|
LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$3,112.00
|
|
|
Service Code
|
HCPCS 44970 62
|
| Hospital Charge Code |
44970
|
| Min. Negotiated Rate |
$489.00 |
| Max. Negotiated Rate |
$3,112.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,049.76
|
| Rate for Payer: Aetna of WY Medicare |
$575.29
|
| Rate for Payer: Beech Street Commercial |
$2,956.40
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,018.64
|
| Rate for Payer: Cigna of WY Commercial |
$3,049.76
|
| Rate for Payer: First Choice Health Commercial |
$2,800.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,956.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$575.29
|
| Rate for Payer: HealthUtah PPO |
$3,112.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,018.64
|
| Rate for Payer: Multiplan Medicare/VA |
$489.00
|
| Rate for Payer: One Health Plan of WY PPO |
$3,049.76
|
| Rate for Payer: PacificSource Commercial |
$2,800.80
|
| Rate for Payer: PHCS PPO |
$2,956.40
|
| Rate for Payer: Three Rivers PPO |
$2,334.00
|
| Rate for Payer: TriWest Veterans Administration |
$575.29
|
| Rate for Payer: United Healthcare Commercial |
$2,707.44
|
| Rate for Payer: United Healthcare Medicare |
$575.29
|
| Rate for Payer: WINHealth Partners Commercial |
$2,645.20
|
|
|
LAPAROSCOPIC SURGICAL SPLENECTOMY
|
Professional
|
Both
|
$3,590.00
|
|
|
Service Code
|
HCPCS 38120 AS
|
| Hospital Charge Code |
38120
|
| Min. Negotiated Rate |
$855.02 |
| Max. Negotiated Rate |
$3,590.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,518.20
|
| Rate for Payer: Aetna of WY Medicare |
$1,005.91
|
| Rate for Payer: Beech Street Commercial |
$3,410.50
|
| Rate for Payer: Cash Price |
$2,513.00
|
| Rate for Payer: Cash Price |
$2,513.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,482.30
|
| Rate for Payer: Cigna of WY Commercial |
$3,518.20
|
| Rate for Payer: First Choice Health Commercial |
$3,231.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,410.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,005.91
|
| Rate for Payer: HealthUtah PPO |
$3,590.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,482.30
|
| Rate for Payer: Multiplan Medicare/VA |
$855.02
|
| Rate for Payer: One Health Plan of WY PPO |
$3,518.20
|
| Rate for Payer: PacificSource Commercial |
$3,231.00
|
| Rate for Payer: PHCS PPO |
$3,410.50
|
| Rate for Payer: Three Rivers PPO |
$2,692.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,005.91
|
| Rate for Payer: United Healthcare Commercial |
$3,123.30
|
| Rate for Payer: United Healthcare Medicare |
$1,005.91
|
| Rate for Payer: WINHealth Partners Commercial |
$3,051.50
|
|
|
LAPAROSCOPIC SURGICAL SPLENECTOMY
|
Professional
|
Both
|
$3,590.00
|
|
|
Service Code
|
HCPCS 38120
|
| Hospital Charge Code |
38120
|
| Min. Negotiated Rate |
$855.02 |
| Max. Negotiated Rate |
$3,590.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,518.20
|
| Rate for Payer: Aetna of WY Medicare |
$1,005.91
|
| Rate for Payer: Beech Street Commercial |
$3,410.50
|
| Rate for Payer: Cash Price |
$2,513.00
|
| Rate for Payer: Cash Price |
$2,513.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,482.30
|
| Rate for Payer: Cigna of WY Commercial |
$3,518.20
|
| Rate for Payer: First Choice Health Commercial |
$3,231.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,410.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,005.91
|
| Rate for Payer: HealthUtah PPO |
$3,590.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,482.30
|
| Rate for Payer: Multiplan Medicare/VA |
$855.02
|
| Rate for Payer: One Health Plan of WY PPO |
$3,518.20
|
| Rate for Payer: PacificSource Commercial |
$3,231.00
|
| Rate for Payer: PHCS PPO |
$3,410.50
|
| Rate for Payer: Three Rivers PPO |
$2,692.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,005.91
|
| Rate for Payer: United Healthcare Commercial |
$3,123.30
|
| Rate for Payer: United Healthcare Medicare |
$1,005.91
|
| Rate for Payer: WINHealth Partners Commercial |
$3,051.50
|
|
|
LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$7,956.00
|
|
|
Service Code
|
HCPCS 44204
|
| Hospital Charge Code |
44204
|
| Min. Negotiated Rate |
$1,233.10 |
| Max. Negotiated Rate |
$7,956.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,796.88
|
| Rate for Payer: Aetna of WY Medicare |
$1,450.71
|
| Rate for Payer: Beech Street Commercial |
$7,558.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,717.32
|
| Rate for Payer: Cigna of WY Commercial |
$7,796.88
|
| Rate for Payer: First Choice Health Commercial |
$7,160.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,558.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,450.71
|
| Rate for Payer: HealthUtah PPO |
$7,956.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,717.32
|
| Rate for Payer: Multiplan Medicare/VA |
$1,233.10
|
| Rate for Payer: One Health Plan of WY PPO |
$7,796.88
|
| Rate for Payer: PacificSource Commercial |
$7,160.40
|
| Rate for Payer: PHCS PPO |
$7,558.20
|
| Rate for Payer: Three Rivers PPO |
$5,967.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,450.71
|
| Rate for Payer: United Healthcare Commercial |
$6,921.72
|
| Rate for Payer: United Healthcare Medicare |
$1,450.71
|
| Rate for Payer: WINHealth Partners Commercial |
$6,762.60
|
|
|
LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$7,956.00
|
|
|
Service Code
|
HCPCS 44204 AS
|
| Hospital Charge Code |
44204
|
| Min. Negotiated Rate |
$1,233.10 |
| Max. Negotiated Rate |
$7,956.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,796.88
|
| Rate for Payer: Aetna of WY Medicare |
$1,450.71
|
| Rate for Payer: Beech Street Commercial |
$7,558.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,717.32
|
| Rate for Payer: Cigna of WY Commercial |
$7,796.88
|
| Rate for Payer: First Choice Health Commercial |
$7,160.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,558.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,450.71
|
| Rate for Payer: HealthUtah PPO |
$7,956.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,717.32
|
| Rate for Payer: Multiplan Medicare/VA |
$1,233.10
|
| Rate for Payer: One Health Plan of WY PPO |
$7,796.88
|
| Rate for Payer: PacificSource Commercial |
$7,160.40
|
| Rate for Payer: PHCS PPO |
$7,558.20
|
| Rate for Payer: Three Rivers PPO |
$5,967.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,450.71
|
| Rate for Payer: United Healthcare Commercial |
$6,921.72
|
| Rate for Payer: United Healthcare Medicare |
$1,450.71
|
| Rate for Payer: WINHealth Partners Commercial |
$6,762.60
|
|
|
LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$7,956.00
|
|
|
Service Code
|
HCPCS 44204 81
|
| Hospital Charge Code |
44204
|
| Min. Negotiated Rate |
$1,233.10 |
| Max. Negotiated Rate |
$7,956.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,796.88
|
| Rate for Payer: Aetna of WY Medicare |
$1,450.71
|
| Rate for Payer: Beech Street Commercial |
$7,558.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,717.32
|
| Rate for Payer: Cigna of WY Commercial |
$7,796.88
|
| Rate for Payer: First Choice Health Commercial |
$7,160.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,558.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,450.71
|
| Rate for Payer: HealthUtah PPO |
$7,956.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,717.32
|
| Rate for Payer: Multiplan Medicare/VA |
$1,233.10
|
| Rate for Payer: One Health Plan of WY PPO |
$7,796.88
|
| Rate for Payer: PacificSource Commercial |
$7,160.40
|
| Rate for Payer: PHCS PPO |
$7,558.20
|
| Rate for Payer: Three Rivers PPO |
$5,967.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,450.71
|
| Rate for Payer: United Healthcare Commercial |
$6,921.72
|
| Rate for Payer: United Healthcare Medicare |
$1,450.71
|
| Rate for Payer: WINHealth Partners Commercial |
$6,762.60
|
|
|
LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$7,956.00
|
|
|
Service Code
|
HCPCS 44204 80
|
| Hospital Charge Code |
44204
|
| Min. Negotiated Rate |
$1,233.10 |
| Max. Negotiated Rate |
$7,956.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,796.88
|
| Rate for Payer: Aetna of WY Medicare |
$1,450.71
|
| Rate for Payer: Beech Street Commercial |
$7,558.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: Cash Price |
$5,569.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,717.32
|
| Rate for Payer: Cigna of WY Commercial |
$7,796.88
|
| Rate for Payer: First Choice Health Commercial |
$7,160.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,558.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,450.71
|
| Rate for Payer: HealthUtah PPO |
$7,956.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,717.32
|
| Rate for Payer: Multiplan Medicare/VA |
$1,233.10
|
| Rate for Payer: One Health Plan of WY PPO |
$7,796.88
|
| Rate for Payer: PacificSource Commercial |
$7,160.40
|
| Rate for Payer: PHCS PPO |
$7,558.20
|
| Rate for Payer: Three Rivers PPO |
$5,967.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,450.71
|
| Rate for Payer: United Healthcare Commercial |
$6,921.72
|
| Rate for Payer: United Healthcare Medicare |
$1,450.71
|
| Rate for Payer: WINHealth Partners Commercial |
$6,762.60
|
|
|
LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX
|
Professional
|
Both
|
$3,905.00
|
|
|
Service Code
|
HCPCS 57425
|
| Hospital Charge Code |
57425
|
| Min. Negotiated Rate |
$794.99 |
| Max. Negotiated Rate |
$3,905.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,826.90
|
| Rate for Payer: Aetna of WY Medicare |
$935.28
|
| Rate for Payer: Beech Street Commercial |
$3,709.75
|
| Rate for Payer: Cash Price |
$2,733.50
|
| Rate for Payer: Cash Price |
$2,733.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,787.85
|
| Rate for Payer: Cigna of WY Commercial |
$3,826.90
|
| Rate for Payer: First Choice Health Commercial |
$3,514.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,709.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$935.28
|
| Rate for Payer: HealthUtah PPO |
$3,905.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,787.85
|
| Rate for Payer: Multiplan Medicare/VA |
$794.99
|
| Rate for Payer: One Health Plan of WY PPO |
$3,826.90
|
| Rate for Payer: PacificSource Commercial |
$3,514.50
|
| Rate for Payer: PHCS PPO |
$3,709.75
|
| Rate for Payer: Three Rivers PPO |
$2,928.75
|
| Rate for Payer: TriWest Veterans Administration |
$935.28
|
| Rate for Payer: United Healthcare Commercial |
$3,397.35
|
| Rate for Payer: United Healthcare Medicare |
$935.28
|
| Rate for Payer: WINHealth Partners Commercial |
$3,319.25
|
|
|
LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$4,763.00
|
|
|
Service Code
|
HCPCS 44180
|
| Hospital Charge Code |
44180
|
| Min. Negotiated Rate |
$741.57 |
| Max. Negotiated Rate |
$4,763.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,667.74
|
| Rate for Payer: Aetna of WY Medicare |
$872.43
|
| Rate for Payer: Beech Street Commercial |
$4,524.85
|
| Rate for Payer: Cash Price |
$3,334.10
|
| Rate for Payer: Cash Price |
$3,334.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,620.11
|
| Rate for Payer: Cigna of WY Commercial |
$4,667.74
|
| Rate for Payer: First Choice Health Commercial |
$4,286.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,524.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$872.43
|
| Rate for Payer: HealthUtah PPO |
$4,763.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,620.11
|
| Rate for Payer: Multiplan Medicare/VA |
$741.57
|
| Rate for Payer: One Health Plan of WY PPO |
$4,667.74
|
| Rate for Payer: PacificSource Commercial |
$4,286.70
|
| Rate for Payer: PHCS PPO |
$4,524.85
|
| Rate for Payer: Three Rivers PPO |
$3,572.25
|
| Rate for Payer: TriWest Veterans Administration |
$872.43
|
| Rate for Payer: United Healthcare Commercial |
$4,143.81
|
| Rate for Payer: United Healthcare Medicare |
$872.43
|
| Rate for Payer: WINHealth Partners Commercial |
$4,048.55
|
|
|
LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$4,763.00
|
|
|
Service Code
|
HCPCS 44180 AS
|
| Hospital Charge Code |
44180
|
| Min. Negotiated Rate |
$741.57 |
| Max. Negotiated Rate |
$4,763.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,667.74
|
| Rate for Payer: Aetna of WY Medicare |
$872.43
|
| Rate for Payer: Beech Street Commercial |
$4,524.85
|
| Rate for Payer: Cash Price |
$3,334.10
|
| Rate for Payer: Cash Price |
$3,334.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,620.11
|
| Rate for Payer: Cigna of WY Commercial |
$4,667.74
|
| Rate for Payer: First Choice Health Commercial |
$4,286.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,524.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$872.43
|
| Rate for Payer: HealthUtah PPO |
$4,763.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,620.11
|
| Rate for Payer: Multiplan Medicare/VA |
$741.57
|
| Rate for Payer: One Health Plan of WY PPO |
$4,667.74
|
| Rate for Payer: PacificSource Commercial |
$4,286.70
|
| Rate for Payer: PHCS PPO |
$4,524.85
|
| Rate for Payer: Three Rivers PPO |
$3,572.25
|
| Rate for Payer: TriWest Veterans Administration |
$872.43
|
| Rate for Payer: United Healthcare Commercial |
$4,143.81
|
| Rate for Payer: United Healthcare Medicare |
$872.43
|
| Rate for Payer: WINHealth Partners Commercial |
$4,048.55
|
|
|
LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$4,763.00
|
|
|
Service Code
|
HCPCS 44180 80
|
| Hospital Charge Code |
44180
|
| Min. Negotiated Rate |
$741.57 |
| Max. Negotiated Rate |
$4,763.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,667.74
|
| Rate for Payer: Aetna of WY Medicare |
$872.43
|
| Rate for Payer: Beech Street Commercial |
$4,524.85
|
| Rate for Payer: Cash Price |
$3,334.10
|
| Rate for Payer: Cash Price |
$3,334.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,620.11
|
| Rate for Payer: Cigna of WY Commercial |
$4,667.74
|
| Rate for Payer: First Choice Health Commercial |
$4,286.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,524.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$872.43
|
| Rate for Payer: HealthUtah PPO |
$4,763.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,620.11
|
| Rate for Payer: Multiplan Medicare/VA |
$741.57
|
| Rate for Payer: One Health Plan of WY PPO |
$4,667.74
|
| Rate for Payer: PacificSource Commercial |
$4,286.70
|
| Rate for Payer: PHCS PPO |
$4,524.85
|
| Rate for Payer: Three Rivers PPO |
$3,572.25
|
| Rate for Payer: TriWest Veterans Administration |
$872.43
|
| Rate for Payer: United Healthcare Commercial |
$4,143.81
|
| Rate for Payer: United Healthcare Medicare |
$872.43
|
| Rate for Payer: WINHealth Partners Commercial |
$4,048.55
|
|
|
LAPAROSCOPY FIMBRIOPLASTY
|
Professional
|
Both
|
$3,064.00
|
|
|
Service Code
|
HCPCS 58672
|
| Hospital Charge Code |
58672
|
| Min. Negotiated Rate |
$596.41 |
| Max. Negotiated Rate |
$3,064.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,002.72
|
| Rate for Payer: Aetna of WY Medicare |
$701.66
|
| Rate for Payer: Beech Street Commercial |
$2,910.80
|
| Rate for Payer: Cash Price |
$2,144.80
|
| Rate for Payer: Cash Price |
$2,144.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,972.08
|
| Rate for Payer: Cigna of WY Commercial |
$3,002.72
|
| Rate for Payer: First Choice Health Commercial |
$2,757.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,910.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$701.66
|
| Rate for Payer: HealthUtah PPO |
$3,064.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,972.08
|
| Rate for Payer: Multiplan Medicare/VA |
$596.41
|
| Rate for Payer: One Health Plan of WY PPO |
$3,002.72
|
| Rate for Payer: PacificSource Commercial |
$2,757.60
|
| Rate for Payer: PHCS PPO |
$2,910.80
|
| Rate for Payer: Three Rivers PPO |
$2,298.00
|
| Rate for Payer: TriWest Veterans Administration |
$701.66
|
| Rate for Payer: United Healthcare Commercial |
$2,665.68
|
| Rate for Payer: United Healthcare Medicare |
$701.66
|
| Rate for Payer: WINHealth Partners Commercial |
$2,604.40
|
|
|
LAPAROSCOPY FULGURATION OVIDUCTS
|
Professional
|
Both
|
$6,888.00
|
|
|
Service Code
|
HCPCS 58670
|
| Hospital Charge Code |
58670
|
| 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
|
|
|
LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT
|
Professional
|
Both
|
$7,833.00
|
|
|
Service Code
|
HCPCS 50546 80
|
| Hospital Charge Code |
50546
|
| Min. Negotiated Rate |
$975.54 |
| Max. Negotiated Rate |
$7,833.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,676.34
|
| Rate for Payer: Aetna of WY Medicare |
$1,147.70
|
| Rate for Payer: Beech Street Commercial |
$7,441.35
|
| Rate for Payer: Cash Price |
$5,483.10
|
| Rate for Payer: Cash Price |
$5,483.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,598.01
|
| Rate for Payer: Cigna of WY Commercial |
$7,676.34
|
| Rate for Payer: First Choice Health Commercial |
$7,049.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,441.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,147.70
|
| Rate for Payer: HealthUtah PPO |
$7,833.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,598.01
|
| Rate for Payer: Multiplan Medicare/VA |
$975.54
|
| Rate for Payer: One Health Plan of WY PPO |
$7,676.34
|
| Rate for Payer: PacificSource Commercial |
$7,049.70
|
| Rate for Payer: PHCS PPO |
$7,441.35
|
| Rate for Payer: Three Rivers PPO |
$5,874.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,147.70
|
| Rate for Payer: United Healthcare Commercial |
$6,814.71
|
| Rate for Payer: United Healthcare Medicare |
$1,147.70
|
| Rate for Payer: WINHealth Partners Commercial |
$6,658.05
|
|
|
LAPAROSCOPY PACK
|
Facility
|
OP
|
$40.58
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.36 |
| Max. Negotiated Rate |
$40.58 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.77
|
| Rate for Payer: Aetna of WY Medicare |
$26.78
|
| Rate for Payer: Altius Auto/Workers Compensation |
$38.96
|
| Rate for Payer: Altius Commercial |
$38.96
|
| Rate for Payer: Beech Street Commercial |
$39.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.32
|
| Rate for Payer: Cash Price |
$28.41
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.36
|
| Rate for Payer: Cigna of WY Commercial |
$39.77
|
| Rate for Payer: Entrust Commercial |
$38.55
|
| Rate for Payer: First Choice Health Commercial |
$38.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.54
|
| Rate for Payer: HealthUtah PPO |
$40.58
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.36
|
| Rate for Payer: Multiplan Medicare/VA |
$22.36
|
| Rate for Payer: One Health Plan of WY PPO |
$39.77
|
| Rate for Payer: PacificSource Commercial |
$36.52
|
| Rate for Payer: PHCS PPO |
$39.77
|
| Rate for Payer: Three Rivers PPO |
$30.44
|
| Rate for Payer: TriWest Veterans Administration |
$23.54
|
| Rate for Payer: United Healthcare Commercial |
$35.30
|
| Rate for Payer: United Healthcare Medicare |
$23.54
|
| Rate for Payer: WINHealth Partners Commercial |
$39.77
|
| Rate for Payer: Wise Provider Network Commercial |
$38.55
|
|
|
LAPAROSCOPY PACK
|
Facility
|
IP
|
$40.58
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.44 |
| Max. Negotiated Rate |
$40.58 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.77
|
| Rate for Payer: Altius Auto/Workers Compensation |
$38.96
|
| Rate for Payer: Altius Commercial |
$38.96
|
| Rate for Payer: Beech Street Commercial |
$39.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.32
|
| Rate for Payer: Cash Price |
$28.41
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.36
|
| Rate for Payer: Cigna of WY Commercial |
$39.77
|
| Rate for Payer: Entrust Commercial |
$38.55
|
| Rate for Payer: First Choice Health Commercial |
$38.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.78
|
| Rate for Payer: HealthUtah PPO |
$40.58
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.36
|
| Rate for Payer: Multiplan Medicare/VA |
$25.44
|
| Rate for Payer: One Health Plan of WY PPO |
$39.77
|
| Rate for Payer: PacificSource Commercial |
$36.52
|
| Rate for Payer: PHCS PPO |
$39.77
|
| Rate for Payer: Three Rivers PPO |
$30.44
|
| Rate for Payer: TriWest Veterans Administration |
$26.78
|
| Rate for Payer: United Healthcare Commercial |
$35.30
|
| Rate for Payer: United Healthcare Medicare |
$26.78
|
| Rate for Payer: WINHealth Partners Commercial |
$38.55
|
| Rate for Payer: Wise Provider Network Commercial |
$38.55
|
|
|
LAPAROSCOPY RADICAL NEPHRECTOMY
|
Professional
|
Both
|
$6,222.00
|
|
|
Service Code
|
HCPCS 50545
|
| Hospital Charge Code |
50545
|
| Min. Negotiated Rate |
$1,079.86 |
| Max. Negotiated Rate |
$6,222.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,097.56
|
| Rate for Payer: Aetna of WY Medicare |
$1,270.42
|
| Rate for Payer: Beech Street Commercial |
$5,910.90
|
| Rate for Payer: Cash Price |
$4,355.40
|
| Rate for Payer: Cash Price |
$4,355.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,035.34
|
| Rate for Payer: Cigna of WY Commercial |
$6,097.56
|
| Rate for Payer: First Choice Health Commercial |
$5,599.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,910.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,270.42
|
| Rate for Payer: HealthUtah PPO |
$6,222.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,035.34
|
| Rate for Payer: Multiplan Medicare/VA |
$1,079.86
|
| Rate for Payer: One Health Plan of WY PPO |
$6,097.56
|
| Rate for Payer: PacificSource Commercial |
$5,599.80
|
| Rate for Payer: PHCS PPO |
$5,910.90
|
| Rate for Payer: Three Rivers PPO |
$4,666.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,270.42
|
| Rate for Payer: United Healthcare Commercial |
$5,413.14
|
| Rate for Payer: United Healthcare Medicare |
$1,270.42
|
| Rate for Payer: WINHealth Partners Commercial |
$5,288.70
|
|
|
LAPAROSCOPY RADICAL NEPHRECTOMY
|
Professional
|
Both
|
$6,222.00
|
|
|
Service Code
|
HCPCS 50545 80
|
| Hospital Charge Code |
50545
|
| Min. Negotiated Rate |
$1,079.86 |
| Max. Negotiated Rate |
$6,222.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,097.56
|
| Rate for Payer: Aetna of WY Medicare |
$1,270.42
|
| Rate for Payer: Beech Street Commercial |
$5,910.90
|
| Rate for Payer: Cash Price |
$4,355.40
|
| Rate for Payer: Cash Price |
$4,355.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,035.34
|
| Rate for Payer: Cigna of WY Commercial |
$6,097.56
|
| Rate for Payer: First Choice Health Commercial |
$5,599.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,910.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,270.42
|
| Rate for Payer: HealthUtah PPO |
$6,222.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,035.34
|
| Rate for Payer: Multiplan Medicare/VA |
$1,079.86
|
| Rate for Payer: One Health Plan of WY PPO |
$6,097.56
|
| Rate for Payer: PacificSource Commercial |
$5,599.80
|
| Rate for Payer: PHCS PPO |
$5,910.90
|
| Rate for Payer: Three Rivers PPO |
$4,666.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,270.42
|
| Rate for Payer: United Healthcare Commercial |
$5,413.14
|
| Rate for Payer: United Healthcare Medicare |
$1,270.42
|
| Rate for Payer: WINHealth Partners Commercial |
$5,288.70
|
|
|
LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE
|
Professional
|
Both
|
$4,377.00
|
|
|
Service Code
|
HCPCS 49654
|
| Hospital Charge Code |
49654
|
| Min. Negotiated Rate |
$3,282.75 |
| Max. Negotiated Rate |
$4,377.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,289.46
|
| Rate for Payer: Beech Street Commercial |
$4,158.15
|
| Rate for Payer: Cash Price |
$3,063.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,245.69
|
| Rate for Payer: Cigna of WY Commercial |
$4,289.46
|
| Rate for Payer: First Choice Health Commercial |
$3,939.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,158.15
|
| Rate for Payer: HealthUtah PPO |
$4,377.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,245.69
|
| Rate for Payer: One Health Plan of WY PPO |
$4,289.46
|
| Rate for Payer: PacificSource Commercial |
$3,939.30
|
| Rate for Payer: PHCS PPO |
$4,158.15
|
| Rate for Payer: Three Rivers PPO |
$3,282.75
|
| Rate for Payer: United Healthcare Commercial |
$3,807.99
|
| Rate for Payer: WINHealth Partners Commercial |
$3,720.45
|
|
|
LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE
|
Professional
|
Both
|
$4,377.00
|
|
|
Service Code
|
HCPCS 49654 AS
|
| Hospital Charge Code |
49654
|
| Min. Negotiated Rate |
$3,282.75 |
| Max. Negotiated Rate |
$4,377.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,289.46
|
| Rate for Payer: Beech Street Commercial |
$4,158.15
|
| Rate for Payer: Cash Price |
$3,063.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,245.69
|
| Rate for Payer: Cigna of WY Commercial |
$4,289.46
|
| Rate for Payer: First Choice Health Commercial |
$3,939.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,158.15
|
| Rate for Payer: HealthUtah PPO |
$4,377.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,245.69
|
| Rate for Payer: One Health Plan of WY PPO |
$4,289.46
|
| Rate for Payer: PacificSource Commercial |
$3,939.30
|
| Rate for Payer: PHCS PPO |
$4,158.15
|
| Rate for Payer: Three Rivers PPO |
$3,282.75
|
| Rate for Payer: United Healthcare Commercial |
$3,807.99
|
| Rate for Payer: WINHealth Partners Commercial |
$3,720.45
|
|
|
LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE
|
Professional
|
Both
|
$4,377.00
|
|
|
Service Code
|
HCPCS 49654 80
|
| Hospital Charge Code |
49654
|
| Min. Negotiated Rate |
$3,282.75 |
| Max. Negotiated Rate |
$4,377.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,289.46
|
| Rate for Payer: Beech Street Commercial |
$4,158.15
|
| Rate for Payer: Cash Price |
$3,063.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,245.69
|
| Rate for Payer: Cigna of WY Commercial |
$4,289.46
|
| Rate for Payer: First Choice Health Commercial |
$3,939.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,158.15
|
| Rate for Payer: HealthUtah PPO |
$4,377.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,245.69
|
| Rate for Payer: One Health Plan of WY PPO |
$4,289.46
|
| Rate for Payer: PacificSource Commercial |
$3,939.30
|
| Rate for Payer: PHCS PPO |
$4,158.15
|
| Rate for Payer: Three Rivers PPO |
$3,282.75
|
| Rate for Payer: United Healthcare Commercial |
$3,807.99
|
| Rate for Payer: WINHealth Partners Commercial |
$3,720.45
|
|
|
LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<
|
Professional
|
Both
|
$5,139.00
|
|
|
Service Code
|
HCPCS 58541
|
| Hospital Charge Code |
58541
|
| Min. Negotiated Rate |
$599.19 |
| Max. Negotiated Rate |
$5,139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,036.22
|
| Rate for Payer: Aetna of WY Medicare |
$704.93
|
| Rate for Payer: Beech Street Commercial |
$4,882.05
|
| Rate for Payer: Cash Price |
$3,597.30
|
| Rate for Payer: Cash Price |
$3,597.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,984.83
|
| Rate for Payer: Cigna of WY Commercial |
$5,036.22
|
| Rate for Payer: First Choice Health Commercial |
$4,625.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,882.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$704.93
|
| Rate for Payer: HealthUtah PPO |
$5,139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,984.83
|
| Rate for Payer: Multiplan Medicare/VA |
$599.19
|
| Rate for Payer: One Health Plan of WY PPO |
$5,036.22
|
| Rate for Payer: PacificSource Commercial |
$4,625.10
|
| Rate for Payer: PHCS PPO |
$4,882.05
|
| Rate for Payer: Three Rivers PPO |
$3,854.25
|
| Rate for Payer: TriWest Veterans Administration |
$704.93
|
| Rate for Payer: United Healthcare Commercial |
$4,470.93
|
| Rate for Payer: United Healthcare Medicare |
$704.93
|
| Rate for Payer: WINHealth Partners Commercial |
$4,368.15
|
|
|
LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$5,451.00
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
47562
|
| Min. Negotiated Rate |
$535.24 |
| Max. Negotiated Rate |
$5,451.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,341.98
|
| Rate for Payer: Aetna of WY Medicare |
$629.70
|
| Rate for Payer: Beech Street Commercial |
$5,178.45
|
| Rate for Payer: Cash Price |
$3,815.70
|
| Rate for Payer: Cash Price |
$3,815.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,287.47
|
| Rate for Payer: Cigna of WY Commercial |
$5,341.98
|
| Rate for Payer: First Choice Health Commercial |
$4,905.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,178.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$629.70
|
| Rate for Payer: HealthUtah PPO |
$5,451.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,287.47
|
| Rate for Payer: Multiplan Medicare/VA |
$535.24
|
| Rate for Payer: One Health Plan of WY PPO |
$5,341.98
|
| Rate for Payer: PacificSource Commercial |
$4,905.90
|
| Rate for Payer: PHCS PPO |
$5,178.45
|
| Rate for Payer: Three Rivers PPO |
$4,088.25
|
| Rate for Payer: TriWest Veterans Administration |
$629.70
|
| Rate for Payer: United Healthcare Commercial |
$4,742.37
|
| Rate for Payer: United Healthcare Medicare |
$629.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4,633.35
|
|
|
LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$5,451.00
|
|
|
Service Code
|
HCPCS 47562 AS
|
| Hospital Charge Code |
47562
|
| Min. Negotiated Rate |
$535.24 |
| Max. Negotiated Rate |
$5,451.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,341.98
|
| Rate for Payer: Aetna of WY Medicare |
$629.70
|
| Rate for Payer: Beech Street Commercial |
$5,178.45
|
| Rate for Payer: Cash Price |
$3,815.70
|
| Rate for Payer: Cash Price |
$3,815.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,287.47
|
| Rate for Payer: Cigna of WY Commercial |
$5,341.98
|
| Rate for Payer: First Choice Health Commercial |
$4,905.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,178.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$629.70
|
| Rate for Payer: HealthUtah PPO |
$5,451.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,287.47
|
| Rate for Payer: Multiplan Medicare/VA |
$535.24
|
| Rate for Payer: One Health Plan of WY PPO |
$5,341.98
|
| Rate for Payer: PacificSource Commercial |
$4,905.90
|
| Rate for Payer: PHCS PPO |
$5,178.45
|
| Rate for Payer: Three Rivers PPO |
$4,088.25
|
| Rate for Payer: TriWest Veterans Administration |
$629.70
|
| Rate for Payer: United Healthcare Commercial |
$4,742.37
|
| Rate for Payer: United Healthcare Medicare |
$629.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4,633.35
|
|
|
LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$5,451.00
|
|
|
Service Code
|
HCPCS 47562 80
|
| Hospital Charge Code |
47562
|
| Min. Negotiated Rate |
$535.24 |
| Max. Negotiated Rate |
$5,451.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,341.98
|
| Rate for Payer: Aetna of WY Medicare |
$629.70
|
| Rate for Payer: Beech Street Commercial |
$5,178.45
|
| Rate for Payer: Cash Price |
$3,815.70
|
| Rate for Payer: Cash Price |
$3,815.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,287.47
|
| Rate for Payer: Cigna of WY Commercial |
$5,341.98
|
| Rate for Payer: First Choice Health Commercial |
$4,905.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,178.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$629.70
|
| Rate for Payer: HealthUtah PPO |
$5,451.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,287.47
|
| Rate for Payer: Multiplan Medicare/VA |
$535.24
|
| Rate for Payer: One Health Plan of WY PPO |
$5,341.98
|
| Rate for Payer: PacificSource Commercial |
$4,905.90
|
| Rate for Payer: PHCS PPO |
$5,178.45
|
| Rate for Payer: Three Rivers PPO |
$4,088.25
|
| Rate for Payer: TriWest Veterans Administration |
$629.70
|
| Rate for Payer: United Healthcare Commercial |
$4,742.37
|
| Rate for Payer: United Healthcare Medicare |
$629.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4,633.35
|
|
