|
OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$6,270.00
|
|
|
Service Code
|
HCPCS 27828 AS
|
| Hospital Charge Code |
27828
|
| Min. Negotiated Rate |
$1,088.40 |
| Max. Negotiated Rate |
$6,270.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,144.60
|
| Rate for Payer: Aetna of WY Medicare |
$1,280.47
|
| Rate for Payer: Beech Street Commercial |
$5,956.50
|
| Rate for Payer: Cash Price |
$4,389.00
|
| Rate for Payer: Cash Price |
$4,389.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,081.90
|
| Rate for Payer: Cigna of WY Commercial |
$6,144.60
|
| Rate for Payer: First Choice Health Commercial |
$5,643.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,956.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,280.47
|
| Rate for Payer: HealthUtah PPO |
$6,270.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,081.90
|
| Rate for Payer: Multiplan Medicare/VA |
$1,088.40
|
| Rate for Payer: One Health Plan of WY PPO |
$6,144.60
|
| Rate for Payer: PacificSource Commercial |
$5,643.00
|
| Rate for Payer: PHCS PPO |
$5,956.50
|
| Rate for Payer: Three Rivers PPO |
$4,702.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,280.47
|
| Rate for Payer: United Healthcare Commercial |
$5,454.90
|
| Rate for Payer: United Healthcare Medicare |
$1,280.47
|
| Rate for Payer: WINHealth Partners Commercial |
$5,329.50
|
|
|
OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$5,733.00
|
|
|
Service Code
|
HCPCS 27827 AS
|
| Hospital Charge Code |
27827
|
| Min. Negotiated Rate |
$922.18 |
| Max. Negotiated Rate |
$5,733.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,618.34
|
| Rate for Payer: Aetna of WY Medicare |
$1,084.92
|
| Rate for Payer: Beech Street Commercial |
$5,446.35
|
| Rate for Payer: Cash Price |
$4,013.10
|
| Rate for Payer: Cash Price |
$4,013.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,561.01
|
| Rate for Payer: Cigna of WY Commercial |
$5,618.34
|
| Rate for Payer: First Choice Health Commercial |
$5,159.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,446.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,084.92
|
| Rate for Payer: HealthUtah PPO |
$5,733.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,561.01
|
| Rate for Payer: Multiplan Medicare/VA |
$922.18
|
| Rate for Payer: One Health Plan of WY PPO |
$5,618.34
|
| Rate for Payer: PacificSource Commercial |
$5,159.70
|
| Rate for Payer: PHCS PPO |
$5,446.35
|
| Rate for Payer: Three Rivers PPO |
$4,299.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,084.92
|
| Rate for Payer: United Healthcare Commercial |
$4,987.71
|
| Rate for Payer: United Healthcare Medicare |
$1,084.92
|
| Rate for Payer: WINHealth Partners Commercial |
$4,873.05
|
|
|
OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$5,733.00
|
|
|
Service Code
|
HCPCS 27827 80
|
| Hospital Charge Code |
27827
|
| Min. Negotiated Rate |
$922.18 |
| Max. Negotiated Rate |
$5,733.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,618.34
|
| Rate for Payer: Aetna of WY Medicare |
$1,084.92
|
| Rate for Payer: Beech Street Commercial |
$5,446.35
|
| Rate for Payer: Cash Price |
$4,013.10
|
| Rate for Payer: Cash Price |
$4,013.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,561.01
|
| Rate for Payer: Cigna of WY Commercial |
$5,618.34
|
| Rate for Payer: First Choice Health Commercial |
$5,159.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,446.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,084.92
|
| Rate for Payer: HealthUtah PPO |
$5,733.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,561.01
|
| Rate for Payer: Multiplan Medicare/VA |
$922.18
|
| Rate for Payer: One Health Plan of WY PPO |
$5,618.34
|
| Rate for Payer: PacificSource Commercial |
$5,159.70
|
| Rate for Payer: PHCS PPO |
$5,446.35
|
| Rate for Payer: Three Rivers PPO |
$4,299.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,084.92
|
| Rate for Payer: United Healthcare Commercial |
$4,987.71
|
| Rate for Payer: United Healthcare Medicare |
$1,084.92
|
| Rate for Payer: WINHealth Partners Commercial |
$4,873.05
|
|
|
OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$5,733.00
|
|
|
Service Code
|
HCPCS 27827
|
| Hospital Charge Code |
27827
|
| Min. Negotiated Rate |
$922.18 |
| Max. Negotiated Rate |
$5,733.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,618.34
|
| Rate for Payer: Aetna of WY Medicare |
$1,084.92
|
| Rate for Payer: Beech Street Commercial |
$5,446.35
|
| Rate for Payer: Cash Price |
$4,013.10
|
| Rate for Payer: Cash Price |
$4,013.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,561.01
|
| Rate for Payer: Cigna of WY Commercial |
$5,618.34
|
| Rate for Payer: First Choice Health Commercial |
$5,159.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,446.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,084.92
|
| Rate for Payer: HealthUtah PPO |
$5,733.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,561.01
|
| Rate for Payer: Multiplan Medicare/VA |
$922.18
|
| Rate for Payer: One Health Plan of WY PPO |
$5,618.34
|
| Rate for Payer: PacificSource Commercial |
$5,159.70
|
| Rate for Payer: PHCS PPO |
$5,446.35
|
| Rate for Payer: Three Rivers PPO |
$4,299.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,084.92
|
| Rate for Payer: United Healthcare Commercial |
$4,987.71
|
| Rate for Payer: United Healthcare Medicare |
$1,084.92
|
| Rate for Payer: WINHealth Partners Commercial |
$4,873.05
|
|
|
OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$3,854.00
|
|
|
Service Code
|
HCPCS 27248 80
|
| Hospital Charge Code |
27248
|
| Min. Negotiated Rate |
$611.29 |
| Max. Negotiated Rate |
$3,854.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,776.92
|
| Rate for Payer: Aetna of WY Medicare |
$719.17
|
| Rate for Payer: Beech Street Commercial |
$3,661.30
|
| Rate for Payer: Cash Price |
$2,697.80
|
| Rate for Payer: Cash Price |
$2,697.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,738.38
|
| Rate for Payer: Cigna of WY Commercial |
$3,776.92
|
| Rate for Payer: First Choice Health Commercial |
$3,468.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,661.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$719.17
|
| Rate for Payer: HealthUtah PPO |
$3,854.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,738.38
|
| Rate for Payer: Multiplan Medicare/VA |
$611.29
|
| Rate for Payer: One Health Plan of WY PPO |
$3,776.92
|
| Rate for Payer: PacificSource Commercial |
$3,468.60
|
| Rate for Payer: PHCS PPO |
$3,661.30
|
| Rate for Payer: Three Rivers PPO |
$2,890.50
|
| Rate for Payer: TriWest Veterans Administration |
$719.17
|
| Rate for Payer: United Healthcare Commercial |
$3,352.98
|
| Rate for Payer: United Healthcare Medicare |
$719.17
|
| Rate for Payer: WINHealth Partners Commercial |
$3,275.90
|
|
|
OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$3,854.00
|
|
|
Service Code
|
HCPCS 27248
|
| Hospital Charge Code |
27248
|
| Min. Negotiated Rate |
$611.29 |
| Max. Negotiated Rate |
$3,854.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,776.92
|
| Rate for Payer: Aetna of WY Medicare |
$719.17
|
| Rate for Payer: Beech Street Commercial |
$3,661.30
|
| Rate for Payer: Cash Price |
$2,697.80
|
| Rate for Payer: Cash Price |
$2,697.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,738.38
|
| Rate for Payer: Cigna of WY Commercial |
$3,776.92
|
| Rate for Payer: First Choice Health Commercial |
$3,468.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,661.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$719.17
|
| Rate for Payer: HealthUtah PPO |
$3,854.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,738.38
|
| Rate for Payer: Multiplan Medicare/VA |
$611.29
|
| Rate for Payer: One Health Plan of WY PPO |
$3,776.92
|
| Rate for Payer: PacificSource Commercial |
$3,468.60
|
| Rate for Payer: PHCS PPO |
$3,661.30
|
| Rate for Payer: Three Rivers PPO |
$2,890.50
|
| Rate for Payer: TriWest Veterans Administration |
$719.17
|
| Rate for Payer: United Healthcare Commercial |
$3,352.98
|
| Rate for Payer: United Healthcare Medicare |
$719.17
|
| Rate for Payer: WINHealth Partners Commercial |
$3,275.90
|
|
|
OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,896.00
|
|
|
Service Code
|
HCPCS 24579 80
|
| Hospital Charge Code |
24579
|
| Min. Negotiated Rate |
$689.62 |
| Max. Negotiated Rate |
$2,896.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,838.08
|
| Rate for Payer: Aetna of WY Medicare |
$811.32
|
| Rate for Payer: Beech Street Commercial |
$2,751.20
|
| Rate for Payer: Cash Price |
$2,027.20
|
| Rate for Payer: Cash Price |
$2,027.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,809.12
|
| Rate for Payer: Cigna of WY Commercial |
$2,838.08
|
| Rate for Payer: First Choice Health Commercial |
$2,606.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,751.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$811.32
|
| Rate for Payer: HealthUtah PPO |
$2,896.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,809.12
|
| Rate for Payer: Multiplan Medicare/VA |
$689.62
|
| Rate for Payer: One Health Plan of WY PPO |
$2,838.08
|
| Rate for Payer: PacificSource Commercial |
$2,606.40
|
| Rate for Payer: PHCS PPO |
$2,751.20
|
| Rate for Payer: Three Rivers PPO |
$2,172.00
|
| Rate for Payer: TriWest Veterans Administration |
$811.32
|
| Rate for Payer: United Healthcare Commercial |
$2,519.52
|
| Rate for Payer: United Healthcare Medicare |
$811.32
|
| Rate for Payer: WINHealth Partners Commercial |
$2,461.60
|
|
|
OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,896.00
|
|
|
Service Code
|
HCPCS 24579
|
| Hospital Charge Code |
24579
|
| Min. Negotiated Rate |
$689.62 |
| Max. Negotiated Rate |
$2,896.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,838.08
|
| Rate for Payer: Aetna of WY Medicare |
$811.32
|
| Rate for Payer: Beech Street Commercial |
$2,751.20
|
| Rate for Payer: Cash Price |
$2,027.20
|
| Rate for Payer: Cash Price |
$2,027.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,809.12
|
| Rate for Payer: Cigna of WY Commercial |
$2,838.08
|
| Rate for Payer: First Choice Health Commercial |
$2,606.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,751.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$811.32
|
| Rate for Payer: HealthUtah PPO |
$2,896.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,809.12
|
| Rate for Payer: Multiplan Medicare/VA |
$689.62
|
| Rate for Payer: One Health Plan of WY PPO |
$2,838.08
|
| Rate for Payer: PacificSource Commercial |
$2,606.40
|
| Rate for Payer: PHCS PPO |
$2,751.20
|
| Rate for Payer: Three Rivers PPO |
$2,172.00
|
| Rate for Payer: TriWest Veterans Administration |
$811.32
|
| Rate for Payer: United Healthcare Commercial |
$2,519.52
|
| Rate for Payer: United Healthcare Medicare |
$811.32
|
| Rate for Payer: WINHealth Partners Commercial |
$2,461.60
|
|
|
OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,896.00
|
|
|
Service Code
|
HCPCS 24579 AS
|
| Hospital Charge Code |
24579
|
| Min. Negotiated Rate |
$689.62 |
| Max. Negotiated Rate |
$2,896.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,838.08
|
| Rate for Payer: Aetna of WY Medicare |
$811.32
|
| Rate for Payer: Beech Street Commercial |
$2,751.20
|
| Rate for Payer: Cash Price |
$2,027.20
|
| Rate for Payer: Cash Price |
$2,027.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,809.12
|
| Rate for Payer: Cigna of WY Commercial |
$2,838.08
|
| Rate for Payer: First Choice Health Commercial |
$2,606.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,751.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$811.32
|
| Rate for Payer: HealthUtah PPO |
$2,896.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,809.12
|
| Rate for Payer: Multiplan Medicare/VA |
$689.62
|
| Rate for Payer: One Health Plan of WY PPO |
$2,838.08
|
| Rate for Payer: PacificSource Commercial |
$2,606.40
|
| Rate for Payer: PHCS PPO |
$2,751.20
|
| Rate for Payer: Three Rivers PPO |
$2,172.00
|
| Rate for Payer: TriWest Veterans Administration |
$811.32
|
| Rate for Payer: United Healthcare Commercial |
$2,519.52
|
| Rate for Payer: United Healthcare Medicare |
$811.32
|
| Rate for Payer: WINHealth Partners Commercial |
$2,461.60
|
|
|
OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 27766
|
| Hospital Charge Code |
27766
|
| Min. Negotiated Rate |
$501.85 |
| Max. Negotiated Rate |
$3,116.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,053.68
|
| Rate for Payer: Aetna of WY Medicare |
$590.41
|
| Rate for Payer: Beech Street Commercial |
$2,960.20
|
| Rate for Payer: Cash Price |
$2,181.20
|
| Rate for Payer: Cash Price |
$2,181.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,022.52
|
| Rate for Payer: Cigna of WY Commercial |
$3,053.68
|
| Rate for Payer: First Choice Health Commercial |
$2,804.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,960.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$590.41
|
| Rate for Payer: HealthUtah PPO |
$3,116.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,022.52
|
| Rate for Payer: Multiplan Medicare/VA |
$501.85
|
| Rate for Payer: One Health Plan of WY PPO |
$3,053.68
|
| Rate for Payer: PacificSource Commercial |
$2,804.40
|
| Rate for Payer: PHCS PPO |
$2,960.20
|
| Rate for Payer: Three Rivers PPO |
$2,337.00
|
| Rate for Payer: TriWest Veterans Administration |
$590.41
|
| Rate for Payer: United Healthcare Commercial |
$2,710.92
|
| Rate for Payer: United Healthcare Medicare |
$590.41
|
| Rate for Payer: WINHealth Partners Commercial |
$2,648.60
|
|
|
OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 27766 80
|
| Hospital Charge Code |
27766
|
| Min. Negotiated Rate |
$501.85 |
| Max. Negotiated Rate |
$3,116.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,053.68
|
| Rate for Payer: Aetna of WY Medicare |
$590.41
|
| Rate for Payer: Beech Street Commercial |
$2,960.20
|
| Rate for Payer: Cash Price |
$2,181.20
|
| Rate for Payer: Cash Price |
$2,181.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,022.52
|
| Rate for Payer: Cigna of WY Commercial |
$3,053.68
|
| Rate for Payer: First Choice Health Commercial |
$2,804.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,960.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$590.41
|
| Rate for Payer: HealthUtah PPO |
$3,116.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,022.52
|
| Rate for Payer: Multiplan Medicare/VA |
$501.85
|
| Rate for Payer: One Health Plan of WY PPO |
$3,053.68
|
| Rate for Payer: PacificSource Commercial |
$2,804.40
|
| Rate for Payer: PHCS PPO |
$2,960.20
|
| Rate for Payer: Three Rivers PPO |
$2,337.00
|
| Rate for Payer: TriWest Veterans Administration |
$590.41
|
| Rate for Payer: United Healthcare Commercial |
$2,710.92
|
| Rate for Payer: United Healthcare Medicare |
$590.41
|
| Rate for Payer: WINHealth Partners Commercial |
$2,648.60
|
|
|
OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$2,855.00
|
|
|
Service Code
|
HCPCS 28485 80
|
| Hospital Charge Code |
28485
|
| Min. Negotiated Rate |
$469.93 |
| Max. Negotiated Rate |
$2,855.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,797.90
|
| Rate for Payer: Aetna of WY Medicare |
$552.86
|
| Rate for Payer: Beech Street Commercial |
$2,712.25
|
| Rate for Payer: Cash Price |
$1,998.50
|
| Rate for Payer: Cash Price |
$1,998.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,769.35
|
| Rate for Payer: Cigna of WY Commercial |
$2,797.90
|
| Rate for Payer: First Choice Health Commercial |
$2,569.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,712.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$552.86
|
| Rate for Payer: HealthUtah PPO |
$2,855.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,769.35
|
| Rate for Payer: Multiplan Medicare/VA |
$469.93
|
| Rate for Payer: One Health Plan of WY PPO |
$2,797.90
|
| Rate for Payer: PacificSource Commercial |
$2,569.50
|
| Rate for Payer: PHCS PPO |
$2,712.25
|
| Rate for Payer: Three Rivers PPO |
$2,141.25
|
| Rate for Payer: TriWest Veterans Administration |
$552.86
|
| Rate for Payer: United Healthcare Commercial |
$2,483.85
|
| Rate for Payer: United Healthcare Medicare |
$552.86
|
| Rate for Payer: WINHealth Partners Commercial |
$2,426.75
|
|
|
OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$2,855.00
|
|
|
Service Code
|
HCPCS 28485
|
| Hospital Charge Code |
28485
|
| Min. Negotiated Rate |
$469.93 |
| Max. Negotiated Rate |
$2,855.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,797.90
|
| Rate for Payer: Aetna of WY Medicare |
$552.86
|
| Rate for Payer: Beech Street Commercial |
$2,712.25
|
| Rate for Payer: Cash Price |
$1,998.50
|
| Rate for Payer: Cash Price |
$1,998.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,769.35
|
| Rate for Payer: Cigna of WY Commercial |
$2,797.90
|
| Rate for Payer: First Choice Health Commercial |
$2,569.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,712.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$552.86
|
| Rate for Payer: HealthUtah PPO |
$2,855.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,769.35
|
| Rate for Payer: Multiplan Medicare/VA |
$469.93
|
| Rate for Payer: One Health Plan of WY PPO |
$2,797.90
|
| Rate for Payer: PacificSource Commercial |
$2,569.50
|
| Rate for Payer: PHCS PPO |
$2,712.25
|
| Rate for Payer: Three Rivers PPO |
$2,141.25
|
| Rate for Payer: TriWest Veterans Administration |
$552.86
|
| Rate for Payer: United Healthcare Commercial |
$2,483.85
|
| Rate for Payer: United Healthcare Medicare |
$552.86
|
| Rate for Payer: WINHealth Partners Commercial |
$2,426.75
|
|
|
OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$3,010.00
|
|
|
Service Code
|
HCPCS 27784
|
| Hospital Charge Code |
27784
|
| Min. Negotiated Rate |
$591.91 |
| Max. Negotiated Rate |
$3,010.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,949.80
|
| Rate for Payer: Aetna of WY Medicare |
$696.36
|
| Rate for Payer: Beech Street Commercial |
$2,859.50
|
| Rate for Payer: Cash Price |
$2,107.00
|
| Rate for Payer: Cash Price |
$2,107.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,919.70
|
| Rate for Payer: Cigna of WY Commercial |
$2,949.80
|
| Rate for Payer: First Choice Health Commercial |
$2,709.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,859.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$696.36
|
| Rate for Payer: HealthUtah PPO |
$3,010.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,919.70
|
| Rate for Payer: Multiplan Medicare/VA |
$591.91
|
| Rate for Payer: One Health Plan of WY PPO |
$2,949.80
|
| Rate for Payer: PacificSource Commercial |
$2,709.00
|
| Rate for Payer: PHCS PPO |
$2,859.50
|
| Rate for Payer: Three Rivers PPO |
$2,257.50
|
| Rate for Payer: TriWest Veterans Administration |
$696.36
|
| Rate for Payer: United Healthcare Commercial |
$2,618.70
|
| Rate for Payer: United Healthcare Medicare |
$696.36
|
| Rate for Payer: WINHealth Partners Commercial |
$2,558.50
|
|
|
OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$3,010.00
|
|
|
Service Code
|
HCPCS 27784 AS
|
| Hospital Charge Code |
27784
|
| Min. Negotiated Rate |
$591.91 |
| Max. Negotiated Rate |
$3,010.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,949.80
|
| Rate for Payer: Aetna of WY Medicare |
$696.36
|
| Rate for Payer: Beech Street Commercial |
$2,859.50
|
| Rate for Payer: Cash Price |
$2,107.00
|
| Rate for Payer: Cash Price |
$2,107.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,919.70
|
| Rate for Payer: Cigna of WY Commercial |
$2,949.80
|
| Rate for Payer: First Choice Health Commercial |
$2,709.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,859.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$696.36
|
| Rate for Payer: HealthUtah PPO |
$3,010.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,919.70
|
| Rate for Payer: Multiplan Medicare/VA |
$591.91
|
| Rate for Payer: One Health Plan of WY PPO |
$2,949.80
|
| Rate for Payer: PacificSource Commercial |
$2,709.00
|
| Rate for Payer: PHCS PPO |
$2,859.50
|
| Rate for Payer: Three Rivers PPO |
$2,257.50
|
| Rate for Payer: TriWest Veterans Administration |
$696.36
|
| Rate for Payer: United Healthcare Commercial |
$2,618.70
|
| Rate for Payer: United Healthcare Medicare |
$696.36
|
| Rate for Payer: WINHealth Partners Commercial |
$2,558.50
|
|
|
OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$3,010.00
|
|
|
Service Code
|
HCPCS 27784 80
|
| Hospital Charge Code |
27784
|
| Min. Negotiated Rate |
$591.91 |
| Max. Negotiated Rate |
$3,010.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,949.80
|
| Rate for Payer: Aetna of WY Medicare |
$696.36
|
| Rate for Payer: Beech Street Commercial |
$2,859.50
|
| Rate for Payer: Cash Price |
$2,107.00
|
| Rate for Payer: Cash Price |
$2,107.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,919.70
|
| Rate for Payer: Cigna of WY Commercial |
$2,949.80
|
| Rate for Payer: First Choice Health Commercial |
$2,709.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,859.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$696.36
|
| Rate for Payer: HealthUtah PPO |
$3,010.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,919.70
|
| Rate for Payer: Multiplan Medicare/VA |
$591.91
|
| Rate for Payer: One Health Plan of WY PPO |
$2,949.80
|
| Rate for Payer: PacificSource Commercial |
$2,709.00
|
| Rate for Payer: PHCS PPO |
$2,859.50
|
| Rate for Payer: Three Rivers PPO |
$2,257.50
|
| Rate for Payer: TriWest Veterans Administration |
$696.36
|
| Rate for Payer: United Healthcare Commercial |
$2,618.70
|
| Rate for Payer: United Healthcare Medicare |
$696.36
|
| Rate for Payer: WINHealth Partners Commercial |
$2,558.50
|
|
|
OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,341.00
|
|
|
Service Code
|
HCPCS 25515 AS
|
| Hospital Charge Code |
25515
|
| Min. Negotiated Rate |
$557.65 |
| Max. Negotiated Rate |
$2,341.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,294.18
|
| Rate for Payer: Aetna of WY Medicare |
$656.06
|
| Rate for Payer: Beech Street Commercial |
$2,223.95
|
| Rate for Payer: Cash Price |
$1,638.70
|
| Rate for Payer: Cash Price |
$1,638.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,270.77
|
| Rate for Payer: Cigna of WY Commercial |
$2,294.18
|
| Rate for Payer: First Choice Health Commercial |
$2,106.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,223.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$656.06
|
| Rate for Payer: HealthUtah PPO |
$2,341.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,270.77
|
| Rate for Payer: Multiplan Medicare/VA |
$557.65
|
| Rate for Payer: One Health Plan of WY PPO |
$2,294.18
|
| Rate for Payer: PacificSource Commercial |
$2,106.90
|
| Rate for Payer: PHCS PPO |
$2,223.95
|
| Rate for Payer: Three Rivers PPO |
$1,755.75
|
| Rate for Payer: TriWest Veterans Administration |
$656.06
|
| Rate for Payer: United Healthcare Commercial |
$2,036.67
|
| Rate for Payer: United Healthcare Medicare |
$656.06
|
| Rate for Payer: WINHealth Partners Commercial |
$1,989.85
|
|
|
OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,341.00
|
|
|
Service Code
|
HCPCS 25515 80
|
| Hospital Charge Code |
25515
|
| Min. Negotiated Rate |
$557.65 |
| Max. Negotiated Rate |
$2,341.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,294.18
|
| Rate for Payer: Aetna of WY Medicare |
$656.06
|
| Rate for Payer: Beech Street Commercial |
$2,223.95
|
| Rate for Payer: Cash Price |
$1,638.70
|
| Rate for Payer: Cash Price |
$1,638.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,270.77
|
| Rate for Payer: Cigna of WY Commercial |
$2,294.18
|
| Rate for Payer: First Choice Health Commercial |
$2,106.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,223.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$656.06
|
| Rate for Payer: HealthUtah PPO |
$2,341.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,270.77
|
| Rate for Payer: Multiplan Medicare/VA |
$557.65
|
| Rate for Payer: One Health Plan of WY PPO |
$2,294.18
|
| Rate for Payer: PacificSource Commercial |
$2,106.90
|
| Rate for Payer: PHCS PPO |
$2,223.95
|
| Rate for Payer: Three Rivers PPO |
$1,755.75
|
| Rate for Payer: TriWest Veterans Administration |
$656.06
|
| Rate for Payer: United Healthcare Commercial |
$2,036.67
|
| Rate for Payer: United Healthcare Medicare |
$656.06
|
| Rate for Payer: WINHealth Partners Commercial |
$1,989.85
|
|
|
OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,341.00
|
|
|
Service Code
|
HCPCS 25515
|
| Hospital Charge Code |
25515
|
| Min. Negotiated Rate |
$557.65 |
| Max. Negotiated Rate |
$2,341.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,294.18
|
| Rate for Payer: Aetna of WY Medicare |
$656.06
|
| Rate for Payer: Beech Street Commercial |
$2,223.95
|
| Rate for Payer: Cash Price |
$1,638.70
|
| Rate for Payer: Cash Price |
$1,638.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,270.77
|
| Rate for Payer: Cigna of WY Commercial |
$2,294.18
|
| Rate for Payer: First Choice Health Commercial |
$2,106.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,223.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$656.06
|
| Rate for Payer: HealthUtah PPO |
$2,341.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,270.77
|
| Rate for Payer: Multiplan Medicare/VA |
$557.65
|
| Rate for Payer: One Health Plan of WY PPO |
$2,294.18
|
| Rate for Payer: PacificSource Commercial |
$2,106.90
|
| Rate for Payer: PHCS PPO |
$2,223.95
|
| Rate for Payer: Three Rivers PPO |
$1,755.75
|
| Rate for Payer: TriWest Veterans Administration |
$656.06
|
| Rate for Payer: United Healthcare Commercial |
$2,036.67
|
| Rate for Payer: United Healthcare Medicare |
$656.06
|
| Rate for Payer: WINHealth Partners Commercial |
$1,989.85
|
|
|
OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$5,354.00
|
|
|
Service Code
|
HCPCS 28445
|
| Hospital Charge Code |
28445
|
| Min. Negotiated Rate |
$862.61 |
| Max. Negotiated Rate |
$5,354.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,246.92
|
| Rate for Payer: Aetna of WY Medicare |
$1,014.83
|
| Rate for Payer: Beech Street Commercial |
$5,086.30
|
| Rate for Payer: Cash Price |
$3,747.80
|
| Rate for Payer: Cash Price |
$3,747.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,193.38
|
| Rate for Payer: Cigna of WY Commercial |
$5,246.92
|
| Rate for Payer: First Choice Health Commercial |
$4,818.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,086.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,014.83
|
| Rate for Payer: HealthUtah PPO |
$5,354.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,193.38
|
| Rate for Payer: Multiplan Medicare/VA |
$862.61
|
| Rate for Payer: One Health Plan of WY PPO |
$5,246.92
|
| Rate for Payer: PacificSource Commercial |
$4,818.60
|
| Rate for Payer: PHCS PPO |
$5,086.30
|
| Rate for Payer: Three Rivers PPO |
$4,015.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,014.83
|
| Rate for Payer: United Healthcare Commercial |
$4,657.98
|
| Rate for Payer: United Healthcare Medicare |
$1,014.83
|
| Rate for Payer: WINHealth Partners Commercial |
$4,550.90
|
|
|
OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$5,354.00
|
|
|
Service Code
|
HCPCS 28445 AS
|
| Hospital Charge Code |
28445
|
| Min. Negotiated Rate |
$862.61 |
| Max. Negotiated Rate |
$5,354.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,246.92
|
| Rate for Payer: Aetna of WY Medicare |
$1,014.83
|
| Rate for Payer: Beech Street Commercial |
$5,086.30
|
| Rate for Payer: Cash Price |
$3,747.80
|
| Rate for Payer: Cash Price |
$3,747.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,193.38
|
| Rate for Payer: Cigna of WY Commercial |
$5,246.92
|
| Rate for Payer: First Choice Health Commercial |
$4,818.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,086.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,014.83
|
| Rate for Payer: HealthUtah PPO |
$5,354.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,193.38
|
| Rate for Payer: Multiplan Medicare/VA |
$862.61
|
| Rate for Payer: One Health Plan of WY PPO |
$5,246.92
|
| Rate for Payer: PacificSource Commercial |
$4,818.60
|
| Rate for Payer: PHCS PPO |
$5,086.30
|
| Rate for Payer: Three Rivers PPO |
$4,015.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,014.83
|
| Rate for Payer: United Healthcare Commercial |
$4,657.98
|
| Rate for Payer: United Healthcare Medicare |
$1,014.83
|
| Rate for Payer: WINHealth Partners Commercial |
$4,550.90
|
|
|
OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$5,354.00
|
|
|
Service Code
|
HCPCS 28445 80
|
| Hospital Charge Code |
28445
|
| Min. Negotiated Rate |
$862.61 |
| Max. Negotiated Rate |
$5,354.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,246.92
|
| Rate for Payer: Aetna of WY Medicare |
$1,014.83
|
| Rate for Payer: Beech Street Commercial |
$5,086.30
|
| Rate for Payer: Cash Price |
$3,747.80
|
| Rate for Payer: Cash Price |
$3,747.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,193.38
|
| Rate for Payer: Cigna of WY Commercial |
$5,246.92
|
| Rate for Payer: First Choice Health Commercial |
$4,818.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,086.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,014.83
|
| Rate for Payer: HealthUtah PPO |
$5,354.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,193.38
|
| Rate for Payer: Multiplan Medicare/VA |
$862.61
|
| Rate for Payer: One Health Plan of WY PPO |
$5,246.92
|
| Rate for Payer: PacificSource Commercial |
$4,818.60
|
| Rate for Payer: PHCS PPO |
$5,086.30
|
| Rate for Payer: Three Rivers PPO |
$4,015.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,014.83
|
| Rate for Payer: United Healthcare Commercial |
$4,657.98
|
| Rate for Payer: United Healthcare Medicare |
$1,014.83
|
| Rate for Payer: WINHealth Partners Commercial |
$4,550.90
|
|
|
OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 28615 80
|
| Hospital Charge Code |
28615
|
| Min. Negotiated Rate |
$686.85 |
| Max. Negotiated Rate |
$4,200.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,116.00
|
| Rate for Payer: Aetna of WY Medicare |
$808.06
|
| Rate for Payer: Beech Street Commercial |
$3,990.00
|
| Rate for Payer: Cash Price |
$2,940.00
|
| Rate for Payer: Cash Price |
$2,940.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,074.00
|
| Rate for Payer: Cigna of WY Commercial |
$4,116.00
|
| Rate for Payer: First Choice Health Commercial |
$3,780.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,990.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$808.06
|
| Rate for Payer: HealthUtah PPO |
$4,200.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,074.00
|
| Rate for Payer: Multiplan Medicare/VA |
$686.85
|
| Rate for Payer: One Health Plan of WY PPO |
$4,116.00
|
| Rate for Payer: PacificSource Commercial |
$3,780.00
|
| Rate for Payer: PHCS PPO |
$3,990.00
|
| Rate for Payer: Three Rivers PPO |
$3,150.00
|
| Rate for Payer: TriWest Veterans Administration |
$808.06
|
| Rate for Payer: United Healthcare Commercial |
$3,654.00
|
| Rate for Payer: United Healthcare Medicare |
$808.06
|
| Rate for Payer: WINHealth Partners Commercial |
$3,570.00
|
|
|
OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 28615 AS
|
| Hospital Charge Code |
28615
|
| Min. Negotiated Rate |
$686.85 |
| Max. Negotiated Rate |
$4,200.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,116.00
|
| Rate for Payer: Aetna of WY Medicare |
$808.06
|
| Rate for Payer: Beech Street Commercial |
$3,990.00
|
| Rate for Payer: Cash Price |
$2,940.00
|
| Rate for Payer: Cash Price |
$2,940.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,074.00
|
| Rate for Payer: Cigna of WY Commercial |
$4,116.00
|
| Rate for Payer: First Choice Health Commercial |
$3,780.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,990.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$808.06
|
| Rate for Payer: HealthUtah PPO |
$4,200.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,074.00
|
| Rate for Payer: Multiplan Medicare/VA |
$686.85
|
| Rate for Payer: One Health Plan of WY PPO |
$4,116.00
|
| Rate for Payer: PacificSource Commercial |
$3,780.00
|
| Rate for Payer: PHCS PPO |
$3,990.00
|
| Rate for Payer: Three Rivers PPO |
$3,150.00
|
| Rate for Payer: TriWest Veterans Administration |
$808.06
|
| Rate for Payer: United Healthcare Commercial |
$3,654.00
|
| Rate for Payer: United Healthcare Medicare |
$808.06
|
| Rate for Payer: WINHealth Partners Commercial |
$3,570.00
|
|
|
OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 28615
|
| Hospital Charge Code |
28615
|
| Min. Negotiated Rate |
$686.85 |
| Max. Negotiated Rate |
$4,200.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,116.00
|
| Rate for Payer: Aetna of WY Medicare |
$808.06
|
| Rate for Payer: Beech Street Commercial |
$3,990.00
|
| Rate for Payer: Cash Price |
$2,940.00
|
| Rate for Payer: Cash Price |
$2,940.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,074.00
|
| Rate for Payer: Cigna of WY Commercial |
$4,116.00
|
| Rate for Payer: First Choice Health Commercial |
$3,780.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,990.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$808.06
|
| Rate for Payer: HealthUtah PPO |
$4,200.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,074.00
|
| Rate for Payer: Multiplan Medicare/VA |
$686.85
|
| Rate for Payer: One Health Plan of WY PPO |
$4,116.00
|
| Rate for Payer: PacificSource Commercial |
$3,780.00
|
| Rate for Payer: PHCS PPO |
$3,990.00
|
| Rate for Payer: Three Rivers PPO |
$3,150.00
|
| Rate for Payer: TriWest Veterans Administration |
$808.06
|
| Rate for Payer: United Healthcare Commercial |
$3,654.00
|
| Rate for Payer: United Healthcare Medicare |
$808.06
|
| Rate for Payer: WINHealth Partners Commercial |
$3,570.00
|
|
