857.50
|
| Rate for Payer: One Health Plan of WY PPO |
$1,423.94
|
| Rate for Payer: PacificSource Commercial |
$1,307.70
|
| Rate for Payer: PacificSource Commercial |
$787.50
|
| Rate for Payer: PHCS PPO |
$831.25
|
| Rate for Payer: PHCS PPO |
$1,380.35
|
| Rate for Payer: Three Rivers PPO |
$656.25
|
| Rate for Payer: Three Rivers PPO |
$1,089.75
|
| Rate for Payer: TriWest Veterans Administration |
$208.44
|
| Rate for Payer: TriWest Veterans Administration |
$208.44
|
| Rate for Payer: United Healthcare Commercial |
$1,264.11
|
| Rate for Payer: United Healthcare Commercial |
$761.25
|
| Rate for Payer: United Healthcare Medicare |
$208.44
|
| Rate for Payer: United Healthcare Medicare |
$208.44
|
| Rate for Payer: WINHealth Partners Commercial |
$743.75
|
| Rate for Payer: WINHealth Partners Commercial |
$1,235.05
|
|
|
HC PRO I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,094.00
|
|
|
Service Code
|
HCPCS 23930 NONPBBPAYER
|
| Hospital Charge Code |
9832393001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$177.17 |
| Max. Negotiated Rate |
$1,094.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,072.12
|
| Rate for Payer: Aetna of WY Medicare |
$208.44
|
| Rate for Payer: Beech Street Commercial |
$1,039.30
|
| Rate for Payer: Cash Price |
$765.80
|
| Rate for Payer: Cash Price |
$765.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,061.18
|
| Rate for Payer: Cigna of WY Commercial |
$1,072.12
|
| Rate for Payer: First Choice Health Commercial |
$984.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,039.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$208.44
|
| Rate for Payer: HealthUtah PPO |
$1,094.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,061.18
|
| Rate for Payer: Multiplan Medicare/VA |
$177.17
|
| Rate for Payer: One Health Plan of WY PPO |
$1,072.12
|
| Rate for Payer: PacificSource Commercial |
$984.60
|
| Rate for Payer: PHCS PPO |
$1,039.30
|
| Rate for Payer: Three Rivers PPO |
$820.50
|
| Rate for Payer: TriWest Veterans Administration |
$208.44
|
| Rate for Payer: United Healthcare Commercial |
$951.78
|
| Rate for Payer: United Healthcare Medicare |
$208.44
|
| Rate for Payer: WINHealth Partners Commercial |
$929.90
|
|
|
HC PRO I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 56405
|
| Hospital Charge Code |
9835640501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$105.34 |
| Max. Negotiated Rate |
$477.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$467.46
|
| Rate for Payer: Aetna of WY Medicare |
$123.93
|
| Rate for Payer: Beech Street Commercial |
$453.15
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$462.69
|
| Rate for Payer: Cigna of WY Commercial |
$467.46
|
| Rate for Payer: First Choice Health Commercial |
$429.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$453.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$123.93
|
| Rate for Payer: HealthUtah PPO |
$477.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$462.69
|
| Rate for Payer: Multiplan Medicare/VA |
$105.34
|
| Rate for Payer: One Health Plan of WY PPO |
$467.46
|
| Rate for Payer: PacificSource Commercial |
$429.30
|
| Rate for Payer: PHCS PPO |
$453.15
|
| Rate for Payer: Three Rivers PPO |
$357.75
|
| Rate for Payer: TriWest Veterans Administration |
$123.93
|
| Rate for Payer: United Healthcare Commercial |
$414.99
|
| Rate for Payer: United Healthcare Medicare |
$123.93
|
| Rate for Payer: WINHealth Partners Commercial |
$405.45
|
|
|
HC PRO I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 56405 NONPBBPAYER
|
| Hospital Charge Code |
9835640501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$105.34 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$584.08
|
| Rate for Payer: Aetna of WY Medicare |
$123.93
|
| Rate for Payer: Beech Street Commercial |
$566.20
|
| Rate for Payer: Cash Price |
$417.20
|
| Rate for Payer: Cash Price |
$417.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$578.12
|
| Rate for Payer: Cigna of WY Commercial |
$584.08
|
| Rate for Payer: First Choice Health Commercial |
$536.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$566.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$123.93
|
| Rate for Payer: HealthUtah PPO |
$596.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$578.12
|
| Rate for Payer: Multiplan Medicare/VA |
$105.34
|
| Rate for Payer: One Health Plan of WY PPO |
$584.08
|
| Rate for Payer: PacificSource Commercial |
$536.40
|
| Rate for Payer: PHCS PPO |
$566.20
|
| Rate for Payer: Three Rivers PPO |
$447.00
|
| Rate for Payer: TriWest Veterans Administration |
$123.93
|
| Rate for Payer: United Healthcare Commercial |
$518.52
|
| Rate for Payer: United Healthcare Medicare |
$123.93
|
| Rate for Payer: WINHealth Partners Commercial |
$506.60
|
|
