|
HC PRO TREAT THUMB FX/DISLOC,MANIP
|
Professional
|
Both
|
$2,028.00
|
|
|
Service Code
|
HCPCS 26645 NONPBBPAYER
|
| Hospital Charge Code |
9832664501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$335.16 |
| Max. Negotiated Rate |
$2,028.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,987.44
|
| Rate for Payer: Aetna of WY Medicare |
$394.31
|
| Rate for Payer: Beech Street Commercial |
$1,926.60
|
| Rate for Payer: Cash Price |
$1,419.60
|
| Rate for Payer: Cash Price |
$1,419.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,967.16
|
| Rate for Payer: Cigna of WY Commercial |
$1,987.44
|
| Rate for Payer: First Choice Health Commercial |
$1,825.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,926.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$394.31
|
| Rate for Payer: HealthUtah PPO |
$2,028.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,967.16
|
| Rate for Payer: Multiplan Medicare/VA |
$335.16
|
| Rate for Payer: One Health Plan of WY PPO |
$1,987.44
|
| Rate for Payer: PacificSource Commercial |
$1,825.20
|
| Rate for Payer: PHCS PPO |
$1,926.60
|
| Rate for Payer: Three Rivers PPO |
$1,521.00
|
| Rate for Payer: TriWest Veterans Administration |
$394.31
|
| Rate for Payer: United Healthcare Commercial |
$1,764.36
|
| Rate for Payer: United Healthcare Medicare |
$394.31
|
| Rate for Payer: WINHealth Partners Commercial |
$1,723.80
|
|
|
HC PRO TREAT THUMB FX/DISLOC,MANIP
|
Professional
|
Both
|
$1,622.00
|
|
|
Service Code
|
HCPCS 26645
|
| Hospital Charge Code |
9832664501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$335.16 |
| Max. Negotiated Rate |
$1,622.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,589.56
|
| Rate for Payer: Aetna of WY Medicare |
$394.31
|
| Rate for Payer: Beech Street Commercial |
$1,540.90
|
| Rate for Payer: Cash Price |
$1,135.40
|
| Rate for Payer: Cash Price |
$1,135.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,573.34
|
| Rate for Payer: Cigna of WY Commercial |
$1,589.56
|
| Rate for Payer: First Choice Health Commercial |
$1,459.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,540.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$394.31
|
| Rate for Payer: HealthUtah PPO |
$1,622.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,573.34
|
| Rate for Payer: Multiplan Medicare/VA |
$335.16
|
| Rate for Payer: One Health Plan of WY PPO |
$1,589.56
|
| Rate for Payer: PacificSource Commercial |
$1,459.80
|
| Rate for Payer: PHCS PPO |
$1,540.90
|
| Rate for Payer: Three Rivers PPO |
$1,216.50
|
| Rate for Payer: TriWest Veterans Administration |
$394.31
|
| Rate for Payer: United Healthcare Commercial |
$1,411.14
|
| Rate for Payer: United Healthcare Medicare |
$394.31
|
| Rate for Payer: WINHealth Partners Commercial |
$1,378.70
|
|
|
HC PRO TRIM BENIGH HYPERKERATOTIC SKIN LESION, SINGLE
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 11055 NONPBBPAYER
|
| Hospital Charge Code |
9831105501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$79.38
|
| Rate for Payer: Aetna of WY Medicare |
$14.81
|
| Rate for Payer: Beech Street Commercial |
$76.95
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$78.57
|
| Rate for Payer: Cigna of WY Commercial |
$79.38
|
| Rate for Payer: First Choice Health Commercial |
$72.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$76.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.81
|
| Rate for Payer: HealthUtah PPO |
$81.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$78.57
|
| Rate for Payer: Multiplan Medicare/VA |
$12.59
|
| Rate for Payer: One Health Plan of WY PPO |
$79.38
|
| Rate for Payer: PacificSource Commercial |
$72.90
|
| Rate for Payer: PHCS PPO |
$76.95
|
| Rate for Payer: Three Rivers PPO |
$60.75
|
| Rate for Payer: TriWest Veterans Administration |
$14.81
|
| Rate for Payer: United Healthcare Commercial |
$70.47
|
| Rate for Payer: United Healthcare Medicare |
$14.81
|
| Rate for Payer: WINHealth Partners Commercial |
$68.85
|
|
|
HC PRO TRIM BENIGH HYPERKERATOTIC SKIN LESION, SINGLE
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
9831105501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$136.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$133.28
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$63.70
|
| Rate for Payer: Aetna of WY Medicare |
$14.81
|
| Rate for Payer: Aetna of WY Medicare |
$14.81
|
| Rate for Payer: Beech Street Commercial |
$61.75
|
| Rate for Payer: Beech Street Commercial |
$129.20
|
| Rate for Payer: Cash Price |
$45.50
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$45.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$63.05
|
| Rate for Payer: ChoiceCare Network Commercial |
$131.92
|
| Rate for Payer: Cigna of WY Commercial |
$133.28
|
| Rate for Payer: Cigna of WY Commercial |
$63.70
|
| Rate for Payer: First Choice Health Commercial |
$58.50
|
| Rate for Payer: First Choice Health Commercial |
$122.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$129.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$61.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.81
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.81
|
| Rate for Payer: HealthUtah PPO |
$136.00
|
| Rate for Payer: HealthUtah PPO |
$65.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$63.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$131.92
|
| Rate for Payer: Multiplan Medicare/VA |
$12.59
|
| Rate for Payer: Multiplan Medicare/VA |
$12.59
|
| Rate for Payer: One Health Plan of WY PPO |
$63.70
|
| Rate for Payer: One Health Plan of WY PPO |
$133.28
|
| Rate for Payer: PacificSource Commercial |
$122.40
|
| Rate for Payer: PacificSource Commercial |
$58.50
|
| Rate for Payer: PHCS PPO |
$129.20
|
| Rate for Payer: PHCS PPO |
$61.75
|
| Rate for Payer: Three Rivers PPO |
$102.00
|
| Rate for Payer: Three Rivers PPO |
$48.75
|
| Rate for Payer: TriWest Veterans Administration |
$14.81
|
| Rate for Payer: TriWest Veterans Administration |
$14.81
|
| Rate for Payer: United Healthcare Commercial |
$56.55
|
| Rate for Payer: United Healthcare Commercial |
$118.32
|
| Rate for Payer: United Healthcare Medicare |
$14.81
|
| Rate for Payer: United Healthcare Medicare |
$14.81
|
| Rate for Payer: WINHealth Partners Commercial |
$115.60
|
| Rate for Payer: WINHealth Partners Commercial |
$55.25
|
|
|
HC PRO TRIM BENIGN HYPERKERATOTIC SKIN LESION,2-4
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 11056 NONPBBPAYER
|
| Hospital Charge Code |
9831105601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$116.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$113.68
|
| Rate for Payer: Aetna of WY Medicare |
$20.94
|
| Rate for Payer: Beech Street Commercial |
$110.20
|
| Rate for Payer: Cash Price |
$81.20
|
| Rate for Payer: Cash Price |
$81.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$112.52
|
| Rate for Payer: Cigna of WY Commercial |
$113.68
|
| Rate for Payer: First Choice Health Commercial |
$104.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$110.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$20.94
|
| Rate for Payer: HealthUtah PPO |
$116.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$112.52
|
| Rate for Payer: Multiplan Medicare/VA |
$17.80
|
| Rate for Payer: One Health Plan of WY PPO |
$113.68
|
| Rate for Payer: PacificSource Commercial |
$104.40
|
| Rate for Payer: PHCS PPO |
$110.20
|
| Rate for Payer: Three Rivers PPO |
$87.00
|
| Rate for Payer: TriWest Veterans Administration |
$20.94
|
| Rate for Payer: United Healthcare Commercial |
$100.92
|
| Rate for Payer: United Healthcare Medicare |
$20.94
|
| Rate for Payer: WINHealth Partners Commercial |
$98.60
|
|
|
HC PRO TRIM BENIGN HYPERKERATOTIC SKIN LESION,2-4
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 11056
|
| Hospital Charge Code |
9831105601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$91.14
|
| Rate for Payer: Aetna of WY Medicare |
$20.94
|
| Rate for Payer: Beech Street Commercial |
$88.35
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$90.21
|
| Rate for Payer: Cigna of WY Commercial |
$91.14
|
| Rate for Payer: First Choice Health Commercial |
$83.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$88.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$20.94
|
| Rate for Payer: HealthUtah PPO |
$93.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$90.21
|
| Rate for Payer: Multiplan Medicare/VA |
$17.80
|
| Rate for Payer: One Health Plan of WY PPO |
$91.14
|
| Rate for Payer: PacificSource Commercial |
$83.70
|
| Rate for Payer: PHCS PPO |
$88.35
|
| Rate for Payer: Three Rivers PPO |
$69.75
|
| Rate for Payer: TriWest Veterans Administration |
$20.94
|
| Rate for Payer: United Healthcare Commercial |
$80.91
|
| Rate for Payer: United Healthcare Medicare |
$20.94
|
| Rate for Payer: WINHealth Partners Commercial |
$79.05
|
|
|
HC PRO TRIM BENIGN HYPERKERATOTIC SKIN LESION,4+
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 11057 NONPBBPAYER
|
| Hospital Charge Code |
9831105701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$23.30 |
| Max. Negotiated Rate |
$149.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$146.02
|
| Rate for Payer: Aetna of WY Medicare |
$27.41
|
| Rate for Payer: Beech Street Commercial |
$141.55
|
| Rate for Payer: Cash Price |
$104.30
|
| Rate for Payer: Cash Price |
$104.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$144.53
|
| Rate for Payer: Cigna of WY Commercial |
$146.02
|
| Rate for Payer: First Choice Health Commercial |
$134.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$141.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.41
|
| Rate for Payer: HealthUtah PPO |
$149.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$144.53
|
| Rate for Payer: Multiplan Medicare/VA |
$23.30
|
| Rate for Payer: One Health Plan of WY PPO |
$146.02
|
| Rate for Payer: PacificSource Commercial |
$134.10
|
| Rate for Payer: PHCS PPO |
$141.55
|
| Rate for Payer: Three Rivers PPO |
$111.75
|
| Rate for Payer: TriWest Veterans Administration |
$27.41
|
| Rate for Payer: United Healthcare Commercial |
$129.63
|
| Rate for Payer: United Healthcare Medicare |
$27.41
|
| Rate for Payer: WINHealth Partners Commercial |
$126.65
|
|
|
HC PRO TRIM BENIGN HYPERKERATOTIC SKIN LESION,4+
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 11057
|
| Hospital Charge Code |
9831105701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$23.30 |
| Max. Negotiated Rate |
$119.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$116.62
|
| Rate for Payer: Aetna of WY Medicare |
$27.41
|
| Rate for Payer: Beech Street Commercial |
$113.05
|
| Rate for Payer: Cash Price |
$83.30
|
| Rate for Payer: Cash Price |
$83.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$115.43
|
| Rate for Payer: Cigna of WY Commercial |
$116.62
|
| Rate for Payer: First Choice Health Commercial |
$107.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$113.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.41
|
| Rate for Payer: HealthUtah PPO |
$119.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$115.43
|
| Rate for Payer: Multiplan Medicare/VA |
$23.30
|
| Rate for Payer: One Health Plan of WY PPO |
$116.62
|
| Rate for Payer: PacificSource Commercial |
$107.10
|
| Rate for Payer: PHCS PPO |
$113.05
|
| Rate for Payer: Three Rivers PPO |
$89.25
|
| Rate for Payer: TriWest Veterans Administration |
$27.41
|
| Rate for Payer: United Healthcare Commercial |
$103.53
|
| Rate for Payer: United Healthcare Medicare |
$27.41
|
| Rate for Payer: WINHealth Partners Commercial |
$101.15
|
|
|
HC PRO TRIM NONDYSTROPHIC NAILS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 11719 NONPBBPAYER
|
| Hospital Charge Code |
9831171901
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$38.22
|
| Rate for Payer: Aetna of WY Medicare |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$37.83
|
| Rate for Payer: Cigna of WY Commercial |
$38.22
|
| Rate for Payer: First Choice Health Commercial |
$35.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$37.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.12
|
| Rate for Payer: HealthUtah PPO |
$39.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$37.83
|
| Rate for Payer: Multiplan Medicare/VA |
$6.05
|
| Rate for Payer: One Health Plan of WY PPO |
$38.22
|
| Rate for Payer: PacificSource Commercial |
$35.10
|
| Rate for Payer: PHCS PPO |
$37.05
|
| Rate for Payer: Three Rivers PPO |
$29.25
|
| Rate for Payer: TriWest Veterans Administration |
$7.12
|
| Rate for Payer: United Healthcare Commercial |
$33.93
|
| Rate for Payer: United Healthcare Medicare |
$7.12
|
| Rate for Payer: WINHealth Partners Commercial |
$33.15
|
|
|
HC PRO TRIM NONDYSTROPHIC NAILS
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 11719
|
| Hospital Charge Code |
9831171901
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$31.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$30.38
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$49.98
|
| Rate for Payer: Aetna of WY Medicare |
$7.12
|
| Rate for Payer: Aetna of WY Medicare |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$48.45
|
| Rate for Payer: Beech Street Commercial |
$29.45
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: Cash Price |
$21.70
|
| Rate for Payer: Cash Price |
$21.70
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.47
|
| Rate for Payer: ChoiceCare Network Commercial |
$30.07
|
| Rate for Payer: Cigna of WY Commercial |
$30.38
|
| Rate for Payer: Cigna of WY Commercial |
$49.98
|
| Rate for Payer: First Choice Health Commercial |
$45.90
|
| Rate for Payer: First Choice Health Commercial |
$27.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$29.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.12
|
| Rate for Payer: HealthUtah PPO |
$31.00
|
| Rate for Payer: HealthUtah PPO |
$51.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.47
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$30.07
|
| Rate for Payer: Multiplan Medicare/VA |
$6.05
|
| Rate for Payer: Multiplan Medicare/VA |
$6.05
|
| Rate for Payer: One Health Plan of WY PPO |
$49.98
|
| Rate for Payer: One Health Plan of WY PPO |
$30.38
|
| Rate for Payer: PacificSource Commercial |
$27.90
|
| Rate for Payer: PacificSource Commercial |
$45.90
|
| Rate for Payer: PHCS PPO |
$29.45
|
| Rate for Payer: PHCS PPO |
$48.45
|
| Rate for Payer: Three Rivers PPO |
$23.25
|
| Rate for Payer: Three Rivers PPO |
$38.25
|
| Rate for Payer: TriWest Veterans Administration |
$7.12
|
| Rate for Payer: TriWest Veterans Administration |
$7.12
|
| Rate for Payer: United Healthcare Commercial |
$44.37
|
| Rate for Payer: United Healthcare Commercial |
$26.97
|
| Rate for Payer: United Healthcare Medicare |
$7.12
|
| Rate for Payer: United Healthcare Medicare |
$7.12
|
| Rate for Payer: WINHealth Partners Commercial |
$26.35
|
| Rate for Payer: WINHealth Partners Commercial |
$43.35
|
|
|
HC PRO TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP
|
Professional
|
Both
|
$2,580.00
|
|
|
Service Code
|
HCPCS 27691
|
| Hospital Charge Code |
9752769101
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$614.07 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,528.40
|
| Rate for Payer: Aetna of WY Medicare |
$722.44
|
| Rate for Payer: Beech Street Commercial |
$2,451.00
|
| Rate for Payer: Cash Price |
$1,806.00
|
| Rate for Payer: Cash Price |
$1,806.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,502.60
|
| Rate for Payer: Cigna of WY Commercial |
$2,528.40
|
| Rate for Payer: First Choice Health Commercial |
$2,322.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,451.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$722.44
|
| Rate for Payer: HealthUtah PPO |
$2,580.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,502.60
|
| Rate for Payer: Multiplan Medicare/VA |
$614.07
|
| Rate for Payer: One Health Plan of WY PPO |
$2,528.40
|
| Rate for Payer: PacificSource Commercial |
$2,322.00
|
| Rate for Payer: PHCS PPO |
$2,451.00
|
| Rate for Payer: Three Rivers PPO |
$1,935.00
|
| Rate for Payer: TriWest Veterans Administration |
$722.44
|
| Rate for Payer: United Healthcare Commercial |
$2,244.60
|
| Rate for Payer: United Healthcare Medicare |
$722.44
|
| Rate for Payer: WINHealth Partners Commercial |
$2,193.00
|
|
|
HC PRO TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 26480
|
| Hospital Charge Code |
9832648001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$654.99 |
| Max. Negotiated Rate |
$3,299.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,233.02
|
| Rate for Payer: Aetna of WY Medicare |
$770.58
|
| Rate for Payer: Beech Street Commercial |
$3,134.05
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,200.03
|
| Rate for Payer: Cigna of WY Commercial |
$3,233.02
|
| Rate for Payer: First Choice Health Commercial |
$2,969.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,134.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$770.58
|
| Rate for Payer: HealthUtah PPO |
$3,299.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,200.03
|
| Rate for Payer: Multiplan Medicare/VA |
$654.99
|
| Rate for Payer: One Health Plan of WY PPO |
$3,233.02
|
| Rate for Payer: PacificSource Commercial |
$2,969.10
|
| Rate for Payer: PHCS PPO |
$3,134.05
|
| Rate for Payer: Three Rivers PPO |
$2,474.25
|
| Rate for Payer: TriWest Veterans Administration |
$770.58
|
| Rate for Payer: United Healthcare Commercial |
$2,870.13
|
| Rate for Payer: United Healthcare Medicare |
$770.58
|
| Rate for Payer: WINHealth Partners Commercial |
$2,804.15
|
|
|
HC PRO TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE
|
Professional
|
Both
|
$2,890.00
|
|
|
Service Code
|
HCPCS 52601
|
| Hospital Charge Code |
9835260101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$593.10 |
| Max. Negotiated Rate |
$2,890.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,832.20
|
| Rate for Payer: Aetna of WY Medicare |
$697.77
|
| Rate for Payer: Beech Street Commercial |
$2,745.50
|
| Rate for Payer: Cash Price |
$2,023.00
|
| Rate for Payer: Cash Price |
$2,023.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,803.30
|
| Rate for Payer: Cigna of WY Commercial |
$2,832.20
|
| Rate for Payer: First Choice Health Commercial |
$2,601.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,745.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$697.77
|
| Rate for Payer: HealthUtah PPO |
$2,890.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,803.30
|
| Rate for Payer: Multiplan Medicare/VA |
$593.10
|
| Rate for Payer: One Health Plan of WY PPO |
$2,832.20
|
| Rate for Payer: PacificSource Commercial |
$2,601.00
|
| Rate for Payer: PHCS PPO |
$2,745.50
|
| Rate for Payer: Three Rivers PPO |
$2,167.50
|
| Rate for Payer: TriWest Veterans Administration |
$697.77
|
| Rate for Payer: United Healthcare Commercial |
$2,514.30
|
| Rate for Payer: United Healthcare Medicare |
$697.77
|
| Rate for Payer: WINHealth Partners Commercial |
$2,456.50
|
|
|
HC PRO TTE F-UP OR LMTD - TTE LIMITED
|
Professional
|
Both
|
$1,214.00
|
|
|
Service Code
|
HCPCS 93308
|
| Hospital Charge Code |
9839330801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$82.09 |
| Max. Negotiated Rate |
$1,214.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,189.72
|
| Rate for Payer: Aetna of WY Medicare |
$96.58
|
| Rate for Payer: Beech Street Commercial |
$1,153.30
|
| Rate for Payer: Cash Price |
$849.80
|
| Rate for Payer: Cash Price |
$849.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,177.58
|
| Rate for Payer: Cigna of WY Commercial |
$1,189.72
|
| Rate for Payer: First Choice Health Commercial |
$1,092.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,153.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$96.58
|
| Rate for Payer: HealthUtah PPO |
$1,214.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,177.58
|
| Rate for Payer: Multiplan Medicare/VA |
$82.09
|
| Rate for Payer: One Health Plan of WY PPO |
$1,189.72
|
| Rate for Payer: PacificSource Commercial |
$1,092.60
|
| Rate for Payer: PHCS PPO |
$1,153.30
|
| Rate for Payer: Three Rivers PPO |
$910.50
|
| Rate for Payer: TriWest Veterans Administration |
$96.58
|
| Rate for Payer: United Healthcare Commercial |
$1,056.18
|
| Rate for Payer: United Healthcare Medicare |
$96.58
|
| Rate for Payer: WINHealth Partners Commercial |
$1,153.30
|
|
|
HC PRO TTE W/DOPPLER COMPLETE - TTE COMPLETE
|
Professional
|
Both
|
$594.00
|
|
|
Service Code
|
HCPCS 93306
|
| Hospital Charge Code |
9609330601
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$163.35 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$582.12
|
| Rate for Payer: Aetna of WY Medicare |
$192.18
|
| Rate for Payer: Beech Street Commercial |
$564.30
|
| Rate for Payer: Cash Price |
$415.80
|
| Rate for Payer: Cash Price |
$415.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$576.18
|
| Rate for Payer: Cigna of WY Commercial |
$582.12
|
| Rate for Payer: First Choice Health Commercial |
$534.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$564.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$192.18
|
| Rate for Payer: HealthUtah PPO |
$594.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$576.18
|
| Rate for Payer: Multiplan Medicare/VA |
$163.35
|
| Rate for Payer: One Health Plan of WY PPO |
$582.12
|
| Rate for Payer: PacificSource Commercial |
$534.60
|
| Rate for Payer: PHCS PPO |
$564.30
|
| Rate for Payer: Three Rivers PPO |
$445.50
|
| Rate for Payer: TriWest Veterans Administration |
$192.18
|
| Rate for Payer: United Healthcare Commercial |
$516.78
|
| Rate for Payer: United Healthcare Medicare |
$192.18
|
| Rate for Payer: WINHealth Partners Commercial |
$564.30
|
|
|
HC PRO TUBAL LIGATION/ FULG OVIDUCTS
|
Professional
|
Both
|
$6,888.00
|
|
|
Service Code
|
HCPCS 58670
|
| Hospital Charge Code |
9835867001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$305.78 |
| Max. Negotiated Rate |
$6,888.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,750.24
|
| Rate for Payer: Aetna of WY Medicare |
$359.74
|
| Rate for Payer: Beech Street Commercial |
$6,543.60
|
| Rate for Payer: Cash Price |
$4,821.60
|
| Rate for Payer: Cash Price |
$4,821.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,681.36
|
| Rate for Payer: Cigna of WY Commercial |
$6,750.24
|
| Rate for Payer: First Choice Health Commercial |
$6,199.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,543.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$359.74
|
| Rate for Payer: HealthUtah PPO |
$6,888.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,681.36
|
| Rate for Payer: Multiplan Medicare/VA |
$305.78
|
| Rate for Payer: One Health Plan of WY PPO |
$6,750.24
|
| Rate for Payer: PacificSource Commercial |
$6,199.20
|
| Rate for Payer: PHCS PPO |
$6,543.60
|
| Rate for Payer: Three Rivers PPO |
$5,166.00
|
| Rate for Payer: TriWest Veterans Administration |
$359.74
|
| Rate for Payer: United Healthcare Commercial |
$5,992.56
|
| Rate for Payer: United Healthcare Medicare |
$359.74
|
| Rate for Payer: WINHealth Partners Commercial |
$5,854.80
|
|
|
HC PRO TUBAL LIGATION POST PARTUM
|
Professional
|
Both
|
$2,978.00
|
|
|
Service Code
|
HCPCS 58605
|
| Hospital Charge Code |
9835860501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$277.64 |
| Max. Negotiated Rate |
$2,978.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,918.44
|
| Rate for Payer: Aetna of WY Medicare |
$326.63
|
| Rate for Payer: Beech Street Commercial |
$2,829.10
|
| Rate for Payer: Cash Price |
$2,084.60
|
| Rate for Payer: Cash Price |
$2,084.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,888.66
|
| Rate for Payer: Cigna of WY Commercial |
$2,918.44
|
| Rate for Payer: First Choice Health Commercial |
$2,680.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,829.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$326.63
|
| Rate for Payer: HealthUtah PPO |
$2,978.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,888.66
|
| Rate for Payer: Multiplan Medicare/VA |
$277.64
|
| Rate for Payer: One Health Plan of WY PPO |
$2,918.44
|
| Rate for Payer: PacificSource Commercial |
$2,680.20
|
| Rate for Payer: PHCS PPO |
$2,829.10
|
| Rate for Payer: Three Rivers PPO |
$2,233.50
|
| Rate for Payer: TriWest Veterans Administration |
$326.63
|
| Rate for Payer: United Healthcare Commercial |
$2,590.86
|
| Rate for Payer: United Healthcare Medicare |
$326.63
|
| Rate for Payer: WINHealth Partners Commercial |
$2,531.30
|
|
|
HC PRO TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$1,575.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
9833255101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$123.90 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,543.50
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,018.22
|
| Rate for Payer: Aetna of WY Medicare |
$145.77
|
| Rate for Payer: Aetna of WY Medicare |
$145.77
|
| Rate for Payer: Beech Street Commercial |
$987.05
|
| Rate for Payer: Beech Street Commercial |
$1,496.25
|
| Rate for Payer: Cash Price |
$727.30
|
| Rate for Payer: Cash Price |
$727.30
|
| Rate for Payer: Cash Price |
$1,102.50
|
| Rate for Payer: Cash Price |
$1,102.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,527.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,007.83
|
| Rate for Payer: Cigna of WY Commercial |
$1,018.22
|
| Rate for Payer: Cigna of WY Commercial |
$1,543.50
|
| Rate for Payer: First Choice Health Commercial |
$935.10
|
| Rate for Payer: First Choice Health Commercial |
$1,417.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,496.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$987.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.77
|
| Rate for Payer: HealthUtah PPO |
$1,575.00
|
| Rate for Payer: HealthUtah PPO |
$1,039.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,527.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,007.83
|
| Rate for Payer: Multiplan Medicare/VA |
$123.90
|
| Rate for Payer: Multiplan Medicare/VA |
$123.90
|
| Rate for Payer: One Health Plan of WY PPO |
$1,543.50
|
| Rate for Payer: One Health Plan of WY PPO |
$1,018.22
|
| Rate for Payer: PacificSource Commercial |
$935.10
|
| Rate for Payer: PacificSource Commercial |
$1,417.50
|
| Rate for Payer: PHCS PPO |
$1,496.25
|
| Rate for Payer: PHCS PPO |
$987.05
|
| Rate for Payer: Three Rivers PPO |
$1,181.25
|
| Rate for Payer: Three Rivers PPO |
$779.25
|
| Rate for Payer: TriWest Veterans Administration |
$145.77
|
| Rate for Payer: TriWest Veterans Administration |
$145.77
|
| Rate for Payer: United Healthcare Commercial |
$903.93
|
| Rate for Payer: United Healthcare Commercial |
$1,370.25
|
| Rate for Payer: United Healthcare Medicare |
$145.77
|
| Rate for Payer: United Healthcare Medicare |
$145.77
|
| Rate for Payer: WINHealth Partners Commercial |
$1,338.75
|
| Rate for Payer: WINHealth Partners Commercial |
$883.15
|
|
|
HC PRO TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL
|
Professional
|
Both
|
$909.00
|
|
|
Service Code
|
HCPCS 59812
|
| Hospital Charge Code |
9835981201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$250.43 |
| Max. Negotiated Rate |
$909.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$890.82
|
| Rate for Payer: Aetna of WY Medicare |
$294.62
|
| Rate for Payer: Beech Street Commercial |
$863.55
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$881.73
|
| Rate for Payer: Cigna of WY Commercial |
$890.82
|
| Rate for Payer: First Choice Health Commercial |
$818.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$863.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$294.62
|
| Rate for Payer: HealthUtah PPO |
$909.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$881.73
|
| Rate for Payer: Multiplan Medicare/VA |
$250.43
|
| Rate for Payer: One Health Plan of WY PPO |
$890.82
|
| Rate for Payer: PacificSource Commercial |
$818.10
|
| Rate for Payer: PHCS PPO |
$863.55
|
| Rate for Payer: Three Rivers PPO |
$681.75
|
| Rate for Payer: TriWest Veterans Administration |
$294.62
|
| Rate for Payer: United Healthcare Commercial |
$790.83
|
| Rate for Payer: United Healthcare Medicare |
$294.62
|
| Rate for Payer: WINHealth Partners Commercial |
$772.65
|
|
|
HC PRO TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
|
Professional
|
Both
|
$4,996.00
|
|
|
Service Code
|
HCPCS 27245
|
| Hospital Charge Code |
9832724501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,001.54 |
| Max. Negotiated Rate |
$4,996.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,896.08
|
| Rate for Payer: Aetna of WY Medicare |
$1,178.28
|
| Rate for Payer: Beech Street Commercial |
$4,746.20
|
| Rate for Payer: Cash Price |
$3,497.20
|
| Rate for Payer: Cash Price |
$3,497.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,846.12
|
| Rate for Payer: Cigna of WY Commercial |
$4,896.08
|
| Rate for Payer: First Choice Health Commercial |
$4,496.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,746.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,178.28
|
| Rate for Payer: HealthUtah PPO |
$4,996.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,846.12
|
| Rate for Payer: Multiplan Medicare/VA |
$1,001.54
|
| Rate for Payer: One Health Plan of WY PPO |
$4,896.08
|
| Rate for Payer: PacificSource Commercial |
$4,496.40
|
| Rate for Payer: PHCS PPO |
$4,746.20
|
| Rate for Payer: Three Rivers PPO |
$3,747.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,178.28
|
| Rate for Payer: United Healthcare Commercial |
$4,346.52
|
| Rate for Payer: United Healthcare Medicare |
$1,178.28
|
| Rate for Payer: WINHealth Partners Commercial |
$4,246.60
|
|
|
HC PRO TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT
|
Professional
|
Both
|
$2,362.00
|
|
|
Service Code
|
HCPCS 27244
|
| Hospital Charge Code |
9752724401
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,002.78 |
| Max. Negotiated Rate |
$2,362.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,314.76
|
| Rate for Payer: Aetna of WY Medicare |
$1,179.74
|
| Rate for Payer: Beech Street Commercial |
$2,243.90
|
| Rate for Payer: Cash Price |
$1,653.40
|
| Rate for Payer: Cash Price |
$1,653.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,291.14
|
| Rate for Payer: Cigna of WY Commercial |
$2,314.76
|
| Rate for Payer: First Choice Health Commercial |
$2,125.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,243.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,179.74
|
| Rate for Payer: HealthUtah PPO |
$2,362.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,291.14
|
| Rate for Payer: Multiplan Medicare/VA |
$1,002.78
|
| Rate for Payer: One Health Plan of WY PPO |
$2,314.76
|
| Rate for Payer: PacificSource Commercial |
$2,125.80
|
| Rate for Payer: PHCS PPO |
$2,243.90
|
| Rate for Payer: Three Rivers PPO |
$1,771.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,179.74
|
| Rate for Payer: United Healthcare Commercial |
$2,054.94
|
| Rate for Payer: United Healthcare Medicare |
$1,179.74
|
| Rate for Payer: WINHealth Partners Commercial |
$2,007.70
|
|
|
HC PRO TX LS TRSL FX W/O MAN
|
Professional
|
Both
|
$1,473.00
|
|
|
Service Code
|
HCPCS 28450
|
| Hospital Charge Code |
9832845001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$163.36 |
| Max. Negotiated Rate |
$1,473.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,443.54
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$771.26
|
| Rate for Payer: Aetna of WY Medicare |
$192.19
|
| Rate for Payer: Aetna of WY Medicare |
$192.19
|
| Rate for Payer: Beech Street Commercial |
$747.65
|
| Rate for Payer: Beech Street Commercial |
$1,399.35
|
| Rate for Payer: Cash Price |
$550.90
|
| Rate for Payer: Cash Price |
$1,031.10
|
| Rate for Payer: Cash Price |
$1,031.10
|
| Rate for Payer: Cash Price |
$550.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$763.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,428.81
|
| Rate for Payer: Cigna of WY Commercial |
$1,443.54
|
| Rate for Payer: Cigna of WY Commercial |
$771.26
|
| Rate for Payer: First Choice Health Commercial |
$708.30
|
| Rate for Payer: First Choice Health Commercial |
$1,325.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,399.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$747.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$192.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$192.19
|
| Rate for Payer: HealthUtah PPO |
$1,473.00
|
| Rate for Payer: HealthUtah PPO |
$787.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$763.39
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,428.81
|
| Rate for Payer: Multiplan Medicare/VA |
$163.36
|
| Rate for Payer: Multiplan Medicare/VA |
$163.36
|
| Rate for Payer: One Health Plan of WY PPO |
$771.26
|
| Rate for Payer: One Health Plan of WY PPO |
$1,443.54
|
| Rate for Payer: PacificSource Commercial |
$1,325.70
|
| Rate for Payer: PacificSource Commercial |
$708.30
|
| Rate for Payer: PHCS PPO |
$1,399.35
|
| Rate for Payer: PHCS PPO |
$747.65
|
| Rate for Payer: Three Rivers PPO |
$1,104.75
|
| Rate for Payer: Three Rivers PPO |
$590.25
|
| Rate for Payer: TriWest Veterans Administration |
$192.19
|
| Rate for Payer: TriWest Veterans Administration |
$192.19
|
| Rate for Payer: United Healthcare Commercial |
$684.69
|
| Rate for Payer: United Healthcare Commercial |
$1,281.51
|
| Rate for Payer: United Healthcare Medicare |
$192.19
|
| Rate for Payer: United Healthcare Medicare |
$192.19
|
| Rate for Payer: WINHealth Partners Commercial |
$1,252.05
|
| Rate for Payer: WINHealth Partners Commercial |
$668.95
|
|
|
HC PRO TX LS TRSL FX W/O MAN
|
Professional
|
Both
|
$984.00
|
|
|
Service Code
|
HCPCS 28450 NONPBBPAYER
|
| Hospital Charge Code |
9832845001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$163.36 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$964.32
|
| Rate for Payer: Aetna of WY Medicare |
$192.19
|
| Rate for Payer: Beech Street Commercial |
$934.80
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$954.48
|
| Rate for Payer: Cigna of WY Commercial |
$964.32
|
| Rate for Payer: First Choice Health Commercial |
$885.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$934.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$192.19
|
| Rate for Payer: HealthUtah PPO |
$984.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$954.48
|
| Rate for Payer: Multiplan Medicare/VA |
$163.36
|
| Rate for Payer: One Health Plan of WY PPO |
$964.32
|
| Rate for Payer: PacificSource Commercial |
$885.60
|
| Rate for Payer: PHCS PPO |
$934.80
|
| Rate for Payer: Three Rivers PPO |
$738.00
|
| Rate for Payer: TriWest Veterans Administration |
$192.19
|
| Rate for Payer: United Healthcare Commercial |
$856.08
|
| Rate for Payer: United Healthcare Medicare |
$192.19
|
| Rate for Payer: WINHealth Partners Commercial |
$836.40
|
|
|
HC PRO TX MISSED MISCARRIAGE FIRST TRIMESTER SURGICAL
|
Professional
|
Both
|
$1,117.00
|
|
|
Service Code
|
HCPCS 59820
|
| Hospital Charge Code |
9835982001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$316.91 |
| Max. Negotiated Rate |
$1,117.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,094.66
|
| Rate for Payer: Aetna of WY Medicare |
$372.84
|
| Rate for Payer: Beech Street Commercial |
$1,061.15
|
| Rate for Payer: Cash Price |
$781.90
|
| Rate for Payer: Cash Price |
$781.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,083.49
|
| Rate for Payer: Cigna of WY Commercial |
$1,094.66
|
| Rate for Payer: First Choice Health Commercial |
$1,005.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,061.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$372.84
|
| Rate for Payer: HealthUtah PPO |
$1,117.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,083.49
|
| Rate for Payer: Multiplan Medicare/VA |
$316.91
|
| Rate for Payer: One Health Plan of WY PPO |
$1,094.66
|
| Rate for Payer: PacificSource Commercial |
$1,005.30
|
| Rate for Payer: PHCS PPO |
$1,061.15
|
| Rate for Payer: Three Rivers PPO |
$837.75
|
| Rate for Payer: TriWest Veterans Administration |
$372.84
|
| Rate for Payer: United Healthcare Commercial |
$971.79
|
| Rate for Payer: United Healthcare Medicare |
$372.84
|
| Rate for Payer: WINHealth Partners Commercial |
$949.45
|
|
|
HC PRO TX OPEN TENDON FLEXOR TOE 1 TENDON SPX
|
Professional
|
Both
|
$1,252.00
|
|
|
Service Code
|
HCPCS 28232
|
| Hospital Charge Code |
9822823201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$201.41 |
| Max. Negotiated Rate |
$1,252.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,226.96
|
| Rate for Payer: Aetna of WY Medicare |
$236.95
|
| Rate for Payer: Beech Street Commercial |
$1,189.40
|
| Rate for Payer: Cash Price |
$876.40
|
| Rate for Payer: Cash Price |
$876.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,214.44
|
| Rate for Payer: Cigna of WY Commercial |
$1,226.96
|
| Rate for Payer: First Choice Health Commercial |
$1,126.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,189.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$236.95
|
| Rate for Payer: HealthUtah PPO |
$1,252.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,214.44
|
| Rate for Payer: Multiplan Medicare/VA |
$201.41
|
| Rate for Payer: One Health Plan of WY PPO |
$1,226.96
|
| Rate for Payer: PacificSource Commercial |
$1,126.80
|
| Rate for Payer: PHCS PPO |
$1,189.40
|
| Rate for Payer: Three Rivers PPO |
$939.00
|
| Rate for Payer: TriWest Veterans Administration |
$236.95
|
| Rate for Payer: United Healthcare Commercial |
$1,089.24
|
| Rate for Payer: United Healthcare Medicare |
$236.95
|
| Rate for Payer: WINHealth Partners Commercial |
$1,064.20
|
|
