New Intermountain in Nevada My Health +

Shoppable Services at American Fork Hospital

General Disclosure

Use MyHealth+ or visit your insurer for the most accurate cost estimations

The two lists of standard charges displayed represent the pricing information for medical items and services required by the federal Hospital Price Transparency Rule. The pricing information does not necessarily reflect your financial responsibility for your hospital visit, for several reasons, including:

  • The listings reflect prices paid by your insurer for services provided during your hospital visit, which may not reflect your share of the costs for these services under the terms of your health plan.
  • The prices for your insurer are only available if your insurer covers the medical items or services under the terms of your health plan.
  • The actual medical items, including medications, and services that are furnished to you during your visit may vary from what is anticipated.
  • You may receive services or supplies from physicians, practitioners or contractors who are not employed by this hospital; the prices for such services or supplies are not listed here.
  • Your insurer may not be contracted with this hospital for all services. The posted prices will not apply to services for which your insurer has not contracted.

These listings do not guarantee pricing, coverage, benefits, or payments. Your financial liability will be based on the medical items and services billed by the hospital, the terms of your insurance policy, and the status of your benefits (i.e., deductibles, out of pocket maximum, co-insurance, and copays) at the time you receive care. Your eligibility and the amounts covered by your insurance are solely determined by your health insurance provider.

We encourage you to contact a Hospital Cost Estimation Specialist at (855) 442-8601 or INTCostEstimate@R1RCM.com or your insurer to obtain more precise information regarding your potential financial liability.

CDM Bill Item Service Code Service Description Payer Plan Name Inpatient Cash Price Inpatient Min Price Inpatient Max Price Inpatient Negotiated Price Outpatient Cash Price Outpatient Min Price Outpatient Max Price Outpatient Negotiated Price Charge Price
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 1-800 Contacts 1-800 Contacts $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Wise Wise Network $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 WCF Insurance WCF Insurance $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $24.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Utah Cancer Control Program (UCCP) Utah Cancer Control Program (UCCP) $25.00 $8.67 $33.33 $33.33 $25.00 $8.67 $33.33 $33.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 University of Utah University of Utah Healthy Premier - Marketplace $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 University of Utah University of Utah Healthy Preferred $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 University of Utah University of Utah Healthy Preferred - Marketplace $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 University of Utah University of Utah Healthy Premier $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 United Healthcare United Healthcare Options PPO $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 United Healthcare United Healthcare Choice Plus Network $25.00 $8.67 $33.33 $23.66 $25.00 $8.67 $33.33 $23.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Tanner LLC Tanner LLC $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SpringTide SpringTide $25.00 $8.67 $33.33 $27.66 $25.00 $8.67 $33.33 $27.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Sinclair Services Company Sinclair Services Company $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Value Network $25.00 $8.67 $33.33 $15.67 $25.00 $8.67 $33.33 $15.67 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Med Network $25.00 $8.67 $33.33 $18.00 $25.00 $8.67 $33.33 $18.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Share Network $25.00 $8.67 $33.33 $15.67 $25.00 $8.67 $33.33 $15.67 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Franklin County Medical Center Franklin County Medical Center $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Value Network Individual Plan (ACA) $25.00 $8.67 $33.33 $8.67 $25.00 $8.67 $33.33 $8.67 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Care Network $25.00 $8.67 $33.33 $18.66 $25.00 $8.67 $33.33 $18.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Med Network CHIP $25.00 $8.67 $33.33 $18.00 $25.00 $8.67 $33.33 $18.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Med Network Individual Plan (ACA) $25.00 $8.67 $33.33 $10.00 $25.00 $8.67 $33.33 $10.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 SelectHealth SelectHealth Med Network Federal Employee (FEHBP) $25.00 $8.67 $33.33 $18.00 $25.00 $8.67 $33.33 $18.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Regence BlueCross BlueShield of Utah Regence Bridgespan RealValue $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Regence BlueCross BlueShield of Utah Regence Individual and Family Network $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Regence BlueCross BlueShield of Utah Regence BCBS Preferred BlueOption (PBO) $25.00 $8.67 $33.33 $25.66 $25.00 $8.67 $33.33 $25.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Regence BlueCross BlueShield of Utah Regence BCBS ValueCare $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Regence BlueCross BlueShield of Utah Regence BCBS Federal (FEHBP) $25.00 $8.67 $33.33 $25.33 $25.00 $8.67 $33.33 $25.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Regence BlueCross BlueShield of Utah Regence BCBS Traditional Plan $25.00 $8.67 $33.33 $27.66 $25.00 $8.67 $33.33 $27.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Regence BlueCross BlueShield of Utah Regence Focal Point $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Provider Networks of America Provider Networks of America (PNOA) $25.00 $8.67 $33.33 $25.00 $25.00 $8.67 $33.33 $25.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Prodegi Corporate Benefit Services, LLC Prodegi Corporate Benefit Services, LLC $25.00 $8.67 $33.33 $27.33 $25.00 $8.67 $33.33 $27.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Petersen, Inc. Petersen, Inc. $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 PEHP PEHP Summit Exclusive $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 PEHP PEHP Advantage Care - Non State $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 PEHP PEHP Summit Care $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 PEHP PEHP Capital Care $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 PEHP PEHP Advantage Care State Employees and Advantage Care Exclusive $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 PEHP PEHP Preferred Care $25.00 $8.67 $33.33 $29.66 $25.00 $8.67 $33.33 $29.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 MotivHealth MotivHealth $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Molina Healthcare of Utah Molina Marketplace $25.00 $8.67 $33.33 $27.66 $25.00 $8.67 $33.33 $27.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Molina Healthcare of Utah Molina CHIP $25.00 $8.67 $33.33 $27.66 $25.00 $8.67 $33.33 $27.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 MedCare International, Inc. MedCare International, Inc. $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Managed Care Administrators, Inc. Managed Care Administrators, Inc. $25.00 $8.67 $33.33 $26.00 $25.00 $8.67 $33.33 $26.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 LW Miller LW Miller $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Juniper Systems Juniper Systems $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Inovar Inovar $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Injury Care of Nevada Injury Care of Nevada $25.00 $8.67 $33.33 $25.00 $25.00 $8.67 $33.33 $25.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Icon Health Fitness Icon Health Fitness $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Hygeia Corporation Hygeia Corporation $25.00 $8.67 $33.33 $30.00 $25.00 $8.67 $33.33 $30.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Humana Humana ChoiceCare $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 HealthSCOPE Benefits, Inc. HealthSCOPE Benefits, Inc. $25.00 $8.67 $33.33 $26.00 $25.00 $8.67 $33.33 $26.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Health Utah Health Utah $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Global Excel Global Excel $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Franklin County Franklin County $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 EMI Health EMI Health $25.00 $8.67 $33.33 $22.33 $25.00 $8.67 $33.33 $22.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 EMI Health EMI Health Choice $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 EMI Health EMI Health Network Care $25.00 $8.67 $33.33 $23.00 $25.00 $8.67 $33.33 $23.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Deseret Mutual DMBA Deseret Select $25.00 $8.67 $33.33 $19.00 $25.00 $8.67 $33.33 $19.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Deseret Mutual DMBA Deseret Premier $25.00 $8.67 $33.33 $20.66 $25.00 $8.67 $33.33 $20.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Deseret Mutual DMBA Deseret Value $25.00 $8.67 $33.33 $20.66 $25.00 $8.67 $33.33 $20.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Corporation of the President Corporation of the President $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $24.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 CorVel Corporation CorVel Corporation $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Cigna Healthcare CIGNA PPO and EPO $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Cigna Healthcare CIGNA Managed Care (HMO or Open Access Plus aka OAP) $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Cigna Healthcare CIGNA Utah Connect $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Campbell Scientific Campbell Scientific $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 CCCM CCCM $25.00 $8.67 $33.33 $29.66 $25.00 $8.67 $33.33 $29.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Big-D Construction Big-D Construction $25.00 $8.67 $33.33 $24.00 $25.00 $8.67 $33.33 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BYU Risk Management BYU Risk Management $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $24.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BCBS OOS -TRAD BCBS Association-Blue Card Traditional Plan $25.00 $8.67 $33.33 $27.66 $25.00 $8.67 $33.33 $27.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BCBS OOS - PPO BCBS Association-Blue Card PPO Plan $25.00 $8.67 $33.33 $23.33 $25.00 $8.67 $33.33 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Altius Altius (Coventry) Limited Facility $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Aetna Aetna Standard Network AKA Aetna Health Plan Network for Utah $25.00 $8.67 $33.33 $28.33 $25.00 $8.67 $33.33 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Aetna Aetna Utah Connected Network $25.00 $8.67 $33.33 $26.66 $25.00 $8.67 $33.33 $27.00 $33.33
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 BCBS OOS - PPO BCBS Association-Blue Card PPO Plan $35.00 $12.13 $46.67 $32.67 $35.00 $12.13 $46.67 $32.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Humana Humana ChoiceCare $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 HealthSCOPE Benefits, Inc. HealthSCOPE Benefits, Inc. $35.00 $12.13 $46.67 $36.40 $35.00 $12.13 $46.67 $36.40 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Health Utah Health Utah $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Global Excel Global Excel $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Franklin County Medical Center Franklin County Medical Center $35.00 $12.13 $46.67 $33.60 $35.00 $12.13 $46.67 $33.60 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Franklin County Franklin County $35.00 $12.13 $46.67 $33.60 $35.00 $12.13 $46.67 $33.60 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 EMI Health EMI Health Network Care $35.00 $12.13 $46.67 $32.20 $35.00 $12.13 $46.67 $32.20 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 EMI Health EMI Health Choice $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 EMI Health EMI Health $35.00 $12.13 $46.67 $31.27 $35.00 $12.13 $46.67 $31.27 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Altius Altius (Coventry) Limited Facility $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Aetna Aetna Standard Network AKA Aetna Health Plan Network for Utah $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Aetna Aetna Utah Connected Network $35.00 $12.13 $46.67 $37.34 $35.00 $12.13 $46.67 $37.80 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 1-800 Contacts 1-800 Contacts $35.00 $12.13 $46.67 $33.60 $35.00 $12.13 $46.67 $33.60 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Deseret Mutual DMBA Deseret Select $35.00 $12.13 $46.67 $26.60 $35.00 $12.13 $46.67 $26.60 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Deseret Mutual DMBA Deseret Premier $35.00 $12.13 $46.67 $28.94 $35.00 $12.13 $46.67 $28.94 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Deseret Mutual DMBA Deseret Value $35.00 $12.13 $46.67 $28.94 $35.00 $12.13 $46.67 $28.94 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Corporation of the President Corporation of the President $35.00 $12.13 $46.67 $32.67 $35.00 $12.13 $46.67 $34.07 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 CorVel Corporation CorVel Corporation $35.00 $12.13 $46.67 $33.60 $35.00 $12.13 $46.67 $33.60 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Cigna Healthcare CIGNA Managed Care (HMO or Open Access Plus aka OAP) $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Cigna Healthcare CIGNA PPO and EPO $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Cigna Healthcare CIGNA Utah Connect $35.00 $12.13 $46.67 $39.67 $35.00 $12.13 $46.67 $39.67 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Campbell Scientific Campbell Scientific $35.00 $12.13 $46.67 $33.60 $35.00 $12.13 $46.67 $33.60 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 CCCM CCCM $35.00 $12.13 $46.67 $41.54 $35.00 $12.13 $46.67 $41.54 $46.67
1901005726 19518970 20561 PT DRY NEEDLING 3 OR MORE MUSC 20561 Big-D Construction Big-D Construction $35.00 $12.13 $46.67 $33.60 $35.00 $12.13 $46.67 $33.60 $46.67

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