|
CORTINA CAGE 4 X 28 X 12
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 13
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 13
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 7
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 7
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 8
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 8
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 9
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 28 X 9
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 10
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 10
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 10
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 10
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 11
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 11
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4X31X11
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4X31X11
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 12
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 12
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 13
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 13
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 8
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 8
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 9
|
Facility
|
IP
|
$9,450.00
|
|
| Hospital Charge Code |
2800152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,476.28 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,048.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,764.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,476.28
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,764.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,764.50
|
| Rate for Payer: WINHealth Partners Commercial |
$8,977.50
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
|
CORTINA CAGE 4 X 31 X 9
|
Facility
|
OP
|
$9,450.00
|
|
| Hospital Charge Code |
2800152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,117.18 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9,261.00
|
| Rate for Payer: Aetna of WY Medicare |
$6,237.00
|
| Rate for Payer: Altius Commercial |
$9,072.00
|
| Rate for Payer: Beech Street Commercial |
$9,261.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9,166.50
|
| Rate for Payer: Cash Price |
$6,615.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$9,166.50
|
| Rate for Payer: Cigna of WY Commercial |
$9,261.00
|
| Rate for Payer: Entrust Commercial |
$8,977.50
|
| Rate for Payer: First Choice Health Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8,977.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5,386.50
|
| Rate for Payer: HealthUtah PPO |
$9,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9,166.50
|
| Rate for Payer: Multiplan Medicare/VA |
$5,117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$9,261.00
|
| Rate for Payer: PacificSource Commercial |
$8,505.00
|
| Rate for Payer: PHCS PPO |
$9,261.00
|
| Rate for Payer: Three Rivers PPO |
$7,087.50
|
| Rate for Payer: TriWest Veterans Administration |
$5,386.50
|
| Rate for Payer: United Healthcare Commercial |
$9,024.75
|
| Rate for Payer: United Healthcare Medicare |
$5,386.50
|
| Rate for Payer: WINHealth Partners Commercial |
$9,261.00
|
| Rate for Payer: Wise Provider Network Commercial |
$8,977.50
|
|
