|
DRILL BIT 2.5 702418
|
Facility
|
IP
|
$730.80
|
|
| Hospital Charge Code |
3100358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$423.50 |
| Max. Negotiated Rate |
$730.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$716.18
|
| Rate for Payer: Aetna of WY Medicare |
$467.71
|
| Rate for Payer: Altius Commercial |
$701.57
|
| Rate for Payer: Beech Street Commercial |
$716.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$708.88
|
| Rate for Payer: Cash Price |
$511.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$708.88
|
| Rate for Payer: Cigna of WY Commercial |
$716.18
|
| Rate for Payer: Entrust Commercial |
$694.26
|
| Rate for Payer: First Choice Health Commercial |
$694.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$694.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$445.79
|
| Rate for Payer: HealthUtah PPO |
$730.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$708.88
|
| Rate for Payer: Multiplan Medicare/VA |
$423.50
|
| Rate for Payer: One Health Plan of WY PPO |
$716.18
|
| Rate for Payer: PacificSource Commercial |
$657.72
|
| Rate for Payer: PHCS PPO |
$716.18
|
| Rate for Payer: Three Rivers PPO |
$548.10
|
| Rate for Payer: TriWest Veterans Administration |
$445.79
|
| Rate for Payer: United Healthcare Commercial |
$697.91
|
| Rate for Payer: United Healthcare Medicare |
$445.79
|
| Rate for Payer: WINHealth Partners Commercial |
$694.26
|
| Rate for Payer: Wise Provider Network Commercial |
$694.26
|
|
|
DRILL BIT 2.5 702418
|
Facility
|
OP
|
$730.80
|
|
| Hospital Charge Code |
3100358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.73 |
| Max. Negotiated Rate |
$730.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$716.18
|
| Rate for Payer: Aetna of WY Medicare |
$482.33
|
| Rate for Payer: Altius Commercial |
$701.57
|
| Rate for Payer: Beech Street Commercial |
$716.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$708.88
|
| Rate for Payer: Cash Price |
$511.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$708.88
|
| Rate for Payer: Cigna of WY Commercial |
$716.18
|
| Rate for Payer: Entrust Commercial |
$694.26
|
| Rate for Payer: First Choice Health Commercial |
$694.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$694.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$416.56
|
| Rate for Payer: HealthUtah PPO |
$730.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$708.88
|
| Rate for Payer: Multiplan Medicare/VA |
$395.73
|
| Rate for Payer: One Health Plan of WY PPO |
$716.18
|
| Rate for Payer: PacificSource Commercial |
$657.72
|
| Rate for Payer: PHCS PPO |
$716.18
|
| Rate for Payer: Three Rivers PPO |
$548.10
|
| Rate for Payer: TriWest Veterans Administration |
$416.56
|
| Rate for Payer: United Healthcare Commercial |
$697.91
|
| Rate for Payer: United Healthcare Medicare |
$416.56
|
| Rate for Payer: WINHealth Partners Commercial |
$716.18
|
| Rate for Payer: Wise Provider Network Commercial |
$694.26
|
|
|
DRILL BIT 2.5 ANCHORAGE SET
|
Facility
|
OP
|
$446.88
|
|
| Hospital Charge Code |
3100268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$241.99 |
| Max. Negotiated Rate |
$446.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$437.94
|
| Rate for Payer: Aetna of WY Medicare |
$294.94
|
| Rate for Payer: Altius Commercial |
$429.00
|
| Rate for Payer: Beech Street Commercial |
$437.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$433.47
|
| Rate for Payer: Cash Price |
$312.82
|
| Rate for Payer: ChoiceCare Network Commercial |
$433.47
|
| Rate for Payer: Cigna of WY Commercial |
$437.94
|
| Rate for Payer: Entrust Commercial |
$424.54
|
| Rate for Payer: First Choice Health Commercial |
$424.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$424.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$254.72
|
| Rate for Payer: HealthUtah PPO |
$446.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$433.47
|
| Rate for Payer: Multiplan Medicare/VA |
$241.99
|
| Rate for Payer: One Health Plan of WY PPO |
$437.94
|
| Rate for Payer: PacificSource Commercial |
$402.19
|
| Rate for Payer: PHCS PPO |
$437.94
|
| Rate for Payer: Three Rivers PPO |
$335.16
|
| Rate for Payer: TriWest Veterans Administration |
$254.72
|
| Rate for Payer: United Healthcare Commercial |
$426.77
|
| Rate for Payer: United Healthcare Medicare |
$254.72
|
| Rate for Payer: WINHealth Partners Commercial |
$437.94
|
| Rate for Payer: Wise Provider Network Commercial |
$424.54
|
|
|
DRILL BIT 2.5 ANCHORAGE SET
|
Facility
|
IP
|
$446.88
|
|
| Hospital Charge Code |
3100268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.97 |
| Max. Negotiated Rate |
$446.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$437.94
|
| Rate for Payer: Aetna of WY Medicare |
$286.00
|
| Rate for Payer: Altius Commercial |
$429.00
|
| Rate for Payer: Beech Street Commercial |
$437.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$433.47
|
| Rate for Payer: Cash Price |
$312.82
|
| Rate for Payer: ChoiceCare Network Commercial |
$433.47
|
| Rate for Payer: Cigna of WY Commercial |
$437.94
|
| Rate for Payer: Entrust Commercial |
$424.54
|
| Rate for Payer: First Choice Health Commercial |
$424.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$424.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$272.60
|
| Rate for Payer: HealthUtah PPO |
$446.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$433.47
|
| Rate for Payer: Multiplan Medicare/VA |
$258.97
|
| Rate for Payer: One Health Plan of WY PPO |
$437.94
|
| Rate for Payer: PacificSource Commercial |
$402.19
|
| Rate for Payer: PHCS PPO |
$437.94
|
| Rate for Payer: Three Rivers PPO |
$335.16
|
| Rate for Payer: TriWest Veterans Administration |
$272.60
|
| Rate for Payer: United Healthcare Commercial |
$426.77
|
| Rate for Payer: United Healthcare Medicare |
$272.60
|
| Rate for Payer: WINHealth Partners Commercial |
$424.54
|
| Rate for Payer: Wise Provider Network Commercial |
$424.54
|
|
|
DRILL BIT 2.5 AO
|
Facility
|
OP
|
$450.73
|
|
| Hospital Charge Code |
3100261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$244.07 |
| Max. Negotiated Rate |
$450.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$441.72
|
| Rate for Payer: Aetna of WY Medicare |
$297.48
|
| Rate for Payer: Altius Commercial |
$432.70
|
| Rate for Payer: Beech Street Commercial |
$441.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$437.21
|
| Rate for Payer: Cash Price |
$315.51
|
| Rate for Payer: ChoiceCare Network Commercial |
$437.21
|
| Rate for Payer: Cigna of WY Commercial |
$441.72
|
| Rate for Payer: Entrust Commercial |
$428.19
|
| Rate for Payer: First Choice Health Commercial |
$428.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$428.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$256.92
|
| Rate for Payer: HealthUtah PPO |
$450.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$437.21
|
| Rate for Payer: Multiplan Medicare/VA |
$244.07
|
| Rate for Payer: One Health Plan of WY PPO |
$441.72
|
| Rate for Payer: PacificSource Commercial |
$405.66
|
| Rate for Payer: PHCS PPO |
$441.72
|
| Rate for Payer: Three Rivers PPO |
$338.05
|
| Rate for Payer: TriWest Veterans Administration |
$256.92
|
| Rate for Payer: United Healthcare Commercial |
$430.45
|
| Rate for Payer: United Healthcare Medicare |
$256.92
|
| Rate for Payer: WINHealth Partners Commercial |
$441.72
|
| Rate for Payer: Wise Provider Network Commercial |
$428.19
|
|
|
DRILL BIT 2.5 AO
|
Facility
|
IP
|
$450.73
|
|
| Hospital Charge Code |
3100261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$261.20 |
| Max. Negotiated Rate |
$450.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$441.72
|
| Rate for Payer: Aetna of WY Medicare |
$288.47
|
| Rate for Payer: Altius Commercial |
$432.70
|
| Rate for Payer: Beech Street Commercial |
$441.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$437.21
|
| Rate for Payer: Cash Price |
$315.51
|
| Rate for Payer: ChoiceCare Network Commercial |
$437.21
|
| Rate for Payer: Cigna of WY Commercial |
$441.72
|
| Rate for Payer: Entrust Commercial |
$428.19
|
| Rate for Payer: First Choice Health Commercial |
$428.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$428.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$274.95
|
| Rate for Payer: HealthUtah PPO |
$450.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$437.21
|
| Rate for Payer: Multiplan Medicare/VA |
$261.20
|
| Rate for Payer: One Health Plan of WY PPO |
$441.72
|
| Rate for Payer: PacificSource Commercial |
$405.66
|
| Rate for Payer: PHCS PPO |
$441.72
|
| Rate for Payer: Three Rivers PPO |
$338.05
|
| Rate for Payer: TriWest Veterans Administration |
$274.95
|
| Rate for Payer: United Healthcare Commercial |
$430.45
|
| Rate for Payer: United Healthcare Medicare |
$274.95
|
| Rate for Payer: WINHealth Partners Commercial |
$428.19
|
| Rate for Payer: Wise Provider Network Commercial |
$428.19
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$285.60
|
|
| Hospital Charge Code |
3003244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.51 |
| Max. Negotiated Rate |
$285.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$279.89
|
| Rate for Payer: Aetna of WY Medicare |
$182.78
|
| Rate for Payer: Altius Commercial |
$274.18
|
| Rate for Payer: Beech Street Commercial |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$277.03
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$277.03
|
| Rate for Payer: Cigna of WY Commercial |
$279.89
|
| Rate for Payer: Entrust Commercial |
$271.32
|
| Rate for Payer: First Choice Health Commercial |
$271.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$271.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$174.22
|
| Rate for Payer: HealthUtah PPO |
$285.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$277.03
|
| Rate for Payer: Multiplan Medicare/VA |
$165.51
|
| Rate for Payer: One Health Plan of WY PPO |
$279.89
|
| Rate for Payer: PacificSource Commercial |
$257.04
|
| Rate for Payer: PHCS PPO |
$279.89
|
| Rate for Payer: Three Rivers PPO |
$214.20
|
| Rate for Payer: TriWest Veterans Administration |
$174.22
|
| Rate for Payer: United Healthcare Commercial |
$272.75
|
| Rate for Payer: United Healthcare Medicare |
$174.22
|
| Rate for Payer: WINHealth Partners Commercial |
$271.32
|
| Rate for Payer: Wise Provider Network Commercial |
$271.32
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$285.60
|
|
| Hospital Charge Code |
3003244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$154.65 |
| Max. Negotiated Rate |
$285.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$279.89
|
| Rate for Payer: Aetna of WY Medicare |
$188.50
|
| Rate for Payer: Altius Commercial |
$274.18
|
| Rate for Payer: Beech Street Commercial |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$277.03
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$277.03
|
| Rate for Payer: Cigna of WY Commercial |
$279.89
|
| Rate for Payer: Entrust Commercial |
$271.32
|
| Rate for Payer: First Choice Health Commercial |
$271.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$271.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$162.79
|
| Rate for Payer: HealthUtah PPO |
$285.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$277.03
|
| Rate for Payer: Multiplan Medicare/VA |
$154.65
|
| Rate for Payer: One Health Plan of WY PPO |
$279.89
|
| Rate for Payer: PacificSource Commercial |
$257.04
|
| Rate for Payer: PHCS PPO |
$279.89
|
| Rate for Payer: Three Rivers PPO |
$214.20
|
| Rate for Payer: TriWest Veterans Administration |
$162.79
|
| Rate for Payer: United Healthcare Commercial |
$272.75
|
| Rate for Payer: United Healthcare Medicare |
$162.79
|
| Rate for Payer: WINHealth Partners Commercial |
$279.89
|
| Rate for Payer: Wise Provider Network Commercial |
$271.32
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$297.50
|
|
| Hospital Charge Code |
3002423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.10 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$291.55
|
| Rate for Payer: Aetna of WY Medicare |
$196.35
|
| Rate for Payer: Altius Commercial |
$285.60
|
| Rate for Payer: Beech Street Commercial |
$291.55
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$288.58
|
| Rate for Payer: Cash Price |
$208.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$288.58
|
| Rate for Payer: Cigna of WY Commercial |
$291.55
|
| Rate for Payer: Entrust Commercial |
$282.62
|
| Rate for Payer: First Choice Health Commercial |
$282.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$282.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$169.58
|
| Rate for Payer: HealthUtah PPO |
$297.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$288.58
|
| Rate for Payer: Multiplan Medicare/VA |
$161.10
|
| Rate for Payer: One Health Plan of WY PPO |
$291.55
|
| Rate for Payer: PacificSource Commercial |
$267.75
|
| Rate for Payer: PHCS PPO |
$291.55
|
| Rate for Payer: Three Rivers PPO |
$223.12
|
| Rate for Payer: TriWest Veterans Administration |
$169.58
|
| Rate for Payer: United Healthcare Commercial |
$284.11
|
| Rate for Payer: United Healthcare Medicare |
$169.58
|
| Rate for Payer: WINHealth Partners Commercial |
$291.55
|
| Rate for Payer: Wise Provider Network Commercial |
$282.62
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$297.50
|
|
| Hospital Charge Code |
3002423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.40 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$291.55
|
| Rate for Payer: Aetna of WY Medicare |
$190.40
|
| Rate for Payer: Altius Commercial |
$285.60
|
| Rate for Payer: Beech Street Commercial |
$291.55
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$288.58
|
| Rate for Payer: Cash Price |
$208.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$288.58
|
| Rate for Payer: Cigna of WY Commercial |
$291.55
|
| Rate for Payer: Entrust Commercial |
$282.62
|
| Rate for Payer: First Choice Health Commercial |
$282.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$282.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$181.48
|
| Rate for Payer: HealthUtah PPO |
$297.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$288.58
|
| Rate for Payer: Multiplan Medicare/VA |
$172.40
|
| Rate for Payer: One Health Plan of WY PPO |
$291.55
|
| Rate for Payer: PacificSource Commercial |
$267.75
|
| Rate for Payer: PHCS PPO |
$291.55
|
| Rate for Payer: Three Rivers PPO |
$223.12
|
| Rate for Payer: TriWest Veterans Administration |
$181.48
|
| Rate for Payer: United Healthcare Commercial |
$284.11
|
| Rate for Payer: United Healthcare Medicare |
$181.48
|
| Rate for Payer: WINHealth Partners Commercial |
$282.62
|
| Rate for Payer: Wise Provider Network Commercial |
$282.62
|
|
|
DRILL BIT 2.5MM MINI-QUICK CON
|
Facility
|
OP
|
$227.50
|
|
| Hospital Charge Code |
3003912
|
|
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 2.5MM MINI-QUICK CON
|
Facility
|
IP
|
$227.50
|
|
| Hospital Charge Code |
3003912
|
|
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 2.5 X 110MM Q-C
|
Facility
|
IP
|
$208.25
|
|
| Hospital Charge Code |
3002923
|
|
Hospital Revenue Code
|
278
|
| 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 2.5 X 110MM Q-C
|
Facility
|
OP
|
$208.25
|
|
| Hospital Charge Code |
3002923
|
|
Hospital Revenue Code
|
278
|
| 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 2.5X110MM QC
|
Facility
|
OP
|
$208.25
|
|
| Hospital Charge Code |
2650882
|
|
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 2.5X110MM QC
|
Facility
|
IP
|
$208.25
|
|
| Hospital Charge Code |
2650882
|
|
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
|
|
|
DRILLBIT 2.5 X 125MM
|
Facility
|
IP
|
$313.88
|
|
| Hospital Charge Code |
3150114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$181.89 |
| Max. Negotiated Rate |
$313.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.60
|
| Rate for Payer: Aetna of WY Medicare |
$200.88
|
| Rate for Payer: Altius Commercial |
$301.32
|
| Rate for Payer: Beech Street Commercial |
$307.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$304.46
|
| Rate for Payer: Cash Price |
$219.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$304.46
|
| Rate for Payer: Cigna of WY Commercial |
$307.60
|
| Rate for Payer: Entrust Commercial |
$298.19
|
| Rate for Payer: First Choice Health Commercial |
$298.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$191.47
|
| Rate for Payer: HealthUtah PPO |
$313.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.46
|
| Rate for Payer: Multiplan Medicare/VA |
$181.89
|
| Rate for Payer: One Health Plan of WY PPO |
$307.60
|
| Rate for Payer: PacificSource Commercial |
$282.49
|
| Rate for Payer: PHCS PPO |
$307.60
|
| Rate for Payer: Three Rivers PPO |
$235.41
|
| Rate for Payer: TriWest Veterans Administration |
$191.47
|
| Rate for Payer: United Healthcare Commercial |
$299.76
|
| Rate for Payer: United Healthcare Medicare |
$191.47
|
| Rate for Payer: WINHealth Partners Commercial |
$298.19
|
| Rate for Payer: Wise Provider Network Commercial |
$298.19
|
|
|
DRILLBIT 2.5 X 125MM
|
Facility
|
OP
|
$313.88
|
|
| Hospital Charge Code |
3150114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.97 |
| Max. Negotiated Rate |
$313.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.60
|
| Rate for Payer: Aetna of WY Medicare |
$207.16
|
| Rate for Payer: Altius Commercial |
$301.32
|
| Rate for Payer: Beech Street Commercial |
$307.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$304.46
|
| Rate for Payer: Cash Price |
$219.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$304.46
|
| Rate for Payer: Cigna of WY Commercial |
$307.60
|
| Rate for Payer: Entrust Commercial |
$298.19
|
| Rate for Payer: First Choice Health Commercial |
$298.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$178.91
|
| Rate for Payer: HealthUtah PPO |
$313.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.46
|
| Rate for Payer: Multiplan Medicare/VA |
$169.97
|
| Rate for Payer: One Health Plan of WY PPO |
$307.60
|
| Rate for Payer: PacificSource Commercial |
$282.49
|
| Rate for Payer: PHCS PPO |
$307.60
|
| Rate for Payer: Three Rivers PPO |
$235.41
|
| Rate for Payer: TriWest Veterans Administration |
$178.91
|
| Rate for Payer: United Healthcare Commercial |
$299.76
|
| Rate for Payer: United Healthcare Medicare |
$178.91
|
| Rate for Payer: WINHealth Partners Commercial |
$307.60
|
| Rate for Payer: Wise Provider Network Commercial |
$298.19
|
|
|
DRILL BIT 2.5 X 26MM
|
Facility
|
IP
|
$271.42
|
|
| Hospital Charge Code |
3100162
|
|
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 2.5 X 26MM
|
Facility
|
OP
|
$271.42
|
|
| Hospital Charge Code |
3100162
|
|
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 2.6 LONG CLAVIC
|
Facility
|
OP
|
$432.64
|
|
| Hospital Charge Code |
3100201
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$234.27 |
| Max. Negotiated Rate |
$432.64 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$423.99
|
| Rate for Payer: Aetna of WY Medicare |
$285.54
|
| Rate for Payer: Altius Commercial |
$415.33
|
| Rate for Payer: Beech Street Commercial |
$423.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$419.66
|
| Rate for Payer: Cash Price |
$302.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$419.66
|
| Rate for Payer: Cigna of WY Commercial |
$423.99
|
| Rate for Payer: Entrust Commercial |
$411.01
|
| Rate for Payer: First Choice Health Commercial |
$411.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$411.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$246.60
|
| Rate for Payer: HealthUtah PPO |
$432.64
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$419.66
|
| Rate for Payer: Multiplan Medicare/VA |
$234.27
|
| Rate for Payer: One Health Plan of WY PPO |
$423.99
|
| Rate for Payer: PacificSource Commercial |
$389.38
|
| Rate for Payer: PHCS PPO |
$423.99
|
| Rate for Payer: Three Rivers PPO |
$324.48
|
| Rate for Payer: TriWest Veterans Administration |
$246.60
|
| Rate for Payer: United Healthcare Commercial |
$413.17
|
| Rate for Payer: United Healthcare Medicare |
$246.60
|
| Rate for Payer: WINHealth Partners Commercial |
$423.99
|
| Rate for Payer: Wise Provider Network Commercial |
$411.01
|
|
|
DRILL BIT 2.6 LONG CLAVIC
|
Facility
|
IP
|
$432.64
|
|
| Hospital Charge Code |
3100201
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.71 |
| Max. Negotiated Rate |
$432.64 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$423.99
|
| Rate for Payer: Aetna of WY Medicare |
$276.89
|
| Rate for Payer: Altius Commercial |
$415.33
|
| Rate for Payer: Beech Street Commercial |
$423.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$419.66
|
| Rate for Payer: Cash Price |
$302.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$419.66
|
| Rate for Payer: Cigna of WY Commercial |
$423.99
|
| Rate for Payer: Entrust Commercial |
$411.01
|
| Rate for Payer: First Choice Health Commercial |
$411.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$411.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$263.91
|
| Rate for Payer: HealthUtah PPO |
$432.64
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$419.66
|
| Rate for Payer: Multiplan Medicare/VA |
$250.71
|
| Rate for Payer: One Health Plan of WY PPO |
$423.99
|
| Rate for Payer: PacificSource Commercial |
$389.38
|
| Rate for Payer: PHCS PPO |
$423.99
|
| Rate for Payer: Three Rivers PPO |
$324.48
|
| Rate for Payer: TriWest Veterans Administration |
$263.91
|
| Rate for Payer: United Healthcare Commercial |
$413.17
|
| Rate for Payer: United Healthcare Medicare |
$263.91
|
| Rate for Payer: WINHealth Partners Commercial |
$411.01
|
| Rate for Payer: Wise Provider Network Commercial |
$411.01
|
|
|
DRILL BIT 2.6 STRYKER
|
Facility
|
OP
|
$381.64
|
|
| Hospital Charge Code |
3100144
|
|
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 2.6 STRYKER
|
Facility
|
IP
|
$381.64
|
|
| Hospital Charge Code |
3100144
|
|
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 2.6 VARIAX
|
Facility
|
OP
|
$333.83
|
|
| Hospital Charge Code |
3100118
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.77 |
| Max. Negotiated Rate |
$333.83 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$327.15
|
| Rate for Payer: Aetna of WY Medicare |
$220.33
|
| Rate for Payer: Altius Commercial |
$320.48
|
| Rate for Payer: Beech Street Commercial |
$327.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$323.82
|
| Rate for Payer: Cash Price |
$233.68
|
| Rate for Payer: ChoiceCare Network Commercial |
$323.82
|
| Rate for Payer: Cigna of WY Commercial |
$327.15
|
| Rate for Payer: Entrust Commercial |
$317.14
|
| Rate for Payer: First Choice Health Commercial |
$317.14
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$317.14
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$190.28
|
| Rate for Payer: HealthUtah PPO |
$333.83
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$323.82
|
| Rate for Payer: Multiplan Medicare/VA |
$180.77
|
| Rate for Payer: One Health Plan of WY PPO |
$327.15
|
| Rate for Payer: PacificSource Commercial |
$300.45
|
| Rate for Payer: PHCS PPO |
$327.15
|
| Rate for Payer: Three Rivers PPO |
$250.37
|
| Rate for Payer: TriWest Veterans Administration |
$190.28
|
| Rate for Payer: United Healthcare Commercial |
$318.81
|
| Rate for Payer: United Healthcare Medicare |
$190.28
|
| Rate for Payer: WINHealth Partners Commercial |
$327.15
|
| Rate for Payer: Wise Provider Network Commercial |
$317.14
|
|
