|
DRILL BIT CANN 5.6MM AO
|
Facility
|
OP
|
$1,105.44
|
|
| Hospital Charge Code |
3100103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$598.60 |
| Max. Negotiated Rate |
$1,105.44 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,083.33
|
| Rate for Payer: Aetna of WY Medicare |
$729.59
|
| Rate for Payer: Altius Commercial |
$1,061.22
|
| Rate for Payer: Beech Street Commercial |
$1,083.33
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,072.28
|
| Rate for Payer: Cash Price |
$773.81
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,072.28
|
| Rate for Payer: Cigna of WY Commercial |
$1,083.33
|
| Rate for Payer: Entrust Commercial |
$1,050.17
|
| Rate for Payer: First Choice Health Commercial |
$1,050.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,050.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$630.10
|
| Rate for Payer: HealthUtah PPO |
$1,105.44
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,072.28
|
| Rate for Payer: Multiplan Medicare/VA |
$598.60
|
| Rate for Payer: One Health Plan of WY PPO |
$1,083.33
|
| Rate for Payer: PacificSource Commercial |
$994.90
|
| Rate for Payer: PHCS PPO |
$1,083.33
|
| Rate for Payer: Three Rivers PPO |
$829.08
|
| Rate for Payer: TriWest Veterans Administration |
$630.10
|
| Rate for Payer: United Healthcare Commercial |
$1,055.70
|
| Rate for Payer: United Healthcare Medicare |
$630.10
|
| Rate for Payer: WINHealth Partners Commercial |
$1,083.33
|
| Rate for Payer: Wise Provider Network Commercial |
$1,050.17
|
|
|
DRILL BIT CANN 5.6MM AO
|
Facility
|
IP
|
$1,105.44
|
|
| Hospital Charge Code |
3100103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$640.60 |
| Max. Negotiated Rate |
$1,105.44 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,083.33
|
| Rate for Payer: Aetna of WY Medicare |
$707.48
|
| Rate for Payer: Altius Commercial |
$1,061.22
|
| Rate for Payer: Beech Street Commercial |
$1,083.33
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,072.28
|
| Rate for Payer: Cash Price |
$773.81
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,072.28
|
| Rate for Payer: Cigna of WY Commercial |
$1,083.33
|
| Rate for Payer: Entrust Commercial |
$1,050.17
|
| Rate for Payer: First Choice Health Commercial |
$1,050.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,050.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$674.32
|
| Rate for Payer: HealthUtah PPO |
$1,105.44
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,072.28
|
| Rate for Payer: Multiplan Medicare/VA |
$640.60
|
| Rate for Payer: One Health Plan of WY PPO |
$1,083.33
|
| Rate for Payer: PacificSource Commercial |
$994.90
|
| Rate for Payer: PHCS PPO |
$1,083.33
|
| Rate for Payer: Three Rivers PPO |
$829.08
|
| Rate for Payer: TriWest Veterans Administration |
$674.32
|
| Rate for Payer: United Healthcare Commercial |
$1,055.70
|
| Rate for Payer: United Healthcare Medicare |
$674.32
|
| Rate for Payer: WINHealth Partners Commercial |
$1,050.17
|
| Rate for Payer: Wise Provider Network Commercial |
$1,050.17
|
|
|
DRILL BIT CANN 8.0MM AO
|
Facility
|
OP
|
$1,216.32
|
|
| Hospital Charge Code |
3100104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$658.64 |
| Max. Negotiated Rate |
$1,216.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,191.99
|
| Rate for Payer: Aetna of WY Medicare |
$802.77
|
| Rate for Payer: Altius Commercial |
$1,167.67
|
| Rate for Payer: Beech Street Commercial |
$1,191.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,179.83
|
| Rate for Payer: Cash Price |
$851.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,179.83
|
| Rate for Payer: Cigna of WY Commercial |
$1,191.99
|
| Rate for Payer: Entrust Commercial |
$1,155.50
|
| Rate for Payer: First Choice Health Commercial |
$1,155.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,155.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$693.30
|
| Rate for Payer: HealthUtah PPO |
$1,216.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,179.83
|
| Rate for Payer: Multiplan Medicare/VA |
$658.64
|
| Rate for Payer: One Health Plan of WY PPO |
$1,191.99
|
| Rate for Payer: PacificSource Commercial |
$1,094.69
|
| Rate for Payer: PHCS PPO |
$1,191.99
|
| Rate for Payer: Three Rivers PPO |
$912.24
|
| Rate for Payer: TriWest Veterans Administration |
$693.30
|
| Rate for Payer: United Healthcare Commercial |
$1,161.59
|
| Rate for Payer: United Healthcare Medicare |
$693.30
|
| Rate for Payer: WINHealth Partners Commercial |
$1,191.99
|
| Rate for Payer: Wise Provider Network Commercial |
$1,155.50
|
|
|
DRILL BIT CANN 8.0MM AO
|
Facility
|
IP
|
$1,216.32
|
|
| Hospital Charge Code |
3100104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$704.86 |
| Max. Negotiated Rate |
$1,216.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,191.99
|
| Rate for Payer: Aetna of WY Medicare |
$778.44
|
| Rate for Payer: Altius Commercial |
$1,167.67
|
| Rate for Payer: Beech Street Commercial |
$1,191.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,179.83
|
| Rate for Payer: Cash Price |
$851.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,179.83
|
| Rate for Payer: Cigna of WY Commercial |
$1,191.99
|
| Rate for Payer: Entrust Commercial |
$1,155.50
|
| Rate for Payer: First Choice Health Commercial |
$1,155.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,155.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$741.96
|
| Rate for Payer: HealthUtah PPO |
$1,216.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,179.83
|
| Rate for Payer: Multiplan Medicare/VA |
$704.86
|
| Rate for Payer: One Health Plan of WY PPO |
$1,191.99
|
| Rate for Payer: PacificSource Commercial |
$1,094.69
|
| Rate for Payer: PHCS PPO |
$1,191.99
|
| Rate for Payer: Three Rivers PPO |
$912.24
|
| Rate for Payer: TriWest Veterans Administration |
$741.96
|
| Rate for Payer: United Healthcare Commercial |
$1,161.59
|
| Rate for Payer: United Healthcare Medicare |
$741.96
|
| Rate for Payer: WINHealth Partners Commercial |
$1,155.50
|
| Rate for Payer: Wise Provider Network Commercial |
$1,155.50
|
|
|
DRILL BIT CANNULATED 2.6MM
|
Facility
|
IP
|
$612.50
|
|
| Hospital Charge Code |
3002327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$354.94 |
| Max. Negotiated Rate |
$612.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$600.25
|
| Rate for Payer: Aetna of WY Medicare |
$392.00
|
| Rate for Payer: Altius Commercial |
$588.00
|
| Rate for Payer: Beech Street Commercial |
$600.25
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$594.12
|
| Rate for Payer: Cash Price |
$428.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$594.12
|
| Rate for Payer: Cigna of WY Commercial |
$600.25
|
| Rate for Payer: Entrust Commercial |
$581.88
|
| Rate for Payer: First Choice Health Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$373.62
|
| Rate for Payer: HealthUtah PPO |
$612.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$594.12
|
| Rate for Payer: Multiplan Medicare/VA |
$354.94
|
| Rate for Payer: One Health Plan of WY PPO |
$600.25
|
| Rate for Payer: PacificSource Commercial |
$551.25
|
| Rate for Payer: PHCS PPO |
$600.25
|
| Rate for Payer: Three Rivers PPO |
$459.38
|
| Rate for Payer: TriWest Veterans Administration |
$373.62
|
| Rate for Payer: United Healthcare Commercial |
$584.94
|
| Rate for Payer: United Healthcare Medicare |
$373.62
|
| Rate for Payer: WINHealth Partners Commercial |
$581.88
|
| Rate for Payer: Wise Provider Network Commercial |
$581.88
|
|
|
DRILL BIT CANNULATED 2.6MM
|
Facility
|
OP
|
$612.50
|
|
| Hospital Charge Code |
3002327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$331.67 |
| Max. Negotiated Rate |
$612.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$600.25
|
| Rate for Payer: Aetna of WY Medicare |
$404.25
|
| Rate for Payer: Altius Commercial |
$588.00
|
| Rate for Payer: Beech Street Commercial |
$600.25
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$594.12
|
| Rate for Payer: Cash Price |
$428.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$594.12
|
| Rate for Payer: Cigna of WY Commercial |
$600.25
|
| Rate for Payer: Entrust Commercial |
$581.88
|
| Rate for Payer: First Choice Health Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$349.12
|
| Rate for Payer: HealthUtah PPO |
$612.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$594.12
|
| Rate for Payer: Multiplan Medicare/VA |
$331.67
|
| Rate for Payer: One Health Plan of WY PPO |
$600.25
|
| Rate for Payer: PacificSource Commercial |
$551.25
|
| Rate for Payer: PHCS PPO |
$600.25
|
| Rate for Payer: Three Rivers PPO |
$459.38
|
| Rate for Payer: TriWest Veterans Administration |
$349.12
|
| Rate for Payer: United Healthcare Commercial |
$584.94
|
| Rate for Payer: United Healthcare Medicare |
$349.12
|
| Rate for Payer: WINHealth Partners Commercial |
$600.25
|
| Rate for Payer: Wise Provider Network Commercial |
$581.88
|
|
|
DRILL BIT CANNULATED 7.3X300MM
|
Facility
|
OP
|
$1,895.25
|
|
| Hospital Charge Code |
3004540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,026.28 |
| Max. Negotiated Rate |
$1,895.25 |
| Rate for Payer: United Healthcare Commercial |
$1,809.96
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,857.34
|
| Rate for Payer: Aetna of WY Medicare |
$1,250.86
|
| Rate for Payer: Altius Commercial |
$1,819.44
|
| Rate for Payer: Beech Street Commercial |
$1,857.34
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,838.39
|
| Rate for Payer: Cash Price |
$1,326.67
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,838.39
|
| Rate for Payer: Cigna of WY Commercial |
$1,857.34
|
| Rate for Payer: Entrust Commercial |
$1,800.49
|
| Rate for Payer: First Choice Health Commercial |
$1,800.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,800.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,080.29
|
| Rate for Payer: HealthUtah PPO |
$1,895.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,838.39
|
| Rate for Payer: Multiplan Medicare/VA |
$1,026.28
|
| Rate for Payer: One Health Plan of WY PPO |
$1,857.34
|
| Rate for Payer: PacificSource Commercial |
$1,705.72
|
| Rate for Payer: PHCS PPO |
$1,857.34
|
| Rate for Payer: Three Rivers PPO |
$1,421.44
|
| Rate for Payer: TriWest Veterans Administration |
$1,080.29
|
| Rate for Payer: United Healthcare Medicare |
$1,080.29
|
| Rate for Payer: WINHealth Partners Commercial |
$1,857.34
|
| Rate for Payer: Wise Provider Network Commercial |
$1,800.49
|
|
|
DRILL BIT CANNULATED 7.3X300MM
|
Facility
|
IP
|
$1,895.25
|
|
| Hospital Charge Code |
3004540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,098.30 |
| Max. Negotiated Rate |
$1,895.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,857.34
|
| Rate for Payer: Aetna of WY Medicare |
$1,212.96
|
| Rate for Payer: Altius Commercial |
$1,819.44
|
| Rate for Payer: Beech Street Commercial |
$1,857.34
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,838.39
|
| Rate for Payer: Cash Price |
$1,326.67
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,838.39
|
| Rate for Payer: Cigna of WY Commercial |
$1,857.34
|
| Rate for Payer: Entrust Commercial |
$1,800.49
|
| Rate for Payer: First Choice Health Commercial |
$1,800.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,800.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,156.10
|
| Rate for Payer: HealthUtah PPO |
$1,895.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,838.39
|
| Rate for Payer: Multiplan Medicare/VA |
$1,098.30
|
| Rate for Payer: One Health Plan of WY PPO |
$1,857.34
|
| Rate for Payer: PacificSource Commercial |
$1,705.72
|
| Rate for Payer: PHCS PPO |
$1,857.34
|
| Rate for Payer: Three Rivers PPO |
$1,421.44
|
| Rate for Payer: TriWest Veterans Administration |
$1,156.10
|
| Rate for Payer: United Healthcare Commercial |
$1,809.96
|
| Rate for Payer: United Healthcare Medicare |
$1,156.10
|
| Rate for Payer: WINHealth Partners Commercial |
$1,800.49
|
| Rate for Payer: Wise Provider Network Commercial |
$1,800.49
|
|
|
DRILL BIT CERVICAL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
3004241
|
|
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 CERVICAL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
3004241
|
|
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 CLAV 2.2MM SHORT
|
Facility
|
IP
|
$146.02
|
|
| Hospital Charge Code |
3004021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.62 |
| Max. Negotiated Rate |
$146.02 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$143.10
|
| Rate for Payer: Aetna of WY Medicare |
$93.45
|
| Rate for Payer: Altius Commercial |
$140.18
|
| Rate for Payer: Beech Street Commercial |
$143.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$141.64
|
| Rate for Payer: Cash Price |
$102.21
|
| Rate for Payer: ChoiceCare Network Commercial |
$141.64
|
| Rate for Payer: Cigna of WY Commercial |
$143.10
|
| Rate for Payer: Entrust Commercial |
$138.72
|
| Rate for Payer: First Choice Health Commercial |
$138.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$138.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$89.07
|
| Rate for Payer: HealthUtah PPO |
$146.02
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$141.64
|
| Rate for Payer: Multiplan Medicare/VA |
$84.62
|
| Rate for Payer: One Health Plan of WY PPO |
$143.10
|
| Rate for Payer: PacificSource Commercial |
$131.42
|
| Rate for Payer: PHCS PPO |
$143.10
|
| Rate for Payer: Three Rivers PPO |
$109.52
|
| Rate for Payer: TriWest Veterans Administration |
$89.07
|
| Rate for Payer: United Healthcare Commercial |
$139.45
|
| Rate for Payer: United Healthcare Medicare |
$89.07
|
| Rate for Payer: WINHealth Partners Commercial |
$138.72
|
| Rate for Payer: Wise Provider Network Commercial |
$138.72
|
|
|
DRILL BIT CLAV 2.2MM SHORT
|
Facility
|
OP
|
$146.02
|
|
| Hospital Charge Code |
3004021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.07 |
| Max. Negotiated Rate |
$146.02 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$143.10
|
| Rate for Payer: Aetna of WY Medicare |
$96.37
|
| Rate for Payer: Altius Commercial |
$140.18
|
| Rate for Payer: Beech Street Commercial |
$143.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$141.64
|
| Rate for Payer: Cash Price |
$102.21
|
| Rate for Payer: ChoiceCare Network Commercial |
$141.64
|
| Rate for Payer: Cigna of WY Commercial |
$143.10
|
| Rate for Payer: Entrust Commercial |
$138.72
|
| Rate for Payer: First Choice Health Commercial |
$138.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$138.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.23
|
| Rate for Payer: HealthUtah PPO |
$146.02
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$141.64
|
| Rate for Payer: Multiplan Medicare/VA |
$79.07
|
| Rate for Payer: One Health Plan of WY PPO |
$143.10
|
| Rate for Payer: PacificSource Commercial |
$131.42
|
| Rate for Payer: PHCS PPO |
$143.10
|
| Rate for Payer: Three Rivers PPO |
$109.52
|
| Rate for Payer: TriWest Veterans Administration |
$83.23
|
| Rate for Payer: United Healthcare Commercial |
$139.45
|
| Rate for Payer: United Healthcare Medicare |
$83.23
|
| Rate for Payer: WINHealth Partners Commercial |
$143.10
|
| Rate for Payer: Wise Provider Network Commercial |
$138.72
|
|
|
DRILL BIT CLAV 2.7MM X 135MM
|
Facility
|
OP
|
$269.50
|
|
| Hospital Charge Code |
3004027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.93 |
| Max. Negotiated Rate |
$269.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$264.11
|
| Rate for Payer: Aetna of WY Medicare |
$177.87
|
| Rate for Payer: Altius Commercial |
$258.72
|
| Rate for Payer: Beech Street Commercial |
$264.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$261.42
|
| Rate for Payer: Cash Price |
$188.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$261.42
|
| Rate for Payer: Cigna of WY Commercial |
$264.11
|
| Rate for Payer: Entrust Commercial |
$256.02
|
| Rate for Payer: First Choice Health Commercial |
$256.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$256.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$153.62
|
| Rate for Payer: HealthUtah PPO |
$269.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$261.42
|
| Rate for Payer: Multiplan Medicare/VA |
$145.93
|
| Rate for Payer: One Health Plan of WY PPO |
$264.11
|
| Rate for Payer: PacificSource Commercial |
$242.55
|
| Rate for Payer: PHCS PPO |
$264.11
|
| Rate for Payer: Three Rivers PPO |
$202.12
|
| Rate for Payer: TriWest Veterans Administration |
$153.62
|
| Rate for Payer: United Healthcare Commercial |
$257.37
|
| Rate for Payer: United Healthcare Medicare |
$153.62
|
| Rate for Payer: WINHealth Partners Commercial |
$264.11
|
| Rate for Payer: Wise Provider Network Commercial |
$256.02
|
|
|
DRILL BIT CLAV 2.7MM X 135MM
|
Facility
|
IP
|
$269.50
|
|
| Hospital Charge Code |
3004027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.18 |
| Max. Negotiated Rate |
$269.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$264.11
|
| Rate for Payer: Aetna of WY Medicare |
$172.48
|
| Rate for Payer: Altius Commercial |
$258.72
|
| Rate for Payer: Beech Street Commercial |
$264.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$261.42
|
| Rate for Payer: Cash Price |
$188.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$261.42
|
| Rate for Payer: Cigna of WY Commercial |
$264.11
|
| Rate for Payer: Entrust Commercial |
$256.02
|
| Rate for Payer: First Choice Health Commercial |
$256.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$256.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$164.40
|
| Rate for Payer: HealthUtah PPO |
$269.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$261.42
|
| Rate for Payer: Multiplan Medicare/VA |
$156.18
|
| Rate for Payer: One Health Plan of WY PPO |
$264.11
|
| Rate for Payer: PacificSource Commercial |
$242.55
|
| Rate for Payer: PHCS PPO |
$264.11
|
| Rate for Payer: Three Rivers PPO |
$202.12
|
| Rate for Payer: TriWest Veterans Administration |
$164.40
|
| Rate for Payer: United Healthcare Commercial |
$257.37
|
| Rate for Payer: United Healthcare Medicare |
$164.40
|
| Rate for Payer: WINHealth Partners Commercial |
$256.02
|
| Rate for Payer: Wise Provider Network Commercial |
$256.02
|
|
|
DRILL BIT CONICAL 04
|
Facility
|
IP
|
$2,357.25
|
|
| Hospital Charge Code |
3100189
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,366.03 |
| Max. Negotiated Rate |
$2,357.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,310.10
|
| Rate for Payer: Aetna of WY Medicare |
$1,508.64
|
| Rate for Payer: Altius Commercial |
$2,262.96
|
| Rate for Payer: Beech Street Commercial |
$2,310.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,286.53
|
| Rate for Payer: Cash Price |
$1,650.07
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,286.53
|
| Rate for Payer: Cigna of WY Commercial |
$2,310.10
|
| Rate for Payer: Entrust Commercial |
$2,239.39
|
| Rate for Payer: First Choice Health Commercial |
$2,239.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,239.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,437.92
|
| Rate for Payer: HealthUtah PPO |
$2,357.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,286.53
|
| Rate for Payer: Multiplan Medicare/VA |
$1,366.03
|
| Rate for Payer: One Health Plan of WY PPO |
$2,310.10
|
| Rate for Payer: PacificSource Commercial |
$2,121.52
|
| Rate for Payer: PHCS PPO |
$2,310.10
|
| Rate for Payer: Three Rivers PPO |
$1,767.94
|
| Rate for Payer: TriWest Veterans Administration |
$1,437.92
|
| Rate for Payer: United Healthcare Commercial |
$2,251.17
|
| Rate for Payer: United Healthcare Medicare |
$1,437.92
|
| Rate for Payer: WINHealth Partners Commercial |
$2,239.39
|
| Rate for Payer: Wise Provider Network Commercial |
$2,239.39
|
|
|
DRILL BIT CONICAL 04
|
Facility
|
OP
|
$2,357.25
|
|
| Hospital Charge Code |
3100189
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,276.45 |
| Max. Negotiated Rate |
$2,357.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,310.10
|
| Rate for Payer: Aetna of WY Medicare |
$1,555.78
|
| Rate for Payer: Altius Commercial |
$2,262.96
|
| Rate for Payer: Beech Street Commercial |
$2,310.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,286.53
|
| Rate for Payer: Cash Price |
$1,650.07
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,286.53
|
| Rate for Payer: Cigna of WY Commercial |
$2,310.10
|
| Rate for Payer: Entrust Commercial |
$2,239.39
|
| Rate for Payer: First Choice Health Commercial |
$2,239.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,239.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,343.63
|
| Rate for Payer: HealthUtah PPO |
$2,357.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,286.53
|
| Rate for Payer: Multiplan Medicare/VA |
$1,276.45
|
| Rate for Payer: One Health Plan of WY PPO |
$2,310.10
|
| Rate for Payer: PacificSource Commercial |
$2,121.52
|
| Rate for Payer: PHCS PPO |
$2,310.10
|
| Rate for Payer: Three Rivers PPO |
$1,767.94
|
| Rate for Payer: TriWest Veterans Administration |
$1,343.63
|
| Rate for Payer: United Healthcare Commercial |
$2,251.17
|
| Rate for Payer: United Healthcare Medicare |
$1,343.63
|
| Rate for Payer: WINHealth Partners Commercial |
$2,310.10
|
| Rate for Payer: Wise Provider Network Commercial |
$2,239.39
|
|
|
DRILL BIT GRADUATED 2.5MM
|
Facility
|
OP
|
$297.50
|
|
| Hospital Charge Code |
3002328
|
|
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 GRADUATED 2.5MM
|
Facility
|
IP
|
$297.50
|
|
| Hospital Charge Code |
3002328
|
|
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 JUGGERKNOT 2.9MM
|
Facility
|
OP
|
$286.34
|
|
| Hospital Charge Code |
3003798
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$155.05 |
| Max. Negotiated Rate |
$286.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$280.61
|
| Rate for Payer: Aetna of WY Medicare |
$188.98
|
| Rate for Payer: Altius Commercial |
$274.89
|
| Rate for Payer: Beech Street Commercial |
$280.61
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$277.75
|
| Rate for Payer: Cash Price |
$200.43
|
| Rate for Payer: ChoiceCare Network Commercial |
$277.75
|
| Rate for Payer: Cigna of WY Commercial |
$280.61
|
| Rate for Payer: Entrust Commercial |
$272.02
|
| Rate for Payer: First Choice Health Commercial |
$272.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.21
|
| Rate for Payer: HealthUtah PPO |
$286.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$277.75
|
| Rate for Payer: Multiplan Medicare/VA |
$155.05
|
| Rate for Payer: One Health Plan of WY PPO |
$280.61
|
| Rate for Payer: PacificSource Commercial |
$257.71
|
| Rate for Payer: PHCS PPO |
$280.61
|
| Rate for Payer: Three Rivers PPO |
$214.76
|
| Rate for Payer: TriWest Veterans Administration |
$163.21
|
| Rate for Payer: United Healthcare Commercial |
$273.45
|
| Rate for Payer: United Healthcare Medicare |
$163.21
|
| Rate for Payer: WINHealth Partners Commercial |
$280.61
|
| Rate for Payer: Wise Provider Network Commercial |
$272.02
|
|
|
DRILL BIT JUGGERKNOT 2.9MM
|
Facility
|
IP
|
$286.34
|
|
| Hospital Charge Code |
3003798
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.93 |
| Max. Negotiated Rate |
$286.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$280.61
|
| Rate for Payer: Aetna of WY Medicare |
$183.26
|
| Rate for Payer: Altius Commercial |
$274.89
|
| Rate for Payer: Beech Street Commercial |
$280.61
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$277.75
|
| Rate for Payer: Cash Price |
$200.43
|
| Rate for Payer: ChoiceCare Network Commercial |
$277.75
|
| Rate for Payer: Cigna of WY Commercial |
$280.61
|
| Rate for Payer: Entrust Commercial |
$272.02
|
| Rate for Payer: First Choice Health Commercial |
$272.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$174.67
|
| Rate for Payer: HealthUtah PPO |
$286.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$277.75
|
| Rate for Payer: Multiplan Medicare/VA |
$165.93
|
| Rate for Payer: One Health Plan of WY PPO |
$280.61
|
| Rate for Payer: PacificSource Commercial |
$257.71
|
| Rate for Payer: PHCS PPO |
$280.61
|
| Rate for Payer: Three Rivers PPO |
$214.76
|
| Rate for Payer: TriWest Veterans Administration |
$174.67
|
| Rate for Payer: United Healthcare Commercial |
$273.45
|
| Rate for Payer: United Healthcare Medicare |
$174.67
|
| Rate for Payer: WINHealth Partners Commercial |
$272.02
|
| Rate for Payer: Wise Provider Network Commercial |
$272.02
|
|
|
DRILL BIT KIT EXACTECH
|
Facility
|
OP
|
$1,470.00
|
|
| Hospital Charge Code |
3001388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$796.00 |
| Max. Negotiated Rate |
$1,470.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,440.60
|
| Rate for Payer: Aetna of WY Medicare |
$970.20
|
| Rate for Payer: Altius Commercial |
$1,411.20
|
| Rate for Payer: Beech Street Commercial |
$1,440.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,425.90
|
| Rate for Payer: Cash Price |
$1,029.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,425.90
|
| Rate for Payer: Cigna of WY Commercial |
$1,440.60
|
| Rate for Payer: Entrust Commercial |
$1,396.50
|
| Rate for Payer: First Choice Health Commercial |
$1,396.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,396.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$837.90
|
| Rate for Payer: HealthUtah PPO |
$1,470.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,425.90
|
| Rate for Payer: Multiplan Medicare/VA |
$796.00
|
| Rate for Payer: One Health Plan of WY PPO |
$1,440.60
|
| Rate for Payer: PacificSource Commercial |
$1,323.00
|
| Rate for Payer: PHCS PPO |
$1,440.60
|
| Rate for Payer: Three Rivers PPO |
$1,102.50
|
| Rate for Payer: TriWest Veterans Administration |
$837.90
|
| Rate for Payer: United Healthcare Commercial |
$1,403.85
|
| Rate for Payer: United Healthcare Medicare |
$837.90
|
| Rate for Payer: WINHealth Partners Commercial |
$1,440.60
|
| Rate for Payer: Wise Provider Network Commercial |
$1,396.50
|
|
|
DRILL BIT KIT EXACTECH
|
Facility
|
IP
|
$1,470.00
|
|
| Hospital Charge Code |
3001388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$851.86 |
| Max. Negotiated Rate |
$1,470.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,440.60
|
| Rate for Payer: Aetna of WY Medicare |
$940.80
|
| Rate for Payer: Altius Commercial |
$1,411.20
|
| Rate for Payer: Beech Street Commercial |
$1,440.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,425.90
|
| Rate for Payer: Cash Price |
$1,029.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,425.90
|
| Rate for Payer: Cigna of WY Commercial |
$1,440.60
|
| Rate for Payer: Entrust Commercial |
$1,396.50
|
| Rate for Payer: First Choice Health Commercial |
$1,396.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,396.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$896.70
|
| Rate for Payer: HealthUtah PPO |
$1,470.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,425.90
|
| Rate for Payer: Multiplan Medicare/VA |
$851.86
|
| Rate for Payer: One Health Plan of WY PPO |
$1,440.60
|
| Rate for Payer: PacificSource Commercial |
$1,323.00
|
| Rate for Payer: PHCS PPO |
$1,440.60
|
| Rate for Payer: Three Rivers PPO |
$1,102.50
|
| Rate for Payer: TriWest Veterans Administration |
$896.70
|
| Rate for Payer: United Healthcare Commercial |
$1,403.85
|
| Rate for Payer: United Healthcare Medicare |
$896.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,396.50
|
| Rate for Payer: Wise Provider Network Commercial |
$1,396.50
|
|
|
DRILL BIT LONG 2.6
|
Facility
|
OP
|
$737.52
|
|
| Hospital Charge Code |
3100191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$399.37 |
| Max. Negotiated Rate |
$737.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$722.77
|
| Rate for Payer: Aetna of WY Medicare |
$486.76
|
| Rate for Payer: Altius Commercial |
$708.02
|
| Rate for Payer: Beech Street Commercial |
$722.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$715.39
|
| Rate for Payer: Cash Price |
$516.26
|
| Rate for Payer: ChoiceCare Network Commercial |
$715.39
|
| Rate for Payer: Cigna of WY Commercial |
$722.77
|
| Rate for Payer: Entrust Commercial |
$700.64
|
| Rate for Payer: First Choice Health Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$420.39
|
| Rate for Payer: HealthUtah PPO |
$737.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$715.39
|
| Rate for Payer: Multiplan Medicare/VA |
$399.37
|
| Rate for Payer: One Health Plan of WY PPO |
$722.77
|
| Rate for Payer: PacificSource Commercial |
$663.77
|
| Rate for Payer: PHCS PPO |
$722.77
|
| Rate for Payer: Three Rivers PPO |
$553.14
|
| Rate for Payer: TriWest Veterans Administration |
$420.39
|
| Rate for Payer: United Healthcare Commercial |
$704.33
|
| Rate for Payer: United Healthcare Medicare |
$420.39
|
| Rate for Payer: WINHealth Partners Commercial |
$722.77
|
| Rate for Payer: Wise Provider Network Commercial |
$700.64
|
|
|
DRILL BIT LONG 2.6
|
Facility
|
IP
|
$737.52
|
|
| Hospital Charge Code |
3100191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$427.39 |
| Max. Negotiated Rate |
$737.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$722.77
|
| Rate for Payer: Aetna of WY Medicare |
$472.01
|
| Rate for Payer: Altius Commercial |
$708.02
|
| Rate for Payer: Beech Street Commercial |
$722.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$715.39
|
| Rate for Payer: Cash Price |
$516.26
|
| Rate for Payer: ChoiceCare Network Commercial |
$715.39
|
| Rate for Payer: Cigna of WY Commercial |
$722.77
|
| Rate for Payer: Entrust Commercial |
$700.64
|
| Rate for Payer: First Choice Health Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$449.89
|
| Rate for Payer: HealthUtah PPO |
$737.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$715.39
|
| Rate for Payer: Multiplan Medicare/VA |
$427.39
|
| Rate for Payer: One Health Plan of WY PPO |
$722.77
|
| Rate for Payer: PacificSource Commercial |
$663.77
|
| Rate for Payer: PHCS PPO |
$722.77
|
| Rate for Payer: Three Rivers PPO |
$553.14
|
| Rate for Payer: TriWest Veterans Administration |
$449.89
|
| Rate for Payer: United Healthcare Commercial |
$704.33
|
| Rate for Payer: United Healthcare Medicare |
$449.89
|
| Rate for Payer: WINHealth Partners Commercial |
$700.64
|
| Rate for Payer: Wise Provider Network Commercial |
$700.64
|
|
|
DRILL BIT QC 4.3 X 180MM
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
3004542
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.29 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$514.50
|
| Rate for Payer: Aetna of WY Medicare |
$346.50
|
| Rate for Payer: Altius Commercial |
$504.00
|
| Rate for Payer: Beech Street Commercial |
$514.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$509.25
|
| Rate for Payer: Cash Price |
$367.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$509.25
|
| Rate for Payer: Cigna of WY Commercial |
$514.50
|
| Rate for Payer: Entrust Commercial |
$498.75
|
| Rate for Payer: First Choice Health Commercial |
$498.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$498.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$299.25
|
| Rate for Payer: HealthUtah PPO |
$525.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$509.25
|
| Rate for Payer: Multiplan Medicare/VA |
$284.29
|
| Rate for Payer: One Health Plan of WY PPO |
$514.50
|
| Rate for Payer: PacificSource Commercial |
$472.50
|
| Rate for Payer: PHCS PPO |
$514.50
|
| Rate for Payer: Three Rivers PPO |
$393.75
|
| Rate for Payer: TriWest Veterans Administration |
$299.25
|
| Rate for Payer: United Healthcare Commercial |
$501.38
|
| Rate for Payer: United Healthcare Medicare |
$299.25
|
| Rate for Payer: WINHealth Partners Commercial |
$514.50
|
| Rate for Payer: Wise Provider Network Commercial |
$498.75
|
|
