|
HC PRO SEC CLOSURE WND/DEHIS;COMPLIC
|
Professional
|
Both
|
$3,101.00
|
|
|
Service Code
|
HCPCS 13160 NONPBBPAYER
|
| Hospital Charge Code |
9831316001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$649.88 |
| Max. Negotiated Rate |
$3,101.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,038.98
|
| Rate for Payer: Aetna of WY Medicare |
$764.57
|
| Rate for Payer: Beech Street Commercial |
$2,945.95
|
| Rate for Payer: Cash Price |
$2,170.70
|
| Rate for Payer: Cash Price |
$2,170.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,007.97
|
| Rate for Payer: Cigna of WY Commercial |
$3,038.98
|
| Rate for Payer: First Choice Health Commercial |
$2,790.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,945.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$764.57
|
| Rate for Payer: HealthUtah PPO |
$3,101.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,007.97
|
| Rate for Payer: Multiplan Medicare/VA |
$649.88
|
| Rate for Payer: One Health Plan of WY PPO |
$3,038.98
|
| Rate for Payer: PacificSource Commercial |
$2,790.90
|
| Rate for Payer: PHCS PPO |
$2,945.95
|
| Rate for Payer: Three Rivers PPO |
$2,325.75
|
| Rate for Payer: TriWest Veterans Administration |
$764.57
|
| Rate for Payer: United Healthcare Commercial |
$2,697.87
|
| Rate for Payer: United Healthcare Medicare |
$764.57
|
| Rate for Payer: WINHealth Partners Commercial |
$2,635.85
|
|
|
HC PRO SEC CLOSURE WND/DEHIS;COMPLIC
|
Professional
|
Both
|
$2,481.00
|
|
|
Service Code
|
HCPCS 13160
|
| Hospital Charge Code |
9831316001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$649.88 |
| Max. Negotiated Rate |
$2,481.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,431.38
|
| Rate for Payer: Aetna of WY Medicare |
$764.57
|
| Rate for Payer: Beech Street Commercial |
$2,356.95
|
| Rate for Payer: Cash Price |
$1,736.70
|
| Rate for Payer: Cash Price |
$1,736.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,406.57
|
| Rate for Payer: Cigna of WY Commercial |
$2,431.38
|
| Rate for Payer: First Choice Health Commercial |
$2,232.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,356.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$764.57
|
| Rate for Payer: HealthUtah PPO |
$2,481.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,406.57
|
| Rate for Payer: Multiplan Medicare/VA |
$649.88
|
| Rate for Payer: One Health Plan of WY PPO |
$2,431.38
|
| Rate for Payer: PacificSource Commercial |
$2,232.90
|
| Rate for Payer: PHCS PPO |
$2,356.95
|
| Rate for Payer: Three Rivers PPO |
$1,860.75
|
| Rate for Payer: TriWest Veterans Administration |
$764.57
|
| Rate for Payer: United Healthcare Commercial |
$2,158.47
|
| Rate for Payer: United Healthcare Medicare |
$764.57
|
| Rate for Payer: WINHealth Partners Commercial |
$2,108.85
|
|
|
HC PRO SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$5,066.00
|
|
|
Service Code
|
HCPCS 28315
|
| Hospital Charge Code |
9832831501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$271.01 |
| Max. Negotiated Rate |
$5,066.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,964.68
|
| Rate for Payer: Aetna of WY Medicare |
$318.83
|
| Rate for Payer: Beech Street Commercial |
$4,812.70
|
| Rate for Payer: Cash Price |
$3,546.20
|
| Rate for Payer: Cash Price |
$3,546.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,914.02
|
| Rate for Payer: Cigna of WY Commercial |
$4,964.68
|
| Rate for Payer: First Choice Health Commercial |
$4,559.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,812.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$318.83
|
| Rate for Payer: HealthUtah PPO |
$5,066.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,914.02
|
| Rate for Payer: Multiplan Medicare/VA |
$271.01
|
| Rate for Payer: One Health Plan of WY PPO |
$4,964.68
|
| Rate for Payer: PacificSource Commercial |
$4,559.40
|
| Rate for Payer: PHCS PPO |
$4,812.70
|
| Rate for Payer: Three Rivers PPO |
$3,799.50
|
| Rate for Payer: TriWest Veterans Administration |
$318.83
|
| Rate for Payer: United Healthcare Commercial |
$4,407.42
|
| Rate for Payer: United Healthcare Medicare |
$318.83
|
| Rate for Payer: WINHealth Partners Commercial |
$4,306.10
|
|
|
HC PRO SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$1,805.00
|
|
|
Service Code
|
HCPCS 45338
|
| Hospital Charge Code |
9834533801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$1,805.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,768.90
|
| Rate for Payer: Aetna of WY Medicare |
$114.35
|
| Rate for Payer: Beech Street Commercial |
$1,714.75
|
| Rate for Payer: Cash Price |
$1,263.50
|
| Rate for Payer: Cash Price |
$1,263.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,750.85
|
| Rate for Payer: Cigna of WY Commercial |
$1,768.90
|
| Rate for Payer: First Choice Health Commercial |
$1,624.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,714.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$114.35
|
| Rate for Payer: HealthUtah PPO |
$1,805.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,750.85
|
| Rate for Payer: Multiplan Medicare/VA |
$97.20
|
| Rate for Payer: One Health Plan of WY PPO |
$1,768.90
|
| Rate for Payer: PacificSource Commercial |
$1,624.50
|
| Rate for Payer: PHCS PPO |
$1,714.75
|
| Rate for Payer: Three Rivers PPO |
$1,353.75
|
| Rate for Payer: TriWest Veterans Administration |
$114.35
|
| Rate for Payer: United Healthcare Commercial |
$1,570.35
|
| Rate for Payer: United Healthcare Medicare |
$114.35
|
| Rate for Payer: WINHealth Partners Commercial |
$1,534.25
|
|
|
HC PRO SHAVE SKIN LESION <0.5 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 11300
|
| Hospital Charge Code |
9831130001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.24
|
| Rate for Payer: Aetna of WY Medicare |
$32.47
|
| Rate for Payer: Beech Street Commercial |
$131.10
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$133.86
|
| Rate for Payer: Cigna of WY Commercial |
$135.24
|
| Rate for Payer: First Choice Health Commercial |
$124.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.47
|
| Rate for Payer: HealthUtah PPO |
$138.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$133.86
|
| Rate for Payer: Multiplan Medicare/VA |
$27.60
|
| Rate for Payer: One Health Plan of WY PPO |
$135.24
|
| Rate for Payer: PacificSource Commercial |
$124.20
|
| Rate for Payer: PHCS PPO |
$131.10
|
| Rate for Payer: Three Rivers PPO |
$103.50
|
| Rate for Payer: TriWest Veterans Administration |
$32.47
|
| Rate for Payer: United Healthcare Commercial |
$120.06
|
| Rate for Payer: United Healthcare Medicare |
$32.47
|
| Rate for Payer: WINHealth Partners Commercial |
$117.30
|
|
|
HC PRO SHAVE SKIN LESION <0.5 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 11300 NONPBBPAYER
|
| Hospital Charge Code |
9831130001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$172.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$168.56
|
| Rate for Payer: Aetna of WY Medicare |
$32.47
|
| Rate for Payer: Beech Street Commercial |
$163.40
|
| Rate for Payer: Cash Price |
$120.40
|
| Rate for Payer: Cash Price |
$120.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$166.84
|
| Rate for Payer: Cigna of WY Commercial |
$168.56
|
| Rate for Payer: First Choice Health Commercial |
$154.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$163.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.47
|
| Rate for Payer: HealthUtah PPO |
$172.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$166.84
|
| Rate for Payer: Multiplan Medicare/VA |
$27.60
|
| Rate for Payer: One Health Plan of WY PPO |
$168.56
|
| Rate for Payer: PacificSource Commercial |
$154.80
|
| Rate for Payer: PHCS PPO |
$163.40
|
| Rate for Payer: Three Rivers PPO |
$129.00
|
| Rate for Payer: TriWest Veterans Administration |
$32.47
|
| Rate for Payer: United Healthcare Commercial |
$149.64
|
| Rate for Payer: United Healthcare Medicare |
$32.47
|
| Rate for Payer: WINHealth Partners Commercial |
$146.20
|
|
|
HC PRO SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 11306 NONPBBPAYER
|
| Hospital Charge Code |
9831130601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$254.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$248.92
|
| Rate for Payer: Aetna of WY Medicare |
$46.71
|
| Rate for Payer: Beech Street Commercial |
$241.30
|
| Rate for Payer: Cash Price |
$177.80
|
| Rate for Payer: Cash Price |
$177.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$246.38
|
| Rate for Payer: Cigna of WY Commercial |
$248.92
|
| Rate for Payer: First Choice Health Commercial |
$228.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$241.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.71
|
| Rate for Payer: HealthUtah PPO |
$254.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$246.38
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$248.92
|
| Rate for Payer: PacificSource Commercial |
$228.60
|
| Rate for Payer: PHCS PPO |
$241.30
|
| Rate for Payer: Three Rivers PPO |
$190.50
|
| Rate for Payer: TriWest Veterans Administration |
$46.71
|
| Rate for Payer: United Healthcare Commercial |
$220.98
|
| Rate for Payer: United Healthcare Medicare |
$46.71
|
| Rate for Payer: WINHealth Partners Commercial |
$215.90
|
|
|
HC PRO SHAVE SKIN LESION 0.6-1.0 CM
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 11306
|
| Hospital Charge Code |
9831130601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$198.94
|
| Rate for Payer: Aetna of WY Medicare |
$46.71
|
| Rate for Payer: Beech Street Commercial |
$192.85
|
| Rate for Payer: Cash Price |
$142.10
|
| Rate for Payer: Cash Price |
$142.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$196.91
|
| Rate for Payer: Cigna of WY Commercial |
$198.94
|
| Rate for Payer: First Choice Health Commercial |
$182.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$192.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.71
|
| Rate for Payer: HealthUtah PPO |
$203.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$196.91
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$198.94
|
| Rate for Payer: PacificSource Commercial |
$182.70
|
| Rate for Payer: PHCS PPO |
$192.85
|
| Rate for Payer: Three Rivers PPO |
$152.25
|
| Rate for Payer: TriWest Veterans Administration |
$46.71
|
| Rate for Payer: United Healthcare Commercial |
$176.61
|
| Rate for Payer: United Healthcare Medicare |
$46.71
|
| Rate for Payer: WINHealth Partners Commercial |
$172.55
|
|
|
HC PRO SHAVE SKIN LESION 0.6-1.0 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 11301
|
| Hospital Charge Code |
9831130101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$41.58 |
| Max. Negotiated Rate |
$209.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$204.82
|
| Rate for Payer: Aetna of WY Medicare |
$48.92
|
| Rate for Payer: Beech Street Commercial |
$198.55
|
| Rate for Payer: Cash Price |
$146.30
|
| Rate for Payer: Cash Price |
$146.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$202.73
|
| Rate for Payer: Cigna of WY Commercial |
$204.82
|
| Rate for Payer: First Choice Health Commercial |
$188.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$198.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$48.92
|
| Rate for Payer: HealthUtah PPO |
$209.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$202.73
|
| Rate for Payer: Multiplan Medicare/VA |
$41.58
|
| Rate for Payer: One Health Plan of WY PPO |
$204.82
|
| Rate for Payer: PacificSource Commercial |
$188.10
|
| Rate for Payer: PHCS PPO |
$198.55
|
| Rate for Payer: Three Rivers PPO |
$156.75
|
| Rate for Payer: TriWest Veterans Administration |
$48.92
|
| Rate for Payer: United Healthcare Commercial |
$181.83
|
| Rate for Payer: United Healthcare Medicare |
$48.92
|
| Rate for Payer: WINHealth Partners Commercial |
$177.65
|
|
|
HC PRO SHAVE SKIN LESION 0.6-1.0 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11301 NONPBBPAYER
|
| Hospital Charge Code |
9831130101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$41.58 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$255.78
|
| Rate for Payer: Aetna of WY Medicare |
$48.92
|
| Rate for Payer: Beech Street Commercial |
$247.95
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$253.17
|
| Rate for Payer: Cigna of WY Commercial |
$255.78
|
| Rate for Payer: First Choice Health Commercial |
$234.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$247.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$48.92
|
| Rate for Payer: HealthUtah PPO |
$261.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$253.17
|
| Rate for Payer: Multiplan Medicare/VA |
$41.58
|
| Rate for Payer: One Health Plan of WY PPO |
$255.78
|
| Rate for Payer: PacificSource Commercial |
$234.90
|
| Rate for Payer: PHCS PPO |
$247.95
|
| Rate for Payer: Three Rivers PPO |
$195.75
|
| Rate for Payer: TriWest Veterans Administration |
$48.92
|
| Rate for Payer: United Healthcare Commercial |
$227.07
|
| Rate for Payer: United Healthcare Medicare |
$48.92
|
| Rate for Payer: WINHealth Partners Commercial |
$221.85
|
|
|
HC PRO SHAVING LESION 1.1CM - 2CM
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 11302 NONPBBPAYER
|
| Hospital Charge Code |
9831130201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$48.47 |
| Max. Negotiated Rate |
$308.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$301.84
|
| Rate for Payer: Aetna of WY Medicare |
$57.02
|
| Rate for Payer: Beech Street Commercial |
$292.60
|
| Rate for Payer: Cash Price |
$215.60
|
| Rate for Payer: Cash Price |
$215.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$298.76
|
| Rate for Payer: Cigna of WY Commercial |
$301.84
|
| Rate for Payer: First Choice Health Commercial |
$277.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$292.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$57.02
|
| Rate for Payer: HealthUtah PPO |
$308.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$298.76
|
| Rate for Payer: Multiplan Medicare/VA |
$48.47
|
| Rate for Payer: One Health Plan of WY PPO |
$301.84
|
| Rate for Payer: PacificSource Commercial |
$277.20
|
| Rate for Payer: PHCS PPO |
$292.60
|
| Rate for Payer: Three Rivers PPO |
$231.00
|
| Rate for Payer: TriWest Veterans Administration |
$57.02
|
| Rate for Payer: United Healthcare Commercial |
$267.96
|
| Rate for Payer: United Healthcare Medicare |
$57.02
|
| Rate for Payer: WINHealth Partners Commercial |
$261.80
|
|
|
HC PRO SHAVING LESION 1.1CM - 2CM
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 11302
|
| Hospital Charge Code |
9831130201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$48.47 |
| Max. Negotiated Rate |
$246.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$241.08
|
| Rate for Payer: Aetna of WY Medicare |
$57.02
|
| Rate for Payer: Beech Street Commercial |
$233.70
|
| Rate for Payer: Cash Price |
$172.20
|
| Rate for Payer: Cash Price |
$172.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$238.62
|
| Rate for Payer: Cigna of WY Commercial |
$241.08
|
| Rate for Payer: First Choice Health Commercial |
$221.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$233.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$57.02
|
| Rate for Payer: HealthUtah PPO |
$246.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$238.62
|
| Rate for Payer: Multiplan Medicare/VA |
$48.47
|
| Rate for Payer: One Health Plan of WY PPO |
$241.08
|
| Rate for Payer: PacificSource Commercial |
$221.40
|
| Rate for Payer: PHCS PPO |
$233.70
|
| Rate for Payer: Three Rivers PPO |
$184.50
|
| Rate for Payer: TriWest Veterans Administration |
$57.02
|
| Rate for Payer: United Healthcare Commercial |
$214.02
|
| Rate for Payer: United Healthcare Medicare |
$57.02
|
| Rate for Payer: WINHealth Partners Commercial |
$209.10
|
|
|
HC PRO SHAVING SKIN LESION 0.06 -1.0 CM FACE
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 11311 NONPBBPAYER
|
| Hospital Charge Code |
9831131101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$50.90 |
| Max. Negotiated Rate |
$319.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$312.62
|
| Rate for Payer: Aetna of WY Medicare |
$59.88
|
| Rate for Payer: Beech Street Commercial |
$303.05
|
| Rate for Payer: Cash Price |
$223.30
|
| Rate for Payer: Cash Price |
$223.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$309.43
|
| Rate for Payer: Cigna of WY Commercial |
$312.62
|
| Rate for Payer: First Choice Health Commercial |
$287.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$303.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.88
|
| Rate for Payer: HealthUtah PPO |
$319.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$309.43
|
| Rate for Payer: Multiplan Medicare/VA |
$50.90
|
| Rate for Payer: One Health Plan of WY PPO |
$312.62
|
| Rate for Payer: PacificSource Commercial |
$287.10
|
| Rate for Payer: PHCS PPO |
$303.05
|
| Rate for Payer: Three Rivers PPO |
$239.25
|
| Rate for Payer: TriWest Veterans Administration |
$59.88
|
| Rate for Payer: United Healthcare Commercial |
$277.53
|
| Rate for Payer: United Healthcare Medicare |
$59.88
|
| Rate for Payer: WINHealth Partners Commercial |
$271.15
|
|
|
HC PRO SHAVING SKIN LESION 0.06 -1.0 CM FACE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 11311
|
| Hospital Charge Code |
9831131101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$50.90 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$249.90
|
| Rate for Payer: Aetna of WY Medicare |
$59.88
|
| Rate for Payer: Beech Street Commercial |
$242.25
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$247.35
|
| Rate for Payer: Cigna of WY Commercial |
$249.90
|
| Rate for Payer: First Choice Health Commercial |
$229.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$242.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.88
|
| Rate for Payer: HealthUtah PPO |
$255.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$247.35
|
| Rate for Payer: Multiplan Medicare/VA |
$50.90
|
| Rate for Payer: One Health Plan of WY PPO |
$249.90
|
| Rate for Payer: PacificSource Commercial |
$229.50
|
| Rate for Payer: PHCS PPO |
$242.25
|
| Rate for Payer: Three Rivers PPO |
$191.25
|
| Rate for Payer: TriWest Veterans Administration |
$59.88
|
| Rate for Payer: United Healthcare Commercial |
$221.85
|
| Rate for Payer: United Healthcare Medicare |
$59.88
|
| Rate for Payer: WINHealth Partners Commercial |
$216.75
|
|
|
HC PRO SHAVING SKIN LESION <0.5 CM FACE
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 11310
|
| Hospital Charge Code |
9831131001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$36.92 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$183.26
|
| Rate for Payer: Aetna of WY Medicare |
$43.44
|
| Rate for Payer: Beech Street Commercial |
$177.65
|
| Rate for Payer: Cash Price |
$130.90
|
| Rate for Payer: Cash Price |
$130.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$181.39
|
| Rate for Payer: Cigna of WY Commercial |
$183.26
|
| Rate for Payer: First Choice Health Commercial |
$168.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$177.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.44
|
| Rate for Payer: HealthUtah PPO |
$187.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$181.39
|
| Rate for Payer: Multiplan Medicare/VA |
$36.92
|
| Rate for Payer: One Health Plan of WY PPO |
$183.26
|
| Rate for Payer: PacificSource Commercial |
$168.30
|
| Rate for Payer: PHCS PPO |
$177.65
|
| Rate for Payer: Three Rivers PPO |
$140.25
|
| Rate for Payer: TriWest Veterans Administration |
$43.44
|
| Rate for Payer: United Healthcare Commercial |
$162.69
|
| Rate for Payer: United Healthcare Medicare |
$43.44
|
| Rate for Payer: WINHealth Partners Commercial |
$158.95
|
|
|
HC PRO SHAVING SKIN LESION <0.5 CM FACE
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 11310 NONPBBPAYER
|
| Hospital Charge Code |
9831131001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$36.92 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$229.32
|
| Rate for Payer: Aetna of WY Medicare |
$43.44
|
| Rate for Payer: Beech Street Commercial |
$222.30
|
| Rate for Payer: Cash Price |
$163.80
|
| Rate for Payer: Cash Price |
$163.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$226.98
|
| Rate for Payer: Cigna of WY Commercial |
$229.32
|
| Rate for Payer: First Choice Health Commercial |
$210.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$222.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.44
|
| Rate for Payer: HealthUtah PPO |
$234.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$226.98
|
| Rate for Payer: Multiplan Medicare/VA |
$36.92
|
| Rate for Payer: One Health Plan of WY PPO |
$229.32
|
| Rate for Payer: PacificSource Commercial |
$210.60
|
| Rate for Payer: PHCS PPO |
$222.30
|
| Rate for Payer: Three Rivers PPO |
$175.50
|
| Rate for Payer: TriWest Veterans Administration |
$43.44
|
| Rate for Payer: United Healthcare Commercial |
$203.58
|
| Rate for Payer: United Healthcare Medicare |
$43.44
|
| Rate for Payer: WINHealth Partners Commercial |
$198.90
|
|
|
HC PRO SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 11313
|
| Hospital Charge Code |
9831131301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$77.94 |
| Max. Negotiated Rate |
$314.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
| Rate for Payer: Aetna of WY Medicare |
$91.70
|
| Rate for Payer: Beech Street Commercial |
$298.30
|
| Rate for Payer: Cash Price |
$219.80
|
| Rate for Payer: Cash Price |
$219.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
| Rate for Payer: Cigna of WY Commercial |
$307.72
|
| Rate for Payer: First Choice Health Commercial |
$282.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$91.70
|
| Rate for Payer: HealthUtah PPO |
$314.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
| Rate for Payer: Multiplan Medicare/VA |
$77.94
|
| Rate for Payer: One Health Plan of WY PPO |
$307.72
|
| Rate for Payer: PacificSource Commercial |
$282.60
|
| Rate for Payer: PHCS PPO |
$298.30
|
| Rate for Payer: Three Rivers PPO |
$235.50
|
| Rate for Payer: TriWest Veterans Administration |
$91.70
|
| Rate for Payer: United Healthcare Commercial |
$273.18
|
| Rate for Payer: United Healthcare Medicare |
$91.70
|
| Rate for Payer: WINHealth Partners Commercial |
$266.90
|
|
|
HC PRO SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$393.00
|
|
|
Service Code
|
HCPCS 11313 NONPBBPAYER
|
| Hospital Charge Code |
9831131301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$77.94 |
| Max. Negotiated Rate |
$393.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$385.14
|
| Rate for Payer: Aetna of WY Medicare |
$91.70
|
| Rate for Payer: Beech Street Commercial |
$373.35
|
| Rate for Payer: Cash Price |
$275.10
|
| Rate for Payer: Cash Price |
$275.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$381.21
|
| Rate for Payer: Cigna of WY Commercial |
$385.14
|
| Rate for Payer: First Choice Health Commercial |
$353.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$373.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$91.70
|
| Rate for Payer: HealthUtah PPO |
$393.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$381.21
|
| Rate for Payer: Multiplan Medicare/VA |
$77.94
|
| Rate for Payer: One Health Plan of WY PPO |
$385.14
|
| Rate for Payer: PacificSource Commercial |
$353.70
|
| Rate for Payer: PHCS PPO |
$373.35
|
| Rate for Payer: Three Rivers PPO |
$294.75
|
| Rate for Payer: TriWest Veterans Administration |
$91.70
|
| Rate for Payer: United Healthcare Commercial |
$341.91
|
| Rate for Payer: United Healthcare Medicare |
$91.70
|
| Rate for Payer: WINHealth Partners Commercial |
$334.05
|
|
|
HC PRO SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 11305 NONPBBPAYER
|
| Hospital Charge Code |
9831130501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$30.39 |
| Max. Negotiated Rate |
$197.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$193.06
|
| Rate for Payer: Aetna of WY Medicare |
$35.75
|
| Rate for Payer: Beech Street Commercial |
$187.15
|
| Rate for Payer: Cash Price |
$137.90
|
| Rate for Payer: Cash Price |
$137.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$191.09
|
| Rate for Payer: Cigna of WY Commercial |
$193.06
|
| Rate for Payer: First Choice Health Commercial |
$177.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$187.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$35.75
|
| Rate for Payer: HealthUtah PPO |
$197.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$191.09
|
| Rate for Payer: Multiplan Medicare/VA |
$30.39
|
| Rate for Payer: One Health Plan of WY PPO |
$193.06
|
| Rate for Payer: PacificSource Commercial |
$177.30
|
| Rate for Payer: PHCS PPO |
$187.15
|
| Rate for Payer: Three Rivers PPO |
$147.75
|
| Rate for Payer: TriWest Veterans Administration |
$35.75
|
| Rate for Payer: United Healthcare Commercial |
$171.39
|
| Rate for Payer: United Healthcare Medicare |
$35.75
|
| Rate for Payer: WINHealth Partners Commercial |
$167.45
|
|
|
HC PRO SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 11305
|
| Hospital Charge Code |
9831130501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$30.39 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$154.84
|
| Rate for Payer: Aetna of WY Medicare |
$35.75
|
| Rate for Payer: Beech Street Commercial |
$150.10
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$153.26
|
| Rate for Payer: Cigna of WY Commercial |
$154.84
|
| Rate for Payer: First Choice Health Commercial |
$142.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$35.75
|
| Rate for Payer: HealthUtah PPO |
$158.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$153.26
|
| Rate for Payer: Multiplan Medicare/VA |
$30.39
|
| Rate for Payer: One Health Plan of WY PPO |
$154.84
|
| Rate for Payer: PacificSource Commercial |
$142.20
|
| Rate for Payer: PHCS PPO |
$150.10
|
| Rate for Payer: Three Rivers PPO |
$118.50
|
| Rate for Payer: TriWest Veterans Administration |
$35.75
|
| Rate for Payer: United Healthcare Commercial |
$137.46
|
| Rate for Payer: United Healthcare Medicare |
$35.75
|
| Rate for Payer: WINHealth Partners Commercial |
$134.30
|
|
|
HC PRO SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 11307 NONPBBPAYER
|
| Hospital Charge Code |
9831130701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$326.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$319.48
|
| Rate for Payer: Aetna of WY Medicare |
$59.55
|
| Rate for Payer: Beech Street Commercial |
$309.70
|
| Rate for Payer: Cash Price |
$228.20
|
| Rate for Payer: Cash Price |
$228.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$316.22
|
| Rate for Payer: Cigna of WY Commercial |
$319.48
|
| Rate for Payer: First Choice Health Commercial |
$293.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$309.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.55
|
| Rate for Payer: HealthUtah PPO |
$326.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$316.22
|
| Rate for Payer: Multiplan Medicare/VA |
$50.62
|
| Rate for Payer: One Health Plan of WY PPO |
$319.48
|
| Rate for Payer: PacificSource Commercial |
$293.40
|
| Rate for Payer: PHCS PPO |
$309.70
|
| Rate for Payer: Three Rivers PPO |
$244.50
|
| Rate for Payer: TriWest Veterans Administration |
$59.55
|
| Rate for Payer: United Healthcare Commercial |
$283.62
|
| Rate for Payer: United Healthcare Medicare |
$59.55
|
| Rate for Payer: WINHealth Partners Commercial |
$277.10
|
|
|
HC PRO SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11307
|
| Hospital Charge Code |
9831130701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$255.78
|
| Rate for Payer: Aetna of WY Medicare |
$59.55
|
| Rate for Payer: Beech Street Commercial |
$247.95
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$253.17
|
| Rate for Payer: Cigna of WY Commercial |
$255.78
|
| Rate for Payer: First Choice Health Commercial |
$234.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$247.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.55
|
| Rate for Payer: HealthUtah PPO |
$261.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$253.17
|
| Rate for Payer: Multiplan Medicare/VA |
$50.62
|
| Rate for Payer: One Health Plan of WY PPO |
$255.78
|
| Rate for Payer: PacificSource Commercial |
$234.90
|
| Rate for Payer: PHCS PPO |
$247.95
|
| Rate for Payer: Three Rivers PPO |
$195.75
|
| Rate for Payer: TriWest Veterans Administration |
$59.55
|
| Rate for Payer: United Healthcare Commercial |
$227.07
|
| Rate for Payer: United Healthcare Medicare |
$59.55
|
| Rate for Payer: WINHealth Partners Commercial |
$221.85
|
|
|
HC PRO SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 11308
|
| Hospital Charge Code |
9831130801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$56.67 |
| Max. Negotiated Rate |
$296.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$290.08
|
| Rate for Payer: Aetna of WY Medicare |
$66.67
|
| Rate for Payer: Beech Street Commercial |
$281.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$287.12
|
| Rate for Payer: Cigna of WY Commercial |
$290.08
|
| Rate for Payer: First Choice Health Commercial |
$266.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$281.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$66.67
|
| Rate for Payer: HealthUtah PPO |
$296.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$287.12
|
| Rate for Payer: Multiplan Medicare/VA |
$56.67
|
| Rate for Payer: One Health Plan of WY PPO |
$290.08
|
| Rate for Payer: PacificSource Commercial |
$266.40
|
| Rate for Payer: PHCS PPO |
$281.20
|
| Rate for Payer: Three Rivers PPO |
$222.00
|
| Rate for Payer: TriWest Veterans Administration |
$66.67
|
| Rate for Payer: United Healthcare Commercial |
$257.52
|
| Rate for Payer: United Healthcare Medicare |
$66.67
|
| Rate for Payer: WINHealth Partners Commercial |
$251.60
|
|
|
HC PRO SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 11308 NONPBBPAYER
|
| Hospital Charge Code |
9831130801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$56.67 |
| Max. Negotiated Rate |
$370.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$362.60
|
| Rate for Payer: Aetna of WY Medicare |
$66.67
|
| Rate for Payer: Beech Street Commercial |
$351.50
|
| Rate for Payer: Cash Price |
$259.00
|
| Rate for Payer: Cash Price |
$259.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$358.90
|
| Rate for Payer: Cigna of WY Commercial |
$362.60
|
| Rate for Payer: First Choice Health Commercial |
$333.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$351.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$66.67
|
| Rate for Payer: HealthUtah PPO |
$370.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$358.90
|
| Rate for Payer: Multiplan Medicare/VA |
$56.67
|
| Rate for Payer: One Health Plan of WY PPO |
$362.60
|
| Rate for Payer: PacificSource Commercial |
$333.00
|
| Rate for Payer: PHCS PPO |
$351.50
|
| Rate for Payer: Three Rivers PPO |
$277.50
|
| Rate for Payer: TriWest Veterans Administration |
$66.67
|
| Rate for Payer: United Healthcare Commercial |
$321.90
|
| Rate for Payer: United Healthcare Medicare |
$66.67
|
| Rate for Payer: WINHealth Partners Commercial |
$314.50
|
|
|
HC PRO SHOULDER ARTHROSCOPY DX
|
Professional
|
Both
|
$2,424.00
|
|
|
Service Code
|
HCPCS 29805
|
| Hospital Charge Code |
9832980501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$388.32 |
| Max. Negotiated Rate |
$2,424.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,375.52
|
| Rate for Payer: Aetna of WY Medicare |
$456.85
|
| Rate for Payer: Beech Street Commercial |
$2,302.80
|
| Rate for Payer: Cash Price |
$1,696.80
|
| Rate for Payer: Cash Price |
$1,696.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,351.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,375.52
|
| Rate for Payer: First Choice Health Commercial |
$2,181.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,302.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$456.85
|
| Rate for Payer: HealthUtah PPO |
$2,424.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,351.28
|
| Rate for Payer: Multiplan Medicare/VA |
$388.32
|
| Rate for Payer: One Health Plan of WY PPO |
$2,375.52
|
| Rate for Payer: PacificSource Commercial |
$2,181.60
|
| Rate for Payer: PHCS PPO |
$2,302.80
|
| Rate for Payer: Three Rivers PPO |
$1,818.00
|
| Rate for Payer: TriWest Veterans Administration |
$456.85
|
| Rate for Payer: United Healthcare Commercial |
$2,108.88
|
| Rate for Payer: United Healthcare Medicare |
$456.85
|
| Rate for Payer: WINHealth Partners Commercial |
$2,060.40
|
|
