|
0.1 N SODIUM HYDROXIDE NAOH
|
Facility
|
OP
|
$66.99
|
|
| Hospital Charge Code |
6700216
|
|
Hospital Revenue Code
|
264
|
| Min. Negotiated Rate |
$36.28 |
| Max. Negotiated Rate |
$66.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$65.65
|
| Rate for Payer: Aetna of WY Medicare |
$44.21
|
| Rate for Payer: Altius Commercial |
$64.31
|
| Rate for Payer: Beech Street Commercial |
$65.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$64.98
|
| Rate for Payer: Cash Price |
$46.89
|
| Rate for Payer: ChoiceCare Network Commercial |
$64.98
|
| Rate for Payer: Cigna of WY Commercial |
$65.65
|
| Rate for Payer: Entrust Commercial |
$63.64
|
| Rate for Payer: First Choice Health Commercial |
$63.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$63.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$38.18
|
| Rate for Payer: HealthUtah PPO |
$66.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$64.98
|
| Rate for Payer: Multiplan Medicare/VA |
$36.28
|
| Rate for Payer: One Health Plan of WY PPO |
$65.65
|
| Rate for Payer: PacificSource Commercial |
$60.29
|
| Rate for Payer: PHCS PPO |
$65.65
|
| Rate for Payer: Three Rivers PPO |
$50.24
|
| Rate for Payer: TriWest Veterans Administration |
$38.18
|
| Rate for Payer: United Healthcare Commercial |
$63.98
|
| Rate for Payer: United Healthcare Medicare |
$38.18
|
| Rate for Payer: WINHealth Partners Commercial |
$65.65
|
| Rate for Payer: Wise Provider Network Commercial |
$63.64
|
|
|
0.1 N SODIUM HYDROXIDE NAOH
|
Facility
|
IP
|
$66.99
|
|
| Hospital Charge Code |
6700216
|
|
Hospital Revenue Code
|
264
|
| Min. Negotiated Rate |
$38.82 |
| Max. Negotiated Rate |
$66.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$65.65
|
| Rate for Payer: Aetna of WY Medicare |
$42.87
|
| Rate for Payer: Altius Commercial |
$64.31
|
| Rate for Payer: Beech Street Commercial |
$65.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$64.98
|
| Rate for Payer: Cash Price |
$46.89
|
| Rate for Payer: ChoiceCare Network Commercial |
$64.98
|
| Rate for Payer: Cigna of WY Commercial |
$65.65
|
| Rate for Payer: Entrust Commercial |
$63.64
|
| Rate for Payer: First Choice Health Commercial |
$63.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$63.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$40.86
|
| Rate for Payer: HealthUtah PPO |
$66.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$64.98
|
| Rate for Payer: Multiplan Medicare/VA |
$38.82
|
| Rate for Payer: One Health Plan of WY PPO |
$65.65
|
| Rate for Payer: PacificSource Commercial |
$60.29
|
| Rate for Payer: PHCS PPO |
$65.65
|
| Rate for Payer: Three Rivers PPO |
$50.24
|
| Rate for Payer: TriWest Veterans Administration |
$40.86
|
| Rate for Payer: United Healthcare Commercial |
$63.98
|
| Rate for Payer: United Healthcare Medicare |
$40.86
|
| Rate for Payer: WINHealth Partners Commercial |
$63.64
|
| Rate for Payer: Wise Provider Network Commercial |
$63.64
|
|
|
0.9% SODIUM CHOLRIDE-SALINE
|
Facility
|
IP
|
$85.61
|
|
| Hospital Charge Code |
6700217
|
|
Hospital Revenue Code
|
264
|
| Min. Negotiated Rate |
$49.61 |
| Max. Negotiated Rate |
$85.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$83.90
|
| Rate for Payer: Aetna of WY Medicare |
$54.79
|
| Rate for Payer: Altius Commercial |
$82.19
|
| Rate for Payer: Beech Street Commercial |
$83.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$83.04
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: ChoiceCare Network Commercial |
$83.04
|
| Rate for Payer: Cigna of WY Commercial |
$83.90
|
| Rate for Payer: Entrust Commercial |
$81.33
|
| Rate for Payer: First Choice Health Commercial |
$81.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$81.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.22
|
| Rate for Payer: HealthUtah PPO |
$85.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$83.04
|
| Rate for Payer: Multiplan Medicare/VA |
$49.61
|
| Rate for Payer: One Health Plan of WY PPO |
$83.90
|
| Rate for Payer: PacificSource Commercial |
$77.05
|
| Rate for Payer: PHCS PPO |
$83.90
|
| Rate for Payer: Three Rivers PPO |
$64.21
|
| Rate for Payer: TriWest Veterans Administration |
$52.22
|
| Rate for Payer: United Healthcare Commercial |
$81.76
|
| Rate for Payer: United Healthcare Medicare |
$52.22
|
| Rate for Payer: WINHealth Partners Commercial |
$81.33
|
| Rate for Payer: Wise Provider Network Commercial |
$81.33
|
|
|
0.9% SODIUM CHOLRIDE-SALINE
|
Facility
|
OP
|
$85.61
|
|
| Hospital Charge Code |
6700217
|
|
Hospital Revenue Code
|
264
|
| Min. Negotiated Rate |
$46.36 |
| Max. Negotiated Rate |
$85.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$83.90
|
| Rate for Payer: Aetna of WY Medicare |
$56.50
|
| Rate for Payer: Altius Commercial |
$82.19
|
| Rate for Payer: Beech Street Commercial |
$83.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$83.04
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: ChoiceCare Network Commercial |
$83.04
|
| Rate for Payer: Cigna of WY Commercial |
$83.90
|
| Rate for Payer: Entrust Commercial |
$81.33
|
| Rate for Payer: First Choice Health Commercial |
$81.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$81.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$48.80
|
| Rate for Payer: HealthUtah PPO |
$85.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$83.04
|
| Rate for Payer: Multiplan Medicare/VA |
$46.36
|
| Rate for Payer: One Health Plan of WY PPO |
$83.90
|
| Rate for Payer: PacificSource Commercial |
$77.05
|
| Rate for Payer: PHCS PPO |
$83.90
|
| Rate for Payer: Three Rivers PPO |
$64.21
|
| Rate for Payer: TriWest Veterans Administration |
$48.80
|
| Rate for Payer: United Healthcare Commercial |
$81.76
|
| Rate for Payer: United Healthcare Medicare |
$48.80
|
| Rate for Payer: WINHealth Partners Commercial |
$83.90
|
| Rate for Payer: Wise Provider Network Commercial |
$81.33
|
|
|
0 MM LOCKING END CAP
|
Facility
|
IP
|
$1,092.00
|
|
| Hospital Charge Code |
3002145
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$632.81 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,070.16
|
| Rate for Payer: Aetna of WY Medicare |
$698.88
|
| Rate for Payer: Altius Commercial |
$1,048.32
|
| Rate for Payer: Beech Street Commercial |
$1,070.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,059.24
|
| Rate for Payer: Cash Price |
$764.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,059.24
|
| Rate for Payer: Cigna of WY Commercial |
$1,070.16
|
| Rate for Payer: Entrust Commercial |
$1,037.40
|
| Rate for Payer: First Choice Health Commercial |
$1,037.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,037.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$666.12
|
| Rate for Payer: HealthUtah PPO |
$1,092.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,059.24
|
| Rate for Payer: Multiplan Medicare/VA |
$632.81
|
| Rate for Payer: One Health Plan of WY PPO |
$1,070.16
|
| Rate for Payer: PacificSource Commercial |
$982.80
|
| Rate for Payer: PHCS PPO |
$1,070.16
|
| Rate for Payer: Three Rivers PPO |
$819.00
|
| Rate for Payer: TriWest Veterans Administration |
$666.12
|
| Rate for Payer: United Healthcare Commercial |
$1,042.86
|
| Rate for Payer: United Healthcare Medicare |
$666.12
|
| Rate for Payer: WINHealth Partners Commercial |
$1,037.40
|
| Rate for Payer: Wise Provider Network Commercial |
$1,037.40
|
|
|
0 MM LOCKING END CAP
|
Facility
|
OP
|
$1,092.00
|
|
| Hospital Charge Code |
3002145
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$591.32 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,070.16
|
| Rate for Payer: Aetna of WY Medicare |
$720.72
|
| Rate for Payer: Altius Commercial |
$1,048.32
|
| Rate for Payer: Beech Street Commercial |
$1,070.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,059.24
|
| Rate for Payer: Cash Price |
$764.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,059.24
|
| Rate for Payer: Cigna of WY Commercial |
$1,070.16
|
| Rate for Payer: Entrust Commercial |
$1,037.40
|
| Rate for Payer: First Choice Health Commercial |
$1,037.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,037.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$622.44
|
| Rate for Payer: HealthUtah PPO |
$1,092.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,059.24
|
| Rate for Payer: Multiplan Medicare/VA |
$591.32
|
| Rate for Payer: One Health Plan of WY PPO |
$1,070.16
|
| Rate for Payer: PacificSource Commercial |
$982.80
|
| Rate for Payer: PHCS PPO |
$1,070.16
|
| Rate for Payer: Three Rivers PPO |
$819.00
|
| Rate for Payer: TriWest Veterans Administration |
$622.44
|
| Rate for Payer: United Healthcare Commercial |
$1,042.86
|
| Rate for Payer: United Healthcare Medicare |
$622.44
|
| Rate for Payer: WINHealth Partners Commercial |
$1,070.16
|
| Rate for Payer: Wise Provider Network Commercial |
$1,037.40
|
|
|
100 MM CURVED ROD
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
2800256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$947.62 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,155.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$997.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$947.62
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$997.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$997.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,715.00
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
100 MM CURVED ROD
|
Facility
|
IP
|
$1,750.00
|
|
| Hospital Charge Code |
2800256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,014.12 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,120.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,067.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$1,014.12
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,067.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$1,067.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,662.50
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
100MM STRAIGHT ROD
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
2800372
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$947.62 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,155.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$997.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$947.62
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$997.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$997.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,715.00
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
100MM STRAIGHT ROD
|
Facility
|
IP
|
$1,750.00
|
|
| Hospital Charge Code |
2800372
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,014.12 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,120.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,067.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$1,014.12
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,067.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$1,067.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,662.50
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
10X150 ANKLE COMPRESSION NAIL
|
Facility
|
OP
|
$13,286.00
|
|
| Hospital Charge Code |
3002146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,194.37 |
| Max. Negotiated Rate |
$13,286.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,020.28
|
| Rate for Payer: Aetna of WY Medicare |
$8,768.76
|
| Rate for Payer: Altius Commercial |
$12,754.56
|
| Rate for Payer: Beech Street Commercial |
$13,020.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12,887.42
|
| Rate for Payer: Cash Price |
$9,300.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$12,887.42
|
| Rate for Payer: Cigna of WY Commercial |
$13,020.28
|
| Rate for Payer: Entrust Commercial |
$12,621.70
|
| Rate for Payer: First Choice Health Commercial |
$12,621.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12,621.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7,573.02
|
| Rate for Payer: HealthUtah PPO |
$13,286.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12,887.42
|
| Rate for Payer: Multiplan Medicare/VA |
$7,194.37
|
| Rate for Payer: One Health Plan of WY PPO |
$13,020.28
|
| Rate for Payer: PacificSource Commercial |
$11,957.40
|
| Rate for Payer: PHCS PPO |
$13,020.28
|
| Rate for Payer: Three Rivers PPO |
$9,964.50
|
| Rate for Payer: TriWest Veterans Administration |
$7,573.02
|
| Rate for Payer: United Healthcare Commercial |
$12,688.13
|
| Rate for Payer: United Healthcare Medicare |
$7,573.02
|
| Rate for Payer: WINHealth Partners Commercial |
$13,020.28
|
| Rate for Payer: Wise Provider Network Commercial |
$12,621.70
|
|
|
10X150 ANKLE COMPRESSION NAIL
|
Facility
|
IP
|
$13,286.00
|
|
| Hospital Charge Code |
3002146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,699.24 |
| Max. Negotiated Rate |
$13,286.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,020.28
|
| Rate for Payer: Aetna of WY Medicare |
$8,503.04
|
| Rate for Payer: Altius Commercial |
$12,754.56
|
| Rate for Payer: Beech Street Commercial |
$13,020.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12,887.42
|
| Rate for Payer: Cash Price |
$9,300.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$12,887.42
|
| Rate for Payer: Cigna of WY Commercial |
$13,020.28
|
| Rate for Payer: Entrust Commercial |
$12,621.70
|
| Rate for Payer: First Choice Health Commercial |
$12,621.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12,621.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8,104.46
|
| Rate for Payer: HealthUtah PPO |
$13,286.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12,887.42
|
| Rate for Payer: Multiplan Medicare/VA |
$7,699.24
|
| Rate for Payer: One Health Plan of WY PPO |
$13,020.28
|
| Rate for Payer: PacificSource Commercial |
$11,957.40
|
| Rate for Payer: PHCS PPO |
$13,020.28
|
| Rate for Payer: Three Rivers PPO |
$9,964.50
|
| Rate for Payer: TriWest Veterans Administration |
$8,104.46
|
| Rate for Payer: United Healthcare Commercial |
$12,688.13
|
| Rate for Payer: United Healthcare Medicare |
$8,104.46
|
| Rate for Payer: WINHealth Partners Commercial |
$12,621.70
|
| Rate for Payer: Wise Provider Network Commercial |
$12,621.70
|
|
|
120 MM STRAIGHT ROD
|
Facility
|
IP
|
$1,750.00
|
|
| Hospital Charge Code |
2800327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,014.12 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,120.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,067.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$1,014.12
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,067.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$1,067.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,662.50
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
120 MM STRAIGHT ROD
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
2800327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$947.62 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,155.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$997.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$947.62
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$997.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$997.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,715.00
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
13 MM ENTRY DRILL
|
Facility
|
IP
|
$1,510.60
|
|
| Hospital Charge Code |
3002138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$875.39 |
| Max. Negotiated Rate |
$1,510.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,480.39
|
| Rate for Payer: Aetna of WY Medicare |
$966.78
|
| Rate for Payer: Altius Commercial |
$1,450.18
|
| Rate for Payer: Beech Street Commercial |
$1,480.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,465.28
|
| Rate for Payer: Cash Price |
$1,057.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,465.28
|
| Rate for Payer: Cigna of WY Commercial |
$1,480.39
|
| Rate for Payer: Entrust Commercial |
$1,435.07
|
| Rate for Payer: First Choice Health Commercial |
$1,435.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,435.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$921.47
|
| Rate for Payer: HealthUtah PPO |
$1,510.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,465.28
|
| Rate for Payer: Multiplan Medicare/VA |
$875.39
|
| Rate for Payer: One Health Plan of WY PPO |
$1,480.39
|
| Rate for Payer: PacificSource Commercial |
$1,359.54
|
| Rate for Payer: PHCS PPO |
$1,480.39
|
| Rate for Payer: Three Rivers PPO |
$1,132.95
|
| Rate for Payer: TriWest Veterans Administration |
$921.47
|
| Rate for Payer: United Healthcare Commercial |
$1,442.62
|
| Rate for Payer: United Healthcare Medicare |
$921.47
|
| Rate for Payer: WINHealth Partners Commercial |
$1,435.07
|
| Rate for Payer: Wise Provider Network Commercial |
$1,435.07
|
|
|
13 MM ENTRY DRILL
|
Facility
|
OP
|
$1,510.60
|
|
| Hospital Charge Code |
3002138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$817.99 |
| Max. Negotiated Rate |
$1,510.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,480.39
|
| Rate for Payer: Aetna of WY Medicare |
$997.00
|
| Rate for Payer: Altius Commercial |
$1,450.18
|
| Rate for Payer: Beech Street Commercial |
$1,480.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,465.28
|
| Rate for Payer: Cash Price |
$1,057.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,465.28
|
| Rate for Payer: Cigna of WY Commercial |
$1,480.39
|
| Rate for Payer: Entrust Commercial |
$1,435.07
|
| Rate for Payer: First Choice Health Commercial |
$1,435.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,435.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$861.04
|
| Rate for Payer: HealthUtah PPO |
$1,510.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,465.28
|
| Rate for Payer: Multiplan Medicare/VA |
$817.99
|
| Rate for Payer: One Health Plan of WY PPO |
$1,480.39
|
| Rate for Payer: PacificSource Commercial |
$1,359.54
|
| Rate for Payer: PHCS PPO |
$1,480.39
|
| Rate for Payer: Three Rivers PPO |
$1,132.95
|
| Rate for Payer: TriWest Veterans Administration |
$861.04
|
| Rate for Payer: United Healthcare Commercial |
$1,442.62
|
| Rate for Payer: United Healthcare Medicare |
$861.04
|
| Rate for Payer: WINHealth Partners Commercial |
$1,480.39
|
| Rate for Payer: Wise Provider Network Commercial |
$1,435.07
|
|
|
140 MM STRAIGHT ROD
|
Facility
|
IP
|
$1,750.00
|
|
| Hospital Charge Code |
2800329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,014.12 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,120.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,067.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$1,014.12
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$1,067.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$1,067.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,662.50
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
140 MM STRAIGHT ROD
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
2800329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$947.62 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,715.00
|
| Rate for Payer: Aetna of WY Medicare |
$1,155.00
|
| Rate for Payer: Altius Commercial |
$1,680.00
|
| Rate for Payer: Beech Street Commercial |
$1,715.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,697.50
|
| Rate for Payer: Cash Price |
$1,225.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,697.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,715.00
|
| Rate for Payer: Entrust Commercial |
$1,662.50
|
| Rate for Payer: First Choice Health Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,662.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$997.50
|
| Rate for Payer: HealthUtah PPO |
$1,750.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,697.50
|
| Rate for Payer: Multiplan Medicare/VA |
$947.62
|
| Rate for Payer: One Health Plan of WY PPO |
$1,715.00
|
| Rate for Payer: PacificSource Commercial |
$1,575.00
|
| Rate for Payer: PHCS PPO |
$1,715.00
|
| Rate for Payer: Three Rivers PPO |
$1,312.50
|
| Rate for Payer: TriWest Veterans Administration |
$997.50
|
| Rate for Payer: United Healthcare Commercial |
$1,671.25
|
| Rate for Payer: United Healthcare Medicare |
$997.50
|
| Rate for Payer: WINHealth Partners Commercial |
$1,715.00
|
| Rate for Payer: Wise Provider Network Commercial |
$1,662.50
|
|
|
1.6MM x 150MM K-WIRE
|
Facility
|
IP
|
$227.50
|
|
| Hospital Charge Code |
3004710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.84 |
| Max. Negotiated Rate |
$227.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$222.95
|
| Rate for Payer: Aetna of WY Medicare |
$145.60
|
| Rate for Payer: Altius Commercial |
$218.40
|
| Rate for Payer: Beech Street Commercial |
$222.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$220.68
|
| Rate for Payer: Cash Price |
$159.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$220.68
|
| Rate for Payer: Cigna of WY Commercial |
$222.95
|
| Rate for Payer: Entrust Commercial |
$216.12
|
| Rate for Payer: First Choice Health Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$138.78
|
| Rate for Payer: HealthUtah PPO |
$227.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$220.68
|
| Rate for Payer: Multiplan Medicare/VA |
$131.84
|
| Rate for Payer: One Health Plan of WY PPO |
$222.95
|
| Rate for Payer: PacificSource Commercial |
$204.75
|
| Rate for Payer: PHCS PPO |
$222.95
|
| Rate for Payer: Three Rivers PPO |
$170.62
|
| Rate for Payer: TriWest Veterans Administration |
$138.78
|
| Rate for Payer: United Healthcare Commercial |
$217.26
|
| Rate for Payer: United Healthcare Medicare |
$138.78
|
| Rate for Payer: WINHealth Partners Commercial |
$216.12
|
| Rate for Payer: Wise Provider Network Commercial |
$216.12
|
|
|
1.6MM x 150MM K-WIRE
|
Facility
|
OP
|
$227.50
|
|
| Hospital Charge Code |
3004710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.19 |
| Max. Negotiated Rate |
$227.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$222.95
|
| Rate for Payer: Aetna of WY Medicare |
$150.15
|
| Rate for Payer: Altius Commercial |
$218.40
|
| Rate for Payer: Beech Street Commercial |
$222.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$220.68
|
| Rate for Payer: Cash Price |
$159.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$220.68
|
| Rate for Payer: Cigna of WY Commercial |
$222.95
|
| Rate for Payer: Entrust Commercial |
$216.12
|
| Rate for Payer: First Choice Health Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$129.68
|
| Rate for Payer: HealthUtah PPO |
$227.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$220.68
|
| Rate for Payer: Multiplan Medicare/VA |
$123.19
|
| Rate for Payer: One Health Plan of WY PPO |
$222.95
|
| Rate for Payer: PacificSource Commercial |
$204.75
|
| Rate for Payer: PHCS PPO |
$222.95
|
| Rate for Payer: Three Rivers PPO |
$170.62
|
| Rate for Payer: TriWest Veterans Administration |
$129.68
|
| Rate for Payer: United Healthcare Commercial |
$217.26
|
| Rate for Payer: United Healthcare Medicare |
$129.68
|
| Rate for Payer: WINHealth Partners Commercial |
$222.95
|
| Rate for Payer: Wise Provider Network Commercial |
$216.12
|
|
|
18MM RADIAL HEAD
|
Facility
|
IP
|
$7,066.50
|
|
| Hospital Charge Code |
3004696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,095.04 |
| Max. Negotiated Rate |
$7,066.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,925.17
|
| Rate for Payer: Aetna of WY Medicare |
$4,522.56
|
| Rate for Payer: Altius Commercial |
$6,783.84
|
| Rate for Payer: Beech Street Commercial |
$6,925.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6,854.50
|
| Rate for Payer: Cash Price |
$4,946.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,854.50
|
| Rate for Payer: Cigna of WY Commercial |
$6,925.17
|
| Rate for Payer: Entrust Commercial |
$6,713.18
|
| Rate for Payer: First Choice Health Commercial |
$6,713.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,713.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4,310.56
|
| Rate for Payer: HealthUtah PPO |
$7,066.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,854.50
|
| Rate for Payer: Multiplan Medicare/VA |
$4,095.04
|
| Rate for Payer: One Health Plan of WY PPO |
$6,925.17
|
| Rate for Payer: PacificSource Commercial |
$6,359.85
|
| Rate for Payer: PHCS PPO |
$6,925.17
|
| Rate for Payer: Three Rivers PPO |
$5,299.88
|
| Rate for Payer: TriWest Veterans Administration |
$4,310.56
|
| Rate for Payer: United Healthcare Commercial |
$6,748.51
|
| Rate for Payer: United Healthcare Medicare |
$4,310.56
|
| Rate for Payer: WINHealth Partners Commercial |
$6,713.18
|
| Rate for Payer: Wise Provider Network Commercial |
$6,713.18
|
|
|
18MM RADIAL HEAD
|
Facility
|
OP
|
$7,066.50
|
|
| Hospital Charge Code |
3004696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,826.51 |
| Max. Negotiated Rate |
$7,066.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,925.17
|
| Rate for Payer: Aetna of WY Medicare |
$4,663.89
|
| Rate for Payer: Altius Commercial |
$6,783.84
|
| Rate for Payer: Beech Street Commercial |
$6,925.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6,854.50
|
| Rate for Payer: Cash Price |
$4,946.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,854.50
|
| Rate for Payer: Cigna of WY Commercial |
$6,925.17
|
| Rate for Payer: Entrust Commercial |
$6,713.18
|
| Rate for Payer: First Choice Health Commercial |
$6,713.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,713.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4,027.90
|
| Rate for Payer: HealthUtah PPO |
$7,066.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,854.50
|
| Rate for Payer: Multiplan Medicare/VA |
$3,826.51
|
| Rate for Payer: One Health Plan of WY PPO |
$6,925.17
|
| Rate for Payer: PacificSource Commercial |
$6,359.85
|
| Rate for Payer: PHCS PPO |
$6,925.17
|
| Rate for Payer: Three Rivers PPO |
$5,299.88
|
| Rate for Payer: TriWest Veterans Administration |
$4,027.90
|
| Rate for Payer: United Healthcare Commercial |
$6,748.51
|
| Rate for Payer: United Healthcare Medicare |
$4,027.90
|
| Rate for Payer: WINHealth Partners Commercial |
$6,925.17
|
| Rate for Payer: Wise Provider Network Commercial |
$6,713.18
|
|
|
1.8 X 350 MM GUIDE WIRE
|
Facility
|
IP
|
$546.00
|
|
| Hospital Charge Code |
3002147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$316.41 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$535.08
|
| Rate for Payer: Aetna of WY Medicare |
$349.44
|
| Rate for Payer: Altius Commercial |
$524.16
|
| Rate for Payer: Beech Street Commercial |
$535.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$529.62
|
| Rate for Payer: Cash Price |
$382.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$529.62
|
| Rate for Payer: Cigna of WY Commercial |
$535.08
|
| Rate for Payer: Entrust Commercial |
$518.70
|
| Rate for Payer: First Choice Health Commercial |
$518.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$518.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$333.06
|
| Rate for Payer: HealthUtah PPO |
$546.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$529.62
|
| Rate for Payer: Multiplan Medicare/VA |
$316.41
|
| Rate for Payer: One Health Plan of WY PPO |
$535.08
|
| Rate for Payer: PacificSource Commercial |
$491.40
|
| Rate for Payer: PHCS PPO |
$535.08
|
| Rate for Payer: Three Rivers PPO |
$409.50
|
| Rate for Payer: TriWest Veterans Administration |
$333.06
|
| Rate for Payer: United Healthcare Commercial |
$521.43
|
| Rate for Payer: United Healthcare Medicare |
$333.06
|
| Rate for Payer: WINHealth Partners Commercial |
$518.70
|
| Rate for Payer: Wise Provider Network Commercial |
$518.70
|
|
|
1.8 X 350 MM GUIDE WIRE
|
Facility
|
OP
|
$546.00
|
|
| Hospital Charge Code |
3002147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$295.66 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$535.08
|
| Rate for Payer: Aetna of WY Medicare |
$360.36
|
| Rate for Payer: Altius Commercial |
$524.16
|
| Rate for Payer: Beech Street Commercial |
$535.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$529.62
|
| Rate for Payer: Cash Price |
$382.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$529.62
|
| Rate for Payer: Cigna of WY Commercial |
$535.08
|
| Rate for Payer: Entrust Commercial |
$518.70
|
| Rate for Payer: First Choice Health Commercial |
$518.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$518.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$311.22
|
| Rate for Payer: HealthUtah PPO |
$546.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$529.62
|
| Rate for Payer: Multiplan Medicare/VA |
$295.66
|
| Rate for Payer: One Health Plan of WY PPO |
$535.08
|
| Rate for Payer: PacificSource Commercial |
$491.40
|
| Rate for Payer: PHCS PPO |
$535.08
|
| Rate for Payer: Three Rivers PPO |
$409.50
|
| Rate for Payer: TriWest Veterans Administration |
$311.22
|
| Rate for Payer: United Healthcare Commercial |
$521.43
|
| Rate for Payer: United Healthcare Medicare |
$311.22
|
| Rate for Payer: WINHealth Partners Commercial |
$535.08
|
| Rate for Payer: Wise Provider Network Commercial |
$518.70
|
|
|
1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 99460
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$265.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$259.70
|
| Rate for Payer: Aetna of WY Medicare |
$88.94
|
| Rate for Payer: Beech Street Commercial |
$251.75
|
| Rate for Payer: Cash Price |
$185.50
|
| Rate for Payer: Cash Price |
$185.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$257.05
|
| Rate for Payer: Cigna of WY Commercial |
$259.70
|
| Rate for Payer: First Choice Health Commercial |
$238.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$251.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.94
|
| Rate for Payer: HealthUtah PPO |
$265.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$257.05
|
| Rate for Payer: Multiplan Medicare/VA |
$75.60
|
| Rate for Payer: One Health Plan of WY PPO |
$259.70
|
| Rate for Payer: PacificSource Commercial |
$238.50
|
| Rate for Payer: PHCS PPO |
$251.75
|
| Rate for Payer: Three Rivers PPO |
$198.75
|
| Rate for Payer: TriWest Veterans Administration |
$88.94
|
| Rate for Payer: United Healthcare Commercial |
$251.75
|
| Rate for Payer: WINHealth Partners Commercial |
$251.75
|
|
