|
ESCITALOPRAM 20 MG TABLET [25996]
|
Facility
|
OP
|
$1.27
|
|
|
Service Code
|
NDC 6808461801
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$1.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.24
|
| Rate for Payer: Aetna of WY Medicare |
$0.84
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1.22
|
| Rate for Payer: Altius Commercial |
$1.22
|
| Rate for Payer: Beech Street Commercial |
$1.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.04
|
| Rate for Payer: Cash Price |
$0.89
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.23
|
| Rate for Payer: Cigna of WY Commercial |
$1.24
|
| Rate for Payer: Entrust Commercial |
$1.21
|
| Rate for Payer: First Choice Health Commercial |
$1.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.74
|
| Rate for Payer: HealthUtah PPO |
$1.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.23
|
| Rate for Payer: Multiplan Medicare/VA |
$0.70
|
| Rate for Payer: One Health Plan of WY PPO |
$1.24
|
| Rate for Payer: PacificSource Commercial |
$1.14
|
| Rate for Payer: PHCS PPO |
$1.24
|
| Rate for Payer: Three Rivers PPO |
$0.95
|
| Rate for Payer: TriWest Veterans Administration |
$0.74
|
| Rate for Payer: United Healthcare Commercial |
$1.10
|
| Rate for Payer: United Healthcare Medicare |
$0.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1.24
|
| Rate for Payer: Wise Provider Network Commercial |
$1.21
|
|
|
ESCITALOPRAM 20 MG TABLET [25996]
|
Facility
|
IP
|
$1.27
|
|
|
Service Code
|
NDC 6808461801
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$1.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1.22
|
| Rate for Payer: Altius Commercial |
$1.22
|
| Rate for Payer: Beech Street Commercial |
$1.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.04
|
| Rate for Payer: Cash Price |
$0.89
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.23
|
| Rate for Payer: Cigna of WY Commercial |
$1.24
|
| Rate for Payer: Entrust Commercial |
$1.21
|
| Rate for Payer: First Choice Health Commercial |
$1.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.84
|
| Rate for Payer: HealthUtah PPO |
$1.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.23
|
| Rate for Payer: Multiplan Medicare/VA |
$0.80
|
| Rate for Payer: One Health Plan of WY PPO |
$1.24
|
| Rate for Payer: PacificSource Commercial |
$1.14
|
| Rate for Payer: PHCS PPO |
$1.24
|
| Rate for Payer: Three Rivers PPO |
$0.95
|
| Rate for Payer: TriWest Veterans Administration |
$0.84
|
| Rate for Payer: United Healthcare Commercial |
$1.10
|
| Rate for Payer: United Healthcare Medicare |
$0.84
|
| Rate for Payer: WINHealth Partners Commercial |
$1.21
|
| Rate for Payer: Wise Provider Network Commercial |
$1.21
|
|
|
ESCITALOPRAM 20 MG TABLET [25996]
|
Facility
|
OP
|
$1.27
|
|
|
Service Code
|
NDC 6808461811
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$1.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.24
|
| Rate for Payer: Aetna of WY Medicare |
$0.84
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1.22
|
| Rate for Payer: Altius Commercial |
$1.22
|
| Rate for Payer: Beech Street Commercial |
$1.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.04
|
| Rate for Payer: Cash Price |
$0.89
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.23
|
| Rate for Payer: Cigna of WY Commercial |
$1.24
|
| Rate for Payer: Entrust Commercial |
$1.21
|
| Rate for Payer: First Choice Health Commercial |
$1.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.74
|
| Rate for Payer: HealthUtah PPO |
$1.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.23
|
| Rate for Payer: Multiplan Medicare/VA |
$0.70
|
| Rate for Payer: One Health Plan of WY PPO |
$1.24
|
| Rate for Payer: PacificSource Commercial |
$1.14
|
| Rate for Payer: PHCS PPO |
$1.24
|
| Rate for Payer: Three Rivers PPO |
$0.95
|
| Rate for Payer: TriWest Veterans Administration |
$0.74
|
| Rate for Payer: United Healthcare Commercial |
$1.10
|
| Rate for Payer: United Healthcare Medicare |
$0.74
|
| Rate for Payer: WINHealth Partners Commercial |
$1.24
|
| Rate for Payer: Wise Provider Network Commercial |
$1.21
|
|
|
ESCITALOPRAM 5 MG TABLET [31381]
|
Facility
|
IP
|
$0.40
|
|
|
Service Code
|
NDC 6800159100
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.39
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.38
|
| Rate for Payer: Altius Commercial |
$0.38
|
| Rate for Payer: Beech Street Commercial |
$0.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.33
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.39
|
| Rate for Payer: Cigna of WY Commercial |
$0.39
|
| Rate for Payer: Entrust Commercial |
$0.38
|
| Rate for Payer: First Choice Health Commercial |
$0.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.26
|
| Rate for Payer: HealthUtah PPO |
$0.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.39
|
| Rate for Payer: Multiplan Medicare/VA |
$0.25
|
| Rate for Payer: One Health Plan of WY PPO |
$0.39
|
| Rate for Payer: PacificSource Commercial |
$0.36
|
| Rate for Payer: PHCS PPO |
$0.39
|
| Rate for Payer: Three Rivers PPO |
$0.30
|
| Rate for Payer: TriWest Veterans Administration |
$0.26
|
| Rate for Payer: United Healthcare Commercial |
$0.35
|
| Rate for Payer: United Healthcare Medicare |
$0.26
|
| Rate for Payer: WINHealth Partners Commercial |
$0.38
|
| Rate for Payer: Wise Provider Network Commercial |
$0.38
|
|
|
ESCITALOPRAM 5 MG TABLET [31381]
|
Facility
|
OP
|
$0.40
|
|
|
Service Code
|
NDC 6800159100
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.39
|
| Rate for Payer: Aetna of WY Medicare |
$0.26
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.38
|
| Rate for Payer: Altius Commercial |
$0.38
|
| Rate for Payer: Beech Street Commercial |
$0.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.33
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.39
|
| Rate for Payer: Cigna of WY Commercial |
$0.39
|
| Rate for Payer: Entrust Commercial |
$0.38
|
| Rate for Payer: First Choice Health Commercial |
$0.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.23
|
| Rate for Payer: HealthUtah PPO |
$0.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.39
|
| Rate for Payer: Multiplan Medicare/VA |
$0.22
|
| Rate for Payer: One Health Plan of WY PPO |
$0.39
|
| Rate for Payer: PacificSource Commercial |
$0.36
|
| Rate for Payer: PHCS PPO |
$0.39
|
| Rate for Payer: Three Rivers PPO |
$0.30
|
| Rate for Payer: TriWest Veterans Administration |
$0.23
|
| Rate for Payer: United Healthcare Commercial |
$0.35
|
| Rate for Payer: United Healthcare Medicare |
$0.23
|
| Rate for Payer: WINHealth Partners Commercial |
$0.39
|
| Rate for Payer: Wise Provider Network Commercial |
$0.38
|
|
|
ESMARK BANDAGE 4" STERILE
|
Facility
|
IP
|
$7.56
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$7.56 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.41
|
| Rate for Payer: Altius Auto/Workers Compensation |
$7.26
|
| Rate for Payer: Altius Commercial |
$7.26
|
| Rate for Payer: Beech Street Commercial |
$7.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.21
|
| Rate for Payer: Cash Price |
$5.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.33
|
| Rate for Payer: Cigna of WY Commercial |
$7.41
|
| Rate for Payer: Entrust Commercial |
$7.18
|
| Rate for Payer: First Choice Health Commercial |
$7.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.99
|
| Rate for Payer: HealthUtah PPO |
$7.56
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.33
|
| Rate for Payer: Multiplan Medicare/VA |
$4.74
|
| Rate for Payer: One Health Plan of WY PPO |
$7.41
|
| Rate for Payer: PacificSource Commercial |
$6.80
|
| Rate for Payer: PHCS PPO |
$7.41
|
| Rate for Payer: Three Rivers PPO |
$5.67
|
| Rate for Payer: TriWest Veterans Administration |
$4.99
|
| Rate for Payer: United Healthcare Commercial |
$6.58
|
| Rate for Payer: United Healthcare Medicare |
$4.99
|
| Rate for Payer: WINHealth Partners Commercial |
$7.18
|
| Rate for Payer: Wise Provider Network Commercial |
$7.18
|
|
|
ESMARK BANDAGE 4" STERILE
|
Facility
|
OP
|
$7.56
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.17 |
| Max. Negotiated Rate |
$7.56 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.41
|
| Rate for Payer: Aetna of WY Medicare |
$4.99
|
| Rate for Payer: Altius Auto/Workers Compensation |
$7.26
|
| Rate for Payer: Altius Commercial |
$7.26
|
| Rate for Payer: Beech Street Commercial |
$7.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.21
|
| Rate for Payer: Cash Price |
$5.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.33
|
| Rate for Payer: Cigna of WY Commercial |
$7.41
|
| Rate for Payer: Entrust Commercial |
$7.18
|
| Rate for Payer: First Choice Health Commercial |
$7.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.38
|
| Rate for Payer: HealthUtah PPO |
$7.56
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.33
|
| Rate for Payer: Multiplan Medicare/VA |
$4.17
|
| Rate for Payer: One Health Plan of WY PPO |
$7.41
|
| Rate for Payer: PacificSource Commercial |
$6.80
|
| Rate for Payer: PHCS PPO |
$7.41
|
| Rate for Payer: Three Rivers PPO |
$5.67
|
| Rate for Payer: TriWest Veterans Administration |
$4.38
|
| Rate for Payer: United Healthcare Commercial |
$6.58
|
| Rate for Payer: United Healthcare Medicare |
$4.38
|
| Rate for Payer: WINHealth Partners Commercial |
$7.41
|
| Rate for Payer: Wise Provider Network Commercial |
$7.18
|
|
|
ESMARK BANDAGE 6" STERILE
|
Facility
|
IP
|
$9.54
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.98 |
| Max. Negotiated Rate |
$9.54 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9.35
|
| Rate for Payer: Altius Auto/Workers Compensation |
$9.16
|
| Rate for Payer: Altius Commercial |
$9.16
|
| Rate for Payer: Beech Street Commercial |
$9.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.83
|
| Rate for Payer: Cash Price |
$6.68
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.25
|
| Rate for Payer: Cigna of WY Commercial |
$9.35
|
| Rate for Payer: Entrust Commercial |
$9.06
|
| Rate for Payer: First Choice Health Commercial |
$9.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.30
|
| Rate for Payer: HealthUtah PPO |
$9.54
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.25
|
| Rate for Payer: Multiplan Medicare/VA |
$5.98
|
| Rate for Payer: One Health Plan of WY PPO |
$9.35
|
| Rate for Payer: PacificSource Commercial |
$8.59
|
| Rate for Payer: PHCS PPO |
$9.35
|
| Rate for Payer: Three Rivers PPO |
$7.16
|
| Rate for Payer: TriWest Veterans Administration |
$6.30
|
| Rate for Payer: United Healthcare Commercial |
$8.30
|
| Rate for Payer: United Healthcare Medicare |
$6.30
|
| Rate for Payer: WINHealth Partners Commercial |
$9.06
|
| Rate for Payer: Wise Provider Network Commercial |
$9.06
|
|
|
ESMARK BANDAGE 6" STERILE
|
Facility
|
OP
|
$9.54
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.26 |
| Max. Negotiated Rate |
$9.54 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9.35
|
| Rate for Payer: Aetna of WY Medicare |
$6.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$9.16
|
| Rate for Payer: Altius Commercial |
$9.16
|
| Rate for Payer: Beech Street Commercial |
$9.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.83
|
| Rate for Payer: Cash Price |
$6.68
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.25
|
| Rate for Payer: Cigna of WY Commercial |
$9.35
|
| Rate for Payer: Entrust Commercial |
$9.06
|
| Rate for Payer: First Choice Health Commercial |
$9.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.53
|
| Rate for Payer: HealthUtah PPO |
$9.54
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.25
|
| Rate for Payer: Multiplan Medicare/VA |
$5.26
|
| Rate for Payer: One Health Plan of WY PPO |
$9.35
|
| Rate for Payer: PacificSource Commercial |
$8.59
|
| Rate for Payer: PHCS PPO |
$9.35
|
| Rate for Payer: Three Rivers PPO |
$7.16
|
| Rate for Payer: TriWest Veterans Administration |
$5.53
|
| Rate for Payer: United Healthcare Commercial |
$8.30
|
| Rate for Payer: United Healthcare Medicare |
$5.53
|
| Rate for Payer: WINHealth Partners Commercial |
$9.35
|
| Rate for Payer: Wise Provider Network Commercial |
$9.06
|
|
|
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION [10165]
|
Facility
|
IP
|
$16.76
|
|
|
Service Code
|
HCPCS J1805
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.51 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.42
|
| Rate for Payer: Altius Auto/Workers Compensation |
$16.09
|
| Rate for Payer: Altius Commercial |
$16.09
|
| Rate for Payer: Beech Street Commercial |
$16.42
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.76
|
| Rate for Payer: Cash Price |
$11.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.26
|
| Rate for Payer: Cigna of WY Commercial |
$16.42
|
| Rate for Payer: Entrust Commercial |
$15.92
|
| Rate for Payer: First Choice Health Commercial |
$15.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.06
|
| Rate for Payer: HealthUtah PPO |
$16.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.26
|
| Rate for Payer: Multiplan Medicare/VA |
$10.51
|
| Rate for Payer: One Health Plan of WY PPO |
$16.42
|
| Rate for Payer: PacificSource Commercial |
$15.08
|
| Rate for Payer: PHCS PPO |
$16.42
|
| Rate for Payer: Three Rivers PPO |
$12.57
|
| Rate for Payer: TriWest Veterans Administration |
$11.06
|
| Rate for Payer: United Healthcare Commercial |
$14.58
|
| Rate for Payer: United Healthcare Medicare |
$11.06
|
| Rate for Payer: WINHealth Partners Commercial |
$15.92
|
| Rate for Payer: Wise Provider Network Commercial |
$15.92
|
|
|
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION [10165]
|
Facility
|
OP
|
$16.76
|
|
|
Service Code
|
HCPCS J1805
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.42
|
| Rate for Payer: Aetna of WY Medicare |
$11.06
|
| Rate for Payer: Altius Auto/Workers Compensation |
$16.09
|
| Rate for Payer: Altius Commercial |
$16.09
|
| Rate for Payer: Beech Street Commercial |
$16.42
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.76
|
| Rate for Payer: Cash Price |
$11.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.26
|
| Rate for Payer: Cigna of WY Commercial |
$16.42
|
| Rate for Payer: Entrust Commercial |
$15.92
|
| Rate for Payer: First Choice Health Commercial |
$15.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.72
|
| Rate for Payer: HealthUtah PPO |
$16.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.26
|
| Rate for Payer: Multiplan Medicare/VA |
$9.23
|
| Rate for Payer: One Health Plan of WY PPO |
$16.42
|
| Rate for Payer: PacificSource Commercial |
$15.08
|
| Rate for Payer: PHCS PPO |
$16.42
|
| Rate for Payer: Three Rivers PPO |
$12.57
|
| Rate for Payer: TriWest Veterans Administration |
$9.72
|
| Rate for Payer: United Healthcare Commercial |
$14.58
|
| Rate for Payer: United Healthcare Medicare |
$9.72
|
| Rate for Payer: WINHealth Partners Commercial |
$16.42
|
| Rate for Payer: Wise Provider Network Commercial |
$15.92
|
|
|
ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$1,000.00
|
|
|
Service Code
|
HCPCS 43235
|
| Hospital Charge Code |
43235
|
| Min. Negotiated Rate |
$99.14 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$980.00
|
| Rate for Payer: Aetna of WY Medicare |
$116.64
|
| Rate for Payer: Beech Street Commercial |
$950.00
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$970.00
|
| Rate for Payer: Cigna of WY Commercial |
$980.00
|
| Rate for Payer: First Choice Health Commercial |
$900.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$950.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$116.64
|
| Rate for Payer: HealthUtah PPO |
$1,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$970.00
|
| Rate for Payer: Multiplan Medicare/VA |
$99.14
|
| Rate for Payer: One Health Plan of WY PPO |
$980.00
|
| Rate for Payer: PacificSource Commercial |
$900.00
|
| Rate for Payer: PHCS PPO |
$950.00
|
| Rate for Payer: Three Rivers PPO |
$750.00
|
| Rate for Payer: TriWest Veterans Administration |
$116.64
|
| Rate for Payer: United Healthcare Commercial |
$870.00
|
| Rate for Payer: United Healthcare Medicare |
$116.64
|
| Rate for Payer: WINHealth Partners Commercial |
$850.00
|
|
|
ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM
|
Professional
|
Both
|
$3,110.00
|
|
|
Service Code
|
HCPCS 43220
|
| Hospital Charge Code |
43220
|
| Min. Negotiated Rate |
$95.46 |
| Max. Negotiated Rate |
$3,110.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,047.80
|
| Rate for Payer: Aetna of WY Medicare |
$112.30
|
| Rate for Payer: Beech Street Commercial |
$2,954.50
|
| Rate for Payer: Cash Price |
$2,177.00
|
| Rate for Payer: Cash Price |
$2,177.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,016.70
|
| Rate for Payer: Cigna of WY Commercial |
$3,047.80
|
| Rate for Payer: First Choice Health Commercial |
$2,799.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,954.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$112.30
|
| Rate for Payer: HealthUtah PPO |
$3,110.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,016.70
|
| Rate for Payer: Multiplan Medicare/VA |
$95.46
|
| Rate for Payer: One Health Plan of WY PPO |
$3,047.80
|
| Rate for Payer: PacificSource Commercial |
$2,799.00
|
| Rate for Payer: PHCS PPO |
$2,954.50
|
| Rate for Payer: Three Rivers PPO |
$2,332.50
|
| Rate for Payer: TriWest Veterans Administration |
$112.30
|
| Rate for Payer: United Healthcare Commercial |
$2,705.70
|
| Rate for Payer: United Healthcare Medicare |
$112.30
|
| Rate for Payer: WINHealth Partners Commercial |
$2,643.50
|
|
|
ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,361.00
|
|
|
Service Code
|
HCPCS 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$113.86 |
| Max. Negotiated Rate |
$1,361.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,333.78
|
| Rate for Payer: Aetna of WY Medicare |
$133.95
|
| Rate for Payer: Beech Street Commercial |
$1,292.95
|
| Rate for Payer: Cash Price |
$952.70
|
| Rate for Payer: Cash Price |
$952.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,320.17
|
| Rate for Payer: Cigna of WY Commercial |
$1,333.78
|
| Rate for Payer: First Choice Health Commercial |
$1,224.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,292.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$133.95
|
| Rate for Payer: HealthUtah PPO |
$1,361.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,320.17
|
| Rate for Payer: Multiplan Medicare/VA |
$113.86
|
| Rate for Payer: One Health Plan of WY PPO |
$1,333.78
|
| Rate for Payer: PacificSource Commercial |
$1,224.90
|
| Rate for Payer: PHCS PPO |
$1,292.95
|
| Rate for Payer: Three Rivers PPO |
$1,020.75
|
| Rate for Payer: TriWest Veterans Administration |
$133.95
|
| Rate for Payer: United Healthcare Commercial |
$1,184.07
|
| Rate for Payer: United Healthcare Medicare |
$133.95
|
| Rate for Payer: WINHealth Partners Commercial |
$1,156.85
|
|
|
ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$1,829.00
|
|
|
Service Code
|
HCPCS 43200
|
| Hospital Charge Code |
43200
|
| Min. Negotiated Rate |
$71.32 |
| Max. Negotiated Rate |
$1,829.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,792.42
|
| Rate for Payer: Aetna of WY Medicare |
$83.91
|
| Rate for Payer: Beech Street Commercial |
$1,737.55
|
| Rate for Payer: Cash Price |
$1,280.30
|
| Rate for Payer: Cash Price |
$1,280.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,774.13
|
| Rate for Payer: Cigna of WY Commercial |
$1,792.42
|
| Rate for Payer: First Choice Health Commercial |
$1,646.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,737.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.91
|
| Rate for Payer: HealthUtah PPO |
$1,829.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,774.13
|
| Rate for Payer: Multiplan Medicare/VA |
$71.32
|
| Rate for Payer: One Health Plan of WY PPO |
$1,792.42
|
| Rate for Payer: PacificSource Commercial |
$1,646.10
|
| Rate for Payer: PHCS PPO |
$1,737.55
|
| Rate for Payer: Three Rivers PPO |
$1,371.75
|
| Rate for Payer: TriWest Veterans Administration |
$83.91
|
| Rate for Payer: United Healthcare Commercial |
$1,591.23
|
| Rate for Payer: United Healthcare Medicare |
$83.91
|
| Rate for Payer: WINHealth Partners Commercial |
$1,554.65
|
|
|
ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$1,447.00
|
|
|
Service Code
|
HCPCS 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$1,447.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,418.06
|
| Rate for Payer: Aetna of WY Medicare |
$98.23
|
| Rate for Payer: Beech Street Commercial |
$1,374.65
|
| Rate for Payer: Cash Price |
$1,012.90
|
| Rate for Payer: Cash Price |
$1,012.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,403.59
|
| Rate for Payer: Cigna of WY Commercial |
$1,418.06
|
| Rate for Payer: First Choice Health Commercial |
$1,302.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,374.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$98.23
|
| Rate for Payer: HealthUtah PPO |
$1,447.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,403.59
|
| Rate for Payer: Multiplan Medicare/VA |
$83.50
|
| Rate for Payer: One Health Plan of WY PPO |
$1,418.06
|
| Rate for Payer: PacificSource Commercial |
$1,302.30
|
| Rate for Payer: PHCS PPO |
$1,374.65
|
| Rate for Payer: Three Rivers PPO |
$1,085.25
|
| Rate for Payer: TriWest Veterans Administration |
$98.23
|
| Rate for Payer: United Healthcare Commercial |
$1,258.89
|
| Rate for Payer: United Healthcare Medicare |
$98.23
|
| Rate for Payer: WINHealth Partners Commercial |
$1,229.95
|
|
|
ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION
|
Professional
|
Both
|
$945.00
|
|
|
Service Code
|
HCPCS 43195
|
| Hospital Charge Code |
43195
|
| Min. Negotiated Rate |
$150.93 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$926.10
|
| Rate for Payer: Aetna of WY Medicare |
$177.56
|
| Rate for Payer: Beech Street Commercial |
$897.75
|
| Rate for Payer: Cash Price |
$661.50
|
| Rate for Payer: Cash Price |
$661.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$916.65
|
| Rate for Payer: Cigna of WY Commercial |
$926.10
|
| Rate for Payer: First Choice Health Commercial |
$850.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$897.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$177.56
|
| Rate for Payer: HealthUtah PPO |
$945.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$916.65
|
| Rate for Payer: Multiplan Medicare/VA |
$150.93
|
| Rate for Payer: One Health Plan of WY PPO |
$926.10
|
| Rate for Payer: PacificSource Commercial |
$850.50
|
| Rate for Payer: PHCS PPO |
$897.75
|
| Rate for Payer: Three Rivers PPO |
$708.75
|
| Rate for Payer: TriWest Veterans Administration |
$177.56
|
| Rate for Payer: United Healthcare Commercial |
$822.15
|
| Rate for Payer: United Healthcare Medicare |
$177.56
|
| Rate for Payer: WINHealth Partners Commercial |
$803.25
|
|
|
ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH
|
Professional
|
Both
|
$542.00
|
|
|
Service Code
|
HCPCS 43191
|
| Hospital Charge Code |
43191
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$542.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$531.16
|
| Rate for Payer: Aetna of WY Medicare |
$149.34
|
| Rate for Payer: Beech Street Commercial |
$514.90
|
| Rate for Payer: Cash Price |
$379.40
|
| Rate for Payer: Cash Price |
$379.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$525.74
|
| Rate for Payer: Cigna of WY Commercial |
$531.16
|
| Rate for Payer: First Choice Health Commercial |
$487.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$514.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$149.34
|
| Rate for Payer: HealthUtah PPO |
$542.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$525.74
|
| Rate for Payer: Multiplan Medicare/VA |
$126.94
|
| Rate for Payer: One Health Plan of WY PPO |
$531.16
|
| Rate for Payer: PacificSource Commercial |
$487.80
|
| Rate for Payer: PHCS PPO |
$514.90
|
| Rate for Payer: Three Rivers PPO |
$406.50
|
| Rate for Payer: TriWest Veterans Administration |
$149.34
|
| Rate for Payer: United Healthcare Commercial |
$471.54
|
| Rate for Payer: United Healthcare Medicare |
$149.34
|
| Rate for Payer: WINHealth Partners Commercial |
$460.70
|
|
|
ESOPH PROBE TEMP 12FR 81040412
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Aetna of WY Medicare |
$3.94
|
| Rate for Payer: Altius Auto/Workers Compensation |
$5.73
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.90
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.46
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.29
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.46
|
| Rate for Payer: United Healthcare Commercial |
$5.19
|
| Rate for Payer: United Healthcare Medicare |
$3.46
|
| Rate for Payer: WINHealth Partners Commercial |
$5.85
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
ESOPH PROBE TEMP 12FR 81040412
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Altius Auto/Workers Compensation |
$5.73
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.90
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.94
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.74
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.94
|
| Rate for Payer: United Healthcare Commercial |
$5.19
|
| Rate for Payer: United Healthcare Medicare |
$3.94
|
| Rate for Payer: WINHealth Partners Commercial |
$5.67
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
ESOPH PROBE W/ TEMP 18 FR
|
Facility
|
OP
|
$11.93
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$11.93 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.69
|
| Rate for Payer: Aetna of WY Medicare |
$7.87
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.45
|
| Rate for Payer: Altius Commercial |
$11.45
|
| Rate for Payer: Beech Street Commercial |
$11.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.79
|
| Rate for Payer: Cash Price |
$8.35
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.57
|
| Rate for Payer: Cigna of WY Commercial |
$11.69
|
| Rate for Payer: Entrust Commercial |
$11.33
|
| Rate for Payer: First Choice Health Commercial |
$11.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.92
|
| Rate for Payer: HealthUtah PPO |
$11.93
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.57
|
| Rate for Payer: Multiplan Medicare/VA |
$6.57
|
| Rate for Payer: One Health Plan of WY PPO |
$11.69
|
| Rate for Payer: PacificSource Commercial |
$10.74
|
| Rate for Payer: PHCS PPO |
$11.69
|
| Rate for Payer: Three Rivers PPO |
$8.95
|
| Rate for Payer: TriWest Veterans Administration |
$6.92
|
| Rate for Payer: United Healthcare Commercial |
$10.38
|
| Rate for Payer: United Healthcare Medicare |
$6.92
|
| Rate for Payer: WINHealth Partners Commercial |
$11.69
|
| Rate for Payer: Wise Provider Network Commercial |
$11.33
|
|
|
ESOPH PROBE W/ TEMP 18 FR
|
Facility
|
IP
|
$11.93
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$11.93 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.69
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.45
|
| Rate for Payer: Altius Commercial |
$11.45
|
| Rate for Payer: Beech Street Commercial |
$11.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.79
|
| Rate for Payer: Cash Price |
$8.35
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.57
|
| Rate for Payer: Cigna of WY Commercial |
$11.69
|
| Rate for Payer: Entrust Commercial |
$11.33
|
| Rate for Payer: First Choice Health Commercial |
$11.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.87
|
| Rate for Payer: HealthUtah PPO |
$11.93
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.57
|
| Rate for Payer: Multiplan Medicare/VA |
$7.48
|
| Rate for Payer: One Health Plan of WY PPO |
$11.69
|
| Rate for Payer: PacificSource Commercial |
$10.74
|
| Rate for Payer: PHCS PPO |
$11.69
|
| Rate for Payer: Three Rivers PPO |
$8.95
|
| Rate for Payer: TriWest Veterans Administration |
$7.87
|
| Rate for Payer: United Healthcare Commercial |
$10.38
|
| Rate for Payer: United Healthcare Medicare |
$7.87
|
| Rate for Payer: WINHealth Partners Commercial |
$11.33
|
| Rate for Payer: Wise Provider Network Commercial |
$11.33
|
|
|
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM [17652]
|
Facility
|
IP
|
$9.60
|
|
|
Service Code
|
NDC 0093354143
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9.41
|
| Rate for Payer: Altius Auto/Workers Compensation |
$9.22
|
| Rate for Payer: Altius Commercial |
$9.22
|
| Rate for Payer: Beech Street Commercial |
$9.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.88
|
| Rate for Payer: Cash Price |
$6.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.31
|
| Rate for Payer: Cigna of WY Commercial |
$9.41
|
| Rate for Payer: Entrust Commercial |
$9.12
|
| Rate for Payer: First Choice Health Commercial |
$9.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.34
|
| Rate for Payer: HealthUtah PPO |
$9.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.31
|
| Rate for Payer: Multiplan Medicare/VA |
$6.02
|
| Rate for Payer: One Health Plan of WY PPO |
$9.41
|
| Rate for Payer: PacificSource Commercial |
$8.64
|
| Rate for Payer: PHCS PPO |
$9.41
|
| Rate for Payer: Three Rivers PPO |
$7.20
|
| Rate for Payer: TriWest Veterans Administration |
$6.34
|
| Rate for Payer: United Healthcare Commercial |
$8.35
|
| Rate for Payer: United Healthcare Medicare |
$6.34
|
| Rate for Payer: WINHealth Partners Commercial |
$9.12
|
| Rate for Payer: Wise Provider Network Commercial |
$9.12
|
|
|
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM [17652]
|
Facility
|
OP
|
$9.60
|
|
|
Service Code
|
NDC 0093354143
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9.41
|
| Rate for Payer: Aetna of WY Medicare |
$6.34
|
| Rate for Payer: Altius Auto/Workers Compensation |
$9.22
|
| Rate for Payer: Altius Commercial |
$9.22
|
| Rate for Payer: Beech Street Commercial |
$9.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.88
|
| Rate for Payer: Cash Price |
$6.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.31
|
| Rate for Payer: Cigna of WY Commercial |
$9.41
|
| Rate for Payer: Entrust Commercial |
$9.12
|
| Rate for Payer: First Choice Health Commercial |
$9.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.57
|
| Rate for Payer: HealthUtah PPO |
$9.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.31
|
| Rate for Payer: Multiplan Medicare/VA |
$5.29
|
| Rate for Payer: One Health Plan of WY PPO |
$9.41
|
| Rate for Payer: PacificSource Commercial |
$8.64
|
| Rate for Payer: PHCS PPO |
$9.41
|
| Rate for Payer: Three Rivers PPO |
$7.20
|
| Rate for Payer: TriWest Veterans Administration |
$5.57
|
| Rate for Payer: United Healthcare Commercial |
$8.35
|
| Rate for Payer: United Healthcare Medicare |
$5.57
|
| Rate for Payer: WINHealth Partners Commercial |
$9.41
|
| Rate for Payer: Wise Provider Network Commercial |
$9.12
|
|
|
ESTRADIOL 1 MG TABLET [10391]
|
Facility
|
OP
|
$0.35
|
|
|
Service Code
|
NDC 4280608801
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$0.35 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.34
|
| Rate for Payer: Aetna of WY Medicare |
$0.23
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.34
|
| Rate for Payer: Altius Commercial |
$0.34
|
| Rate for Payer: Beech Street Commercial |
$0.34
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.29
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.34
|
| Rate for Payer: Cigna of WY Commercial |
$0.34
|
| Rate for Payer: Entrust Commercial |
$0.33
|
| Rate for Payer: First Choice Health Commercial |
$0.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.20
|
| Rate for Payer: HealthUtah PPO |
$0.35
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.34
|
| Rate for Payer: Multiplan Medicare/VA |
$0.19
|
| Rate for Payer: One Health Plan of WY PPO |
$0.34
|
| Rate for Payer: PacificSource Commercial |
$0.32
|
| Rate for Payer: PHCS PPO |
$0.34
|
| Rate for Payer: Three Rivers PPO |
$0.26
|
| Rate for Payer: TriWest Veterans Administration |
$0.20
|
| Rate for Payer: United Healthcare Commercial |
$0.30
|
| Rate for Payer: United Healthcare Medicare |
$0.20
|
| Rate for Payer: WINHealth Partners Commercial |
$0.34
|
| Rate for Payer: Wise Provider Network Commercial |
$0.33
|
|
