|
SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Professional
|
Both
|
$4,739.00
|
|
|
Service Code
|
HCPCS 29828 AS
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$752.43 |
| Max. Negotiated Rate |
$4,739.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,644.22
|
| Rate for Payer: Aetna of WY Medicare |
$885.21
|
| Rate for Payer: Beech Street Commercial |
$4,502.05
|
| Rate for Payer: Cash Price |
$3,317.30
|
| Rate for Payer: Cash Price |
$3,317.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,596.83
|
| Rate for Payer: Cigna of WY Commercial |
$4,644.22
|
| Rate for Payer: First Choice Health Commercial |
$4,265.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,502.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$885.21
|
| Rate for Payer: HealthUtah PPO |
$4,739.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,596.83
|
| Rate for Payer: Multiplan Medicare/VA |
$752.43
|
| Rate for Payer: One Health Plan of WY PPO |
$4,644.22
|
| Rate for Payer: PacificSource Commercial |
$4,265.10
|
| Rate for Payer: PHCS PPO |
$4,502.05
|
| Rate for Payer: Three Rivers PPO |
$3,554.25
|
| Rate for Payer: TriWest Veterans Administration |
$885.21
|
| Rate for Payer: United Healthcare Commercial |
$4,122.93
|
| Rate for Payer: United Healthcare Medicare |
$885.21
|
| Rate for Payer: WINHealth Partners Commercial |
$4,028.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Professional
|
Both
|
$4,739.00
|
|
|
Service Code
|
HCPCS 29828 80
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$752.43 |
| Max. Negotiated Rate |
$4,739.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,644.22
|
| Rate for Payer: Aetna of WY Medicare |
$885.21
|
| Rate for Payer: Beech Street Commercial |
$4,502.05
|
| Rate for Payer: Cash Price |
$3,317.30
|
| Rate for Payer: Cash Price |
$3,317.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,596.83
|
| Rate for Payer: Cigna of WY Commercial |
$4,644.22
|
| Rate for Payer: First Choice Health Commercial |
$4,265.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,502.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$885.21
|
| Rate for Payer: HealthUtah PPO |
$4,739.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,596.83
|
| Rate for Payer: Multiplan Medicare/VA |
$752.43
|
| Rate for Payer: One Health Plan of WY PPO |
$4,644.22
|
| Rate for Payer: PacificSource Commercial |
$4,265.10
|
| Rate for Payer: PHCS PPO |
$4,502.05
|
| Rate for Payer: Three Rivers PPO |
$3,554.25
|
| Rate for Payer: TriWest Veterans Administration |
$885.21
|
| Rate for Payer: United Healthcare Commercial |
$4,122.93
|
| Rate for Payer: United Healthcare Medicare |
$885.21
|
| Rate for Payer: WINHealth Partners Commercial |
$4,028.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$5,459.00
|
|
|
Service Code
|
HCPCS 29806 80
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$869.26 |
| Max. Negotiated Rate |
$5,459.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,349.82
|
| Rate for Payer: Aetna of WY Medicare |
$1,022.66
|
| Rate for Payer: Beech Street Commercial |
$5,186.05
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,295.23
|
| Rate for Payer: Cigna of WY Commercial |
$5,349.82
|
| Rate for Payer: First Choice Health Commercial |
$4,913.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,186.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,022.66
|
| Rate for Payer: HealthUtah PPO |
$5,459.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,295.23
|
| Rate for Payer: Multiplan Medicare/VA |
$869.26
|
| Rate for Payer: One Health Plan of WY PPO |
$5,349.82
|
| Rate for Payer: PacificSource Commercial |
$4,913.10
|
| Rate for Payer: PHCS PPO |
$5,186.05
|
| Rate for Payer: Three Rivers PPO |
$4,094.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,022.66
|
| Rate for Payer: United Healthcare Commercial |
$4,749.33
|
| Rate for Payer: United Healthcare Medicare |
$1,022.66
|
| Rate for Payer: WINHealth Partners Commercial |
$4,640.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$5,459.00
|
|
|
Service Code
|
HCPCS 29806 AS
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$869.26 |
| Max. Negotiated Rate |
$5,459.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,349.82
|
| Rate for Payer: Aetna of WY Medicare |
$1,022.66
|
| Rate for Payer: Beech Street Commercial |
$5,186.05
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,295.23
|
| Rate for Payer: Cigna of WY Commercial |
$5,349.82
|
| Rate for Payer: First Choice Health Commercial |
$4,913.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,186.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,022.66
|
| Rate for Payer: HealthUtah PPO |
$5,459.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,295.23
|
| Rate for Payer: Multiplan Medicare/VA |
$869.26
|
| Rate for Payer: One Health Plan of WY PPO |
$5,349.82
|
| Rate for Payer: PacificSource Commercial |
$4,913.10
|
| Rate for Payer: PHCS PPO |
$5,186.05
|
| Rate for Payer: Three Rivers PPO |
$4,094.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,022.66
|
| Rate for Payer: United Healthcare Commercial |
$4,749.33
|
| Rate for Payer: United Healthcare Medicare |
$1,022.66
|
| Rate for Payer: WINHealth Partners Commercial |
$4,640.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$5,459.00
|
|
|
Service Code
|
HCPCS 29806
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$869.26 |
| Max. Negotiated Rate |
$5,459.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,349.82
|
| Rate for Payer: Aetna of WY Medicare |
$1,022.66
|
| Rate for Payer: Beech Street Commercial |
$5,186.05
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,295.23
|
| Rate for Payer: Cigna of WY Commercial |
$5,349.82
|
| Rate for Payer: First Choice Health Commercial |
$4,913.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,186.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,022.66
|
| Rate for Payer: HealthUtah PPO |
$5,459.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,295.23
|
| Rate for Payer: Multiplan Medicare/VA |
$869.26
|
| Rate for Payer: One Health Plan of WY PPO |
$5,349.82
|
| Rate for Payer: PacificSource Commercial |
$4,913.10
|
| Rate for Payer: PHCS PPO |
$5,186.05
|
| Rate for Payer: Three Rivers PPO |
$4,094.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,022.66
|
| Rate for Payer: United Healthcare Commercial |
$4,749.33
|
| Rate for Payer: United Healthcare Medicare |
$1,022.66
|
| Rate for Payer: WINHealth Partners Commercial |
$4,640.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY
|
Professional
|
Both
|
$3,060.00
|
|
|
Service Code
|
HCPCS 29821
|
| Hospital Charge Code |
29821
|
| Min. Negotiated Rate |
$490.49 |
| Max. Negotiated Rate |
$3,060.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,998.80
|
| Rate for Payer: Aetna of WY Medicare |
$577.05
|
| Rate for Payer: Beech Street Commercial |
$2,907.00
|
| Rate for Payer: Cash Price |
$2,142.00
|
| Rate for Payer: Cash Price |
$2,142.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,968.20
|
| Rate for Payer: Cigna of WY Commercial |
$2,998.80
|
| Rate for Payer: First Choice Health Commercial |
$2,754.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,907.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$577.05
|
| Rate for Payer: HealthUtah PPO |
$3,060.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,968.20
|
| Rate for Payer: Multiplan Medicare/VA |
$490.49
|
| Rate for Payer: One Health Plan of WY PPO |
$2,998.80
|
| Rate for Payer: PacificSource Commercial |
$2,754.00
|
| Rate for Payer: PHCS PPO |
$2,907.00
|
| Rate for Payer: Three Rivers PPO |
$2,295.00
|
| Rate for Payer: TriWest Veterans Administration |
$577.05
|
| Rate for Payer: United Healthcare Commercial |
$2,662.20
|
| Rate for Payer: United Healthcare Medicare |
$577.05
|
| Rate for Payer: WINHealth Partners Commercial |
$2,601.00
|
|
|
SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY
|
Professional
|
Both
|
$3,060.00
|
|
|
Service Code
|
HCPCS 29821 AS
|
| Hospital Charge Code |
29821
|
| Min. Negotiated Rate |
$490.49 |
| Max. Negotiated Rate |
$3,060.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,998.80
|
| Rate for Payer: Aetna of WY Medicare |
$577.05
|
| Rate for Payer: Beech Street Commercial |
$2,907.00
|
| Rate for Payer: Cash Price |
$2,142.00
|
| Rate for Payer: Cash Price |
$2,142.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,968.20
|
| Rate for Payer: Cigna of WY Commercial |
$2,998.80
|
| Rate for Payer: First Choice Health Commercial |
$2,754.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,907.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$577.05
|
| Rate for Payer: HealthUtah PPO |
$3,060.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,968.20
|
| Rate for Payer: Multiplan Medicare/VA |
$490.49
|
| Rate for Payer: One Health Plan of WY PPO |
$2,998.80
|
| Rate for Payer: PacificSource Commercial |
$2,754.00
|
| Rate for Payer: PHCS PPO |
$2,907.00
|
| Rate for Payer: Three Rivers PPO |
$2,295.00
|
| Rate for Payer: TriWest Veterans Administration |
$577.05
|
| Rate for Payer: United Healthcare Commercial |
$2,662.20
|
| Rate for Payer: United Healthcare Medicare |
$577.05
|
| Rate for Payer: WINHealth Partners Commercial |
$2,601.00
|
|
|
SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$3,482.00
|
|
|
Service Code
|
HCPCS 29824 AS
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$560.22 |
| Max. Negotiated Rate |
$3,482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,412.36
|
| Rate for Payer: Aetna of WY Medicare |
$659.08
|
| Rate for Payer: Beech Street Commercial |
$3,307.90
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,377.54
|
| Rate for Payer: Cigna of WY Commercial |
$3,412.36
|
| Rate for Payer: First Choice Health Commercial |
$3,133.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,307.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$659.08
|
| Rate for Payer: HealthUtah PPO |
$3,482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,377.54
|
| Rate for Payer: Multiplan Medicare/VA |
$560.22
|
| Rate for Payer: One Health Plan of WY PPO |
$3,412.36
|
| Rate for Payer: PacificSource Commercial |
$3,133.80
|
| Rate for Payer: PHCS PPO |
$3,307.90
|
| Rate for Payer: Three Rivers PPO |
$2,611.50
|
| Rate for Payer: TriWest Veterans Administration |
$659.08
|
| Rate for Payer: United Healthcare Commercial |
$3,029.34
|
| Rate for Payer: United Healthcare Medicare |
$659.08
|
| Rate for Payer: WINHealth Partners Commercial |
$2,959.70
|
|
|
SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$3,482.00
|
|
|
Service Code
|
HCPCS 29824
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$560.22 |
| Max. Negotiated Rate |
$3,482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,412.36
|
| Rate for Payer: Aetna of WY Medicare |
$659.08
|
| Rate for Payer: Beech Street Commercial |
$3,307.90
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,377.54
|
| Rate for Payer: Cigna of WY Commercial |
$3,412.36
|
| Rate for Payer: First Choice Health Commercial |
$3,133.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,307.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$659.08
|
| Rate for Payer: HealthUtah PPO |
$3,482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,377.54
|
| Rate for Payer: Multiplan Medicare/VA |
$560.22
|
| Rate for Payer: One Health Plan of WY PPO |
$3,412.36
|
| Rate for Payer: PacificSource Commercial |
$3,133.80
|
| Rate for Payer: PHCS PPO |
$3,307.90
|
| Rate for Payer: Three Rivers PPO |
$2,611.50
|
| Rate for Payer: TriWest Veterans Administration |
$659.08
|
| Rate for Payer: United Healthcare Commercial |
$3,029.34
|
| Rate for Payer: United Healthcare Medicare |
$659.08
|
| Rate for Payer: WINHealth Partners Commercial |
$2,959.70
|
|
|
SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$3,482.00
|
|
|
Service Code
|
HCPCS 29824 80
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$560.22 |
| Max. Negotiated Rate |
$3,482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,412.36
|
| Rate for Payer: Aetna of WY Medicare |
$659.08
|
| Rate for Payer: Beech Street Commercial |
$3,307.90
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: Cash Price |
$2,437.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,377.54
|
| Rate for Payer: Cigna of WY Commercial |
$3,412.36
|
| Rate for Payer: First Choice Health Commercial |
$3,133.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,307.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$659.08
|
| Rate for Payer: HealthUtah PPO |
$3,482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,377.54
|
| Rate for Payer: Multiplan Medicare/VA |
$560.22
|
| Rate for Payer: One Health Plan of WY PPO |
$3,412.36
|
| Rate for Payer: PacificSource Commercial |
$3,133.80
|
| Rate for Payer: PHCS PPO |
$3,307.90
|
| Rate for Payer: Three Rivers PPO |
$2,611.50
|
| Rate for Payer: TriWest Veterans Administration |
$659.08
|
| Rate for Payer: United Healthcare Commercial |
$3,029.34
|
| Rate for Payer: United Healthcare Medicare |
$659.08
|
| Rate for Payer: WINHealth Partners Commercial |
$2,959.70
|
|
|
SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,975.00
|
|
|
Service Code
|
HCPCS 29822 80
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,975.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,915.50
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,826.25
|
| Rate for Payer: Cash Price |
$2,082.50
|
| Rate for Payer: Cash Price |
$2,082.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,885.75
|
| Rate for Payer: Cigna of WY Commercial |
$2,915.50
|
| Rate for Payer: First Choice Health Commercial |
$2,677.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,826.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,975.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,885.75
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,915.50
|
| Rate for Payer: PacificSource Commercial |
$2,677.50
|
| Rate for Payer: PHCS PPO |
$2,826.25
|
| Rate for Payer: Three Rivers PPO |
$2,231.25
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,588.25
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,528.75
|
|
|
SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,975.00
|
|
|
Service Code
|
HCPCS 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,975.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,915.50
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,826.25
|
| Rate for Payer: Cash Price |
$2,082.50
|
| Rate for Payer: Cash Price |
$2,082.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,885.75
|
| Rate for Payer: Cigna of WY Commercial |
$2,915.50
|
| Rate for Payer: First Choice Health Commercial |
$2,677.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,826.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,975.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,885.75
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,915.50
|
| Rate for Payer: PacificSource Commercial |
$2,677.50
|
| Rate for Payer: PHCS PPO |
$2,826.25
|
| Rate for Payer: Three Rivers PPO |
$2,231.25
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,588.25
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,528.75
|
|
|
SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,975.00
|
|
|
Service Code
|
HCPCS 29822 AS
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,975.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,915.50
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,826.25
|
| Rate for Payer: Cash Price |
$2,082.50
|
| Rate for Payer: Cash Price |
$2,082.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,885.75
|
| Rate for Payer: Cigna of WY Commercial |
$2,915.50
|
| Rate for Payer: First Choice Health Commercial |
$2,677.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,826.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,975.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,885.75
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,915.50
|
| Rate for Payer: PacificSource Commercial |
$2,677.50
|
| Rate for Payer: PHCS PPO |
$2,826.25
|
| Rate for Payer: Three Rivers PPO |
$2,231.25
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,588.25
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,528.75
|
|
|
SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 29820 80
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$441.63 |
| Max. Negotiated Rate |
$2,768.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,712.64
|
| Rate for Payer: Aetna of WY Medicare |
$519.56
|
| Rate for Payer: Beech Street Commercial |
$2,629.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,684.96
|
| Rate for Payer: Cigna of WY Commercial |
$2,712.64
|
| Rate for Payer: First Choice Health Commercial |
$2,491.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,629.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$519.56
|
| Rate for Payer: HealthUtah PPO |
$2,768.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,684.96
|
| Rate for Payer: Multiplan Medicare/VA |
$441.63
|
| Rate for Payer: One Health Plan of WY PPO |
$2,712.64
|
| Rate for Payer: PacificSource Commercial |
$2,491.20
|
| Rate for Payer: PHCS PPO |
$2,629.60
|
| Rate for Payer: Three Rivers PPO |
$2,076.00
|
| Rate for Payer: TriWest Veterans Administration |
$519.56
|
| Rate for Payer: United Healthcare Commercial |
$2,408.16
|
| Rate for Payer: United Healthcare Medicare |
$519.56
|
| Rate for Payer: WINHealth Partners Commercial |
$2,352.80
|
|
|
SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 29820 AS
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$441.63 |
| Max. Negotiated Rate |
$2,768.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,712.64
|
| Rate for Payer: Aetna of WY Medicare |
$519.56
|
| Rate for Payer: Beech Street Commercial |
$2,629.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,684.96
|
| Rate for Payer: Cigna of WY Commercial |
$2,712.64
|
| Rate for Payer: First Choice Health Commercial |
$2,491.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,629.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$519.56
|
| Rate for Payer: HealthUtah PPO |
$2,768.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,684.96
|
| Rate for Payer: Multiplan Medicare/VA |
$441.63
|
| Rate for Payer: One Health Plan of WY PPO |
$2,712.64
|
| Rate for Payer: PacificSource Commercial |
$2,491.20
|
| Rate for Payer: PHCS PPO |
$2,629.60
|
| Rate for Payer: Three Rivers PPO |
$2,076.00
|
| Rate for Payer: TriWest Veterans Administration |
$519.56
|
| Rate for Payer: United Healthcare Commercial |
$2,408.16
|
| Rate for Payer: United Healthcare Medicare |
$519.56
|
| Rate for Payer: WINHealth Partners Commercial |
$2,352.80
|
|
|
SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 29820
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$441.63 |
| Max. Negotiated Rate |
$2,768.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,712.64
|
| Rate for Payer: Aetna of WY Medicare |
$519.56
|
| Rate for Payer: Beech Street Commercial |
$2,629.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,684.96
|
| Rate for Payer: Cigna of WY Commercial |
$2,712.64
|
| Rate for Payer: First Choice Health Commercial |
$2,491.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,629.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$519.56
|
| Rate for Payer: HealthUtah PPO |
$2,768.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,684.96
|
| Rate for Payer: Multiplan Medicare/VA |
$441.63
|
| Rate for Payer: One Health Plan of WY PPO |
$2,712.64
|
| Rate for Payer: PacificSource Commercial |
$2,491.20
|
| Rate for Payer: PHCS PPO |
$2,629.60
|
| Rate for Payer: Three Rivers PPO |
$2,076.00
|
| Rate for Payer: TriWest Veterans Administration |
$519.56
|
| Rate for Payer: United Healthcare Commercial |
$2,408.16
|
| Rate for Payer: United Healthcare Medicare |
$519.56
|
| Rate for Payer: WINHealth Partners Commercial |
$2,352.80
|
|
|
SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 29819 AS
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$486.18 |
| Max. Negotiated Rate |
$3,024.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,963.52
|
| Rate for Payer: Aetna of WY Medicare |
$571.98
|
| Rate for Payer: Beech Street Commercial |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,933.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,963.52
|
| Rate for Payer: First Choice Health Commercial |
$2,721.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$571.98
|
| Rate for Payer: HealthUtah PPO |
$3,024.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,933.28
|
| Rate for Payer: Multiplan Medicare/VA |
$486.18
|
| Rate for Payer: One Health Plan of WY PPO |
$2,963.52
|
| Rate for Payer: PacificSource Commercial |
$2,721.60
|
| Rate for Payer: PHCS PPO |
$2,872.80
|
| Rate for Payer: Three Rivers PPO |
$2,268.00
|
| Rate for Payer: TriWest Veterans Administration |
$571.98
|
| Rate for Payer: United Healthcare Commercial |
$2,630.88
|
| Rate for Payer: United Healthcare Medicare |
$571.98
|
| Rate for Payer: WINHealth Partners Commercial |
$2,570.40
|
|
|
SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 29819
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$486.18 |
| Max. Negotiated Rate |
$3,024.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,963.52
|
| Rate for Payer: Aetna of WY Medicare |
$571.98
|
| Rate for Payer: Beech Street Commercial |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,933.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,963.52
|
| Rate for Payer: First Choice Health Commercial |
$2,721.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$571.98
|
| Rate for Payer: HealthUtah PPO |
$3,024.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,933.28
|
| Rate for Payer: Multiplan Medicare/VA |
$486.18
|
| Rate for Payer: One Health Plan of WY PPO |
$2,963.52
|
| Rate for Payer: PacificSource Commercial |
$2,721.60
|
| Rate for Payer: PHCS PPO |
$2,872.80
|
| Rate for Payer: Three Rivers PPO |
$2,268.00
|
| Rate for Payer: TriWest Veterans Administration |
$571.98
|
| Rate for Payer: United Healthcare Commercial |
$2,630.88
|
| Rate for Payer: United Healthcare Medicare |
$571.98
|
| Rate for Payer: WINHealth Partners Commercial |
$2,570.40
|
|
|
SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$5,339.00
|
|
|
Service Code
|
HCPCS 29807
|
| Hospital Charge Code |
29807
|
| Min. Negotiated Rate |
$849.04 |
| Max. Negotiated Rate |
$5,339.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,232.22
|
| Rate for Payer: Aetna of WY Medicare |
$998.87
|
| Rate for Payer: Beech Street Commercial |
$5,072.05
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,178.83
|
| Rate for Payer: Cigna of WY Commercial |
$5,232.22
|
| Rate for Payer: First Choice Health Commercial |
$4,805.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,072.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$998.87
|
| Rate for Payer: HealthUtah PPO |
$5,339.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,178.83
|
| Rate for Payer: Multiplan Medicare/VA |
$849.04
|
| Rate for Payer: One Health Plan of WY PPO |
$5,232.22
|
| Rate for Payer: PacificSource Commercial |
$4,805.10
|
| Rate for Payer: PHCS PPO |
$5,072.05
|
| Rate for Payer: Three Rivers PPO |
$4,004.25
|
| Rate for Payer: TriWest Veterans Administration |
$998.87
|
| Rate for Payer: United Healthcare Commercial |
$4,644.93
|
| Rate for Payer: United Healthcare Medicare |
$998.87
|
| Rate for Payer: WINHealth Partners Commercial |
$4,538.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$5,339.00
|
|
|
Service Code
|
HCPCS 29807 AS
|
| Hospital Charge Code |
29807
|
| Min. Negotiated Rate |
$849.04 |
| Max. Negotiated Rate |
$5,339.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,232.22
|
| Rate for Payer: Aetna of WY Medicare |
$998.87
|
| Rate for Payer: Beech Street Commercial |
$5,072.05
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,178.83
|
| Rate for Payer: Cigna of WY Commercial |
$5,232.22
|
| Rate for Payer: First Choice Health Commercial |
$4,805.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,072.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$998.87
|
| Rate for Payer: HealthUtah PPO |
$5,339.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,178.83
|
| Rate for Payer: Multiplan Medicare/VA |
$849.04
|
| Rate for Payer: One Health Plan of WY PPO |
$5,232.22
|
| Rate for Payer: PacificSource Commercial |
$4,805.10
|
| Rate for Payer: PHCS PPO |
$5,072.05
|
| Rate for Payer: Three Rivers PPO |
$4,004.25
|
| Rate for Payer: TriWest Veterans Administration |
$998.87
|
| Rate for Payer: United Healthcare Commercial |
$4,644.93
|
| Rate for Payer: United Healthcare Medicare |
$998.87
|
| Rate for Payer: WINHealth Partners Commercial |
$4,538.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$5,339.00
|
|
|
Service Code
|
HCPCS 29807 80
|
| Hospital Charge Code |
29807
|
| Min. Negotiated Rate |
$849.04 |
| Max. Negotiated Rate |
$5,339.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,232.22
|
| Rate for Payer: Aetna of WY Medicare |
$998.87
|
| Rate for Payer: Beech Street Commercial |
$5,072.05
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,178.83
|
| Rate for Payer: Cigna of WY Commercial |
$5,232.22
|
| Rate for Payer: First Choice Health Commercial |
$4,805.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,072.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$998.87
|
| Rate for Payer: HealthUtah PPO |
$5,339.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,178.83
|
| Rate for Payer: Multiplan Medicare/VA |
$849.04
|
| Rate for Payer: One Health Plan of WY PPO |
$5,232.22
|
| Rate for Payer: PacificSource Commercial |
$4,805.10
|
| Rate for Payer: PHCS PPO |
$5,072.05
|
| Rate for Payer: Three Rivers PPO |
$4,004.25
|
| Rate for Payer: TriWest Veterans Administration |
$998.87
|
| Rate for Payer: United Healthcare Commercial |
$4,644.93
|
| Rate for Payer: United Healthcare Medicare |
$998.87
|
| Rate for Payer: WINHealth Partners Commercial |
$4,538.15
|
|
|
SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 29825 80
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$3,024.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,963.52
|
| Rate for Payer: Aetna of WY Medicare |
$570.84
|
| Rate for Payer: Beech Street Commercial |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,933.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,963.52
|
| Rate for Payer: First Choice Health Commercial |
$2,721.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$570.84
|
| Rate for Payer: HealthUtah PPO |
$3,024.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,933.28
|
| Rate for Payer: Multiplan Medicare/VA |
$485.21
|
| Rate for Payer: One Health Plan of WY PPO |
$2,963.52
|
| Rate for Payer: PacificSource Commercial |
$2,721.60
|
| Rate for Payer: PHCS PPO |
$2,872.80
|
| Rate for Payer: Three Rivers PPO |
$2,268.00
|
| Rate for Payer: TriWest Veterans Administration |
$570.84
|
| Rate for Payer: United Healthcare Commercial |
$2,630.88
|
| Rate for Payer: United Healthcare Medicare |
$570.84
|
| Rate for Payer: WINHealth Partners Commercial |
$2,570.40
|
|
|
SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 29825
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$3,024.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,963.52
|
| Rate for Payer: Aetna of WY Medicare |
$570.84
|
| Rate for Payer: Beech Street Commercial |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,933.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,963.52
|
| Rate for Payer: First Choice Health Commercial |
$2,721.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$570.84
|
| Rate for Payer: HealthUtah PPO |
$3,024.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,933.28
|
| Rate for Payer: Multiplan Medicare/VA |
$485.21
|
| Rate for Payer: One Health Plan of WY PPO |
$2,963.52
|
| Rate for Payer: PacificSource Commercial |
$2,721.60
|
| Rate for Payer: PHCS PPO |
$2,872.80
|
| Rate for Payer: Three Rivers PPO |
$2,268.00
|
| Rate for Payer: TriWest Veterans Administration |
$570.84
|
| Rate for Payer: United Healthcare Commercial |
$2,630.88
|
| Rate for Payer: United Healthcare Medicare |
$570.84
|
| Rate for Payer: WINHealth Partners Commercial |
$2,570.40
|
|
|
SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 29825 AS
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$3,024.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,963.52
|
| Rate for Payer: Aetna of WY Medicare |
$570.84
|
| Rate for Payer: Beech Street Commercial |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,933.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,963.52
|
| Rate for Payer: First Choice Health Commercial |
$2,721.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$570.84
|
| Rate for Payer: HealthUtah PPO |
$3,024.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,933.28
|
| Rate for Payer: Multiplan Medicare/VA |
$485.21
|
| Rate for Payer: One Health Plan of WY PPO |
$2,963.52
|
| Rate for Payer: PacificSource Commercial |
$2,721.60
|
| Rate for Payer: PHCS PPO |
$2,872.80
|
| Rate for Payer: Three Rivers PPO |
$2,268.00
|
| Rate for Payer: TriWest Veterans Administration |
$570.84
|
| Rate for Payer: United Healthcare Commercial |
$2,630.88
|
| Rate for Payer: United Healthcare Medicare |
$570.84
|
| Rate for Payer: WINHealth Partners Commercial |
$2,570.40
|
|
|
SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$5,522.00
|
|
|
Service Code
|
HCPCS 29827 80
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$875.58 |
| Max. Negotiated Rate |
$5,522.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,411.56
|
| Rate for Payer: Aetna of WY Medicare |
$1,030.09
|
| Rate for Payer: Beech Street Commercial |
$5,245.90
|
| Rate for Payer: Cash Price |
$3,865.40
|
| Rate for Payer: Cash Price |
$3,865.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,356.34
|
| Rate for Payer: Cigna of WY Commercial |
$5,411.56
|
| Rate for Payer: First Choice Health Commercial |
$4,969.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,245.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,030.09
|
| Rate for Payer: HealthUtah PPO |
$5,522.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,356.34
|
| Rate for Payer: Multiplan Medicare/VA |
$875.58
|
| Rate for Payer: One Health Plan of WY PPO |
$5,411.56
|
| Rate for Payer: PacificSource Commercial |
$4,969.80
|
| Rate for Payer: PHCS PPO |
$5,245.90
|
| Rate for Payer: Three Rivers PPO |
$4,141.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,030.09
|
| Rate for Payer: United Healthcare Commercial |
$4,804.14
|
| Rate for Payer: United Healthcare Medicare |
$1,030.09
|
| Rate for Payer: WINHealth Partners Commercial |
$4,693.70
|
|
