|
DRILL BIT 2.0MM QUICK W/ DEPTH
|
Facility
|
OP
|
$1,137.50
|
|
| Hospital Charge Code |
3003515
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$615.96 |
| Max. Negotiated Rate |
$1,137.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,114.75
|
| Rate for Payer: Aetna of WY Medicare |
$750.75
|
| Rate for Payer: Altius Commercial |
$1,092.00
|
| Rate for Payer: Beech Street Commercial |
$1,114.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,103.38
|
| Rate for Payer: Cash Price |
$796.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,103.38
|
| Rate for Payer: Cigna of WY Commercial |
$1,114.75
|
| Rate for Payer: Entrust Commercial |
$1,080.62
|
| Rate for Payer: First Choice Health Commercial |
$1,080.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,080.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$648.38
|
| Rate for Payer: HealthUtah PPO |
$1,137.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,103.38
|
| Rate for Payer: Multiplan Medicare/VA |
$615.96
|
| Rate for Payer: One Health Plan of WY PPO |
$1,114.75
|
| Rate for Payer: PacificSource Commercial |
$1,023.75
|
| Rate for Payer: PHCS PPO |
$1,114.75
|
| Rate for Payer: Three Rivers PPO |
$853.12
|
| Rate for Payer: TriWest Veterans Administration |
$648.38
|
| Rate for Payer: United Healthcare Commercial |
$1,086.31
|
| Rate for Payer: United Healthcare Medicare |
$648.38
|
| Rate for Payer: WINHealth Partners Commercial |
$1,114.75
|
| Rate for Payer: Wise Provider Network Commercial |
$1,080.62
|
|
|
DRILL BIT 2.0MM ZIMMER
|
Facility
|
IP
|
$195.86
|
|
| Hospital Charge Code |
3003944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.50 |
| Max. Negotiated Rate |
$195.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$191.94
|
| Rate for Payer: Aetna of WY Medicare |
$125.35
|
| Rate for Payer: Altius Commercial |
$188.03
|
| Rate for Payer: Beech Street Commercial |
$191.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$189.98
|
| Rate for Payer: Cash Price |
$137.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$189.98
|
| Rate for Payer: Cigna of WY Commercial |
$191.94
|
| Rate for Payer: Entrust Commercial |
$186.07
|
| Rate for Payer: First Choice Health Commercial |
$186.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$186.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$119.47
|
| Rate for Payer: HealthUtah PPO |
$195.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$189.98
|
| Rate for Payer: Multiplan Medicare/VA |
$113.50
|
| Rate for Payer: One Health Plan of WY PPO |
$191.94
|
| Rate for Payer: PacificSource Commercial |
$176.27
|
| Rate for Payer: PHCS PPO |
$191.94
|
| Rate for Payer: Three Rivers PPO |
$146.90
|
| Rate for Payer: TriWest Veterans Administration |
$119.47
|
| Rate for Payer: United Healthcare Commercial |
$187.05
|
| Rate for Payer: United Healthcare Medicare |
$119.47
|
| Rate for Payer: WINHealth Partners Commercial |
$186.07
|
| Rate for Payer: Wise Provider Network Commercial |
$186.07
|
|
|
DRILL BIT 2.0MM ZIMMER
|
Facility
|
OP
|
$195.86
|
|
| Hospital Charge Code |
3003944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.06 |
| Max. Negotiated Rate |
$195.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$191.94
|
| Rate for Payer: Aetna of WY Medicare |
$129.27
|
| Rate for Payer: Altius Commercial |
$188.03
|
| Rate for Payer: Beech Street Commercial |
$191.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$189.98
|
| Rate for Payer: Cash Price |
$137.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$189.98
|
| Rate for Payer: Cigna of WY Commercial |
$191.94
|
| Rate for Payer: Entrust Commercial |
$186.07
|
| Rate for Payer: First Choice Health Commercial |
$186.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$186.07
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$111.64
|
| Rate for Payer: HealthUtah PPO |
$195.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$189.98
|
| Rate for Payer: Multiplan Medicare/VA |
$106.06
|
| Rate for Payer: One Health Plan of WY PPO |
$191.94
|
| Rate for Payer: PacificSource Commercial |
$176.27
|
| Rate for Payer: PHCS PPO |
$191.94
|
| Rate for Payer: Three Rivers PPO |
$146.90
|
| Rate for Payer: TriWest Veterans Administration |
$111.64
|
| Rate for Payer: United Healthcare Commercial |
$187.05
|
| Rate for Payer: United Healthcare Medicare |
$111.64
|
| Rate for Payer: WINHealth Partners Commercial |
$191.94
|
| Rate for Payer: Wise Provider Network Commercial |
$186.07
|
|
|
DRILL BIT 2.0 STRYKER
|
Facility
|
OP
|
$271.42
|
|
| Hospital Charge Code |
3300155
|
|
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 2.0 STRYKER
|
Facility
|
IP
|
$271.42
|
|
| Hospital Charge Code |
3300155
|
|
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
|
|
|
DRILLBIT 2.0 VARIAX
|
Facility
|
IP
|
$268.80
|
|
| Hospital Charge Code |
3100213
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$155.77 |
| Max. Negotiated Rate |
$268.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$263.42
|
| Rate for Payer: Aetna of WY Medicare |
$172.03
|
| Rate for Payer: Altius Commercial |
$258.05
|
| Rate for Payer: Beech Street Commercial |
$263.42
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$260.74
|
| Rate for Payer: Cash Price |
$188.16
|
| Rate for Payer: ChoiceCare Network Commercial |
$260.74
|
| Rate for Payer: Cigna of WY Commercial |
$263.42
|
| Rate for Payer: Entrust Commercial |
$255.36
|
| Rate for Payer: First Choice Health Commercial |
$255.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$255.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.97
|
| Rate for Payer: HealthUtah PPO |
$268.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$260.74
|
| Rate for Payer: Multiplan Medicare/VA |
$155.77
|
| Rate for Payer: One Health Plan of WY PPO |
$263.42
|
| Rate for Payer: PacificSource Commercial |
$241.92
|
| Rate for Payer: PHCS PPO |
$263.42
|
| Rate for Payer: Three Rivers PPO |
$201.60
|
| Rate for Payer: TriWest Veterans Administration |
$163.97
|
| Rate for Payer: United Healthcare Commercial |
$256.70
|
| Rate for Payer: United Healthcare Medicare |
$163.97
|
| Rate for Payer: WINHealth Partners Commercial |
$255.36
|
| Rate for Payer: Wise Provider Network Commercial |
$255.36
|
|
|
DRILLBIT 2.0 VARIAX
|
Facility
|
OP
|
$268.80
|
|
| Hospital Charge Code |
3100213
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.56 |
| Max. Negotiated Rate |
$268.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$263.42
|
| Rate for Payer: Aetna of WY Medicare |
$177.41
|
| Rate for Payer: Altius Commercial |
$258.05
|
| Rate for Payer: Beech Street Commercial |
$263.42
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$260.74
|
| Rate for Payer: Cash Price |
$188.16
|
| Rate for Payer: ChoiceCare Network Commercial |
$260.74
|
| Rate for Payer: Cigna of WY Commercial |
$263.42
|
| Rate for Payer: Entrust Commercial |
$255.36
|
| Rate for Payer: First Choice Health Commercial |
$255.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$255.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$153.22
|
| Rate for Payer: HealthUtah PPO |
$268.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$260.74
|
| Rate for Payer: Multiplan Medicare/VA |
$145.56
|
| Rate for Payer: One Health Plan of WY PPO |
$263.42
|
| Rate for Payer: PacificSource Commercial |
$241.92
|
| Rate for Payer: PHCS PPO |
$263.42
|
| Rate for Payer: Three Rivers PPO |
$201.60
|
| Rate for Payer: TriWest Veterans Administration |
$153.22
|
| Rate for Payer: United Healthcare Commercial |
$256.70
|
| Rate for Payer: United Healthcare Medicare |
$153.22
|
| Rate for Payer: WINHealth Partners Commercial |
$263.42
|
| Rate for Payer: Wise Provider Network Commercial |
$255.36
|
|
|
DRILL BIT 2.0 X 100MM Q-C
|
Facility
|
OP
|
$208.25
|
|
| Hospital Charge Code |
3002903
|
|
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 2.0 X 100MM Q-C
|
Facility
|
IP
|
$208.25
|
|
| Hospital Charge Code |
3002903
|
|
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 2.0 X 122 AO
|
Facility
|
IP
|
$381.64
|
|
| Hospital Charge Code |
3100170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.16 |
| Max. Negotiated Rate |
$381.64 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$374.01
|
| Rate for Payer: Aetna of WY Medicare |
$244.25
|
| Rate for Payer: Altius Commercial |
$366.37
|
| Rate for Payer: Beech Street Commercial |
$374.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$370.19
|
| Rate for Payer: Cash Price |
$267.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$370.19
|
| Rate for Payer: Cigna of WY Commercial |
$374.01
|
| Rate for Payer: Entrust Commercial |
$362.56
|
| Rate for Payer: First Choice Health Commercial |
$362.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$362.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$232.80
|
| Rate for Payer: HealthUtah PPO |
$381.64
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$370.19
|
| Rate for Payer: Multiplan Medicare/VA |
$221.16
|
| Rate for Payer: One Health Plan of WY PPO |
$374.01
|
| Rate for Payer: PacificSource Commercial |
$343.48
|
| Rate for Payer: PHCS PPO |
$374.01
|
| Rate for Payer: Three Rivers PPO |
$286.23
|
| Rate for Payer: TriWest Veterans Administration |
$232.80
|
| Rate for Payer: United Healthcare Commercial |
$364.47
|
| Rate for Payer: United Healthcare Medicare |
$232.80
|
| Rate for Payer: WINHealth Partners Commercial |
$362.56
|
| Rate for Payer: Wise Provider Network Commercial |
$362.56
|
|
|
DRILL BIT 2.0 X 122 AO
|
Facility
|
OP
|
$381.64
|
|
| Hospital Charge Code |
3100170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$206.66 |
| Max. Negotiated Rate |
$381.64 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$374.01
|
| Rate for Payer: Aetna of WY Medicare |
$251.88
|
| Rate for Payer: Altius Commercial |
$366.37
|
| Rate for Payer: Beech Street Commercial |
$374.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$370.19
|
| Rate for Payer: Cash Price |
$267.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$370.19
|
| Rate for Payer: Cigna of WY Commercial |
$374.01
|
| Rate for Payer: Entrust Commercial |
$362.56
|
| Rate for Payer: First Choice Health Commercial |
$362.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$362.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$217.53
|
| Rate for Payer: HealthUtah PPO |
$381.64
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$370.19
|
| Rate for Payer: Multiplan Medicare/VA |
$206.66
|
| Rate for Payer: One Health Plan of WY PPO |
$374.01
|
| Rate for Payer: PacificSource Commercial |
$343.48
|
| Rate for Payer: PHCS PPO |
$374.01
|
| Rate for Payer: Three Rivers PPO |
$286.23
|
| Rate for Payer: TriWest Veterans Administration |
$217.53
|
| Rate for Payer: United Healthcare Commercial |
$364.47
|
| Rate for Payer: United Healthcare Medicare |
$217.53
|
| Rate for Payer: WINHealth Partners Commercial |
$374.01
|
| Rate for Payer: Wise Provider Network Commercial |
$362.56
|
|
|
DRILL BIT 2.1 ASNIS
|
Facility
|
IP
|
$658.56
|
|
| Hospital Charge Code |
3100210
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$381.64 |
| Max. Negotiated Rate |
$658.56 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$645.39
|
| Rate for Payer: Aetna of WY Medicare |
$421.48
|
| Rate for Payer: Altius Commercial |
$632.22
|
| Rate for Payer: Beech Street Commercial |
$645.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$638.80
|
| Rate for Payer: Cash Price |
$460.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$638.80
|
| Rate for Payer: Cigna of WY Commercial |
$645.39
|
| Rate for Payer: Entrust Commercial |
$625.63
|
| Rate for Payer: First Choice Health Commercial |
$625.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$625.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$401.72
|
| Rate for Payer: HealthUtah PPO |
$658.56
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$638.80
|
| Rate for Payer: Multiplan Medicare/VA |
$381.64
|
| Rate for Payer: One Health Plan of WY PPO |
$645.39
|
| Rate for Payer: PacificSource Commercial |
$592.70
|
| Rate for Payer: PHCS PPO |
$645.39
|
| Rate for Payer: Three Rivers PPO |
$493.92
|
| Rate for Payer: TriWest Veterans Administration |
$401.72
|
| Rate for Payer: United Healthcare Commercial |
$628.92
|
| Rate for Payer: United Healthcare Medicare |
$401.72
|
| Rate for Payer: WINHealth Partners Commercial |
$625.63
|
| Rate for Payer: Wise Provider Network Commercial |
$625.63
|
|
|
DRILL BIT 2.1 ASNIS
|
Facility
|
OP
|
$658.56
|
|
| Hospital Charge Code |
3100210
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$356.61 |
| Max. Negotiated Rate |
$658.56 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$645.39
|
| Rate for Payer: Aetna of WY Medicare |
$434.65
|
| Rate for Payer: Altius Commercial |
$632.22
|
| Rate for Payer: Beech Street Commercial |
$645.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$638.80
|
| Rate for Payer: Cash Price |
$460.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$638.80
|
| Rate for Payer: Cigna of WY Commercial |
$645.39
|
| Rate for Payer: Entrust Commercial |
$625.63
|
| Rate for Payer: First Choice Health Commercial |
$625.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$625.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$375.38
|
| Rate for Payer: HealthUtah PPO |
$658.56
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$638.80
|
| Rate for Payer: Multiplan Medicare/VA |
$356.61
|
| Rate for Payer: One Health Plan of WY PPO |
$645.39
|
| Rate for Payer: PacificSource Commercial |
$592.70
|
| Rate for Payer: PHCS PPO |
$645.39
|
| Rate for Payer: Three Rivers PPO |
$493.92
|
| Rate for Payer: TriWest Veterans Administration |
$375.38
|
| Rate for Payer: United Healthcare Commercial |
$628.92
|
| Rate for Payer: United Healthcare Medicare |
$375.38
|
| Rate for Payer: WINHealth Partners Commercial |
$645.39
|
| Rate for Payer: Wise Provider Network Commercial |
$625.63
|
|
|
DRILL BIT 2.2MM NS
|
Facility
|
OP
|
$448.00
|
|
| Hospital Charge Code |
3002844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.59 |
| Max. Negotiated Rate |
$448.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$439.04
|
| Rate for Payer: Aetna of WY Medicare |
$295.68
|
| Rate for Payer: Altius Commercial |
$430.08
|
| Rate for Payer: Beech Street Commercial |
$439.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$434.56
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$434.56
|
| Rate for Payer: Cigna of WY Commercial |
$439.04
|
| Rate for Payer: Entrust Commercial |
$425.60
|
| Rate for Payer: First Choice Health Commercial |
$425.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$425.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$255.36
|
| Rate for Payer: HealthUtah PPO |
$448.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$434.56
|
| Rate for Payer: Multiplan Medicare/VA |
$242.59
|
| Rate for Payer: One Health Plan of WY PPO |
$439.04
|
| Rate for Payer: PacificSource Commercial |
$403.20
|
| Rate for Payer: PHCS PPO |
$439.04
|
| Rate for Payer: Three Rivers PPO |
$336.00
|
| Rate for Payer: TriWest Veterans Administration |
$255.36
|
| Rate for Payer: United Healthcare Commercial |
$427.84
|
| Rate for Payer: United Healthcare Medicare |
$255.36
|
| Rate for Payer: WINHealth Partners Commercial |
$439.04
|
| Rate for Payer: Wise Provider Network Commercial |
$425.60
|
|
|
DRILL BIT 2.2MM NS
|
Facility
|
IP
|
$448.00
|
|
| Hospital Charge Code |
3002844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.62 |
| Max. Negotiated Rate |
$448.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$439.04
|
| Rate for Payer: Aetna of WY Medicare |
$286.72
|
| Rate for Payer: Altius Commercial |
$430.08
|
| Rate for Payer: Beech Street Commercial |
$439.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$434.56
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$434.56
|
| Rate for Payer: Cigna of WY Commercial |
$439.04
|
| Rate for Payer: Entrust Commercial |
$425.60
|
| Rate for Payer: First Choice Health Commercial |
$425.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$425.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$273.28
|
| Rate for Payer: HealthUtah PPO |
$448.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$434.56
|
| Rate for Payer: Multiplan Medicare/VA |
$259.62
|
| Rate for Payer: One Health Plan of WY PPO |
$439.04
|
| Rate for Payer: PacificSource Commercial |
$403.20
|
| Rate for Payer: PHCS PPO |
$439.04
|
| Rate for Payer: Three Rivers PPO |
$336.00
|
| Rate for Payer: TriWest Veterans Administration |
$273.28
|
| Rate for Payer: United Healthcare Commercial |
$427.84
|
| Rate for Payer: United Healthcare Medicare |
$273.28
|
| Rate for Payer: WINHealth Partners Commercial |
$425.60
|
| Rate for Payer: Wise Provider Network Commercial |
$425.60
|
|
|
DRILL BIT 2.3/080 TRIMED
|
Facility
|
OP
|
$399.00
|
|
| Hospital Charge Code |
3003994
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.06 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$391.02
|
| Rate for Payer: Aetna of WY Medicare |
$263.34
|
| Rate for Payer: Altius Commercial |
$383.04
|
| Rate for Payer: Beech Street Commercial |
$391.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$387.03
|
| Rate for Payer: Cash Price |
$279.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$387.03
|
| Rate for Payer: Cigna of WY Commercial |
$391.02
|
| Rate for Payer: Entrust Commercial |
$379.05
|
| Rate for Payer: First Choice Health Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$227.43
|
| Rate for Payer: HealthUtah PPO |
$399.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$387.03
|
| Rate for Payer: Multiplan Medicare/VA |
$216.06
|
| Rate for Payer: One Health Plan of WY PPO |
$391.02
|
| Rate for Payer: PacificSource Commercial |
$359.10
|
| Rate for Payer: PHCS PPO |
$391.02
|
| Rate for Payer: Three Rivers PPO |
$299.25
|
| Rate for Payer: TriWest Veterans Administration |
$227.43
|
| Rate for Payer: United Healthcare Commercial |
$381.04
|
| Rate for Payer: United Healthcare Medicare |
$227.43
|
| Rate for Payer: WINHealth Partners Commercial |
$391.02
|
| Rate for Payer: Wise Provider Network Commercial |
$379.05
|
|
|
DRILL BIT 2.3/080 TRIMED
|
Facility
|
IP
|
$399.00
|
|
| Hospital Charge Code |
3003994
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.22 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$391.02
|
| Rate for Payer: Aetna of WY Medicare |
$255.36
|
| Rate for Payer: Altius Commercial |
$383.04
|
| Rate for Payer: Beech Street Commercial |
$391.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$387.03
|
| Rate for Payer: Cash Price |
$279.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$387.03
|
| Rate for Payer: Cigna of WY Commercial |
$391.02
|
| Rate for Payer: Entrust Commercial |
$379.05
|
| Rate for Payer: First Choice Health Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$243.39
|
| Rate for Payer: HealthUtah PPO |
$399.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$387.03
|
| Rate for Payer: Multiplan Medicare/VA |
$231.22
|
| Rate for Payer: One Health Plan of WY PPO |
$391.02
|
| Rate for Payer: PacificSource Commercial |
$359.10
|
| Rate for Payer: PHCS PPO |
$391.02
|
| Rate for Payer: Three Rivers PPO |
$299.25
|
| Rate for Payer: TriWest Veterans Administration |
$243.39
|
| Rate for Payer: United Healthcare Commercial |
$381.04
|
| Rate for Payer: United Healthcare Medicare |
$243.39
|
| Rate for Payer: WINHealth Partners Commercial |
$379.05
|
| Rate for Payer: Wise Provider Network Commercial |
$379.05
|
|
|
DRILL BIT 2.3/120 TRIMED
|
Facility
|
OP
|
$399.00
|
|
| Hospital Charge Code |
3001298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.06 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$391.02
|
| Rate for Payer: Aetna of WY Medicare |
$263.34
|
| Rate for Payer: Altius Commercial |
$383.04
|
| Rate for Payer: Beech Street Commercial |
$391.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$387.03
|
| Rate for Payer: Cash Price |
$279.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$387.03
|
| Rate for Payer: Cigna of WY Commercial |
$391.02
|
| Rate for Payer: Entrust Commercial |
$379.05
|
| Rate for Payer: First Choice Health Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$227.43
|
| Rate for Payer: HealthUtah PPO |
$399.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$387.03
|
| Rate for Payer: Multiplan Medicare/VA |
$216.06
|
| Rate for Payer: One Health Plan of WY PPO |
$391.02
|
| Rate for Payer: PacificSource Commercial |
$359.10
|
| Rate for Payer: PHCS PPO |
$391.02
|
| Rate for Payer: Three Rivers PPO |
$299.25
|
| Rate for Payer: TriWest Veterans Administration |
$227.43
|
| Rate for Payer: United Healthcare Commercial |
$381.04
|
| Rate for Payer: United Healthcare Medicare |
$227.43
|
| Rate for Payer: WINHealth Partners Commercial |
$391.02
|
| Rate for Payer: Wise Provider Network Commercial |
$379.05
|
|
|
DRILL BIT 2.3/120 TRIMED
|
Facility
|
IP
|
$399.00
|
|
| Hospital Charge Code |
3001298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.22 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$391.02
|
| Rate for Payer: Aetna of WY Medicare |
$255.36
|
| Rate for Payer: Altius Commercial |
$383.04
|
| Rate for Payer: Beech Street Commercial |
$391.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$387.03
|
| Rate for Payer: Cash Price |
$279.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$387.03
|
| Rate for Payer: Cigna of WY Commercial |
$391.02
|
| Rate for Payer: Entrust Commercial |
$379.05
|
| Rate for Payer: First Choice Health Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$379.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$243.39
|
| Rate for Payer: HealthUtah PPO |
$399.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$387.03
|
| Rate for Payer: Multiplan Medicare/VA |
$231.22
|
| Rate for Payer: One Health Plan of WY PPO |
$391.02
|
| Rate for Payer: PacificSource Commercial |
$359.10
|
| Rate for Payer: PHCS PPO |
$391.02
|
| Rate for Payer: Three Rivers PPO |
$299.25
|
| Rate for Payer: TriWest Veterans Administration |
$243.39
|
| Rate for Payer: United Healthcare Commercial |
$381.04
|
| Rate for Payer: United Healthcare Medicare |
$243.39
|
| Rate for Payer: WINHealth Partners Commercial |
$379.05
|
| Rate for Payer: Wise Provider Network Commercial |
$379.05
|
|
|
DRILL BIT 2.3 AO DISTAL RADIUS
|
Facility
|
OP
|
$271.42
|
|
| Hospital Charge Code |
3300128
|
|
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 2.3 AO DISTAL RADIUS
|
Facility
|
IP
|
$271.42
|
|
| Hospital Charge Code |
3300128
|
|
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 2.3MM ACUMED
|
Facility
|
IP
|
$707.00
|
|
| Hospital Charge Code |
3003702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$409.71 |
| Max. Negotiated Rate |
$707.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$692.86
|
| Rate for Payer: Aetna of WY Medicare |
$452.48
|
| Rate for Payer: Altius Commercial |
$678.72
|
| Rate for Payer: Beech Street Commercial |
$692.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$685.79
|
| Rate for Payer: Cash Price |
$494.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$685.79
|
| Rate for Payer: Cigna of WY Commercial |
$692.86
|
| Rate for Payer: Entrust Commercial |
$671.65
|
| Rate for Payer: First Choice Health Commercial |
$671.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$671.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$431.27
|
| Rate for Payer: HealthUtah PPO |
$707.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$685.79
|
| Rate for Payer: Multiplan Medicare/VA |
$409.71
|
| Rate for Payer: One Health Plan of WY PPO |
$692.86
|
| Rate for Payer: PacificSource Commercial |
$636.30
|
| Rate for Payer: PHCS PPO |
$692.86
|
| Rate for Payer: Three Rivers PPO |
$530.25
|
| Rate for Payer: TriWest Veterans Administration |
$431.27
|
| Rate for Payer: United Healthcare Commercial |
$675.18
|
| Rate for Payer: United Healthcare Medicare |
$431.27
|
| Rate for Payer: WINHealth Partners Commercial |
$671.65
|
| Rate for Payer: Wise Provider Network Commercial |
$671.65
|
|
|
DRILL BIT 2.3MM ACUMED
|
Facility
|
OP
|
$707.00
|
|
| Hospital Charge Code |
3003702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$382.84 |
| Max. Negotiated Rate |
$707.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$692.86
|
| Rate for Payer: Aetna of WY Medicare |
$466.62
|
| Rate for Payer: Altius Commercial |
$678.72
|
| Rate for Payer: Beech Street Commercial |
$692.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$685.79
|
| Rate for Payer: Cash Price |
$494.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$685.79
|
| Rate for Payer: Cigna of WY Commercial |
$692.86
|
| Rate for Payer: Entrust Commercial |
$671.65
|
| Rate for Payer: First Choice Health Commercial |
$671.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$671.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$402.99
|
| Rate for Payer: HealthUtah PPO |
$707.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$685.79
|
| Rate for Payer: Multiplan Medicare/VA |
$382.84
|
| Rate for Payer: One Health Plan of WY PPO |
$692.86
|
| Rate for Payer: PacificSource Commercial |
$636.30
|
| Rate for Payer: PHCS PPO |
$692.86
|
| Rate for Payer: Three Rivers PPO |
$530.25
|
| Rate for Payer: TriWest Veterans Administration |
$402.99
|
| Rate for Payer: United Healthcare Commercial |
$675.18
|
| Rate for Payer: United Healthcare Medicare |
$402.99
|
| Rate for Payer: WINHealth Partners Commercial |
$692.86
|
| Rate for Payer: Wise Provider Network Commercial |
$671.65
|
|
|
DRILL BIT 2.4
|
Facility
|
OP
|
$781.38
|
|
| Hospital Charge Code |
3100267
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$423.12 |
| Max. Negotiated Rate |
$781.38 |
| Rate for Payer: United Healthcare Commercial |
$746.22
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$765.75
|
| Rate for Payer: Aetna of WY Medicare |
$515.71
|
| Rate for Payer: Altius Commercial |
$750.12
|
| Rate for Payer: Beech Street Commercial |
$765.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$757.94
|
| Rate for Payer: Cash Price |
$546.96
|
| Rate for Payer: ChoiceCare Network Commercial |
$757.94
|
| Rate for Payer: Cigna of WY Commercial |
$765.75
|
| Rate for Payer: Entrust Commercial |
$742.31
|
| Rate for Payer: First Choice Health Commercial |
$742.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$742.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$445.39
|
| Rate for Payer: HealthUtah PPO |
$781.38
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$757.94
|
| Rate for Payer: Multiplan Medicare/VA |
$423.12
|
| Rate for Payer: One Health Plan of WY PPO |
$765.75
|
| Rate for Payer: PacificSource Commercial |
$703.24
|
| Rate for Payer: PHCS PPO |
$765.75
|
| Rate for Payer: Three Rivers PPO |
$586.04
|
| Rate for Payer: TriWest Veterans Administration |
$445.39
|
| Rate for Payer: United Healthcare Medicare |
$445.39
|
| Rate for Payer: WINHealth Partners Commercial |
$765.75
|
| Rate for Payer: Wise Provider Network Commercial |
$742.31
|
|
|
DRILL BIT 2.4
|
Facility
|
IP
|
$781.38
|
|
| Hospital Charge Code |
3100267
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.81 |
| Max. Negotiated Rate |
$781.38 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$765.75
|
| Rate for Payer: Aetna of WY Medicare |
$500.08
|
| Rate for Payer: Altius Commercial |
$750.12
|
| Rate for Payer: Beech Street Commercial |
$765.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$757.94
|
| Rate for Payer: Cash Price |
$546.96
|
| Rate for Payer: ChoiceCare Network Commercial |
$757.94
|
| Rate for Payer: Cigna of WY Commercial |
$765.75
|
| Rate for Payer: Entrust Commercial |
$742.31
|
| Rate for Payer: First Choice Health Commercial |
$742.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$742.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$476.64
|
| Rate for Payer: HealthUtah PPO |
$781.38
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$757.94
|
| Rate for Payer: Multiplan Medicare/VA |
$452.81
|
| Rate for Payer: One Health Plan of WY PPO |
$765.75
|
| Rate for Payer: PacificSource Commercial |
$703.24
|
| Rate for Payer: PHCS PPO |
$765.75
|
| Rate for Payer: Three Rivers PPO |
$586.04
|
| Rate for Payer: TriWest Veterans Administration |
$476.64
|
| Rate for Payer: United Healthcare Commercial |
$746.22
|
| Rate for Payer: United Healthcare Medicare |
$476.64
|
| Rate for Payer: WINHealth Partners Commercial |
$742.31
|
| Rate for Payer: Wise Provider Network Commercial |
$742.31
|
|
