DRAPE MICROSCOPE ZEISS TIVATO
|
Facility
|
OP
|
$135.10
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$74.44 |
Max. Negotiated Rate |
$135.10 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$132.40
|
Rate for Payer: Aetna of WY Medicare |
$89.17
|
Rate for Payer: Altius Auto/Workers Compensation |
$129.70
|
Rate for Payer: Altius Commercial |
$129.70
|
Rate for Payer: Beech Street Commercial |
$132.40
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$110.92
|
Rate for Payer: Cash Price |
$94.57
|
Rate for Payer: ChoiceCare Network Commercial |
$131.05
|
Rate for Payer: Cigna of WY Commercial |
$132.40
|
Rate for Payer: Entrust Commercial |
$128.34
|
Rate for Payer: First Choice Health Commercial |
$128.34
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$128.34
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.36
|
Rate for Payer: HealthUtah PPO |
$135.10
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$131.05
|
Rate for Payer: Multiplan Medicare/VA |
$74.44
|
Rate for Payer: One Health Plan of WY PPO |
$132.40
|
Rate for Payer: PacificSource Commercial |
$121.59
|
Rate for Payer: PHCS PPO |
$132.40
|
Rate for Payer: Three Rivers PPO |
$101.32
|
Rate for Payer: TriWest Veterans Administration |
$78.36
|
Rate for Payer: United Healthcare Commercial |
$117.54
|
Rate for Payer: United Healthcare Medicare |
$78.36
|
Rate for Payer: WINHealth Partners Commercial |
$132.40
|
Rate for Payer: Wise Provider Network Commercial |
$128.34
|
|
DRAPE MINOR PROCEDURE CERVICAL
|
Facility
|
OP
|
$18.61
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$10.25 |
Max. Negotiated Rate |
$18.61 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$18.24
|
Rate for Payer: Aetna of WY Medicare |
$12.28
|
Rate for Payer: Altius Auto/Workers Compensation |
$17.87
|
Rate for Payer: Altius Commercial |
$17.87
|
Rate for Payer: Beech Street Commercial |
$18.24
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.28
|
Rate for Payer: Cash Price |
$13.03
|
Rate for Payer: ChoiceCare Network Commercial |
$18.05
|
Rate for Payer: Cigna of WY Commercial |
$18.24
|
Rate for Payer: Entrust Commercial |
$17.68
|
Rate for Payer: First Choice Health Commercial |
$17.68
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$17.68
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.79
|
Rate for Payer: HealthUtah PPO |
$18.61
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$18.05
|
Rate for Payer: Multiplan Medicare/VA |
$10.25
|
Rate for Payer: One Health Plan of WY PPO |
$18.24
|
Rate for Payer: PacificSource Commercial |
$16.75
|
Rate for Payer: PHCS PPO |
$18.24
|
Rate for Payer: Three Rivers PPO |
$13.96
|
Rate for Payer: TriWest Veterans Administration |
$10.79
|
Rate for Payer: United Healthcare Commercial |
$16.19
|
Rate for Payer: United Healthcare Medicare |
$10.79
|
Rate for Payer: WINHealth Partners Commercial |
$18.24
|
Rate for Payer: Wise Provider Network Commercial |
$17.68
|
|
DRAPE MINOR PROCEDURE CERVICAL
|
Facility
|
IP
|
$18.61
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$11.67 |
Max. Negotiated Rate |
$18.61 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$18.24
|
Rate for Payer: Altius Auto/Workers Compensation |
$17.87
|
Rate for Payer: Altius Commercial |
$17.87
|
Rate for Payer: Beech Street Commercial |
$18.24
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.28
|
Rate for Payer: Cash Price |
$13.03
|
Rate for Payer: ChoiceCare Network Commercial |
$18.05
|
Rate for Payer: Cigna of WY Commercial |
$18.24
|
Rate for Payer: Entrust Commercial |
$17.68
|
Rate for Payer: First Choice Health Commercial |
$17.68
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$17.68
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.28
|
Rate for Payer: HealthUtah PPO |
$18.61
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$18.05
|
Rate for Payer: Multiplan Medicare/VA |
$11.67
|
Rate for Payer: One Health Plan of WY PPO |
$18.24
|
Rate for Payer: PacificSource Commercial |
$16.75
|
Rate for Payer: PHCS PPO |
$18.24
|
Rate for Payer: Three Rivers PPO |
$13.96
|
Rate for Payer: TriWest Veterans Administration |
$12.28
|
Rate for Payer: United Healthcare Commercial |
$16.19
|
Rate for Payer: United Healthcare Medicare |
$12.28
|
Rate for Payer: WINHealth Partners Commercial |
$17.68
|
Rate for Payer: Wise Provider Network Commercial |
$17.68
|
|
DRAPE OVERHEAD TABLE COVER
|
Facility
|
OP
|
$25.26
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$13.92 |
Max. Negotiated Rate |
$25.26 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.75
|
Rate for Payer: Aetna of WY Medicare |
$16.67
|
Rate for Payer: Altius Auto/Workers Compensation |
$24.25
|
Rate for Payer: Altius Commercial |
$24.25
|
Rate for Payer: Beech Street Commercial |
$24.75
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.74
|
Rate for Payer: Cash Price |
$17.68
|
Rate for Payer: ChoiceCare Network Commercial |
$24.50
|
Rate for Payer: Cigna of WY Commercial |
$24.75
|
Rate for Payer: Entrust Commercial |
$24.00
|
Rate for Payer: First Choice Health Commercial |
$24.00
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$24.00
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.65
|
Rate for Payer: HealthUtah PPO |
$25.26
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$24.50
|
Rate for Payer: Multiplan Medicare/VA |
$13.92
|
Rate for Payer: One Health Plan of WY PPO |
$24.75
|
Rate for Payer: PacificSource Commercial |
$22.73
|
Rate for Payer: PHCS PPO |
$24.75
|
Rate for Payer: Three Rivers PPO |
$18.94
|
Rate for Payer: TriWest Veterans Administration |
$14.65
|
Rate for Payer: United Healthcare Commercial |
$21.98
|
Rate for Payer: United Healthcare Medicare |
$14.65
|
Rate for Payer: WINHealth Partners Commercial |
$24.75
|
Rate for Payer: Wise Provider Network Commercial |
$24.00
|
|
DRAPE OVERHEAD TABLE COVER
|
Facility
|
IP
|
$25.26
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$15.84 |
Max. Negotiated Rate |
$25.26 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.75
|
Rate for Payer: Altius Auto/Workers Compensation |
$24.25
|
Rate for Payer: Altius Commercial |
$24.25
|
Rate for Payer: Beech Street Commercial |
$24.75
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.74
|
Rate for Payer: Cash Price |
$17.68
|
Rate for Payer: ChoiceCare Network Commercial |
$24.50
|
Rate for Payer: Cigna of WY Commercial |
$24.75
|
Rate for Payer: Entrust Commercial |
$24.00
|
Rate for Payer: First Choice Health Commercial |
$24.00
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$24.00
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.67
|
Rate for Payer: HealthUtah PPO |
$25.26
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$24.50
|
Rate for Payer: Multiplan Medicare/VA |
$15.84
|
Rate for Payer: One Health Plan of WY PPO |
$24.75
|
Rate for Payer: PacificSource Commercial |
$22.73
|
Rate for Payer: PHCS PPO |
$24.75
|
Rate for Payer: Three Rivers PPO |
$18.94
|
Rate for Payer: TriWest Veterans Administration |
$16.67
|
Rate for Payer: United Healthcare Commercial |
$21.98
|
Rate for Payer: United Healthcare Medicare |
$16.67
|
Rate for Payer: WINHealth Partners Commercial |
$24.00
|
Rate for Payer: Wise Provider Network Commercial |
$24.00
|
|
DRAPE PACEMAKER 82X115
|
Facility
|
OP
|
$27.81
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$15.32 |
Max. Negotiated Rate |
$27.81 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.25
|
Rate for Payer: Aetna of WY Medicare |
$18.35
|
Rate for Payer: Altius Auto/Workers Compensation |
$26.70
|
Rate for Payer: Altius Commercial |
$26.70
|
Rate for Payer: Beech Street Commercial |
$27.25
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22.83
|
Rate for Payer: Cash Price |
$19.47
|
Rate for Payer: ChoiceCare Network Commercial |
$26.98
|
Rate for Payer: Cigna of WY Commercial |
$27.25
|
Rate for Payer: Entrust Commercial |
$26.42
|
Rate for Payer: First Choice Health Commercial |
$26.42
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.42
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.13
|
Rate for Payer: HealthUtah PPO |
$27.81
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$26.98
|
Rate for Payer: Multiplan Medicare/VA |
$15.32
|
Rate for Payer: One Health Plan of WY PPO |
$27.25
|
Rate for Payer: PacificSource Commercial |
$25.03
|
Rate for Payer: PHCS PPO |
$27.25
|
Rate for Payer: Three Rivers PPO |
$20.86
|
Rate for Payer: TriWest Veterans Administration |
$16.13
|
Rate for Payer: United Healthcare Commercial |
$24.19
|
Rate for Payer: United Healthcare Medicare |
$16.13
|
Rate for Payer: WINHealth Partners Commercial |
$27.25
|
Rate for Payer: Wise Provider Network Commercial |
$26.42
|
|
DRAPE PACEMAKER 82X115
|
Facility
|
IP
|
$27.81
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$17.44 |
Max. Negotiated Rate |
$27.81 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.25
|
Rate for Payer: Altius Auto/Workers Compensation |
$26.70
|
Rate for Payer: Altius Commercial |
$26.70
|
Rate for Payer: Beech Street Commercial |
$27.25
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22.83
|
Rate for Payer: Cash Price |
$19.47
|
Rate for Payer: ChoiceCare Network Commercial |
$26.98
|
Rate for Payer: Cigna of WY Commercial |
$27.25
|
Rate for Payer: Entrust Commercial |
$26.42
|
Rate for Payer: First Choice Health Commercial |
$26.42
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.42
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.35
|
Rate for Payer: HealthUtah PPO |
$27.81
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$26.98
|
Rate for Payer: Multiplan Medicare/VA |
$17.44
|
Rate for Payer: One Health Plan of WY PPO |
$27.25
|
Rate for Payer: PacificSource Commercial |
$25.03
|
Rate for Payer: PHCS PPO |
$27.25
|
Rate for Payer: Three Rivers PPO |
$20.86
|
Rate for Payer: TriWest Veterans Administration |
$18.35
|
Rate for Payer: United Healthcare Commercial |
$24.19
|
Rate for Payer: United Healthcare Medicare |
$18.35
|
Rate for Payer: WINHealth Partners Commercial |
$26.42
|
Rate for Payer: Wise Provider Network Commercial |
$26.42
|
|
DRAPE SHOULDER BEACH CHAIR
|
Facility
|
OP
|
$68.99
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$38.01 |
Max. Negotiated Rate |
$68.99 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.61
|
Rate for Payer: Aetna of WY Medicare |
$45.53
|
Rate for Payer: Altius Auto/Workers Compensation |
$66.23
|
Rate for Payer: Altius Commercial |
$66.23
|
Rate for Payer: Beech Street Commercial |
$67.61
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$56.64
|
Rate for Payer: Cash Price |
$48.29
|
Rate for Payer: ChoiceCare Network Commercial |
$66.92
|
Rate for Payer: Cigna of WY Commercial |
$67.61
|
Rate for Payer: Entrust Commercial |
$65.54
|
Rate for Payer: First Choice Health Commercial |
$65.54
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.54
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$40.01
|
Rate for Payer: HealthUtah PPO |
$68.99
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.92
|
Rate for Payer: Multiplan Medicare/VA |
$38.01
|
Rate for Payer: One Health Plan of WY PPO |
$67.61
|
Rate for Payer: PacificSource Commercial |
$62.09
|
Rate for Payer: PHCS PPO |
$67.61
|
Rate for Payer: Three Rivers PPO |
$51.74
|
Rate for Payer: TriWest Veterans Administration |
$40.01
|
Rate for Payer: United Healthcare Commercial |
$60.02
|
Rate for Payer: United Healthcare Medicare |
$40.01
|
Rate for Payer: WINHealth Partners Commercial |
$67.61
|
Rate for Payer: Wise Provider Network Commercial |
$65.54
|
|
DRAPE SHOULDER BEACH CHAIR
|
Facility
|
IP
|
$68.99
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$43.26 |
Max. Negotiated Rate |
$68.99 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.61
|
Rate for Payer: Altius Auto/Workers Compensation |
$66.23
|
Rate for Payer: Altius Commercial |
$66.23
|
Rate for Payer: Beech Street Commercial |
$67.61
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$56.64
|
Rate for Payer: Cash Price |
$48.29
|
Rate for Payer: ChoiceCare Network Commercial |
$66.92
|
Rate for Payer: Cigna of WY Commercial |
$67.61
|
Rate for Payer: Entrust Commercial |
$65.54
|
Rate for Payer: First Choice Health Commercial |
$65.54
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.54
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$45.53
|
Rate for Payer: HealthUtah PPO |
$68.99
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.92
|
Rate for Payer: Multiplan Medicare/VA |
$43.26
|
Rate for Payer: One Health Plan of WY PPO |
$67.61
|
Rate for Payer: PacificSource Commercial |
$62.09
|
Rate for Payer: PHCS PPO |
$67.61
|
Rate for Payer: Three Rivers PPO |
$51.74
|
Rate for Payer: TriWest Veterans Administration |
$45.53
|
Rate for Payer: United Healthcare Commercial |
$60.02
|
Rate for Payer: United Healthcare Medicare |
$45.53
|
Rate for Payer: WINHealth Partners Commercial |
$65.54
|
Rate for Payer: Wise Provider Network Commercial |
$65.54
|
|
DRAPE SPLIT SHEET EENT
|
Facility
|
OP
|
$16.13
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$8.89 |
Max. Negotiated Rate |
$16.13 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.81
|
Rate for Payer: Aetna of WY Medicare |
$10.65
|
Rate for Payer: Altius Auto/Workers Compensation |
$15.48
|
Rate for Payer: Altius Commercial |
$15.48
|
Rate for Payer: Beech Street Commercial |
$15.81
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.24
|
Rate for Payer: Cash Price |
$11.29
|
Rate for Payer: ChoiceCare Network Commercial |
$15.65
|
Rate for Payer: Cigna of WY Commercial |
$15.81
|
Rate for Payer: Entrust Commercial |
$15.32
|
Rate for Payer: First Choice Health Commercial |
$15.32
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.32
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.36
|
Rate for Payer: HealthUtah PPO |
$16.13
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.65
|
Rate for Payer: Multiplan Medicare/VA |
$8.89
|
Rate for Payer: One Health Plan of WY PPO |
$15.81
|
Rate for Payer: PacificSource Commercial |
$14.52
|
Rate for Payer: PHCS PPO |
$15.81
|
Rate for Payer: Three Rivers PPO |
$12.10
|
Rate for Payer: TriWest Veterans Administration |
$9.36
|
Rate for Payer: United Healthcare Commercial |
$14.03
|
Rate for Payer: United Healthcare Medicare |
$9.36
|
Rate for Payer: WINHealth Partners Commercial |
$15.81
|
Rate for Payer: Wise Provider Network Commercial |
$15.32
|
|
DRAPE SPLIT SHEET EENT
|
Facility
|
IP
|
$16.13
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$10.11 |
Max. Negotiated Rate |
$16.13 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.81
|
Rate for Payer: Altius Auto/Workers Compensation |
$15.48
|
Rate for Payer: Altius Commercial |
$15.48
|
Rate for Payer: Beech Street Commercial |
$15.81
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.24
|
Rate for Payer: Cash Price |
$11.29
|
Rate for Payer: ChoiceCare Network Commercial |
$15.65
|
Rate for Payer: Cigna of WY Commercial |
$15.81
|
Rate for Payer: Entrust Commercial |
$15.32
|
Rate for Payer: First Choice Health Commercial |
$15.32
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.32
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.65
|
Rate for Payer: HealthUtah PPO |
$16.13
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.65
|
Rate for Payer: Multiplan Medicare/VA |
$10.11
|
Rate for Payer: One Health Plan of WY PPO |
$15.81
|
Rate for Payer: PacificSource Commercial |
$14.52
|
Rate for Payer: PHCS PPO |
$15.81
|
Rate for Payer: Three Rivers PPO |
$12.10
|
Rate for Payer: TriWest Veterans Administration |
$10.65
|
Rate for Payer: United Healthcare Commercial |
$14.03
|
Rate for Payer: United Healthcare Medicare |
$10.65
|
Rate for Payer: WINHealth Partners Commercial |
$15.32
|
Rate for Payer: Wise Provider Network Commercial |
$15.32
|
|
DRAPE SURG IOBAN 6617 3M
|
Facility
|
OP
|
$58.84
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$32.42 |
Max. Negotiated Rate |
$58.84 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$57.66
|
Rate for Payer: Aetna of WY Medicare |
$38.83
|
Rate for Payer: Altius Auto/Workers Compensation |
$56.49
|
Rate for Payer: Altius Commercial |
$56.49
|
Rate for Payer: Beech Street Commercial |
$57.66
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$48.31
|
Rate for Payer: Cash Price |
$41.19
|
Rate for Payer: ChoiceCare Network Commercial |
$57.07
|
Rate for Payer: Cigna of WY Commercial |
$57.66
|
Rate for Payer: Entrust Commercial |
$55.90
|
Rate for Payer: First Choice Health Commercial |
$55.90
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$55.90
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$34.13
|
Rate for Payer: HealthUtah PPO |
$58.84
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$57.07
|
Rate for Payer: Multiplan Medicare/VA |
$32.42
|
Rate for Payer: One Health Plan of WY PPO |
$57.66
|
Rate for Payer: PacificSource Commercial |
$52.96
|
Rate for Payer: PHCS PPO |
$57.66
|
Rate for Payer: Three Rivers PPO |
$44.13
|
Rate for Payer: TriWest Veterans Administration |
$34.13
|
Rate for Payer: United Healthcare Commercial |
$51.19
|
Rate for Payer: United Healthcare Medicare |
$34.13
|
Rate for Payer: WINHealth Partners Commercial |
$57.66
|
Rate for Payer: Wise Provider Network Commercial |
$55.90
|
|
DRAPE SURG IOBAN 6617 3M
|
Facility
|
IP
|
$58.84
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$36.89 |
Max. Negotiated Rate |
$58.84 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$57.66
|
Rate for Payer: Altius Auto/Workers Compensation |
$56.49
|
Rate for Payer: Altius Commercial |
$56.49
|
Rate for Payer: Beech Street Commercial |
$57.66
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$48.31
|
Rate for Payer: Cash Price |
$41.19
|
Rate for Payer: ChoiceCare Network Commercial |
$57.07
|
Rate for Payer: Cigna of WY Commercial |
$57.66
|
Rate for Payer: Entrust Commercial |
$55.90
|
Rate for Payer: First Choice Health Commercial |
$55.90
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$55.90
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$38.83
|
Rate for Payer: HealthUtah PPO |
$58.84
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$57.07
|
Rate for Payer: Multiplan Medicare/VA |
$36.89
|
Rate for Payer: One Health Plan of WY PPO |
$57.66
|
Rate for Payer: PacificSource Commercial |
$52.96
|
Rate for Payer: PHCS PPO |
$57.66
|
Rate for Payer: Three Rivers PPO |
$44.13
|
Rate for Payer: TriWest Veterans Administration |
$38.83
|
Rate for Payer: United Healthcare Commercial |
$51.19
|
Rate for Payer: United Healthcare Medicare |
$38.83
|
Rate for Payer: WINHealth Partners Commercial |
$55.90
|
Rate for Payer: Wise Provider Network Commercial |
$55.90
|
|
DRAPE SWITCH SPIDER2 ARM
|
Facility
|
OP
|
$132.30
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$72.90 |
Max. Negotiated Rate |
$132.30 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$129.65
|
Rate for Payer: Aetna of WY Medicare |
$87.32
|
Rate for Payer: Altius Auto/Workers Compensation |
$127.01
|
Rate for Payer: Altius Commercial |
$127.01
|
Rate for Payer: Beech Street Commercial |
$129.65
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$108.62
|
Rate for Payer: Cash Price |
$92.61
|
Rate for Payer: ChoiceCare Network Commercial |
$128.33
|
Rate for Payer: Cigna of WY Commercial |
$129.65
|
Rate for Payer: Entrust Commercial |
$125.68
|
Rate for Payer: First Choice Health Commercial |
$125.68
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$125.68
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$76.73
|
Rate for Payer: HealthUtah PPO |
$132.30
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$128.33
|
Rate for Payer: Multiplan Medicare/VA |
$72.90
|
Rate for Payer: One Health Plan of WY PPO |
$129.65
|
Rate for Payer: PacificSource Commercial |
$119.07
|
Rate for Payer: PHCS PPO |
$129.65
|
Rate for Payer: Three Rivers PPO |
$99.22
|
Rate for Payer: TriWest Veterans Administration |
$76.73
|
Rate for Payer: United Healthcare Commercial |
$115.10
|
Rate for Payer: United Healthcare Medicare |
$76.73
|
Rate for Payer: WINHealth Partners Commercial |
$129.65
|
Rate for Payer: Wise Provider Network Commercial |
$125.68
|
|
DRAPE SWITCH SPIDER2 ARM
|
Facility
|
IP
|
$132.30
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$82.95 |
Max. Negotiated Rate |
$132.30 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$129.65
|
Rate for Payer: Altius Auto/Workers Compensation |
$127.01
|
Rate for Payer: Altius Commercial |
$127.01
|
Rate for Payer: Beech Street Commercial |
$129.65
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$108.62
|
Rate for Payer: Cash Price |
$92.61
|
Rate for Payer: ChoiceCare Network Commercial |
$128.33
|
Rate for Payer: Cigna of WY Commercial |
$129.65
|
Rate for Payer: Entrust Commercial |
$125.68
|
Rate for Payer: First Choice Health Commercial |
$125.68
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$125.68
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$87.32
|
Rate for Payer: HealthUtah PPO |
$132.30
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$128.33
|
Rate for Payer: Multiplan Medicare/VA |
$82.95
|
Rate for Payer: One Health Plan of WY PPO |
$129.65
|
Rate for Payer: PacificSource Commercial |
$119.07
|
Rate for Payer: PHCS PPO |
$129.65
|
Rate for Payer: Three Rivers PPO |
$99.22
|
Rate for Payer: TriWest Veterans Administration |
$87.32
|
Rate for Payer: United Healthcare Commercial |
$115.10
|
Rate for Payer: United Healthcare Medicare |
$87.32
|
Rate for Payer: WINHealth Partners Commercial |
$125.68
|
Rate for Payer: Wise Provider Network Commercial |
$125.68
|
|
DRAPE TABLE COVER
|
Facility
|
OP
|
$6.33
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3.49 |
Max. Negotiated Rate |
$6.33 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.20
|
Rate for Payer: Aetna of WY Medicare |
$4.18
|
Rate for Payer: Altius Auto/Workers Compensation |
$6.08
|
Rate for Payer: Altius Commercial |
$6.08
|
Rate for Payer: Beech Street Commercial |
$6.20
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.20
|
Rate for Payer: Cash Price |
$4.43
|
Rate for Payer: ChoiceCare Network Commercial |
$6.14
|
Rate for Payer: Cigna of WY Commercial |
$6.20
|
Rate for Payer: Entrust Commercial |
$6.01
|
Rate for Payer: First Choice Health Commercial |
$6.01
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6.01
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.67
|
Rate for Payer: HealthUtah PPO |
$6.33
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$6.14
|
Rate for Payer: Multiplan Medicare/VA |
$3.49
|
Rate for Payer: One Health Plan of WY PPO |
$6.20
|
Rate for Payer: PacificSource Commercial |
$5.70
|
Rate for Payer: PHCS PPO |
$6.20
|
Rate for Payer: Three Rivers PPO |
$4.75
|
Rate for Payer: TriWest Veterans Administration |
$3.67
|
Rate for Payer: United Healthcare Commercial |
$5.51
|
Rate for Payer: United Healthcare Medicare |
$3.67
|
Rate for Payer: WINHealth Partners Commercial |
$6.20
|
Rate for Payer: Wise Provider Network Commercial |
$6.01
|
|
DRAPE TABLE COVER
|
Facility
|
IP
|
$6.33
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3.97 |
Max. Negotiated Rate |
$6.33 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.20
|
Rate for Payer: Altius Auto/Workers Compensation |
$6.08
|
Rate for Payer: Altius Commercial |
$6.08
|
Rate for Payer: Beech Street Commercial |
$6.20
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.20
|
Rate for Payer: Cash Price |
$4.43
|
Rate for Payer: ChoiceCare Network Commercial |
$6.14
|
Rate for Payer: Cigna of WY Commercial |
$6.20
|
Rate for Payer: Entrust Commercial |
$6.01
|
Rate for Payer: First Choice Health Commercial |
$6.01
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6.01
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.18
|
Rate for Payer: HealthUtah PPO |
$6.33
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$6.14
|
Rate for Payer: Multiplan Medicare/VA |
$3.97
|
Rate for Payer: One Health Plan of WY PPO |
$6.20
|
Rate for Payer: PacificSource Commercial |
$5.70
|
Rate for Payer: PHCS PPO |
$6.20
|
Rate for Payer: Three Rivers PPO |
$4.75
|
Rate for Payer: TriWest Veterans Administration |
$4.18
|
Rate for Payer: United Healthcare Commercial |
$5.51
|
Rate for Payer: United Healthcare Medicare |
$4.18
|
Rate for Payer: WINHealth Partners Commercial |
$6.01
|
Rate for Payer: Wise Provider Network Commercial |
$6.01
|
|
DRAPE TABLE SPACE STATION
|
Facility
|
IP
|
$106.46
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$66.75 |
Max. Negotiated Rate |
$106.46 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$104.33
|
Rate for Payer: Altius Auto/Workers Compensation |
$102.20
|
Rate for Payer: Altius Commercial |
$102.20
|
Rate for Payer: Beech Street Commercial |
$104.33
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$87.40
|
Rate for Payer: Cash Price |
$74.52
|
Rate for Payer: ChoiceCare Network Commercial |
$103.27
|
Rate for Payer: Cigna of WY Commercial |
$104.33
|
Rate for Payer: Entrust Commercial |
$101.14
|
Rate for Payer: First Choice Health Commercial |
$101.14
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$101.14
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$70.26
|
Rate for Payer: HealthUtah PPO |
$106.46
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$103.27
|
Rate for Payer: Multiplan Medicare/VA |
$66.75
|
Rate for Payer: One Health Plan of WY PPO |
$104.33
|
Rate for Payer: PacificSource Commercial |
$95.81
|
Rate for Payer: PHCS PPO |
$104.33
|
Rate for Payer: Three Rivers PPO |
$79.84
|
Rate for Payer: TriWest Veterans Administration |
$70.26
|
Rate for Payer: United Healthcare Commercial |
$92.62
|
Rate for Payer: United Healthcare Medicare |
$70.26
|
Rate for Payer: WINHealth Partners Commercial |
$101.14
|
Rate for Payer: Wise Provider Network Commercial |
$101.14
|
|
DRAPE TABLE SPACE STATION
|
Facility
|
OP
|
$106.46
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$58.66 |
Max. Negotiated Rate |
$106.46 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$104.33
|
Rate for Payer: Aetna of WY Medicare |
$70.26
|
Rate for Payer: Altius Auto/Workers Compensation |
$102.20
|
Rate for Payer: Altius Commercial |
$102.20
|
Rate for Payer: Beech Street Commercial |
$104.33
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$87.40
|
Rate for Payer: Cash Price |
$74.52
|
Rate for Payer: ChoiceCare Network Commercial |
$103.27
|
Rate for Payer: Cigna of WY Commercial |
$104.33
|
Rate for Payer: Entrust Commercial |
$101.14
|
Rate for Payer: First Choice Health Commercial |
$101.14
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$101.14
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$61.75
|
Rate for Payer: HealthUtah PPO |
$106.46
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$103.27
|
Rate for Payer: Multiplan Medicare/VA |
$58.66
|
Rate for Payer: One Health Plan of WY PPO |
$104.33
|
Rate for Payer: PacificSource Commercial |
$95.81
|
Rate for Payer: PHCS PPO |
$104.33
|
Rate for Payer: Three Rivers PPO |
$79.84
|
Rate for Payer: TriWest Veterans Administration |
$61.75
|
Rate for Payer: United Healthcare Commercial |
$92.62
|
Rate for Payer: United Healthcare Medicare |
$61.75
|
Rate for Payer: WINHealth Partners Commercial |
$104.33
|
Rate for Payer: Wise Provider Network Commercial |
$101.14
|
|
DRAPE THYROID
|
Facility
|
OP
|
$23.01
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$12.68 |
Max. Negotiated Rate |
$23.01 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.55
|
Rate for Payer: Aetna of WY Medicare |
$15.19
|
Rate for Payer: Altius Auto/Workers Compensation |
$22.09
|
Rate for Payer: Altius Commercial |
$22.09
|
Rate for Payer: Beech Street Commercial |
$22.55
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$18.89
|
Rate for Payer: Cash Price |
$16.11
|
Rate for Payer: ChoiceCare Network Commercial |
$22.32
|
Rate for Payer: Cigna of WY Commercial |
$22.55
|
Rate for Payer: Entrust Commercial |
$21.86
|
Rate for Payer: First Choice Health Commercial |
$21.86
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.86
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.35
|
Rate for Payer: HealthUtah PPO |
$23.01
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$22.32
|
Rate for Payer: Multiplan Medicare/VA |
$12.68
|
Rate for Payer: One Health Plan of WY PPO |
$22.55
|
Rate for Payer: PacificSource Commercial |
$20.71
|
Rate for Payer: PHCS PPO |
$22.55
|
Rate for Payer: Three Rivers PPO |
$17.26
|
Rate for Payer: TriWest Veterans Administration |
$13.35
|
Rate for Payer: United Healthcare Commercial |
$20.02
|
Rate for Payer: United Healthcare Medicare |
$13.35
|
Rate for Payer: WINHealth Partners Commercial |
$22.55
|
Rate for Payer: Wise Provider Network Commercial |
$21.86
|
|
DRAPE THYROID
|
Facility
|
IP
|
$23.01
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$14.43 |
Max. Negotiated Rate |
$23.01 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.55
|
Rate for Payer: Altius Auto/Workers Compensation |
$22.09
|
Rate for Payer: Altius Commercial |
$22.09
|
Rate for Payer: Beech Street Commercial |
$22.55
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$18.89
|
Rate for Payer: Cash Price |
$16.11
|
Rate for Payer: ChoiceCare Network Commercial |
$22.32
|
Rate for Payer: Cigna of WY Commercial |
$22.55
|
Rate for Payer: Entrust Commercial |
$21.86
|
Rate for Payer: First Choice Health Commercial |
$21.86
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.86
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$15.19
|
Rate for Payer: HealthUtah PPO |
$23.01
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$22.32
|
Rate for Payer: Multiplan Medicare/VA |
$14.43
|
Rate for Payer: One Health Plan of WY PPO |
$22.55
|
Rate for Payer: PacificSource Commercial |
$20.71
|
Rate for Payer: PHCS PPO |
$22.55
|
Rate for Payer: Three Rivers PPO |
$17.26
|
Rate for Payer: TriWest Veterans Administration |
$15.19
|
Rate for Payer: United Healthcare Commercial |
$20.02
|
Rate for Payer: United Healthcare Medicare |
$15.19
|
Rate for Payer: WINHealth Partners Commercial |
$21.86
|
Rate for Payer: Wise Provider Network Commercial |
$21.86
|
|
DRAPE U CLEAR
|
Facility
|
IP
|
$9.17
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.75 |
Max. Negotiated Rate |
$9.17 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.99
|
Rate for Payer: Altius Auto/Workers Compensation |
$8.80
|
Rate for Payer: Altius Commercial |
$8.80
|
Rate for Payer: Beech Street Commercial |
$8.99
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.53
|
Rate for Payer: Cash Price |
$6.42
|
Rate for Payer: ChoiceCare Network Commercial |
$8.89
|
Rate for Payer: Cigna of WY Commercial |
$8.99
|
Rate for Payer: Entrust Commercial |
$8.71
|
Rate for Payer: First Choice Health Commercial |
$8.71
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.71
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.05
|
Rate for Payer: HealthUtah PPO |
$9.17
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.89
|
Rate for Payer: Multiplan Medicare/VA |
$5.75
|
Rate for Payer: One Health Plan of WY PPO |
$8.99
|
Rate for Payer: PacificSource Commercial |
$8.25
|
Rate for Payer: PHCS PPO |
$8.99
|
Rate for Payer: Three Rivers PPO |
$6.88
|
Rate for Payer: TriWest Veterans Administration |
$6.05
|
Rate for Payer: United Healthcare Commercial |
$7.98
|
Rate for Payer: United Healthcare Medicare |
$6.05
|
Rate for Payer: WINHealth Partners Commercial |
$8.71
|
Rate for Payer: Wise Provider Network Commercial |
$8.71
|
|
DRAPE U CLEAR
|
Facility
|
OP
|
$9.17
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.05 |
Max. Negotiated Rate |
$9.17 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.99
|
Rate for Payer: Aetna of WY Medicare |
$6.05
|
Rate for Payer: Altius Auto/Workers Compensation |
$8.80
|
Rate for Payer: Altius Commercial |
$8.80
|
Rate for Payer: Beech Street Commercial |
$8.99
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.53
|
Rate for Payer: Cash Price |
$6.42
|
Rate for Payer: ChoiceCare Network Commercial |
$8.89
|
Rate for Payer: Cigna of WY Commercial |
$8.99
|
Rate for Payer: Entrust Commercial |
$8.71
|
Rate for Payer: First Choice Health Commercial |
$8.71
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.71
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.32
|
Rate for Payer: HealthUtah PPO |
$9.17
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.89
|
Rate for Payer: Multiplan Medicare/VA |
$5.05
|
Rate for Payer: One Health Plan of WY PPO |
$8.99
|
Rate for Payer: PacificSource Commercial |
$8.25
|
Rate for Payer: PHCS PPO |
$8.99
|
Rate for Payer: Three Rivers PPO |
$6.88
|
Rate for Payer: TriWest Veterans Administration |
$5.32
|
Rate for Payer: United Healthcare Commercial |
$7.98
|
Rate for Payer: United Healthcare Medicare |
$5.32
|
Rate for Payer: WINHealth Partners Commercial |
$8.99
|
Rate for Payer: Wise Provider Network Commercial |
$8.71
|
|
DRESSING CHANGE KIT DTSTK07
|
Facility
|
IP
|
$34.49
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$21.63 |
Max. Negotiated Rate |
$34.49 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$33.80
|
Rate for Payer: Altius Auto/Workers Compensation |
$33.11
|
Rate for Payer: Altius Commercial |
$33.11
|
Rate for Payer: Beech Street Commercial |
$33.80
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$28.32
|
Rate for Payer: Cash Price |
$24.15
|
Rate for Payer: ChoiceCare Network Commercial |
$33.46
|
Rate for Payer: Cigna of WY Commercial |
$33.80
|
Rate for Payer: Entrust Commercial |
$32.77
|
Rate for Payer: First Choice Health Commercial |
$32.77
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$32.77
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$22.76
|
Rate for Payer: HealthUtah PPO |
$34.49
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$33.46
|
Rate for Payer: Multiplan Medicare/VA |
$21.63
|
Rate for Payer: One Health Plan of WY PPO |
$33.80
|
Rate for Payer: PacificSource Commercial |
$31.04
|
Rate for Payer: PHCS PPO |
$33.80
|
Rate for Payer: Three Rivers PPO |
$25.87
|
Rate for Payer: TriWest Veterans Administration |
$22.76
|
Rate for Payer: United Healthcare Commercial |
$30.01
|
Rate for Payer: United Healthcare Medicare |
$22.76
|
Rate for Payer: WINHealth Partners Commercial |
$32.77
|
Rate for Payer: Wise Provider Network Commercial |
$32.77
|
|
DRESSING CHANGE KIT DTSTK07
|
Facility
|
OP
|
$34.49
|
|
Hospital Charge Code |
27200000S1
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$19.00 |
Max. Negotiated Rate |
$34.49 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$33.80
|
Rate for Payer: Aetna of WY Medicare |
$22.76
|
Rate for Payer: Altius Auto/Workers Compensation |
$33.11
|
Rate for Payer: Altius Commercial |
$33.11
|
Rate for Payer: Beech Street Commercial |
$33.80
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$28.32
|
Rate for Payer: Cash Price |
$24.15
|
Rate for Payer: ChoiceCare Network Commercial |
$33.46
|
Rate for Payer: Cigna of WY Commercial |
$33.80
|
Rate for Payer: Entrust Commercial |
$32.77
|
Rate for Payer: First Choice Health Commercial |
$32.77
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$32.77
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$20.00
|
Rate for Payer: HealthUtah PPO |
$34.49
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$33.46
|
Rate for Payer: Multiplan Medicare/VA |
$19.00
|
Rate for Payer: One Health Plan of WY PPO |
$33.80
|
Rate for Payer: PacificSource Commercial |
$31.04
|
Rate for Payer: PHCS PPO |
$33.80
|
Rate for Payer: Three Rivers PPO |
$25.87
|
Rate for Payer: TriWest Veterans Administration |
$20.00
|
Rate for Payer: United Healthcare Commercial |
$30.01
|
Rate for Payer: United Healthcare Medicare |
$20.00
|
Rate for Payer: WINHealth Partners Commercial |
$33.80
|
Rate for Payer: Wise Provider Network Commercial |
$32.77
|
|