|
OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,283.00
|
|
|
Service Code
|
HCPCS 24685 AS
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$543.69 |
| Max. Negotiated Rate |
$2,283.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,237.34
|
| Rate for Payer: Aetna of WY Medicare |
$639.63
|
| Rate for Payer: Beech Street Commercial |
$2,168.85
|
| Rate for Payer: Cash Price |
$1,598.10
|
| Rate for Payer: Cash Price |
$1,598.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,214.51
|
| Rate for Payer: Cigna of WY Commercial |
$2,237.34
|
| Rate for Payer: First Choice Health Commercial |
$2,054.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,168.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$639.63
|
| Rate for Payer: HealthUtah PPO |
$2,283.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,214.51
|
| Rate for Payer: Multiplan Medicare/VA |
$543.69
|
| Rate for Payer: One Health Plan of WY PPO |
$2,237.34
|
| Rate for Payer: PacificSource Commercial |
$2,054.70
|
| Rate for Payer: PHCS PPO |
$2,168.85
|
| Rate for Payer: Three Rivers PPO |
$1,712.25
|
| Rate for Payer: TriWest Veterans Administration |
$639.63
|
| Rate for Payer: United Healthcare Commercial |
$1,986.21
|
| Rate for Payer: United Healthcare Medicare |
$639.63
|
| Rate for Payer: WINHealth Partners Commercial |
$1,940.55
|
|
|
OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,283.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$543.69 |
| Max. Negotiated Rate |
$2,283.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,237.34
|
| Rate for Payer: Aetna of WY Medicare |
$639.63
|
| Rate for Payer: Beech Street Commercial |
$2,168.85
|
| Rate for Payer: Cash Price |
$1,598.10
|
| Rate for Payer: Cash Price |
$1,598.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,214.51
|
| Rate for Payer: Cigna of WY Commercial |
$2,237.34
|
| Rate for Payer: First Choice Health Commercial |
$2,054.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,168.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$639.63
|
| Rate for Payer: HealthUtah PPO |
$2,283.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,214.51
|
| Rate for Payer: Multiplan Medicare/VA |
$543.69
|
| Rate for Payer: One Health Plan of WY PPO |
$2,237.34
|
| Rate for Payer: PacificSource Commercial |
$2,054.70
|
| Rate for Payer: PHCS PPO |
$2,168.85
|
| Rate for Payer: Three Rivers PPO |
$1,712.25
|
| Rate for Payer: TriWest Veterans Administration |
$639.63
|
| Rate for Payer: United Healthcare Commercial |
$1,986.21
|
| Rate for Payer: United Healthcare Medicare |
$639.63
|
| Rate for Payer: WINHealth Partners Commercial |
$1,940.55
|
|
|
OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,283.00
|
|
|
Service Code
|
HCPCS 24685 80
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$543.69 |
| Max. Negotiated Rate |
$2,283.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,237.34
|
| Rate for Payer: Aetna of WY Medicare |
$639.63
|
| Rate for Payer: Beech Street Commercial |
$2,168.85
|
| Rate for Payer: Cash Price |
$1,598.10
|
| Rate for Payer: Cash Price |
$1,598.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,214.51
|
| Rate for Payer: Cigna of WY Commercial |
$2,237.34
|
| Rate for Payer: First Choice Health Commercial |
$2,054.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,168.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$639.63
|
| Rate for Payer: HealthUtah PPO |
$2,283.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,214.51
|
| Rate for Payer: Multiplan Medicare/VA |
$543.69
|
| Rate for Payer: One Health Plan of WY PPO |
$2,237.34
|
| Rate for Payer: PacificSource Commercial |
$2,054.70
|
| Rate for Payer: PHCS PPO |
$2,168.85
|
| Rate for Payer: Three Rivers PPO |
$1,712.25
|
| Rate for Payer: TriWest Veterans Administration |
$639.63
|
| Rate for Payer: United Healthcare Commercial |
$1,986.21
|
| Rate for Payer: United Healthcare Medicare |
$639.63
|
| Rate for Payer: WINHealth Partners Commercial |
$1,940.55
|
|
|
OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,187.00
|
|
|
Service Code
|
HCPCS 25545 AS
|
| Hospital Charge Code |
25545
|
| Min. Negotiated Rate |
$520.83 |
| Max. Negotiated Rate |
$2,187.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,143.26
|
| Rate for Payer: Aetna of WY Medicare |
$612.74
|
| Rate for Payer: Beech Street Commercial |
$2,077.65
|
| Rate for Payer: Cash Price |
$1,530.90
|
| Rate for Payer: Cash Price |
$1,530.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,121.39
|
| Rate for Payer: Cigna of WY Commercial |
$2,143.26
|
| Rate for Payer: First Choice Health Commercial |
$1,968.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,077.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$612.74
|
| Rate for Payer: HealthUtah PPO |
$2,187.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,121.39
|
| Rate for Payer: Multiplan Medicare/VA |
$520.83
|
| Rate for Payer: One Health Plan of WY PPO |
$2,143.26
|
| Rate for Payer: PacificSource Commercial |
$1,968.30
|
| Rate for Payer: PHCS PPO |
$2,077.65
|
| Rate for Payer: Three Rivers PPO |
$1,640.25
|
| Rate for Payer: TriWest Veterans Administration |
$612.74
|
| Rate for Payer: United Healthcare Commercial |
$1,902.69
|
| Rate for Payer: United Healthcare Medicare |
$612.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,858.95
|
|
|
OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,187.00
|
|
|
Service Code
|
HCPCS 25545 80
|
| Hospital Charge Code |
25545
|
| Min. Negotiated Rate |
$520.83 |
| Max. Negotiated Rate |
$2,187.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,143.26
|
| Rate for Payer: Aetna of WY Medicare |
$612.74
|
| Rate for Payer: Beech Street Commercial |
$2,077.65
|
| Rate for Payer: Cash Price |
$1,530.90
|
| Rate for Payer: Cash Price |
$1,530.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,121.39
|
| Rate for Payer: Cigna of WY Commercial |
$2,143.26
|
| Rate for Payer: First Choice Health Commercial |
$1,968.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,077.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$612.74
|
| Rate for Payer: HealthUtah PPO |
$2,187.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,121.39
|
| Rate for Payer: Multiplan Medicare/VA |
$520.83
|
| Rate for Payer: One Health Plan of WY PPO |
$2,143.26
|
| Rate for Payer: PacificSource Commercial |
$1,968.30
|
| Rate for Payer: PHCS PPO |
$2,077.65
|
| Rate for Payer: Three Rivers PPO |
$1,640.25
|
| Rate for Payer: TriWest Veterans Administration |
$612.74
|
| Rate for Payer: United Healthcare Commercial |
$1,902.69
|
| Rate for Payer: United Healthcare Medicare |
$612.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,858.95
|
|
|
OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,187.00
|
|
|
Service Code
|
HCPCS 25545
|
| Hospital Charge Code |
25545
|
| Min. Negotiated Rate |
$520.83 |
| Max. Negotiated Rate |
$2,187.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,143.26
|
| Rate for Payer: Aetna of WY Medicare |
$612.74
|
| Rate for Payer: Beech Street Commercial |
$2,077.65
|
| Rate for Payer: Cash Price |
$1,530.90
|
| Rate for Payer: Cash Price |
$1,530.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,121.39
|
| Rate for Payer: Cigna of WY Commercial |
$2,143.26
|
| Rate for Payer: First Choice Health Commercial |
$1,968.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,077.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$612.74
|
| Rate for Payer: HealthUtah PPO |
$2,187.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,121.39
|
| Rate for Payer: Multiplan Medicare/VA |
$520.83
|
| Rate for Payer: One Health Plan of WY PPO |
$2,143.26
|
| Rate for Payer: PacificSource Commercial |
$1,968.30
|
| Rate for Payer: PHCS PPO |
$2,077.65
|
| Rate for Payer: Three Rivers PPO |
$1,640.25
|
| Rate for Payer: TriWest Veterans Administration |
$612.74
|
| Rate for Payer: United Healthcare Commercial |
$1,902.69
|
| Rate for Payer: United Healthcare Medicare |
$612.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,858.95
|
|
|
OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$8,004.00
|
|
|
Service Code
|
HCPCS 25652
|
| Hospital Charge Code |
25652
|
| Min. Negotiated Rate |
$518.94 |
| Max. Negotiated Rate |
$8,004.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7,843.92
|
| Rate for Payer: Aetna of WY Medicare |
$610.52
|
| Rate for Payer: Beech Street Commercial |
$7,603.80
|
| Rate for Payer: Cash Price |
$5,602.80
|
| Rate for Payer: Cash Price |
$5,602.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$7,763.88
|
| Rate for Payer: Cigna of WY Commercial |
$7,843.92
|
| Rate for Payer: First Choice Health Commercial |
$7,203.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7,603.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$610.52
|
| Rate for Payer: HealthUtah PPO |
$8,004.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7,763.88
|
| Rate for Payer: Multiplan Medicare/VA |
$518.94
|
| Rate for Payer: One Health Plan of WY PPO |
$7,843.92
|
| Rate for Payer: PacificSource Commercial |
$7,203.60
|
| Rate for Payer: PHCS PPO |
$7,603.80
|
| Rate for Payer: Three Rivers PPO |
$6,003.00
|
| Rate for Payer: TriWest Veterans Administration |
$610.52
|
| Rate for Payer: United Healthcare Commercial |
$6,963.48
|
| Rate for Payer: United Healthcare Medicare |
$610.52
|
| Rate for Payer: WINHealth Partners Commercial |
$6,803.40
|
|
|
OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,771.00
|
|
|
Service Code
|
HCPCS 23550
|
| Hospital Charge Code |
23550
|
| Min. Negotiated Rate |
$475.27 |
| Max. Negotiated Rate |
$2,771.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,715.58
|
| Rate for Payer: Aetna of WY Medicare |
$559.14
|
| Rate for Payer: Beech Street Commercial |
$2,632.45
|
| Rate for Payer: Cash Price |
$1,939.70
|
| Rate for Payer: Cash Price |
$1,939.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,687.87
|
| Rate for Payer: Cigna of WY Commercial |
$2,715.58
|
| Rate for Payer: First Choice Health Commercial |
$2,493.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,632.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$559.14
|
| Rate for Payer: HealthUtah PPO |
$2,771.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,687.87
|
| Rate for Payer: Multiplan Medicare/VA |
$475.27
|
| Rate for Payer: One Health Plan of WY PPO |
$2,715.58
|
| Rate for Payer: PacificSource Commercial |
$2,493.90
|
| Rate for Payer: PHCS PPO |
$2,632.45
|
| Rate for Payer: Three Rivers PPO |
$2,078.25
|
| Rate for Payer: TriWest Veterans Administration |
$559.14
|
| Rate for Payer: United Healthcare Commercial |
$2,410.77
|
| Rate for Payer: United Healthcare Medicare |
$559.14
|
| Rate for Payer: WINHealth Partners Commercial |
$2,355.35
|
|
|
OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,771.00
|
|
|
Service Code
|
HCPCS 23550 AS
|
| Hospital Charge Code |
23550
|
| Min. Negotiated Rate |
$475.27 |
| Max. Negotiated Rate |
$2,771.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,715.58
|
| Rate for Payer: Aetna of WY Medicare |
$559.14
|
| Rate for Payer: Beech Street Commercial |
$2,632.45
|
| Rate for Payer: Cash Price |
$1,939.70
|
| Rate for Payer: Cash Price |
$1,939.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,687.87
|
| Rate for Payer: Cigna of WY Commercial |
$2,715.58
|
| Rate for Payer: First Choice Health Commercial |
$2,493.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,632.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$559.14
|
| Rate for Payer: HealthUtah PPO |
$2,771.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,687.87
|
| Rate for Payer: Multiplan Medicare/VA |
$475.27
|
| Rate for Payer: One Health Plan of WY PPO |
$2,715.58
|
| Rate for Payer: PacificSource Commercial |
$2,493.90
|
| Rate for Payer: PHCS PPO |
$2,632.45
|
| Rate for Payer: Three Rivers PPO |
$2,078.25
|
| Rate for Payer: TriWest Veterans Administration |
$559.14
|
| Rate for Payer: United Healthcare Commercial |
$2,410.77
|
| Rate for Payer: United Healthcare Medicare |
$559.14
|
| Rate for Payer: WINHealth Partners Commercial |
$2,355.35
|
|
|
OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,771.00
|
|
|
Service Code
|
HCPCS 23550 80
|
| Hospital Charge Code |
23550
|
| Min. Negotiated Rate |
$475.27 |
| Max. Negotiated Rate |
$2,771.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,715.58
|
| Rate for Payer: Aetna of WY Medicare |
$559.14
|
| Rate for Payer: Beech Street Commercial |
$2,632.45
|
| Rate for Payer: Cash Price |
$1,939.70
|
| Rate for Payer: Cash Price |
$1,939.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,687.87
|
| Rate for Payer: Cigna of WY Commercial |
$2,715.58
|
| Rate for Payer: First Choice Health Commercial |
$2,493.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,632.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$559.14
|
| Rate for Payer: HealthUtah PPO |
$2,771.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,687.87
|
| Rate for Payer: Multiplan Medicare/VA |
$475.27
|
| Rate for Payer: One Health Plan of WY PPO |
$2,715.58
|
| Rate for Payer: PacificSource Commercial |
$2,493.90
|
| Rate for Payer: PHCS PPO |
$2,632.45
|
| Rate for Payer: Three Rivers PPO |
$2,078.25
|
| Rate for Payer: TriWest Veterans Administration |
$559.14
|
| Rate for Payer: United Healthcare Commercial |
$2,410.77
|
| Rate for Payer: United Healthcare Medicare |
$559.14
|
| Rate for Payer: WINHealth Partners Commercial |
$2,355.35
|
|
|
OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,074.00
|
|
|
Service Code
|
HCPCS 23660
|
| Hospital Charge Code |
23660
|
| Min. Negotiated Rate |
$486.46 |
| Max. Negotiated Rate |
$2,074.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,032.52
|
| Rate for Payer: Aetna of WY Medicare |
$572.31
|
| Rate for Payer: Beech Street Commercial |
$1,970.30
|
| Rate for Payer: Cash Price |
$1,451.80
|
| Rate for Payer: Cash Price |
$1,451.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,011.78
|
| Rate for Payer: Cigna of WY Commercial |
$2,032.52
|
| Rate for Payer: First Choice Health Commercial |
$1,866.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,970.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$572.31
|
| Rate for Payer: HealthUtah PPO |
$2,074.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,011.78
|
| Rate for Payer: Multiplan Medicare/VA |
$486.46
|
| Rate for Payer: One Health Plan of WY PPO |
$2,032.52
|
| Rate for Payer: PacificSource Commercial |
$1,866.60
|
| Rate for Payer: PHCS PPO |
$1,970.30
|
| Rate for Payer: Three Rivers PPO |
$1,555.50
|
| Rate for Payer: TriWest Veterans Administration |
$572.31
|
| Rate for Payer: United Healthcare Commercial |
$1,804.38
|
| Rate for Payer: United Healthcare Medicare |
$572.31
|
| Rate for Payer: WINHealth Partners Commercial |
$1,762.90
|
|
|
OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,583.00
|
|
|
Service Code
|
HCPCS 26746 80
|
| Hospital Charge Code |
26746
|
| Min. Negotiated Rate |
$615.37 |
| Max. Negotiated Rate |
$2,583.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,531.34
|
| Rate for Payer: Aetna of WY Medicare |
$723.97
|
| Rate for Payer: Beech Street Commercial |
$2,453.85
|
| Rate for Payer: Cash Price |
$1,808.10
|
| Rate for Payer: Cash Price |
$1,808.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,505.51
|
| Rate for Payer: Cigna of WY Commercial |
$2,531.34
|
| Rate for Payer: First Choice Health Commercial |
$2,324.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,453.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$723.97
|
| Rate for Payer: HealthUtah PPO |
$2,583.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,505.51
|
| Rate for Payer: Multiplan Medicare/VA |
$615.37
|
| Rate for Payer: One Health Plan of WY PPO |
$2,531.34
|
| Rate for Payer: PacificSource Commercial |
$2,324.70
|
| Rate for Payer: PHCS PPO |
$2,453.85
|
| Rate for Payer: Three Rivers PPO |
$1,937.25
|
| Rate for Payer: TriWest Veterans Administration |
$723.97
|
| Rate for Payer: United Healthcare Commercial |
$2,247.21
|
| Rate for Payer: United Healthcare Medicare |
$723.97
|
| Rate for Payer: WINHealth Partners Commercial |
$2,195.55
|
|
|
OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,583.00
|
|
|
Service Code
|
HCPCS 26746
|
| Hospital Charge Code |
26746
|
| Min. Negotiated Rate |
$615.37 |
| Max. Negotiated Rate |
$2,583.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,531.34
|
| Rate for Payer: Aetna of WY Medicare |
$723.97
|
| Rate for Payer: Beech Street Commercial |
$2,453.85
|
| Rate for Payer: Cash Price |
$1,808.10
|
| Rate for Payer: Cash Price |
$1,808.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,505.51
|
| Rate for Payer: Cigna of WY Commercial |
$2,531.34
|
| Rate for Payer: First Choice Health Commercial |
$2,324.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,453.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$723.97
|
| Rate for Payer: HealthUtah PPO |
$2,583.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,505.51
|
| Rate for Payer: Multiplan Medicare/VA |
$615.37
|
| Rate for Payer: One Health Plan of WY PPO |
$2,531.34
|
| Rate for Payer: PacificSource Commercial |
$2,324.70
|
| Rate for Payer: PHCS PPO |
$2,453.85
|
| Rate for Payer: Three Rivers PPO |
$1,937.25
|
| Rate for Payer: TriWest Veterans Administration |
$723.97
|
| Rate for Payer: United Healthcare Commercial |
$2,247.21
|
| Rate for Payer: United Healthcare Medicare |
$723.97
|
| Rate for Payer: WINHealth Partners Commercial |
$2,195.55
|
|
|
OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$3,711.00
|
|
|
Service Code
|
HCPCS 25628 AS
|
| Hospital Charge Code |
25628
|
| Min. Negotiated Rate |
$596.67 |
| Max. Negotiated Rate |
$3,711.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,636.78
|
| Rate for Payer: Aetna of WY Medicare |
$701.96
|
| Rate for Payer: Beech Street Commercial |
$3,525.45
|
| Rate for Payer: Cash Price |
$2,597.70
|
| Rate for Payer: Cash Price |
$2,597.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,599.67
|
| Rate for Payer: Cigna of WY Commercial |
$3,636.78
|
| Rate for Payer: First Choice Health Commercial |
$3,339.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,525.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$701.96
|
| Rate for Payer: HealthUtah PPO |
$3,711.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,599.67
|
| Rate for Payer: Multiplan Medicare/VA |
$596.67
|
| Rate for Payer: One Health Plan of WY PPO |
$3,636.78
|
| Rate for Payer: PacificSource Commercial |
$3,339.90
|
| Rate for Payer: PHCS PPO |
$3,525.45
|
| Rate for Payer: Three Rivers PPO |
$2,783.25
|
| Rate for Payer: TriWest Veterans Administration |
$701.96
|
| Rate for Payer: United Healthcare Commercial |
$3,228.57
|
| Rate for Payer: United Healthcare Medicare |
$701.96
|
| Rate for Payer: WINHealth Partners Commercial |
$3,154.35
|
|
|
OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$3,711.00
|
|
|
Service Code
|
HCPCS 25628 80
|
| Hospital Charge Code |
25628
|
| Min. Negotiated Rate |
$596.67 |
| Max. Negotiated Rate |
$3,711.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,636.78
|
| Rate for Payer: Aetna of WY Medicare |
$701.96
|
| Rate for Payer: Beech Street Commercial |
$3,525.45
|
| Rate for Payer: Cash Price |
$2,597.70
|
| Rate for Payer: Cash Price |
$2,597.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,599.67
|
| Rate for Payer: Cigna of WY Commercial |
$3,636.78
|
| Rate for Payer: First Choice Health Commercial |
$3,339.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,525.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$701.96
|
| Rate for Payer: HealthUtah PPO |
$3,711.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,599.67
|
| Rate for Payer: Multiplan Medicare/VA |
$596.67
|
| Rate for Payer: One Health Plan of WY PPO |
$3,636.78
|
| Rate for Payer: PacificSource Commercial |
$3,339.90
|
| Rate for Payer: PHCS PPO |
$3,525.45
|
| Rate for Payer: Three Rivers PPO |
$2,783.25
|
| Rate for Payer: TriWest Veterans Administration |
$701.96
|
| Rate for Payer: United Healthcare Commercial |
$3,228.57
|
| Rate for Payer: United Healthcare Medicare |
$701.96
|
| Rate for Payer: WINHealth Partners Commercial |
$3,154.35
|
|
|
OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$3,711.00
|
|
|
Service Code
|
HCPCS 25628
|
| Hospital Charge Code |
25628
|
| Min. Negotiated Rate |
$596.67 |
| Max. Negotiated Rate |
$3,711.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,636.78
|
| Rate for Payer: Aetna of WY Medicare |
$701.96
|
| Rate for Payer: Beech Street Commercial |
$3,525.45
|
| Rate for Payer: Cash Price |
$2,597.70
|
| Rate for Payer: Cash Price |
$2,597.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,599.67
|
| Rate for Payer: Cigna of WY Commercial |
$3,636.78
|
| Rate for Payer: First Choice Health Commercial |
$3,339.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,525.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$701.96
|
| Rate for Payer: HealthUtah PPO |
$3,711.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,599.67
|
| Rate for Payer: Multiplan Medicare/VA |
$596.67
|
| Rate for Payer: One Health Plan of WY PPO |
$3,636.78
|
| Rate for Payer: PacificSource Commercial |
$3,339.90
|
| Rate for Payer: PHCS PPO |
$3,525.45
|
| Rate for Payer: Three Rivers PPO |
$2,783.25
|
| Rate for Payer: TriWest Veterans Administration |
$701.96
|
| Rate for Payer: United Healthcare Commercial |
$3,228.57
|
| Rate for Payer: United Healthcare Medicare |
$701.96
|
| Rate for Payer: WINHealth Partners Commercial |
$3,154.35
|
|
|
OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 26685
|
| Hospital Charge Code |
26685
|
| Min. Negotiated Rate |
$482.38 |
| Max. Negotiated Rate |
$2,725.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,670.50
|
| Rate for Payer: Aetna of WY Medicare |
$567.51
|
| Rate for Payer: Beech Street Commercial |
$2,588.75
|
| Rate for Payer: Cash Price |
$1,907.50
|
| Rate for Payer: Cash Price |
$1,907.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,643.25
|
| Rate for Payer: Cigna of WY Commercial |
$2,670.50
|
| Rate for Payer: First Choice Health Commercial |
$2,452.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,588.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$567.51
|
| Rate for Payer: HealthUtah PPO |
$2,725.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,643.25
|
| Rate for Payer: Multiplan Medicare/VA |
$482.38
|
| Rate for Payer: One Health Plan of WY PPO |
$2,670.50
|
| Rate for Payer: PacificSource Commercial |
$2,452.50
|
| Rate for Payer: PHCS PPO |
$2,588.75
|
| Rate for Payer: Three Rivers PPO |
$2,043.75
|
| Rate for Payer: TriWest Veterans Administration |
$567.51
|
| Rate for Payer: United Healthcare Commercial |
$2,370.75
|
| Rate for Payer: United Healthcare Medicare |
$567.51
|
| Rate for Payer: WINHealth Partners Commercial |
$2,316.25
|
|
|
OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,197.00
|
|
|
Service Code
|
HCPCS 26665
|
| Hospital Charge Code |
26665
|
| Min. Negotiated Rate |
$523.40 |
| Max. Negotiated Rate |
$2,197.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,153.06
|
| Rate for Payer: Aetna of WY Medicare |
$615.76
|
| Rate for Payer: Beech Street Commercial |
$2,087.15
|
| Rate for Payer: Cash Price |
$1,537.90
|
| Rate for Payer: Cash Price |
$1,537.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,131.09
|
| Rate for Payer: Cigna of WY Commercial |
$2,153.06
|
| Rate for Payer: First Choice Health Commercial |
$1,977.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,087.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$615.76
|
| Rate for Payer: HealthUtah PPO |
$2,197.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,131.09
|
| Rate for Payer: Multiplan Medicare/VA |
$523.40
|
| Rate for Payer: One Health Plan of WY PPO |
$2,153.06
|
| Rate for Payer: PacificSource Commercial |
$1,977.30
|
| Rate for Payer: PHCS PPO |
$2,087.15
|
| Rate for Payer: Three Rivers PPO |
$1,647.75
|
| Rate for Payer: TriWest Veterans Administration |
$615.76
|
| Rate for Payer: United Healthcare Commercial |
$1,911.39
|
| Rate for Payer: United Healthcare Medicare |
$615.76
|
| Rate for Payer: WINHealth Partners Commercial |
$1,867.45
|
|
|
OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,197.00
|
|
|
Service Code
|
HCPCS 26665 80
|
| Hospital Charge Code |
26665
|
| Min. Negotiated Rate |
$523.40 |
| Max. Negotiated Rate |
$2,197.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,153.06
|
| Rate for Payer: Aetna of WY Medicare |
$615.76
|
| Rate for Payer: Beech Street Commercial |
$2,087.15
|
| Rate for Payer: Cash Price |
$1,537.90
|
| Rate for Payer: Cash Price |
$1,537.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,131.09
|
| Rate for Payer: Cigna of WY Commercial |
$2,153.06
|
| Rate for Payer: First Choice Health Commercial |
$1,977.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,087.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$615.76
|
| Rate for Payer: HealthUtah PPO |
$2,197.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,131.09
|
| Rate for Payer: Multiplan Medicare/VA |
$523.40
|
| Rate for Payer: One Health Plan of WY PPO |
$2,153.06
|
| Rate for Payer: PacificSource Commercial |
$1,977.30
|
| Rate for Payer: PHCS PPO |
$2,087.15
|
| Rate for Payer: Three Rivers PPO |
$1,647.75
|
| Rate for Payer: TriWest Veterans Administration |
$615.76
|
| Rate for Payer: United Healthcare Commercial |
$1,911.39
|
| Rate for Payer: United Healthcare Medicare |
$615.76
|
| Rate for Payer: WINHealth Partners Commercial |
$1,867.45
|
|
|
OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$3,687.00
|
|
|
Service Code
|
HCPCS 23515 AS
|
| Hospital Charge Code |
23515
|
| Min. Negotiated Rate |
$596.35 |
| Max. Negotiated Rate |
$3,687.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,613.26
|
| Rate for Payer: Aetna of WY Medicare |
$701.59
|
| Rate for Payer: Beech Street Commercial |
$3,502.65
|
| Rate for Payer: Cash Price |
$2,580.90
|
| Rate for Payer: Cash Price |
$2,580.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,576.39
|
| Rate for Payer: Cigna of WY Commercial |
$3,613.26
|
| Rate for Payer: First Choice Health Commercial |
$3,318.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,502.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$701.59
|
| Rate for Payer: HealthUtah PPO |
$3,687.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,576.39
|
| Rate for Payer: Multiplan Medicare/VA |
$596.35
|
| Rate for Payer: One Health Plan of WY PPO |
$3,613.26
|
| Rate for Payer: PacificSource Commercial |
$3,318.30
|
| Rate for Payer: PHCS PPO |
$3,502.65
|
| Rate for Payer: Three Rivers PPO |
$2,765.25
|
| Rate for Payer: TriWest Veterans Administration |
$701.59
|
| Rate for Payer: United Healthcare Commercial |
$3,207.69
|
| Rate for Payer: United Healthcare Medicare |
$701.59
|
| Rate for Payer: WINHealth Partners Commercial |
$3,133.95
|
|
|
OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$3,687.00
|
|
|
Service Code
|
HCPCS 23515 80
|
| Hospital Charge Code |
23515
|
| Min. Negotiated Rate |
$596.35 |
| Max. Negotiated Rate |
$3,687.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,613.26
|
| Rate for Payer: Aetna of WY Medicare |
$701.59
|
| Rate for Payer: Beech Street Commercial |
$3,502.65
|
| Rate for Payer: Cash Price |
$2,580.90
|
| Rate for Payer: Cash Price |
$2,580.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,576.39
|
| Rate for Payer: Cigna of WY Commercial |
$3,613.26
|
| Rate for Payer: First Choice Health Commercial |
$3,318.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,502.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$701.59
|
| Rate for Payer: HealthUtah PPO |
$3,687.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,576.39
|
| Rate for Payer: Multiplan Medicare/VA |
$596.35
|
| Rate for Payer: One Health Plan of WY PPO |
$3,613.26
|
| Rate for Payer: PacificSource Commercial |
$3,318.30
|
| Rate for Payer: PHCS PPO |
$3,502.65
|
| Rate for Payer: Three Rivers PPO |
$2,765.25
|
| Rate for Payer: TriWest Veterans Administration |
$701.59
|
| Rate for Payer: United Healthcare Commercial |
$3,207.69
|
| Rate for Payer: United Healthcare Medicare |
$701.59
|
| Rate for Payer: WINHealth Partners Commercial |
$3,133.95
|
|
|
OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$3,687.00
|
|
|
Service Code
|
HCPCS 23515
|
| Hospital Charge Code |
23515
|
| Min. Negotiated Rate |
$596.35 |
| Max. Negotiated Rate |
$3,687.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,613.26
|
| Rate for Payer: Aetna of WY Medicare |
$701.59
|
| Rate for Payer: Beech Street Commercial |
$3,502.65
|
| Rate for Payer: Cash Price |
$2,580.90
|
| Rate for Payer: Cash Price |
$2,580.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,576.39
|
| Rate for Payer: Cigna of WY Commercial |
$3,613.26
|
| Rate for Payer: First Choice Health Commercial |
$3,318.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,502.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$701.59
|
| Rate for Payer: HealthUtah PPO |
$3,687.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,576.39
|
| Rate for Payer: Multiplan Medicare/VA |
$596.35
|
| Rate for Payer: One Health Plan of WY PPO |
$3,613.26
|
| Rate for Payer: PacificSource Commercial |
$3,318.30
|
| Rate for Payer: PHCS PPO |
$3,502.65
|
| Rate for Payer: Three Rivers PPO |
$2,765.25
|
| Rate for Payer: TriWest Veterans Administration |
$701.59
|
| Rate for Payer: United Healthcare Commercial |
$3,207.69
|
| Rate for Payer: United Healthcare Medicare |
$701.59
|
| Rate for Payer: WINHealth Partners Commercial |
$3,133.95
|
|
|
OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$3,044.00
|
|
|
Service Code
|
HCPCS 27792 AS
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$534.31 |
| Max. Negotiated Rate |
$3,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,983.12
|
| Rate for Payer: Aetna of WY Medicare |
$628.60
|
| Rate for Payer: Beech Street Commercial |
$2,891.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,952.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,983.12
|
| Rate for Payer: First Choice Health Commercial |
$2,739.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,891.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$628.60
|
| Rate for Payer: HealthUtah PPO |
$3,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,952.68
|
| Rate for Payer: Multiplan Medicare/VA |
$534.31
|
| Rate for Payer: One Health Plan of WY PPO |
$2,983.12
|
| Rate for Payer: PacificSource Commercial |
$2,739.60
|
| Rate for Payer: PHCS PPO |
$2,891.80
|
| Rate for Payer: Three Rivers PPO |
$2,283.00
|
| Rate for Payer: TriWest Veterans Administration |
$628.60
|
| Rate for Payer: United Healthcare Commercial |
$2,648.28
|
| Rate for Payer: United Healthcare Medicare |
$628.60
|
| Rate for Payer: WINHealth Partners Commercial |
$2,587.40
|
|
|
OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$3,044.00
|
|
|
Service Code
|
HCPCS 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$534.31 |
| Max. Negotiated Rate |
$3,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,983.12
|
| Rate for Payer: Aetna of WY Medicare |
$628.60
|
| Rate for Payer: Beech Street Commercial |
$2,891.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,952.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,983.12
|
| Rate for Payer: First Choice Health Commercial |
$2,739.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,891.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$628.60
|
| Rate for Payer: HealthUtah PPO |
$3,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,952.68
|
| Rate for Payer: Multiplan Medicare/VA |
$534.31
|
| Rate for Payer: One Health Plan of WY PPO |
$2,983.12
|
| Rate for Payer: PacificSource Commercial |
$2,739.60
|
| Rate for Payer: PHCS PPO |
$2,891.80
|
| Rate for Payer: Three Rivers PPO |
$2,283.00
|
| Rate for Payer: TriWest Veterans Administration |
$628.60
|
| Rate for Payer: United Healthcare Commercial |
$2,648.28
|
| Rate for Payer: United Healthcare Medicare |
$628.60
|
| Rate for Payer: WINHealth Partners Commercial |
$2,587.40
|
|
|
OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$3,044.00
|
|
|
Service Code
|
HCPCS 27792 80
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$534.31 |
| Max. Negotiated Rate |
$3,044.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,983.12
|
| Rate for Payer: Aetna of WY Medicare |
$628.60
|
| Rate for Payer: Beech Street Commercial |
$2,891.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: Cash Price |
$2,130.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,952.68
|
| Rate for Payer: Cigna of WY Commercial |
$2,983.12
|
| Rate for Payer: First Choice Health Commercial |
$2,739.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,891.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$628.60
|
| Rate for Payer: HealthUtah PPO |
$3,044.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,952.68
|
| Rate for Payer: Multiplan Medicare/VA |
$534.31
|
| Rate for Payer: One Health Plan of WY PPO |
$2,983.12
|
| Rate for Payer: PacificSource Commercial |
$2,739.60
|
| Rate for Payer: PHCS PPO |
$2,891.80
|
| Rate for Payer: Three Rivers PPO |
$2,283.00
|
| Rate for Payer: TriWest Veterans Administration |
$628.60
|
| Rate for Payer: United Healthcare Commercial |
$2,648.28
|
| Rate for Payer: United Healthcare Medicare |
$628.60
|
| Rate for Payer: WINHealth Partners Commercial |
$2,587.40
|
|
