|
OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
Both
|
$2,019.00
|
|
|
Service Code
|
HCPCS 26615 AS
|
| Hospital Charge Code |
26615
|
| Min. Negotiated Rate |
$480.88 |
| Max. Negotiated Rate |
$2,019.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,978.62
|
| Rate for Payer: Aetna of WY Medicare |
$565.74
|
| Rate for Payer: Beech Street Commercial |
$1,918.05
|
| Rate for Payer: Cash Price |
$1,413.30
|
| Rate for Payer: Cash Price |
$1,413.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,958.43
|
| Rate for Payer: Cigna of WY Commercial |
$1,978.62
|
| Rate for Payer: First Choice Health Commercial |
$1,817.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,918.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$565.74
|
| Rate for Payer: HealthUtah PPO |
$2,019.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,958.43
|
| Rate for Payer: Multiplan Medicare/VA |
$480.88
|
| Rate for Payer: One Health Plan of WY PPO |
$1,978.62
|
| Rate for Payer: PacificSource Commercial |
$1,817.10
|
| Rate for Payer: PHCS PPO |
$1,918.05
|
| Rate for Payer: Three Rivers PPO |
$1,514.25
|
| Rate for Payer: TriWest Veterans Administration |
$565.74
|
| Rate for Payer: United Healthcare Commercial |
$1,756.53
|
| Rate for Payer: United Healthcare Medicare |
$565.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,716.15
|
|
|
OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
Both
|
$2,019.00
|
|
|
Service Code
|
HCPCS 26615 80
|
| Hospital Charge Code |
26615
|
| Min. Negotiated Rate |
$480.88 |
| Max. Negotiated Rate |
$2,019.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,978.62
|
| Rate for Payer: Aetna of WY Medicare |
$565.74
|
| Rate for Payer: Beech Street Commercial |
$1,918.05
|
| Rate for Payer: Cash Price |
$1,413.30
|
| Rate for Payer: Cash Price |
$1,413.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,958.43
|
| Rate for Payer: Cigna of WY Commercial |
$1,978.62
|
| Rate for Payer: First Choice Health Commercial |
$1,817.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,918.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$565.74
|
| Rate for Payer: HealthUtah PPO |
$2,019.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,958.43
|
| Rate for Payer: Multiplan Medicare/VA |
$480.88
|
| Rate for Payer: One Health Plan of WY PPO |
$1,978.62
|
| Rate for Payer: PacificSource Commercial |
$1,817.10
|
| Rate for Payer: PHCS PPO |
$1,918.05
|
| Rate for Payer: Three Rivers PPO |
$1,514.25
|
| Rate for Payer: TriWest Veterans Administration |
$565.74
|
| Rate for Payer: United Healthcare Commercial |
$1,756.53
|
| Rate for Payer: United Healthcare Medicare |
$565.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1,716.15
|
|
|
OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
Both
|
$2,355.00
|
|
|
Service Code
|
HCPCS 24635 80
|
| Hospital Charge Code |
24635
|
| Min. Negotiated Rate |
$560.99 |
| Max. Negotiated Rate |
$2,355.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,307.90
|
| Rate for Payer: Aetna of WY Medicare |
$659.99
|
| Rate for Payer: Beech Street Commercial |
$2,237.25
|
| Rate for Payer: Cash Price |
$1,648.50
|
| Rate for Payer: Cash Price |
$1,648.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,284.35
|
| Rate for Payer: Cigna of WY Commercial |
$2,307.90
|
| Rate for Payer: First Choice Health Commercial |
$2,119.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,237.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$659.99
|
| Rate for Payer: HealthUtah PPO |
$2,355.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,284.35
|
| Rate for Payer: Multiplan Medicare/VA |
$560.99
|
| Rate for Payer: One Health Plan of WY PPO |
$2,307.90
|
| Rate for Payer: PacificSource Commercial |
$2,119.50
|
| Rate for Payer: PHCS PPO |
$2,237.25
|
| Rate for Payer: Three Rivers PPO |
$1,766.25
|
| Rate for Payer: TriWest Veterans Administration |
$659.99
|
| Rate for Payer: United Healthcare Commercial |
$2,048.85
|
| Rate for Payer: United Healthcare Medicare |
$659.99
|
| Rate for Payer: WINHealth Partners Commercial |
$2,001.75
|
|
|
OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
Both
|
$2,355.00
|
|
|
Service Code
|
HCPCS 24635 AS
|
| Hospital Charge Code |
24635
|
| Min. Negotiated Rate |
$560.99 |
| Max. Negotiated Rate |
$2,355.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,307.90
|
| Rate for Payer: Aetna of WY Medicare |
$659.99
|
| Rate for Payer: Beech Street Commercial |
$2,237.25
|
| Rate for Payer: Cash Price |
$1,648.50
|
| Rate for Payer: Cash Price |
$1,648.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,284.35
|
| Rate for Payer: Cigna of WY Commercial |
$2,307.90
|
| Rate for Payer: First Choice Health Commercial |
$2,119.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,237.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$659.99
|
| Rate for Payer: HealthUtah PPO |
$2,355.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,284.35
|
| Rate for Payer: Multiplan Medicare/VA |
$560.99
|
| Rate for Payer: One Health Plan of WY PPO |
$2,307.90
|
| Rate for Payer: PacificSource Commercial |
$2,119.50
|
| Rate for Payer: PHCS PPO |
$2,237.25
|
| Rate for Payer: Three Rivers PPO |
$1,766.25
|
| Rate for Payer: TriWest Veterans Administration |
$659.99
|
| Rate for Payer: United Healthcare Commercial |
$2,048.85
|
| Rate for Payer: United Healthcare Medicare |
$659.99
|
| Rate for Payer: WINHealth Partners Commercial |
$2,001.75
|
|
|
OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
Both
|
$2,355.00
|
|
|
Service Code
|
HCPCS 24635
|
| Hospital Charge Code |
24635
|
| Min. Negotiated Rate |
$560.99 |
| Max. Negotiated Rate |
$2,355.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,307.90
|
| Rate for Payer: Aetna of WY Medicare |
$659.99
|
| Rate for Payer: Beech Street Commercial |
$2,237.25
|
| Rate for Payer: Cash Price |
$1,648.50
|
| Rate for Payer: Cash Price |
$1,648.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,284.35
|
| Rate for Payer: Cigna of WY Commercial |
$2,307.90
|
| Rate for Payer: First Choice Health Commercial |
$2,119.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,237.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$659.99
|
| Rate for Payer: HealthUtah PPO |
$2,355.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,284.35
|
| Rate for Payer: Multiplan Medicare/VA |
$560.99
|
| Rate for Payer: One Health Plan of WY PPO |
$2,307.90
|
| Rate for Payer: PacificSource Commercial |
$2,119.50
|
| Rate for Payer: PHCS PPO |
$2,237.25
|
| Rate for Payer: Three Rivers PPO |
$1,766.25
|
| Rate for Payer: TriWest Veterans Administration |
$659.99
|
| Rate for Payer: United Healthcare Commercial |
$2,048.85
|
| Rate for Payer: United Healthcare Medicare |
$659.99
|
| Rate for Payer: WINHealth Partners Commercial |
$2,001.75
|
|
|
OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM
|
Professional
|
Both
|
$3,654.00
|
|
|
Service Code
|
HCPCS 21335
|
| Hospital Charge Code |
21335
|
| Min. Negotiated Rate |
$592.42 |
| Max. Negotiated Rate |
$3,654.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,580.92
|
| Rate for Payer: Aetna of WY Medicare |
$696.96
|
| Rate for Payer: Beech Street Commercial |
$3,471.30
|
| Rate for Payer: Cash Price |
$2,557.80
|
| Rate for Payer: Cash Price |
$2,557.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,544.38
|
| Rate for Payer: Cigna of WY Commercial |
$3,580.92
|
| Rate for Payer: First Choice Health Commercial |
$3,288.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,471.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$696.96
|
| Rate for Payer: HealthUtah PPO |
$3,654.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,544.38
|
| Rate for Payer: Multiplan Medicare/VA |
$592.42
|
| Rate for Payer: One Health Plan of WY PPO |
$3,580.92
|
| Rate for Payer: PacificSource Commercial |
$3,288.60
|
| Rate for Payer: PHCS PPO |
$3,471.30
|
| Rate for Payer: Three Rivers PPO |
$2,740.50
|
| Rate for Payer: TriWest Veterans Administration |
$696.96
|
| Rate for Payer: United Healthcare Commercial |
$3,178.98
|
| Rate for Payer: United Healthcare Medicare |
$696.96
|
| Rate for Payer: WINHealth Partners Commercial |
$3,105.90
|
|
|
OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA
|
Professional
|
Both
|
$3,065.00
|
|
|
Service Code
|
HCPCS 26735 80
|
| Hospital Charge Code |
26735
|
| Min. Negotiated Rate |
$496.72 |
| Max. Negotiated Rate |
$3,065.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,003.70
|
| Rate for Payer: Aetna of WY Medicare |
$584.38
|
| Rate for Payer: Beech Street Commercial |
$2,911.75
|
| Rate for Payer: Cash Price |
$2,145.50
|
| Rate for Payer: Cash Price |
$2,145.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,973.05
|
| Rate for Payer: Cigna of WY Commercial |
$3,003.70
|
| Rate for Payer: First Choice Health Commercial |
$2,758.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,911.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$584.38
|
| Rate for Payer: HealthUtah PPO |
$3,065.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,973.05
|
| Rate for Payer: Multiplan Medicare/VA |
$496.72
|
| Rate for Payer: One Health Plan of WY PPO |
$3,003.70
|
| Rate for Payer: PacificSource Commercial |
$2,758.50
|
| Rate for Payer: PHCS PPO |
$2,911.75
|
| Rate for Payer: Three Rivers PPO |
$2,298.75
|
| Rate for Payer: TriWest Veterans Administration |
$584.38
|
| Rate for Payer: United Healthcare Commercial |
$2,666.55
|
| Rate for Payer: United Healthcare Medicare |
$584.38
|
| Rate for Payer: WINHealth Partners Commercial |
$2,605.25
|
|
|
OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA
|
Professional
|
Both
|
$3,065.00
|
|
|
Service Code
|
HCPCS 26735
|
| Hospital Charge Code |
26735
|
| Min. Negotiated Rate |
$496.72 |
| Max. Negotiated Rate |
$3,065.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,003.70
|
| Rate for Payer: Aetna of WY Medicare |
$584.38
|
| Rate for Payer: Beech Street Commercial |
$2,911.75
|
| Rate for Payer: Cash Price |
$2,145.50
|
| Rate for Payer: Cash Price |
$2,145.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,973.05
|
| Rate for Payer: Cigna of WY Commercial |
$3,003.70
|
| Rate for Payer: First Choice Health Commercial |
$2,758.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,911.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$584.38
|
| Rate for Payer: HealthUtah PPO |
$3,065.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,973.05
|
| Rate for Payer: Multiplan Medicare/VA |
$496.72
|
| Rate for Payer: One Health Plan of WY PPO |
$3,003.70
|
| Rate for Payer: PacificSource Commercial |
$2,758.50
|
| Rate for Payer: PHCS PPO |
$2,911.75
|
| Rate for Payer: Three Rivers PPO |
$2,298.75
|
| Rate for Payer: TriWest Veterans Administration |
$584.38
|
| Rate for Payer: United Healthcare Commercial |
$2,666.55
|
| Rate for Payer: United Healthcare Medicare |
$584.38
|
| Rate for Payer: WINHealth Partners Commercial |
$2,605.25
|
|
|
OPEN TX RADIAL HEAD/NECK FRACTURE
|
Professional
|
Both
|
$2,297.00
|
|
|
Service Code
|
HCPCS 24665
|
| Hospital Charge Code |
24665
|
| Min. Negotiated Rate |
$546.97 |
| Max. Negotiated Rate |
$2,297.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,251.06
|
| Rate for Payer: Aetna of WY Medicare |
$643.49
|
| Rate for Payer: Beech Street Commercial |
$2,182.15
|
| Rate for Payer: Cash Price |
$1,607.90
|
| Rate for Payer: Cash Price |
$1,607.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,228.09
|
| Rate for Payer: Cigna of WY Commercial |
$2,251.06
|
| Rate for Payer: First Choice Health Commercial |
$2,067.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,182.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$643.49
|
| Rate for Payer: HealthUtah PPO |
$2,297.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,228.09
|
| Rate for Payer: Multiplan Medicare/VA |
$546.97
|
| Rate for Payer: One Health Plan of WY PPO |
$2,251.06
|
| Rate for Payer: PacificSource Commercial |
$2,067.30
|
| Rate for Payer: PHCS PPO |
$2,182.15
|
| Rate for Payer: Three Rivers PPO |
$1,722.75
|
| Rate for Payer: TriWest Veterans Administration |
$643.49
|
| Rate for Payer: United Healthcare Commercial |
$1,998.39
|
| Rate for Payer: United Healthcare Medicare |
$643.49
|
| Rate for Payer: WINHealth Partners Commercial |
$1,952.45
|
|
|
OPEN TX RADIAL HEAD/NECK FRACTURE
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 24665 AS
|
| Hospital Charge Code |
24665
|
| Min. Negotiated Rate |
$546.97 |
| Max. Negotiated Rate |
$2,299.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,253.02
|
| Rate for Payer: Aetna of WY Medicare |
$643.49
|
| Rate for Payer: Beech Street Commercial |
$2,184.05
|
| Rate for Payer: Cash Price |
$1,609.30
|
| Rate for Payer: Cash Price |
$1,609.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,230.03
|
| Rate for Payer: Cigna of WY Commercial |
$2,253.02
|
| Rate for Payer: First Choice Health Commercial |
$2,069.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,184.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$643.49
|
| Rate for Payer: HealthUtah PPO |
$2,299.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,230.03
|
| Rate for Payer: Multiplan Medicare/VA |
$546.97
|
| Rate for Payer: One Health Plan of WY PPO |
$2,253.02
|
| Rate for Payer: PacificSource Commercial |
$2,069.10
|
| Rate for Payer: PHCS PPO |
$2,184.05
|
| Rate for Payer: Three Rivers PPO |
$1,724.25
|
| Rate for Payer: TriWest Veterans Administration |
$643.49
|
| Rate for Payer: United Healthcare Commercial |
$2,000.13
|
| Rate for Payer: United Healthcare Medicare |
$643.49
|
| Rate for Payer: WINHealth Partners Commercial |
$1,954.15
|
|
|
OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC
|
Professional
|
Both
|
$3,783.00
|
|
|
Service Code
|
HCPCS 24666
|
| Hospital Charge Code |
24666
|
| Min. Negotiated Rate |
$606.15 |
| Max. Negotiated Rate |
$3,783.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,707.34
|
| Rate for Payer: Aetna of WY Medicare |
$713.12
|
| Rate for Payer: Beech Street Commercial |
$3,593.85
|
| Rate for Payer: Cash Price |
$2,648.10
|
| Rate for Payer: Cash Price |
$2,648.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,669.51
|
| Rate for Payer: Cigna of WY Commercial |
$3,707.34
|
| Rate for Payer: First Choice Health Commercial |
$3,404.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,593.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$713.12
|
| Rate for Payer: HealthUtah PPO |
$3,783.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,669.51
|
| Rate for Payer: Multiplan Medicare/VA |
$606.15
|
| Rate for Payer: One Health Plan of WY PPO |
$3,707.34
|
| Rate for Payer: PacificSource Commercial |
$3,404.70
|
| Rate for Payer: PHCS PPO |
$3,593.85
|
| Rate for Payer: Three Rivers PPO |
$2,837.25
|
| Rate for Payer: TriWest Veterans Administration |
$713.12
|
| Rate for Payer: United Healthcare Commercial |
$3,291.21
|
| Rate for Payer: United Healthcare Medicare |
$713.12
|
| Rate for Payer: WINHealth Partners Commercial |
$3,215.55
|
|
|
OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC
|
Professional
|
Both
|
$3,783.00
|
|
|
Service Code
|
HCPCS 24666 80
|
| Hospital Charge Code |
24666
|
| Min. Negotiated Rate |
$606.15 |
| Max. Negotiated Rate |
$3,783.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,707.34
|
| Rate for Payer: Aetna of WY Medicare |
$713.12
|
| Rate for Payer: Beech Street Commercial |
$3,593.85
|
| Rate for Payer: Cash Price |
$2,648.10
|
| Rate for Payer: Cash Price |
$2,648.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,669.51
|
| Rate for Payer: Cigna of WY Commercial |
$3,707.34
|
| Rate for Payer: First Choice Health Commercial |
$3,404.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,593.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$713.12
|
| Rate for Payer: HealthUtah PPO |
$3,783.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,669.51
|
| Rate for Payer: Multiplan Medicare/VA |
$606.15
|
| Rate for Payer: One Health Plan of WY PPO |
$3,707.34
|
| Rate for Payer: PacificSource Commercial |
$3,404.70
|
| Rate for Payer: PHCS PPO |
$3,593.85
|
| Rate for Payer: Three Rivers PPO |
$2,837.25
|
| Rate for Payer: TriWest Veterans Administration |
$713.12
|
| Rate for Payer: United Healthcare Commercial |
$3,291.21
|
| Rate for Payer: United Healthcare Medicare |
$713.12
|
| Rate for Payer: WINHealth Partners Commercial |
$3,215.55
|
|
|
OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC
|
Professional
|
Both
|
$3,783.00
|
|
|
Service Code
|
HCPCS 24666 AS
|
| Hospital Charge Code |
24666
|
| Min. Negotiated Rate |
$606.15 |
| Max. Negotiated Rate |
$3,783.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,707.34
|
| Rate for Payer: Aetna of WY Medicare |
$713.12
|
| Rate for Payer: Beech Street Commercial |
$3,593.85
|
| Rate for Payer: Cash Price |
$2,648.10
|
| Rate for Payer: Cash Price |
$2,648.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,669.51
|
| Rate for Payer: Cigna of WY Commercial |
$3,707.34
|
| Rate for Payer: First Choice Health Commercial |
$3,404.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,593.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$713.12
|
| Rate for Payer: HealthUtah PPO |
$3,783.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,669.51
|
| Rate for Payer: Multiplan Medicare/VA |
$606.15
|
| Rate for Payer: One Health Plan of WY PPO |
$3,707.34
|
| Rate for Payer: PacificSource Commercial |
$3,404.70
|
| Rate for Payer: PHCS PPO |
$3,593.85
|
| Rate for Payer: Three Rivers PPO |
$2,837.25
|
| Rate for Payer: TriWest Veterans Administration |
$713.12
|
| Rate for Payer: United Healthcare Commercial |
$3,291.21
|
| Rate for Payer: United Healthcare Medicare |
$713.12
|
| Rate for Payer: WINHealth Partners Commercial |
$3,215.55
|
|
|
OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS
|
Professional
|
Both
|
$3,064.00
|
|
|
Service Code
|
HCPCS 21811
|
| Hospital Charge Code |
21811
|
| Min. Negotiated Rate |
$472.78 |
| 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 |
$556.21
|
| 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 |
$556.21
|
| Rate for Payer: HealthUtah PPO |
$3,064.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,972.08
|
| Rate for Payer: Multiplan Medicare/VA |
$472.78
|
| 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 |
$556.21
|
| Rate for Payer: United Healthcare Commercial |
$2,665.68
|
| Rate for Payer: United Healthcare Medicare |
$556.21
|
| Rate for Payer: WINHealth Partners Commercial |
$2,604.40
|
|
|
OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS
|
Professional
|
Both
|
$3,064.00
|
|
|
Service Code
|
HCPCS 21811 80
|
| Hospital Charge Code |
21811
|
| Min. Negotiated Rate |
$472.78 |
| 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 |
$556.21
|
| 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 |
$556.21
|
| Rate for Payer: HealthUtah PPO |
$3,064.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,972.08
|
| Rate for Payer: Multiplan Medicare/VA |
$472.78
|
| 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 |
$556.21
|
| Rate for Payer: United Healthcare Commercial |
$2,665.68
|
| Rate for Payer: United Healthcare Medicare |
$556.21
|
| Rate for Payer: WINHealth Partners Commercial |
$2,604.40
|
|
|
OPEN TX SCAPULAR FX W/INT FIXATION WHEN PFRMD
|
Professional
|
Both
|
$3,361.00
|
|
|
Service Code
|
HCPCS 23585
|
| Hospital Charge Code |
23585
|
| Min. Negotiated Rate |
$800.72 |
| Max. Negotiated Rate |
$3,361.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,293.78
|
| Rate for Payer: Aetna of WY Medicare |
$942.02
|
| Rate for Payer: Beech Street Commercial |
$3,192.95
|
| Rate for Payer: Cash Price |
$2,352.70
|
| Rate for Payer: Cash Price |
$2,352.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,260.17
|
| Rate for Payer: Cigna of WY Commercial |
$3,293.78
|
| Rate for Payer: First Choice Health Commercial |
$3,024.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,192.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$942.02
|
| Rate for Payer: HealthUtah PPO |
$3,361.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,260.17
|
| Rate for Payer: Multiplan Medicare/VA |
$800.72
|
| Rate for Payer: One Health Plan of WY PPO |
$3,293.78
|
| Rate for Payer: PacificSource Commercial |
$3,024.90
|
| Rate for Payer: PHCS PPO |
$3,192.95
|
| Rate for Payer: Three Rivers PPO |
$2,520.75
|
| Rate for Payer: TriWest Veterans Administration |
$942.02
|
| Rate for Payer: United Healthcare Commercial |
$2,924.07
|
| Rate for Payer: United Healthcare Medicare |
$942.02
|
| Rate for Payer: WINHealth Partners Commercial |
$2,856.85
|
|
|
OPEN TX SCAPULAR FX W/INT FIXATION WHEN PFRMD
|
Professional
|
Both
|
$3,361.00
|
|
|
Service Code
|
HCPCS 23585 80
|
| Hospital Charge Code |
23585
|
| Min. Negotiated Rate |
$800.72 |
| Max. Negotiated Rate |
$3,361.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,293.78
|
| Rate for Payer: Aetna of WY Medicare |
$942.02
|
| Rate for Payer: Beech Street Commercial |
$3,192.95
|
| Rate for Payer: Cash Price |
$2,352.70
|
| Rate for Payer: Cash Price |
$2,352.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,260.17
|
| Rate for Payer: Cigna of WY Commercial |
$3,293.78
|
| Rate for Payer: First Choice Health Commercial |
$3,024.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,192.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$942.02
|
| Rate for Payer: HealthUtah PPO |
$3,361.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,260.17
|
| Rate for Payer: Multiplan Medicare/VA |
$800.72
|
| Rate for Payer: One Health Plan of WY PPO |
$3,293.78
|
| Rate for Payer: PacificSource Commercial |
$3,024.90
|
| Rate for Payer: PHCS PPO |
$3,192.95
|
| Rate for Payer: Three Rivers PPO |
$2,520.75
|
| Rate for Payer: TriWest Veterans Administration |
$942.02
|
| Rate for Payer: United Healthcare Commercial |
$2,924.07
|
| Rate for Payer: United Healthcare Medicare |
$942.02
|
| Rate for Payer: WINHealth Partners Commercial |
$2,856.85
|
|
|
OPEN TX SCAPULAR FX W/INT FIXATION WHEN PFRMD
|
Professional
|
Both
|
$3,361.00
|
|
|
Service Code
|
HCPCS 23585 AS
|
| Hospital Charge Code |
23585
|
| Min. Negotiated Rate |
$800.72 |
| Max. Negotiated Rate |
$3,361.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,293.78
|
| Rate for Payer: Aetna of WY Medicare |
$942.02
|
| Rate for Payer: Beech Street Commercial |
$3,192.95
|
| Rate for Payer: Cash Price |
$2,352.70
|
| Rate for Payer: Cash Price |
$2,352.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,260.17
|
| Rate for Payer: Cigna of WY Commercial |
$3,293.78
|
| Rate for Payer: First Choice Health Commercial |
$3,024.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,192.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$942.02
|
| Rate for Payer: HealthUtah PPO |
$3,361.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,260.17
|
| Rate for Payer: Multiplan Medicare/VA |
$800.72
|
| Rate for Payer: One Health Plan of WY PPO |
$3,293.78
|
| Rate for Payer: PacificSource Commercial |
$3,024.90
|
| Rate for Payer: PHCS PPO |
$3,192.95
|
| Rate for Payer: Three Rivers PPO |
$2,520.75
|
| Rate for Payer: TriWest Veterans Administration |
$942.02
|
| Rate for Payer: United Healthcare Commercial |
$2,924.07
|
| Rate for Payer: United Healthcare Medicare |
$942.02
|
| Rate for Payer: WINHealth Partners Commercial |
$2,856.85
|
|
|
OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA
|
Professional
|
Both
|
$3,262.00
|
|
|
Service Code
|
HCPCS 28465
|
| Hospital Charge Code |
28465
|
| Min. Negotiated Rate |
$532.74 |
| Max. Negotiated Rate |
$3,262.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,196.76
|
| Rate for Payer: Aetna of WY Medicare |
$626.75
|
| Rate for Payer: Beech Street Commercial |
$3,098.90
|
| Rate for Payer: Cash Price |
$2,283.40
|
| Rate for Payer: Cash Price |
$2,283.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,164.14
|
| Rate for Payer: Cigna of WY Commercial |
$3,196.76
|
| Rate for Payer: First Choice Health Commercial |
$2,935.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,098.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$626.75
|
| Rate for Payer: HealthUtah PPO |
$3,262.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,164.14
|
| Rate for Payer: Multiplan Medicare/VA |
$532.74
|
| Rate for Payer: One Health Plan of WY PPO |
$3,196.76
|
| Rate for Payer: PacificSource Commercial |
$2,935.80
|
| Rate for Payer: PHCS PPO |
$3,098.90
|
| Rate for Payer: Three Rivers PPO |
$2,446.50
|
| Rate for Payer: TriWest Veterans Administration |
$626.75
|
| Rate for Payer: United Healthcare Commercial |
$2,837.94
|
| Rate for Payer: United Healthcare Medicare |
$626.75
|
| Rate for Payer: WINHealth Partners Commercial |
$2,772.70
|
|
|
OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$3,076.00
|
|
|
Service Code
|
HCPCS 27535
|
| Hospital Charge Code |
27535
|
| Min. Negotiated Rate |
$732.69 |
| Max. Negotiated Rate |
$3,076.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,014.48
|
| Rate for Payer: Aetna of WY Medicare |
$861.99
|
| Rate for Payer: Beech Street Commercial |
$2,922.20
|
| Rate for Payer: Cash Price |
$2,153.20
|
| Rate for Payer: Cash Price |
$2,153.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,983.72
|
| Rate for Payer: Cigna of WY Commercial |
$3,014.48
|
| Rate for Payer: First Choice Health Commercial |
$2,768.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,922.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$861.99
|
| Rate for Payer: HealthUtah PPO |
$3,076.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,983.72
|
| Rate for Payer: Multiplan Medicare/VA |
$732.69
|
| Rate for Payer: One Health Plan of WY PPO |
$3,014.48
|
| Rate for Payer: PacificSource Commercial |
$2,768.40
|
| Rate for Payer: PHCS PPO |
$2,922.20
|
| Rate for Payer: Three Rivers PPO |
$2,307.00
|
| Rate for Payer: TriWest Veterans Administration |
$861.99
|
| Rate for Payer: United Healthcare Commercial |
$2,676.12
|
| Rate for Payer: United Healthcare Medicare |
$861.99
|
| Rate for Payer: WINHealth Partners Commercial |
$2,614.60
|
|
|
OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$3,076.00
|
|
|
Service Code
|
HCPCS 27535 80
|
| Hospital Charge Code |
27535
|
| Min. Negotiated Rate |
$732.69 |
| Max. Negotiated Rate |
$3,076.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,014.48
|
| Rate for Payer: Aetna of WY Medicare |
$861.99
|
| Rate for Payer: Beech Street Commercial |
$2,922.20
|
| Rate for Payer: Cash Price |
$2,153.20
|
| Rate for Payer: Cash Price |
$2,153.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,983.72
|
| Rate for Payer: Cigna of WY Commercial |
$3,014.48
|
| Rate for Payer: First Choice Health Commercial |
$2,768.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,922.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$861.99
|
| Rate for Payer: HealthUtah PPO |
$3,076.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,983.72
|
| Rate for Payer: Multiplan Medicare/VA |
$732.69
|
| Rate for Payer: One Health Plan of WY PPO |
$3,014.48
|
| Rate for Payer: PacificSource Commercial |
$2,768.40
|
| Rate for Payer: PHCS PPO |
$2,922.20
|
| Rate for Payer: Three Rivers PPO |
$2,307.00
|
| Rate for Payer: TriWest Veterans Administration |
$861.99
|
| Rate for Payer: United Healthcare Commercial |
$2,676.12
|
| Rate for Payer: United Healthcare Medicare |
$861.99
|
| Rate for Payer: WINHealth Partners Commercial |
$2,614.60
|
|
|
OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$3,076.00
|
|
|
Service Code
|
HCPCS 27535 AS
|
| Hospital Charge Code |
27535
|
| Min. Negotiated Rate |
$732.69 |
| Max. Negotiated Rate |
$3,076.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,014.48
|
| Rate for Payer: Aetna of WY Medicare |
$861.99
|
| Rate for Payer: Beech Street Commercial |
$2,922.20
|
| Rate for Payer: Cash Price |
$2,153.20
|
| Rate for Payer: Cash Price |
$2,153.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,983.72
|
| Rate for Payer: Cigna of WY Commercial |
$3,014.48
|
| Rate for Payer: First Choice Health Commercial |
$2,768.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,922.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$861.99
|
| Rate for Payer: HealthUtah PPO |
$3,076.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,983.72
|
| Rate for Payer: Multiplan Medicare/VA |
$732.69
|
| Rate for Payer: One Health Plan of WY PPO |
$3,014.48
|
| Rate for Payer: PacificSource Commercial |
$2,768.40
|
| Rate for Payer: PHCS PPO |
$2,922.20
|
| Rate for Payer: Three Rivers PPO |
$2,307.00
|
| Rate for Payer: TriWest Veterans Administration |
$861.99
|
| Rate for Payer: United Healthcare Commercial |
$2,676.12
|
| Rate for Payer: United Healthcare Medicare |
$861.99
|
| Rate for Payer: WINHealth Partners Commercial |
$2,614.60
|
|
|
OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP
|
Professional
|
Both
|
$3,942.00
|
|
|
Service Code
|
HCPCS 27823 80
|
| Hospital Charge Code |
27823
|
| Min. Negotiated Rate |
$2,956.50 |
| Max. Negotiated Rate |
$3,942.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,863.16
|
| Rate for Payer: Beech Street Commercial |
$3,744.90
|
| Rate for Payer: Cash Price |
$2,759.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,823.74
|
| Rate for Payer: Cigna of WY Commercial |
$3,863.16
|
| Rate for Payer: First Choice Health Commercial |
$3,547.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,744.90
|
| Rate for Payer: HealthUtah PPO |
$3,942.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,823.74
|
| Rate for Payer: One Health Plan of WY PPO |
$3,863.16
|
| Rate for Payer: PacificSource Commercial |
$3,547.80
|
| Rate for Payer: PHCS PPO |
$3,744.90
|
| Rate for Payer: Three Rivers PPO |
$2,956.50
|
| Rate for Payer: United Healthcare Commercial |
$3,429.54
|
| Rate for Payer: WINHealth Partners Commercial |
$3,350.70
|
|
|
OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP
|
Professional
|
Both
|
$3,942.00
|
|
|
Service Code
|
HCPCS 27823 AS
|
| Hospital Charge Code |
27823
|
| Min. Negotiated Rate |
$2,956.50 |
| Max. Negotiated Rate |
$3,942.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,863.16
|
| Rate for Payer: Beech Street Commercial |
$3,744.90
|
| Rate for Payer: Cash Price |
$2,759.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,823.74
|
| Rate for Payer: Cigna of WY Commercial |
$3,863.16
|
| Rate for Payer: First Choice Health Commercial |
$3,547.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,744.90
|
| Rate for Payer: HealthUtah PPO |
$3,942.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,823.74
|
| Rate for Payer: One Health Plan of WY PPO |
$3,863.16
|
| Rate for Payer: PacificSource Commercial |
$3,547.80
|
| Rate for Payer: PHCS PPO |
$3,744.90
|
| Rate for Payer: Three Rivers PPO |
$2,956.50
|
| Rate for Payer: United Healthcare Commercial |
$3,429.54
|
| Rate for Payer: WINHealth Partners Commercial |
$3,350.70
|
|
|
OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP
|
Professional
|
Both
|
$3,942.00
|
|
|
Service Code
|
HCPCS 27823
|
| Hospital Charge Code |
27823
|
| Min. Negotiated Rate |
$2,956.50 |
| Max. Negotiated Rate |
$3,942.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,863.16
|
| Rate for Payer: Beech Street Commercial |
$3,744.90
|
| Rate for Payer: Cash Price |
$2,759.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,823.74
|
| Rate for Payer: Cigna of WY Commercial |
$3,863.16
|
| Rate for Payer: First Choice Health Commercial |
$3,547.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,744.90
|
| Rate for Payer: HealthUtah PPO |
$3,942.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,823.74
|
| Rate for Payer: One Health Plan of WY PPO |
$3,863.16
|
| Rate for Payer: PacificSource Commercial |
$3,547.80
|
| Rate for Payer: PHCS PPO |
$3,744.90
|
| Rate for Payer: Three Rivers PPO |
$2,956.50
|
| Rate for Payer: United Healthcare Commercial |
$3,429.54
|
| Rate for Payer: WINHealth Partners Commercial |
$3,350.70
|
|
