|
DRILL BIT 11.5 CAN AR-1218-115
|
Facility
|
IP
|
$682.50
|
|
| Hospital Charge Code |
3003819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.51 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$668.85
|
| Rate for Payer: Aetna of WY Medicare |
$436.80
|
| Rate for Payer: Altius Commercial |
$655.20
|
| Rate for Payer: Beech Street Commercial |
$668.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$662.02
|
| Rate for Payer: Cash Price |
$477.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$662.02
|
| Rate for Payer: Cigna of WY Commercial |
$668.85
|
| Rate for Payer: Entrust Commercial |
$648.38
|
| Rate for Payer: First Choice Health Commercial |
$648.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$648.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$416.32
|
| Rate for Payer: HealthUtah PPO |
$682.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$662.02
|
| Rate for Payer: Multiplan Medicare/VA |
$395.51
|
| Rate for Payer: One Health Plan of WY PPO |
$668.85
|
| Rate for Payer: PacificSource Commercial |
$614.25
|
| Rate for Payer: PHCS PPO |
$668.85
|
| Rate for Payer: Three Rivers PPO |
$511.88
|
| Rate for Payer: TriWest Veterans Administration |
$416.32
|
| Rate for Payer: United Healthcare Commercial |
$651.79
|
| Rate for Payer: United Healthcare Medicare |
$416.32
|
| Rate for Payer: WINHealth Partners Commercial |
$648.38
|
| Rate for Payer: Wise Provider Network Commercial |
$648.38
|
|
|
DRILL BIT 1.1MM FAST
|
Facility
|
IP
|
$227.50
|
|
| Hospital Charge Code |
3002951
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.84 |
| Max. Negotiated Rate |
$227.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$222.95
|
| Rate for Payer: Aetna of WY Medicare |
$145.60
|
| Rate for Payer: Altius Commercial |
$218.40
|
| Rate for Payer: Beech Street Commercial |
$222.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$220.68
|
| Rate for Payer: Cash Price |
$159.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$220.68
|
| Rate for Payer: Cigna of WY Commercial |
$222.95
|
| Rate for Payer: Entrust Commercial |
$216.12
|
| Rate for Payer: First Choice Health Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$138.78
|
| Rate for Payer: HealthUtah PPO |
$227.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$220.68
|
| Rate for Payer: Multiplan Medicare/VA |
$131.84
|
| Rate for Payer: One Health Plan of WY PPO |
$222.95
|
| Rate for Payer: PacificSource Commercial |
$204.75
|
| Rate for Payer: PHCS PPO |
$222.95
|
| Rate for Payer: Three Rivers PPO |
$170.62
|
| Rate for Payer: TriWest Veterans Administration |
$138.78
|
| Rate for Payer: United Healthcare Commercial |
$217.26
|
| Rate for Payer: United Healthcare Medicare |
$138.78
|
| Rate for Payer: WINHealth Partners Commercial |
$216.12
|
| Rate for Payer: Wise Provider Network Commercial |
$216.12
|
|
|
DRILL BIT 1.1MM FAST
|
Facility
|
OP
|
$227.50
|
|
| Hospital Charge Code |
3002951
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.19 |
| Max. Negotiated Rate |
$227.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$222.95
|
| Rate for Payer: Aetna of WY Medicare |
$150.15
|
| Rate for Payer: Altius Commercial |
$218.40
|
| Rate for Payer: Beech Street Commercial |
$222.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$220.68
|
| Rate for Payer: Cash Price |
$159.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$220.68
|
| Rate for Payer: Cigna of WY Commercial |
$222.95
|
| Rate for Payer: Entrust Commercial |
$216.12
|
| Rate for Payer: First Choice Health Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$129.68
|
| Rate for Payer: HealthUtah PPO |
$227.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$220.68
|
| Rate for Payer: Multiplan Medicare/VA |
$123.19
|
| Rate for Payer: One Health Plan of WY PPO |
$222.95
|
| Rate for Payer: PacificSource Commercial |
$204.75
|
| Rate for Payer: PHCS PPO |
$222.95
|
| Rate for Payer: Three Rivers PPO |
$170.62
|
| Rate for Payer: TriWest Veterans Administration |
$129.68
|
| Rate for Payer: United Healthcare Commercial |
$217.26
|
| Rate for Payer: United Healthcare Medicare |
$129.68
|
| Rate for Payer: WINHealth Partners Commercial |
$222.95
|
| Rate for Payer: Wise Provider Network Commercial |
$216.12
|
|
|
DRILL BIT 1.1X60MM QC
|
Facility
|
IP
|
$208.25
|
|
| Hospital Charge Code |
2650879
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.68 |
| Max. Negotiated Rate |
$208.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$204.08
|
| Rate for Payer: Aetna of WY Medicare |
$133.28
|
| Rate for Payer: Altius Commercial |
$199.92
|
| Rate for Payer: Beech Street Commercial |
$204.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$202.00
|
| Rate for Payer: Cash Price |
$145.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$202.00
|
| Rate for Payer: Cigna of WY Commercial |
$204.08
|
| Rate for Payer: Entrust Commercial |
$197.84
|
| Rate for Payer: First Choice Health Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$127.03
|
| Rate for Payer: HealthUtah PPO |
$208.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$202.00
|
| Rate for Payer: Multiplan Medicare/VA |
$120.68
|
| Rate for Payer: One Health Plan of WY PPO |
$204.08
|
| Rate for Payer: PacificSource Commercial |
$187.42
|
| Rate for Payer: PHCS PPO |
$204.08
|
| Rate for Payer: Three Rivers PPO |
$156.19
|
| Rate for Payer: TriWest Veterans Administration |
$127.03
|
| Rate for Payer: United Healthcare Commercial |
$198.88
|
| Rate for Payer: United Healthcare Medicare |
$127.03
|
| Rate for Payer: WINHealth Partners Commercial |
$197.84
|
| Rate for Payer: Wise Provider Network Commercial |
$197.84
|
|
|
DRILL BIT 1.1X60MM QC
|
Facility
|
OP
|
$208.25
|
|
| Hospital Charge Code |
2650879
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.77 |
| Max. Negotiated Rate |
$208.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$204.08
|
| Rate for Payer: Aetna of WY Medicare |
$137.44
|
| Rate for Payer: Altius Commercial |
$199.92
|
| Rate for Payer: Beech Street Commercial |
$204.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$202.00
|
| Rate for Payer: Cash Price |
$145.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$202.00
|
| Rate for Payer: Cigna of WY Commercial |
$204.08
|
| Rate for Payer: Entrust Commercial |
$197.84
|
| Rate for Payer: First Choice Health Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$118.70
|
| Rate for Payer: HealthUtah PPO |
$208.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$202.00
|
| Rate for Payer: Multiplan Medicare/VA |
$112.77
|
| Rate for Payer: One Health Plan of WY PPO |
$204.08
|
| Rate for Payer: PacificSource Commercial |
$187.42
|
| Rate for Payer: PHCS PPO |
$204.08
|
| Rate for Payer: Three Rivers PPO |
$156.19
|
| Rate for Payer: TriWest Veterans Administration |
$118.70
|
| Rate for Payer: United Healthcare Commercial |
$198.88
|
| Rate for Payer: United Healthcare Medicare |
$118.70
|
| Rate for Payer: WINHealth Partners Commercial |
$204.08
|
| Rate for Payer: Wise Provider Network Commercial |
$197.84
|
|
|
DRILL BIT 12MM TRANSOM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
2800179
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$224.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$213.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$202.82
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$213.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$213.50
|
| Rate for Payer: WINHealth Partners Commercial |
$332.50
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 12MM TRANSOM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
2800179
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$231.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$199.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$189.52
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$199.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$199.50
|
| Rate for Payer: WINHealth Partners Commercial |
$343.00
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 1.3MM MINI-QUICK CON
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
3003657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$231.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$199.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$189.52
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$199.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$199.50
|
| Rate for Payer: WINHealth Partners Commercial |
$343.00
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 1.3MM MINI-QUICK CON
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
3003657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$224.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$213.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$202.82
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$213.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$213.50
|
| Rate for Payer: WINHealth Partners Commercial |
$332.50
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 14MM TRANSOM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
2800445
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$224.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$213.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$202.82
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$213.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$213.50
|
| Rate for Payer: WINHealth Partners Commercial |
$332.50
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 14MM TRANSOM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
2800445
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$231.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$199.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$189.52
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$199.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$199.50
|
| Rate for Payer: WINHealth Partners Commercial |
$343.00
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 1.4 X 1.5MM
|
Facility
|
OP
|
$492.24
|
|
| Hospital Charge Code |
3100108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$266.55 |
| Max. Negotiated Rate |
$492.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$482.40
|
| Rate for Payer: Aetna of WY Medicare |
$324.88
|
| Rate for Payer: Altius Commercial |
$472.55
|
| Rate for Payer: Beech Street Commercial |
$482.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$477.47
|
| Rate for Payer: Cash Price |
$344.57
|
| Rate for Payer: ChoiceCare Network Commercial |
$477.47
|
| Rate for Payer: Cigna of WY Commercial |
$482.40
|
| Rate for Payer: Entrust Commercial |
$467.63
|
| Rate for Payer: First Choice Health Commercial |
$467.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$467.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$280.58
|
| Rate for Payer: HealthUtah PPO |
$492.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$477.47
|
| Rate for Payer: Multiplan Medicare/VA |
$266.55
|
| Rate for Payer: One Health Plan of WY PPO |
$482.40
|
| Rate for Payer: PacificSource Commercial |
$443.02
|
| Rate for Payer: PHCS PPO |
$482.40
|
| Rate for Payer: Three Rivers PPO |
$369.18
|
| Rate for Payer: TriWest Veterans Administration |
$280.58
|
| Rate for Payer: United Healthcare Commercial |
$470.09
|
| Rate for Payer: United Healthcare Medicare |
$280.58
|
| Rate for Payer: WINHealth Partners Commercial |
$482.40
|
| Rate for Payer: Wise Provider Network Commercial |
$467.63
|
|
|
DRILL BIT 1.4 X 1.5MM
|
Facility
|
IP
|
$492.24
|
|
| Hospital Charge Code |
3100108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$285.25 |
| Max. Negotiated Rate |
$492.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$482.40
|
| Rate for Payer: Aetna of WY Medicare |
$315.03
|
| Rate for Payer: Altius Commercial |
$472.55
|
| Rate for Payer: Beech Street Commercial |
$482.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$477.47
|
| Rate for Payer: Cash Price |
$344.57
|
| Rate for Payer: ChoiceCare Network Commercial |
$477.47
|
| Rate for Payer: Cigna of WY Commercial |
$482.40
|
| Rate for Payer: Entrust Commercial |
$467.63
|
| Rate for Payer: First Choice Health Commercial |
$467.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$467.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$300.27
|
| Rate for Payer: HealthUtah PPO |
$492.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$477.47
|
| Rate for Payer: Multiplan Medicare/VA |
$285.25
|
| Rate for Payer: One Health Plan of WY PPO |
$482.40
|
| Rate for Payer: PacificSource Commercial |
$443.02
|
| Rate for Payer: PHCS PPO |
$482.40
|
| Rate for Payer: Three Rivers PPO |
$369.18
|
| Rate for Payer: TriWest Veterans Administration |
$300.27
|
| Rate for Payer: United Healthcare Commercial |
$470.09
|
| Rate for Payer: United Healthcare Medicare |
$300.27
|
| Rate for Payer: WINHealth Partners Commercial |
$467.63
|
| Rate for Payer: Wise Provider Network Commercial |
$467.63
|
|
|
DRILL BIT 1.4 X 27 AO
|
Facility
|
OP
|
$271.42
|
|
| Hospital Charge Code |
3100165
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.97 |
| Max. Negotiated Rate |
$271.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$265.99
|
| Rate for Payer: Aetna of WY Medicare |
$179.14
|
| Rate for Payer: Altius Commercial |
$260.56
|
| Rate for Payer: Beech Street Commercial |
$265.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$263.28
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$263.28
|
| Rate for Payer: Cigna of WY Commercial |
$265.99
|
| Rate for Payer: Entrust Commercial |
$257.85
|
| Rate for Payer: First Choice Health Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$154.71
|
| Rate for Payer: HealthUtah PPO |
$271.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$263.28
|
| Rate for Payer: Multiplan Medicare/VA |
$146.97
|
| Rate for Payer: One Health Plan of WY PPO |
$265.99
|
| Rate for Payer: PacificSource Commercial |
$244.28
|
| Rate for Payer: PHCS PPO |
$265.99
|
| Rate for Payer: Three Rivers PPO |
$203.56
|
| Rate for Payer: TriWest Veterans Administration |
$154.71
|
| Rate for Payer: United Healthcare Commercial |
$259.21
|
| Rate for Payer: United Healthcare Medicare |
$154.71
|
| Rate for Payer: WINHealth Partners Commercial |
$265.99
|
| Rate for Payer: Wise Provider Network Commercial |
$257.85
|
|
|
DRILL BIT 1.4 X 27 AO
|
Facility
|
IP
|
$271.42
|
|
| Hospital Charge Code |
3100165
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$157.29 |
| Max. Negotiated Rate |
$271.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$265.99
|
| Rate for Payer: Aetna of WY Medicare |
$173.71
|
| Rate for Payer: Altius Commercial |
$260.56
|
| Rate for Payer: Beech Street Commercial |
$265.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$263.28
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$263.28
|
| Rate for Payer: Cigna of WY Commercial |
$265.99
|
| Rate for Payer: Entrust Commercial |
$257.85
|
| Rate for Payer: First Choice Health Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.57
|
| Rate for Payer: HealthUtah PPO |
$271.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$263.28
|
| Rate for Payer: Multiplan Medicare/VA |
$157.29
|
| Rate for Payer: One Health Plan of WY PPO |
$265.99
|
| Rate for Payer: PacificSource Commercial |
$244.28
|
| Rate for Payer: PHCS PPO |
$265.99
|
| Rate for Payer: Three Rivers PPO |
$203.56
|
| Rate for Payer: TriWest Veterans Administration |
$165.57
|
| Rate for Payer: United Healthcare Commercial |
$259.21
|
| Rate for Payer: United Healthcare Medicare |
$165.57
|
| Rate for Payer: WINHealth Partners Commercial |
$257.85
|
| Rate for Payer: Wise Provider Network Commercial |
$257.85
|
|
|
DRILL BIT 1.4 X 27MM
|
Facility
|
OP
|
$271.42
|
|
| Hospital Charge Code |
3100160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.97 |
| Max. Negotiated Rate |
$271.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$265.99
|
| Rate for Payer: Aetna of WY Medicare |
$179.14
|
| Rate for Payer: Altius Commercial |
$260.56
|
| Rate for Payer: Beech Street Commercial |
$265.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$263.28
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$263.28
|
| Rate for Payer: Cigna of WY Commercial |
$265.99
|
| Rate for Payer: Entrust Commercial |
$257.85
|
| Rate for Payer: First Choice Health Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$154.71
|
| Rate for Payer: HealthUtah PPO |
$271.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$263.28
|
| Rate for Payer: Multiplan Medicare/VA |
$146.97
|
| Rate for Payer: One Health Plan of WY PPO |
$265.99
|
| Rate for Payer: PacificSource Commercial |
$244.28
|
| Rate for Payer: PHCS PPO |
$265.99
|
| Rate for Payer: Three Rivers PPO |
$203.56
|
| Rate for Payer: TriWest Veterans Administration |
$154.71
|
| Rate for Payer: United Healthcare Commercial |
$259.21
|
| Rate for Payer: United Healthcare Medicare |
$154.71
|
| Rate for Payer: WINHealth Partners Commercial |
$265.99
|
| Rate for Payer: Wise Provider Network Commercial |
$257.85
|
|
|
DRILL BIT 1.4 X 27MM
|
Facility
|
IP
|
$271.42
|
|
| Hospital Charge Code |
3100160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$157.29 |
| Max. Negotiated Rate |
$271.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$265.99
|
| Rate for Payer: Aetna of WY Medicare |
$173.71
|
| Rate for Payer: Altius Commercial |
$260.56
|
| Rate for Payer: Beech Street Commercial |
$265.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$263.28
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$263.28
|
| Rate for Payer: Cigna of WY Commercial |
$265.99
|
| Rate for Payer: Entrust Commercial |
$257.85
|
| Rate for Payer: First Choice Health Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$257.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.57
|
| Rate for Payer: HealthUtah PPO |
$271.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$263.28
|
| Rate for Payer: Multiplan Medicare/VA |
$157.29
|
| Rate for Payer: One Health Plan of WY PPO |
$265.99
|
| Rate for Payer: PacificSource Commercial |
$244.28
|
| Rate for Payer: PHCS PPO |
$265.99
|
| Rate for Payer: Three Rivers PPO |
$203.56
|
| Rate for Payer: TriWest Veterans Administration |
$165.57
|
| Rate for Payer: United Healthcare Commercial |
$259.21
|
| Rate for Payer: United Healthcare Medicare |
$165.57
|
| Rate for Payer: WINHealth Partners Commercial |
$257.85
|
| Rate for Payer: Wise Provider Network Commercial |
$257.85
|
|
|
DRILL BIT 1.5MM MINI-QUICK CON
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
3003658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$231.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$199.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$189.52
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$199.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$199.50
|
| Rate for Payer: WINHealth Partners Commercial |
$343.00
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 1.5MM MINI-QUICK CON
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
3003658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$224.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$213.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$202.82
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$213.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$213.50
|
| Rate for Payer: WINHealth Partners Commercial |
$332.50
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 1.5X85MM QC
|
Facility
|
OP
|
$208.25
|
|
| Hospital Charge Code |
2650880
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.77 |
| Max. Negotiated Rate |
$208.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$204.08
|
| Rate for Payer: Aetna of WY Medicare |
$137.44
|
| Rate for Payer: Altius Commercial |
$199.92
|
| Rate for Payer: Beech Street Commercial |
$204.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$202.00
|
| Rate for Payer: Cash Price |
$145.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$202.00
|
| Rate for Payer: Cigna of WY Commercial |
$204.08
|
| Rate for Payer: Entrust Commercial |
$197.84
|
| Rate for Payer: First Choice Health Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$118.70
|
| Rate for Payer: HealthUtah PPO |
$208.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$202.00
|
| Rate for Payer: Multiplan Medicare/VA |
$112.77
|
| Rate for Payer: One Health Plan of WY PPO |
$204.08
|
| Rate for Payer: PacificSource Commercial |
$187.42
|
| Rate for Payer: PHCS PPO |
$204.08
|
| Rate for Payer: Three Rivers PPO |
$156.19
|
| Rate for Payer: TriWest Veterans Administration |
$118.70
|
| Rate for Payer: United Healthcare Commercial |
$198.88
|
| Rate for Payer: United Healthcare Medicare |
$118.70
|
| Rate for Payer: WINHealth Partners Commercial |
$204.08
|
| Rate for Payer: Wise Provider Network Commercial |
$197.84
|
|
|
DRILL BIT 1.5X85MM QC
|
Facility
|
IP
|
$208.25
|
|
| Hospital Charge Code |
2650880
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.68 |
| Max. Negotiated Rate |
$208.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$204.08
|
| Rate for Payer: Aetna of WY Medicare |
$133.28
|
| Rate for Payer: Altius Commercial |
$199.92
|
| Rate for Payer: Beech Street Commercial |
$204.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$202.00
|
| Rate for Payer: Cash Price |
$145.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$202.00
|
| Rate for Payer: Cigna of WY Commercial |
$204.08
|
| Rate for Payer: Entrust Commercial |
$197.84
|
| Rate for Payer: First Choice Health Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$197.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$127.03
|
| Rate for Payer: HealthUtah PPO |
$208.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$202.00
|
| Rate for Payer: Multiplan Medicare/VA |
$120.68
|
| Rate for Payer: One Health Plan of WY PPO |
$204.08
|
| Rate for Payer: PacificSource Commercial |
$187.42
|
| Rate for Payer: PHCS PPO |
$204.08
|
| Rate for Payer: Three Rivers PPO |
$156.19
|
| Rate for Payer: TriWest Veterans Administration |
$127.03
|
| Rate for Payer: United Healthcare Commercial |
$198.88
|
| Rate for Payer: United Healthcare Medicare |
$127.03
|
| Rate for Payer: WINHealth Partners Commercial |
$197.84
|
| Rate for Payer: Wise Provider Network Commercial |
$197.84
|
|
|
DRILL BIT 16MM TRANSOM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
2800377
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$224.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$213.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$202.82
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$213.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$213.50
|
| Rate for Payer: WINHealth Partners Commercial |
$332.50
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 16MM TRANSOM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
2800377
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$231.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$199.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$189.52
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$199.50
|
| Rate for Payer: United Healthcare Medicare |
$199.50
|
| Rate for Payer: WINHealth Partners Commercial |
$343.00
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
DRILL BIT 1.7 MM
|
Facility
|
IP
|
$268.14
|
|
| Hospital Charge Code |
3100316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$155.39 |
| Max. Negotiated Rate |
$268.14 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$262.78
|
| Rate for Payer: Aetna of WY Medicare |
$171.61
|
| Rate for Payer: Altius Commercial |
$257.41
|
| Rate for Payer: Beech Street Commercial |
$262.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$260.10
|
| Rate for Payer: Cash Price |
$187.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$260.10
|
| Rate for Payer: Cigna of WY Commercial |
$262.78
|
| Rate for Payer: Entrust Commercial |
$254.73
|
| Rate for Payer: First Choice Health Commercial |
$254.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$254.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.57
|
| Rate for Payer: HealthUtah PPO |
$268.14
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$260.10
|
| Rate for Payer: Multiplan Medicare/VA |
$155.39
|
| Rate for Payer: One Health Plan of WY PPO |
$262.78
|
| Rate for Payer: PacificSource Commercial |
$241.33
|
| Rate for Payer: PHCS PPO |
$262.78
|
| Rate for Payer: Three Rivers PPO |
$201.10
|
| Rate for Payer: TriWest Veterans Administration |
$163.57
|
| Rate for Payer: United Healthcare Commercial |
$256.07
|
| Rate for Payer: United Healthcare Medicare |
$163.57
|
| Rate for Payer: WINHealth Partners Commercial |
$254.73
|
| Rate for Payer: Wise Provider Network Commercial |
$254.73
|
|
|
DRILL BIT 1.7 MM
|
Facility
|
OP
|
$268.14
|
|
| Hospital Charge Code |
3100316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.20 |
| Max. Negotiated Rate |
$268.14 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$262.78
|
| Rate for Payer: Aetna of WY Medicare |
$176.97
|
| Rate for Payer: Altius Commercial |
$257.41
|
| Rate for Payer: Beech Street Commercial |
$262.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$260.10
|
| Rate for Payer: Cash Price |
$187.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$260.10
|
| Rate for Payer: Cigna of WY Commercial |
$262.78
|
| Rate for Payer: Entrust Commercial |
$254.73
|
| Rate for Payer: First Choice Health Commercial |
$254.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$254.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$152.84
|
| Rate for Payer: HealthUtah PPO |
$268.14
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$260.10
|
| Rate for Payer: Multiplan Medicare/VA |
$145.20
|
| Rate for Payer: One Health Plan of WY PPO |
$262.78
|
| Rate for Payer: PacificSource Commercial |
$241.33
|
| Rate for Payer: PHCS PPO |
$262.78
|
| Rate for Payer: Three Rivers PPO |
$201.10
|
| Rate for Payer: TriWest Veterans Administration |
$152.84
|
| Rate for Payer: United Healthcare Commercial |
$256.07
|
| Rate for Payer: United Healthcare Medicare |
$152.84
|
| Rate for Payer: WINHealth Partners Commercial |
$262.78
|
| Rate for Payer: Wise Provider Network Commercial |
$254.73
|
|
