|
HC PRO RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR
|
Professional
|
Both
|
$2,510.00
|
|
|
Service Code
|
HCPCS 28238
|
| Hospital Charge Code |
9822823801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$405.03 |
| Max. Negotiated Rate |
$2,510.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,459.80
|
| Rate for Payer: Aetna of WY Medicare |
$476.51
|
| Rate for Payer: Beech Street Commercial |
$2,384.50
|
| Rate for Payer: Cash Price |
$1,757.00
|
| Rate for Payer: Cash Price |
$1,757.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,434.70
|
| Rate for Payer: Cigna of WY Commercial |
$2,459.80
|
| Rate for Payer: First Choice Health Commercial |
$2,259.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,384.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$476.51
|
| Rate for Payer: HealthUtah PPO |
$2,510.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,434.70
|
| Rate for Payer: Multiplan Medicare/VA |
$405.03
|
| Rate for Payer: One Health Plan of WY PPO |
$2,459.80
|
| Rate for Payer: PacificSource Commercial |
$2,259.00
|
| Rate for Payer: PHCS PPO |
$2,384.50
|
| Rate for Payer: Three Rivers PPO |
$1,882.50
|
| Rate for Payer: TriWest Veterans Administration |
$476.51
|
| Rate for Payer: United Healthcare Commercial |
$2,183.70
|
| Rate for Payer: United Healthcare Medicare |
$476.51
|
| Rate for Payer: WINHealth Partners Commercial |
$2,133.50
|
|
|
HC PRO RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT
|
Professional
|
Both
|
$1,928.00
|
|
|
Service Code
|
HCPCS 44050
|
| Hospital Charge Code |
9754405001
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$754.90 |
| Max. Negotiated Rate |
$1,928.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,889.44
|
| Rate for Payer: Aetna of WY Medicare |
$888.12
|
| Rate for Payer: Beech Street Commercial |
$1,831.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,870.16
|
| Rate for Payer: Cigna of WY Commercial |
$1,889.44
|
| Rate for Payer: First Choice Health Commercial |
$1,735.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,831.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$888.12
|
| Rate for Payer: HealthUtah PPO |
$1,928.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,870.16
|
| Rate for Payer: Multiplan Medicare/VA |
$754.90
|
| Rate for Payer: One Health Plan of WY PPO |
$1,889.44
|
| Rate for Payer: PacificSource Commercial |
$1,735.20
|
| Rate for Payer: PHCS PPO |
$1,831.60
|
| Rate for Payer: Three Rivers PPO |
$1,446.00
|
| Rate for Payer: TriWest Veterans Administration |
$888.12
|
| Rate for Payer: United Healthcare Commercial |
$1,677.36
|
| Rate for Payer: United Healthcare Medicare |
$888.12
|
| Rate for Payer: WINHealth Partners Commercial |
$1,638.80
|
|
|
HC PRO REALIGNMENT EXTENSOR TENDON HAND EACH TENDON
|
Professional
|
Both
|
$4,047.00
|
|
|
Service Code
|
HCPCS 26437
|
| Hospital Charge Code |
9832643701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$556.72 |
| Max. Negotiated Rate |
$4,047.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,966.06
|
| Rate for Payer: Aetna of WY Medicare |
$654.96
|
| Rate for Payer: Beech Street Commercial |
$3,844.65
|
| Rate for Payer: Cash Price |
$2,832.90
|
| Rate for Payer: Cash Price |
$2,832.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,925.59
|
| Rate for Payer: Cigna of WY Commercial |
$3,966.06
|
| Rate for Payer: First Choice Health Commercial |
$3,642.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,844.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$654.96
|
| Rate for Payer: HealthUtah PPO |
$4,047.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,925.59
|
| Rate for Payer: Multiplan Medicare/VA |
$556.72
|
| Rate for Payer: One Health Plan of WY PPO |
$3,966.06
|
| Rate for Payer: PacificSource Commercial |
$3,642.30
|
| Rate for Payer: PHCS PPO |
$3,844.65
|
| Rate for Payer: Three Rivers PPO |
$3,035.25
|
| Rate for Payer: TriWest Veterans Administration |
$654.96
|
| Rate for Payer: United Healthcare Commercial |
$3,520.89
|
| Rate for Payer: United Healthcare Medicare |
$654.96
|
| Rate for Payer: WINHealth Partners Commercial |
$3,439.95
|
|
|
HC PRO RECONSTRUCTION COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF
|
Professional
|
Both
|
$6,567.00
|
|
|
Service Code
|
HCPCS 26541
|
| Hospital Charge Code |
9832654101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$694.54 |
| Max. Negotiated Rate |
$6,567.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,435.66
|
| Rate for Payer: Aetna of WY Medicare |
$817.10
|
| Rate for Payer: Beech Street Commercial |
$6,238.65
|
| Rate for Payer: Cash Price |
$4,596.90
|
| Rate for Payer: Cash Price |
$4,596.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,369.99
|
| Rate for Payer: Cigna of WY Commercial |
$6,435.66
|
| Rate for Payer: First Choice Health Commercial |
$5,910.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,238.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$817.10
|
| Rate for Payer: HealthUtah PPO |
$6,567.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,369.99
|
| Rate for Payer: Multiplan Medicare/VA |
$694.54
|
| Rate for Payer: One Health Plan of WY PPO |
$6,435.66
|
| Rate for Payer: PacificSource Commercial |
$5,910.30
|
| Rate for Payer: PHCS PPO |
$6,238.65
|
| Rate for Payer: Three Rivers PPO |
$4,925.25
|
| Rate for Payer: TriWest Veterans Administration |
$817.10
|
| Rate for Payer: United Healthcare Commercial |
$5,713.29
|
| Rate for Payer: United Healthcare Medicare |
$817.10
|
| Rate for Payer: WINHealth Partners Commercial |
$5,581.95
|
|
|
HC PRO RECONSTRUCTION OF NOSE
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 30400
|
| Hospital Charge Code |
9833040001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,016.32 |
| Max. Negotiated Rate |
$3,414.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,345.72
|
| Rate for Payer: Aetna of WY Medicare |
$1,195.67
|
| Rate for Payer: Beech Street Commercial |
$3,243.30
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: Cash Price |
$2,389.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,311.58
|
| Rate for Payer: Cigna of WY Commercial |
$3,345.72
|
| Rate for Payer: First Choice Health Commercial |
$3,072.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,243.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,195.67
|
| Rate for Payer: HealthUtah PPO |
$3,414.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,311.58
|
| Rate for Payer: Multiplan Medicare/VA |
$1,016.32
|
| Rate for Payer: One Health Plan of WY PPO |
$3,345.72
|
| Rate for Payer: PacificSource Commercial |
$3,072.60
|
| Rate for Payer: PHCS PPO |
$3,243.30
|
| Rate for Payer: Three Rivers PPO |
$2,560.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,195.67
|
| Rate for Payer: United Healthcare Commercial |
$2,970.18
|
| Rate for Payer: United Healthcare Medicare |
$1,195.67
|
| Rate for Payer: WINHealth Partners Commercial |
$2,901.90
|
|
|
HC PRO RECONSTRUCTION OF NOSE
|
Professional
|
Both
|
$4,267.00
|
|
|
Service Code
|
HCPCS 30400 NONPBBPAYER
|
| Hospital Charge Code |
9833040001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,016.32 |
| Max. Negotiated Rate |
$4,267.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,181.66
|
| Rate for Payer: Aetna of WY Medicare |
$1,195.67
|
| Rate for Payer: Beech Street Commercial |
$4,053.65
|
| Rate for Payer: Cash Price |
$2,986.90
|
| Rate for Payer: Cash Price |
$2,986.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,138.99
|
| Rate for Payer: Cigna of WY Commercial |
$4,181.66
|
| Rate for Payer: First Choice Health Commercial |
$3,840.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,053.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,195.67
|
| Rate for Payer: HealthUtah PPO |
$4,267.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,138.99
|
| Rate for Payer: Multiplan Medicare/VA |
$1,016.32
|
| Rate for Payer: One Health Plan of WY PPO |
$4,181.66
|
| Rate for Payer: PacificSource Commercial |
$3,840.30
|
| Rate for Payer: PHCS PPO |
$4,053.65
|
| Rate for Payer: Three Rivers PPO |
$3,200.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,195.67
|
| Rate for Payer: United Healthcare Commercial |
$3,712.29
|
| Rate for Payer: United Healthcare Medicare |
$1,195.67
|
| Rate for Payer: WINHealth Partners Commercial |
$3,626.95
|
|
|
HC PRO RECONSTRUCTION ROTATOR CUFF AVULSION,CHRONIC
|
Professional
|
Both
|
$4,981.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
9832342001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$801.85 |
| Max. Negotiated Rate |
$4,981.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,881.38
|
| Rate for Payer: Aetna of WY Medicare |
$943.35
|
| Rate for Payer: Beech Street Commercial |
$4,731.95
|
| Rate for Payer: Cash Price |
$3,486.70
|
| Rate for Payer: Cash Price |
$3,486.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,831.57
|
| Rate for Payer: Cigna of WY Commercial |
$4,881.38
|
| Rate for Payer: First Choice Health Commercial |
$4,482.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,731.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$943.35
|
| Rate for Payer: HealthUtah PPO |
$4,981.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,831.57
|
| Rate for Payer: Multiplan Medicare/VA |
$801.85
|
| Rate for Payer: One Health Plan of WY PPO |
$4,881.38
|
| Rate for Payer: PacificSource Commercial |
$4,482.90
|
| Rate for Payer: PHCS PPO |
$4,731.95
|
| Rate for Payer: Three Rivers PPO |
$3,735.75
|
| Rate for Payer: TriWest Veterans Administration |
$943.35
|
| Rate for Payer: United Healthcare Commercial |
$4,333.47
|
| Rate for Payer: United Healthcare Medicare |
$943.35
|
| Rate for Payer: WINHealth Partners Commercial |
$4,233.85
|
|
|
HC PRO REDUCIBLE EPIGASTRIC HERNIA REPAIR
|
Professional
|
Both
|
$2,160.00
|
|
|
Service Code
|
HCPCS 49570
|
| Hospital Charge Code |
9834957001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,620.00 |
| Max. Negotiated Rate |
$2,160.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,116.80
|
| Rate for Payer: Beech Street Commercial |
$2,052.00
|
| Rate for Payer: Cash Price |
$1,512.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,095.20
|
| Rate for Payer: Cigna of WY Commercial |
$2,116.80
|
| Rate for Payer: First Choice Health Commercial |
$1,944.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,052.00
|
| Rate for Payer: HealthUtah PPO |
$2,160.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,095.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2,116.80
|
| Rate for Payer: PacificSource Commercial |
$1,944.00
|
| Rate for Payer: PHCS PPO |
$2,052.00
|
| Rate for Payer: Three Rivers PPO |
$1,620.00
|
| Rate for Payer: United Healthcare Commercial |
$1,879.20
|
| Rate for Payer: WINHealth Partners Commercial |
$1,836.00
|
|
|
HC PRO RELEASE I-P JT CONTRACTURE
|
Professional
|
Both
|
$4,168.00
|
|
|
Service Code
|
HCPCS 26525
|
| Hospital Charge Code |
9832652501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$572.61 |
| Max. Negotiated Rate |
$4,168.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,084.64
|
| Rate for Payer: Aetna of WY Medicare |
$673.66
|
| Rate for Payer: Beech Street Commercial |
$3,959.60
|
| Rate for Payer: Cash Price |
$2,917.60
|
| Rate for Payer: Cash Price |
$2,917.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,042.96
|
| Rate for Payer: Cigna of WY Commercial |
$4,084.64
|
| Rate for Payer: First Choice Health Commercial |
$3,751.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,959.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$673.66
|
| Rate for Payer: HealthUtah PPO |
$4,168.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,042.96
|
| Rate for Payer: Multiplan Medicare/VA |
$572.61
|
| Rate for Payer: One Health Plan of WY PPO |
$4,084.64
|
| Rate for Payer: PacificSource Commercial |
$3,751.20
|
| Rate for Payer: PHCS PPO |
$3,959.60
|
| Rate for Payer: Three Rivers PPO |
$3,126.00
|
| Rate for Payer: TriWest Veterans Administration |
$673.66
|
| Rate for Payer: United Healthcare Commercial |
$3,626.16
|
| Rate for Payer: United Healthcare Medicare |
$673.66
|
| Rate for Payer: WINHealth Partners Commercial |
$3,542.80
|
|
|
HC PRO RELEASE MC-P JT CONTRACTURE
|
Professional
|
Both
|
$3,407.00
|
|
|
Service Code
|
HCPCS 26520
|
| Hospital Charge Code |
9832652001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$569.42 |
| Max. Negotiated Rate |
$3,407.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,338.86
|
| Rate for Payer: Aetna of WY Medicare |
$669.90
|
| Rate for Payer: Beech Street Commercial |
$3,236.65
|
| Rate for Payer: Cash Price |
$2,384.90
|
| Rate for Payer: Cash Price |
$2,384.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,304.79
|
| Rate for Payer: Cigna of WY Commercial |
$3,338.86
|
| Rate for Payer: First Choice Health Commercial |
$3,066.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,236.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$669.90
|
| Rate for Payer: HealthUtah PPO |
$3,407.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,304.79
|
| Rate for Payer: Multiplan Medicare/VA |
$569.42
|
| Rate for Payer: One Health Plan of WY PPO |
$3,338.86
|
| Rate for Payer: PacificSource Commercial |
$3,066.30
|
| Rate for Payer: PHCS PPO |
$3,236.65
|
| Rate for Payer: Three Rivers PPO |
$2,555.25
|
| Rate for Payer: TriWest Veterans Administration |
$669.90
|
| Rate for Payer: United Healthcare Commercial |
$2,964.09
|
| Rate for Payer: United Healthcare Medicare |
$669.90
|
| Rate for Payer: WINHealth Partners Commercial |
$2,895.95
|
|
|
HC PRO RELEASE OF FOOT TENDON
|
Professional
|
Both
|
$4,685.00
|
|
|
Service Code
|
HCPCS 28220
|
| Hospital Charge Code |
9832822001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$254.46 |
| Max. Negotiated Rate |
$4,685.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,591.30
|
| Rate for Payer: Aetna of WY Medicare |
$299.37
|
| Rate for Payer: Beech Street Commercial |
$4,450.75
|
| Rate for Payer: Cash Price |
$3,279.50
|
| Rate for Payer: Cash Price |
$3,279.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,544.45
|
| Rate for Payer: Cigna of WY Commercial |
$4,591.30
|
| Rate for Payer: First Choice Health Commercial |
$4,216.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,450.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$299.37
|
| Rate for Payer: HealthUtah PPO |
$4,685.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,544.45
|
| Rate for Payer: Multiplan Medicare/VA |
$254.46
|
| Rate for Payer: One Health Plan of WY PPO |
$4,591.30
|
| Rate for Payer: PacificSource Commercial |
$4,216.50
|
| Rate for Payer: PHCS PPO |
$4,450.75
|
| Rate for Payer: Three Rivers PPO |
$3,513.75
|
| Rate for Payer: TriWest Veterans Administration |
$299.37
|
| Rate for Payer: United Healthcare Commercial |
$4,075.95
|
| Rate for Payer: United Healthcare Medicare |
$299.37
|
| Rate for Payer: WINHealth Partners Commercial |
$3,982.25
|
|
|
HC PRO RELEASE OF NASAL ADHESIONS
|
Professional
|
Both
|
$1,126.00
|
|
|
Service Code
|
HCPCS 30560
|
| Hospital Charge Code |
9833056001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$126.02 |
| Max. Negotiated Rate |
$1,126.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,103.48
|
| Rate for Payer: Aetna of WY Medicare |
$148.26
|
| Rate for Payer: Beech Street Commercial |
$1,069.70
|
| Rate for Payer: Cash Price |
$788.20
|
| Rate for Payer: Cash Price |
$788.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,092.22
|
| Rate for Payer: Cigna of WY Commercial |
$1,103.48
|
| Rate for Payer: First Choice Health Commercial |
$1,013.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,069.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$148.26
|
| Rate for Payer: HealthUtah PPO |
$1,126.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,092.22
|
| Rate for Payer: Multiplan Medicare/VA |
$126.02
|
| Rate for Payer: One Health Plan of WY PPO |
$1,103.48
|
| Rate for Payer: PacificSource Commercial |
$1,013.40
|
| Rate for Payer: PHCS PPO |
$1,069.70
|
| Rate for Payer: Three Rivers PPO |
$844.50
|
| Rate for Payer: TriWest Veterans Administration |
$148.26
|
| Rate for Payer: United Healthcare Commercial |
$979.62
|
| Rate for Payer: United Healthcare Medicare |
$148.26
|
| Rate for Payer: WINHealth Partners Commercial |
$957.10
|
|
|
HC PRO RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,836.00
|
|
|
Service Code
|
HCPCS 28035
|
| Hospital Charge Code |
9822803501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$297.89 |
| Max. Negotiated Rate |
$1,836.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,799.28
|
| Rate for Payer: Aetna of WY Medicare |
$350.46
|
| Rate for Payer: Beech Street Commercial |
$1,744.20
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,780.92
|
| Rate for Payer: Cigna of WY Commercial |
$1,799.28
|
| Rate for Payer: First Choice Health Commercial |
$1,652.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,744.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$350.46
|
| Rate for Payer: HealthUtah PPO |
$1,836.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,780.92
|
| Rate for Payer: Multiplan Medicare/VA |
$297.89
|
| Rate for Payer: One Health Plan of WY PPO |
$1,799.28
|
| Rate for Payer: PacificSource Commercial |
$1,652.40
|
| Rate for Payer: PHCS PPO |
$1,744.20
|
| Rate for Payer: Three Rivers PPO |
$1,377.00
|
| Rate for Payer: TriWest Veterans Administration |
$350.46
|
| Rate for Payer: United Healthcare Commercial |
$1,597.32
|
| Rate for Payer: United Healthcare Medicare |
$350.46
|
| Rate for Payer: WINHealth Partners Commercial |
$1,560.60
|
|
|
HC PRO REMOVAL CONTRACEPTIVE CAPSULE
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 11976
|
| Hospital Charge Code |
9831197601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$74.92 |
| Max. Negotiated Rate |
$474.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$464.52
|
| Rate for Payer: Aetna of WY Medicare |
$88.14
|
| Rate for Payer: Beech Street Commercial |
$450.30
|
| Rate for Payer: Cash Price |
$331.80
|
| Rate for Payer: Cash Price |
$331.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$459.78
|
| Rate for Payer: Cigna of WY Commercial |
$464.52
|
| Rate for Payer: First Choice Health Commercial |
$426.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$450.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.14
|
| Rate for Payer: HealthUtah PPO |
$474.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$459.78
|
| Rate for Payer: Multiplan Medicare/VA |
$74.92
|
| Rate for Payer: One Health Plan of WY PPO |
$464.52
|
| Rate for Payer: PacificSource Commercial |
$426.60
|
| Rate for Payer: PHCS PPO |
$450.30
|
| Rate for Payer: Three Rivers PPO |
$355.50
|
| Rate for Payer: TriWest Veterans Administration |
$88.14
|
| Rate for Payer: United Healthcare Commercial |
$412.38
|
| Rate for Payer: United Healthcare Medicare |
$88.14
|
| Rate for Payer: WINHealth Partners Commercial |
$402.90
|
|
|
HC PRO REMOVAL DEEP IMPLANT
|
Professional
|
Both
|
$2,155.00
|
|
|
Service Code
|
HCPCS 20680
|
| Hospital Charge Code |
9832068001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$346.05 |
| Max. Negotiated Rate |
$2,155.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,111.90
|
| Rate for Payer: Aetna of WY Medicare |
$407.12
|
| Rate for Payer: Beech Street Commercial |
$2,047.25
|
| Rate for Payer: Cash Price |
$1,508.50
|
| Rate for Payer: Cash Price |
$1,508.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,090.35
|
| Rate for Payer: Cigna of WY Commercial |
$2,111.90
|
| Rate for Payer: First Choice Health Commercial |
$1,939.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,047.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$407.12
|
| Rate for Payer: HealthUtah PPO |
$2,155.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,090.35
|
| Rate for Payer: Multiplan Medicare/VA |
$346.05
|
| Rate for Payer: One Health Plan of WY PPO |
$2,111.90
|
| Rate for Payer: PacificSource Commercial |
$1,939.50
|
| Rate for Payer: PHCS PPO |
$2,047.25
|
| Rate for Payer: Three Rivers PPO |
$1,616.25
|
| Rate for Payer: TriWest Veterans Administration |
$407.12
|
| Rate for Payer: United Healthcare Commercial |
$1,874.85
|
| Rate for Payer: United Healthcare Medicare |
$407.12
|
| Rate for Payer: WINHealth Partners Commercial |
$1,831.75
|
|
|
HC PRO REMOVAL DEVITALIZED TISSUE FROM WOUND
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 97602
|
| Hospital Charge Code |
9839760201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$289.50 |
| Max. Negotiated Rate |
$386.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$378.28
|
| Rate for Payer: Beech Street Commercial |
$366.70
|
| Rate for Payer: Cash Price |
$270.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$374.42
|
| Rate for Payer: Cigna of WY Commercial |
$378.28
|
| Rate for Payer: First Choice Health Commercial |
$347.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$366.70
|
| Rate for Payer: HealthUtah PPO |
$386.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$374.42
|
| Rate for Payer: One Health Plan of WY PPO |
$378.28
|
| Rate for Payer: PacificSource Commercial |
$347.40
|
| Rate for Payer: PHCS PPO |
$366.70
|
| Rate for Payer: Three Rivers PPO |
$289.50
|
| Rate for Payer: United Healthcare Commercial |
$335.82
|
| Rate for Payer: WINHealth Partners Commercial |
$366.70
|
|
|
HC PRO REMOVAL DEVITALIZED TISSUE FROM WOUND
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 97602 NONPBBPAYER
|
| Hospital Charge Code |
9839760201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$362.25 |
| Max. Negotiated Rate |
$483.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$473.34
|
| Rate for Payer: Beech Street Commercial |
$458.85
|
| Rate for Payer: Cash Price |
$338.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$468.51
|
| Rate for Payer: Cigna of WY Commercial |
$473.34
|
| Rate for Payer: First Choice Health Commercial |
$434.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$458.85
|
| Rate for Payer: HealthUtah PPO |
$483.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$468.51
|
| Rate for Payer: One Health Plan of WY PPO |
$473.34
|
| Rate for Payer: PacificSource Commercial |
$434.70
|
| Rate for Payer: PHCS PPO |
$458.85
|
| Rate for Payer: Three Rivers PPO |
$362.25
|
| Rate for Payer: United Healthcare Commercial |
$420.21
|
| Rate for Payer: WINHealth Partners Commercial |
$458.85
|
|
|
HC PRO REMOVAL DRUG IMPLANT DEVICE
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 11982
|
| Hospital Charge Code |
9831198201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$58.93 |
| Max. Negotiated Rate |
$379.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$371.42
|
| Rate for Payer: Aetna of WY Medicare |
$69.33
|
| Rate for Payer: Beech Street Commercial |
$360.05
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$367.63
|
| Rate for Payer: Cigna of WY Commercial |
$371.42
|
| Rate for Payer: First Choice Health Commercial |
$341.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$360.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$69.33
|
| Rate for Payer: HealthUtah PPO |
$379.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$367.63
|
| Rate for Payer: Multiplan Medicare/VA |
$58.93
|
| Rate for Payer: One Health Plan of WY PPO |
$371.42
|
| Rate for Payer: PacificSource Commercial |
$341.10
|
| Rate for Payer: PHCS PPO |
$360.05
|
| Rate for Payer: Three Rivers PPO |
$284.25
|
| Rate for Payer: TriWest Veterans Administration |
$69.33
|
| Rate for Payer: United Healthcare Commercial |
$329.73
|
| Rate for Payer: United Healthcare Medicare |
$69.33
|
| Rate for Payer: WINHealth Partners Commercial |
$322.15
|
|
|
HC PRO REMOVAL FB CORNEAL W/O SLIT LAMP
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 65220
|
| Hospital Charge Code |
9836522001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$33.58 |
| Max. Negotiated Rate |
$317.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$310.66
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$209.72
|
| Rate for Payer: Aetna of WY Medicare |
$39.51
|
| Rate for Payer: Aetna of WY Medicare |
$39.51
|
| Rate for Payer: Beech Street Commercial |
$203.30
|
| Rate for Payer: Beech Street Commercial |
$301.15
|
| Rate for Payer: Cash Price |
$149.80
|
| Rate for Payer: Cash Price |
$149.80
|
| Rate for Payer: Cash Price |
$221.90
|
| Rate for Payer: Cash Price |
$221.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$307.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$207.58
|
| Rate for Payer: Cigna of WY Commercial |
$209.72
|
| Rate for Payer: Cigna of WY Commercial |
$310.66
|
| Rate for Payer: First Choice Health Commercial |
$192.60
|
| Rate for Payer: First Choice Health Commercial |
$285.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$301.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$203.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.51
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.51
|
| Rate for Payer: HealthUtah PPO |
$317.00
|
| Rate for Payer: HealthUtah PPO |
$214.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$307.49
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$207.58
|
| Rate for Payer: Multiplan Medicare/VA |
$33.58
|
| Rate for Payer: Multiplan Medicare/VA |
$33.58
|
| Rate for Payer: One Health Plan of WY PPO |
$310.66
|
| Rate for Payer: One Health Plan of WY PPO |
$209.72
|
| Rate for Payer: PacificSource Commercial |
$192.60
|
| Rate for Payer: PacificSource Commercial |
$285.30
|
| Rate for Payer: PHCS PPO |
$301.15
|
| Rate for Payer: PHCS PPO |
$203.30
|
| Rate for Payer: Three Rivers PPO |
$237.75
|
| Rate for Payer: Three Rivers PPO |
$160.50
|
| Rate for Payer: TriWest Veterans Administration |
$39.51
|
| Rate for Payer: TriWest Veterans Administration |
$39.51
|
| Rate for Payer: United Healthcare Commercial |
$186.18
|
| Rate for Payer: United Healthcare Commercial |
$275.79
|
| Rate for Payer: United Healthcare Medicare |
$39.51
|
| Rate for Payer: United Healthcare Medicare |
$39.51
|
| Rate for Payer: WINHealth Partners Commercial |
$269.45
|
| Rate for Payer: WINHealth Partners Commercial |
$181.90
|
|
|
HC PRO REMOVAL FB DEEP THIGH/KNEE
|
Professional
|
Both
|
$2,038.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
9832737201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$331.22 |
| Max. Negotiated Rate |
$2,038.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,997.24
|
| Rate for Payer: Aetna of WY Medicare |
$389.67
|
| Rate for Payer: Beech Street Commercial |
$1,936.10
|
| Rate for Payer: Cash Price |
$1,426.60
|
| Rate for Payer: Cash Price |
$1,426.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,976.86
|
| Rate for Payer: Cigna of WY Commercial |
$1,997.24
|
| Rate for Payer: First Choice Health Commercial |
$1,834.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,936.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$389.67
|
| Rate for Payer: HealthUtah PPO |
$2,038.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,976.86
|
| Rate for Payer: Multiplan Medicare/VA |
$331.22
|
| Rate for Payer: One Health Plan of WY PPO |
$1,997.24
|
| Rate for Payer: PacificSource Commercial |
$1,834.20
|
| Rate for Payer: PHCS PPO |
$1,936.10
|
| Rate for Payer: Three Rivers PPO |
$1,528.50
|
| Rate for Payer: TriWest Veterans Administration |
$389.67
|
| Rate for Payer: United Healthcare Commercial |
$1,773.06
|
| Rate for Payer: United Healthcare Medicare |
$389.67
|
| Rate for Payer: WINHealth Partners Commercial |
$1,732.30
|
|
|
HC PRO REMOVAL FB EXT EYE CONJUCTIVAL EMBEDDED
|
Professional
|
Both
|
$663.00
|
|
|
Service Code
|
HCPCS 65210
|
| Hospital Charge Code |
9836521001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$29.28 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$649.74
|
| Rate for Payer: Aetna of WY Medicare |
$34.45
|
| 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 |
$34.45
|
| Rate for Payer: HealthUtah PPO |
$663.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$643.11
|
| Rate for Payer: Multiplan Medicare/VA |
$29.28
|
| 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 |
$34.45
|
| Rate for Payer: United Healthcare Commercial |
$576.81
|
| Rate for Payer: United Healthcare Medicare |
$34.45
|
| Rate for Payer: WINHealth Partners Commercial |
$563.55
|
|
|
HC PRO REMOVAL FB MUSCLE/TENDON SHEATH DEEP/COMPLICATED
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 20525 NONPBBPAYER
|
| Hospital Charge Code |
9832052501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,272.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,246.56
|
| Rate for Payer: Aetna of WY Medicare |
$238.30
|
| Rate for Payer: Beech Street Commercial |
$1,208.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,233.84
|
| Rate for Payer: Cigna of WY Commercial |
$1,246.56
|
| Rate for Payer: First Choice Health Commercial |
$1,144.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,208.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$238.30
|
| Rate for Payer: HealthUtah PPO |
$1,272.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,233.84
|
| Rate for Payer: Multiplan Medicare/VA |
$202.56
|
| Rate for Payer: One Health Plan of WY PPO |
$1,246.56
|
| Rate for Payer: PacificSource Commercial |
$1,144.80
|
| Rate for Payer: PHCS PPO |
$1,208.40
|
| Rate for Payer: Three Rivers PPO |
$954.00
|
| Rate for Payer: TriWest Veterans Administration |
$238.30
|
| Rate for Payer: United Healthcare Commercial |
$1,106.64
|
| Rate for Payer: United Healthcare Medicare |
$238.30
|
| Rate for Payer: WINHealth Partners Commercial |
$1,081.20
|
|
|
HC PRO REMOVAL FB MUSCLE/TENDON SHEATH DEEP/COMPLICATED
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 20525
|
| Hospital Charge Code |
9832052501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,018.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$997.64
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,856.12
|
| Rate for Payer: Aetna of WY Medicare |
$238.30
|
| Rate for Payer: Aetna of WY Medicare |
$238.30
|
| Rate for Payer: Beech Street Commercial |
$1,799.30
|
| Rate for Payer: Beech Street Commercial |
$967.10
|
| Rate for Payer: Cash Price |
$1,325.80
|
| Rate for Payer: Cash Price |
$712.60
|
| Rate for Payer: Cash Price |
$712.60
|
| Rate for Payer: Cash Price |
$1,325.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,837.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$987.46
|
| Rate for Payer: Cigna of WY Commercial |
$997.64
|
| Rate for Payer: Cigna of WY Commercial |
$1,856.12
|
| Rate for Payer: First Choice Health Commercial |
$1,704.60
|
| 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) Commercial |
$1,799.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$238.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$238.30
|
| Rate for Payer: HealthUtah PPO |
$1,018.00
|
| Rate for Payer: HealthUtah PPO |
$1,894.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,837.18
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$987.46
|
| Rate for Payer: Multiplan Medicare/VA |
$202.56
|
| Rate for Payer: Multiplan Medicare/VA |
$202.56
|
| Rate for Payer: One Health Plan of WY PPO |
$1,856.12
|
| Rate for Payer: One Health Plan of WY PPO |
$997.64
|
| Rate for Payer: PacificSource Commercial |
$916.20
|
| Rate for Payer: PacificSource Commercial |
$1,704.60
|
| Rate for Payer: PHCS PPO |
$967.10
|
| Rate for Payer: PHCS PPO |
$1,799.30
|
| Rate for Payer: Three Rivers PPO |
$763.50
|
| Rate for Payer: Three Rivers PPO |
$1,420.50
|
| Rate for Payer: TriWest Veterans Administration |
$238.30
|
| Rate for Payer: TriWest Veterans Administration |
$238.30
|
| Rate for Payer: United Healthcare Commercial |
$1,647.78
|
| Rate for Payer: United Healthcare Commercial |
$885.66
|
| Rate for Payer: United Healthcare Medicare |
$238.30
|
| Rate for Payer: United Healthcare Medicare |
$238.30
|
| Rate for Payer: WINHealth Partners Commercial |
$865.30
|
| Rate for Payer: WINHealth Partners Commercial |
$1,609.90
|
|
|
HC PRO REMOVAL FB, UPPER ARM/ELBOW; SUBQ
|
Professional
|
Both
|
$766.00
|
|
|
Service Code
|
HCPCS 24200
|
| Hospital Charge Code |
9832420001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$117.28 |
| Max. Negotiated Rate |
$766.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$750.68
|
| Rate for Payer: Aetna of WY Medicare |
$137.98
|
| Rate for Payer: Beech Street Commercial |
$727.70
|
| Rate for Payer: Cash Price |
$536.20
|
| Rate for Payer: Cash Price |
$536.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$743.02
|
| Rate for Payer: Cigna of WY Commercial |
$750.68
|
| Rate for Payer: First Choice Health Commercial |
$689.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$727.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$137.98
|
| Rate for Payer: HealthUtah PPO |
$766.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$743.02
|
| Rate for Payer: Multiplan Medicare/VA |
$117.28
|
| Rate for Payer: One Health Plan of WY PPO |
$750.68
|
| Rate for Payer: PacificSource Commercial |
$689.40
|
| Rate for Payer: PHCS PPO |
$727.70
|
| Rate for Payer: Three Rivers PPO |
$574.50
|
| Rate for Payer: TriWest Veterans Administration |
$137.98
|
| Rate for Payer: United Healthcare Commercial |
$666.42
|
| Rate for Payer: United Healthcare Medicare |
$137.98
|
| Rate for Payer: WINHealth Partners Commercial |
$651.10
|
|
|
HC PRO REMOVAL FOOT FOREIGN BODY,SUBCUTANEOUS
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 28190
|
| Hospital Charge Code |
9832819001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$109.88 |
| Max. Negotiated Rate |
$691.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$677.18
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$999.60
|
| Rate for Payer: Aetna of WY Medicare |
$129.27
|
| Rate for Payer: Aetna of WY Medicare |
$129.27
|
| Rate for Payer: Beech Street Commercial |
$969.00
|
| Rate for Payer: Beech Street Commercial |
$656.45
|
| Rate for Payer: Cash Price |
$714.00
|
| Rate for Payer: Cash Price |
$714.00
|
| Rate for Payer: Cash Price |
$483.70
|
| Rate for Payer: Cash Price |
$483.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$670.27
|
| Rate for Payer: ChoiceCare Network Commercial |
$989.40
|
| Rate for Payer: Cigna of WY Commercial |
$999.60
|
| Rate for Payer: Cigna of WY Commercial |
$677.18
|
| Rate for Payer: First Choice Health Commercial |
$918.00
|
| Rate for Payer: First Choice Health Commercial |
$621.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$656.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$969.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$129.27
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$129.27
|
| Rate for Payer: HealthUtah PPO |
$691.00
|
| Rate for Payer: HealthUtah PPO |
$1,020.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$670.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$989.40
|
| Rate for Payer: Multiplan Medicare/VA |
$109.88
|
| Rate for Payer: Multiplan Medicare/VA |
$109.88
|
| Rate for Payer: One Health Plan of WY PPO |
$677.18
|
| Rate for Payer: One Health Plan of WY PPO |
$999.60
|
| Rate for Payer: PacificSource Commercial |
$918.00
|
| Rate for Payer: PacificSource Commercial |
$621.90
|
| Rate for Payer: PHCS PPO |
$656.45
|
| Rate for Payer: PHCS PPO |
$969.00
|
| Rate for Payer: Three Rivers PPO |
$518.25
|
| Rate for Payer: Three Rivers PPO |
$765.00
|
| Rate for Payer: TriWest Veterans Administration |
$129.27
|
| Rate for Payer: TriWest Veterans Administration |
$129.27
|
| Rate for Payer: United Healthcare Commercial |
$887.40
|
| Rate for Payer: United Healthcare Commercial |
$601.17
|
| Rate for Payer: United Healthcare Medicare |
$129.27
|
| Rate for Payer: United Healthcare Medicare |
$129.27
|
| Rate for Payer: WINHealth Partners Commercial |
$587.35
|
| Rate for Payer: WINHealth Partners Commercial |
$867.00
|
|
