|
DRILL COUNTERBORE MANUAL IMN 5.5 X 280MM
|
Facility
|
IP
|
$525.21
|
|
| Hospital Charge Code |
3100740
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.36 |
| Max. Negotiated Rate |
$525.21 |
| Rate for Payer: United Healthcare Commercial |
$501.58
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$514.71
|
| Rate for Payer: Aetna of WY Medicare |
$336.13
|
| Rate for Payer: Altius Commercial |
$504.20
|
| Rate for Payer: Beech Street Commercial |
$514.71
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$509.45
|
| Rate for Payer: Cash Price |
$367.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$509.45
|
| Rate for Payer: Cigna of WY Commercial |
$514.71
|
| Rate for Payer: Entrust Commercial |
$498.95
|
| Rate for Payer: First Choice Health Commercial |
$498.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$498.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$320.38
|
| Rate for Payer: HealthUtah PPO |
$525.21
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$509.45
|
| Rate for Payer: Multiplan Medicare/VA |
$304.36
|
| Rate for Payer: One Health Plan of WY PPO |
$514.71
|
| Rate for Payer: PacificSource Commercial |
$472.69
|
| Rate for Payer: PHCS PPO |
$514.71
|
| Rate for Payer: Three Rivers PPO |
$393.91
|
| Rate for Payer: TriWest Veterans Administration |
$320.38
|
| Rate for Payer: United Healthcare Medicare |
$320.38
|
| Rate for Payer: WINHealth Partners Commercial |
$498.95
|
| Rate for Payer: Wise Provider Network Commercial |
$498.95
|
|
|
DRILL COUNTERBORE MANUAL IMN 5.5 X 280MM
|
Facility
|
OP
|
$525.21
|
|
| Hospital Charge Code |
3100740
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.40 |
| Max. Negotiated Rate |
$525.21 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$514.71
|
| Rate for Payer: Aetna of WY Medicare |
$346.64
|
| Rate for Payer: Altius Commercial |
$504.20
|
| Rate for Payer: Beech Street Commercial |
$514.71
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$509.45
|
| Rate for Payer: Cash Price |
$367.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$509.45
|
| Rate for Payer: Cigna of WY Commercial |
$514.71
|
| Rate for Payer: Entrust Commercial |
$498.95
|
| Rate for Payer: First Choice Health Commercial |
$498.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$498.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$299.37
|
| Rate for Payer: HealthUtah PPO |
$525.21
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$509.45
|
| Rate for Payer: Multiplan Medicare/VA |
$284.40
|
| Rate for Payer: One Health Plan of WY PPO |
$514.71
|
| Rate for Payer: PacificSource Commercial |
$472.69
|
| Rate for Payer: PHCS PPO |
$514.71
|
| Rate for Payer: Three Rivers PPO |
$393.91
|
| Rate for Payer: TriWest Veterans Administration |
$299.37
|
| Rate for Payer: United Healthcare Commercial |
$501.58
|
| Rate for Payer: United Healthcare Medicare |
$299.37
|
| Rate for Payer: WINHealth Partners Commercial |
$514.71
|
| Rate for Payer: Wise Provider Network Commercial |
$498.95
|
|
|
DRILL COUNTERBORE SHORT IMN 5.5 X 185MM
|
Facility
|
IP
|
$523.74
|
|
| Hospital Charge Code |
3100738
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.51 |
| Max. Negotiated Rate |
$523.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$513.27
|
| Rate for Payer: Aetna of WY Medicare |
$335.19
|
| Rate for Payer: Altius Commercial |
$502.79
|
| Rate for Payer: Beech Street Commercial |
$513.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$508.03
|
| Rate for Payer: Cash Price |
$366.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$508.03
|
| Rate for Payer: Cigna of WY Commercial |
$513.27
|
| Rate for Payer: Entrust Commercial |
$497.55
|
| Rate for Payer: First Choice Health Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$319.48
|
| Rate for Payer: HealthUtah PPO |
$523.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$508.03
|
| Rate for Payer: Multiplan Medicare/VA |
$303.51
|
| Rate for Payer: One Health Plan of WY PPO |
$513.27
|
| Rate for Payer: PacificSource Commercial |
$471.37
|
| Rate for Payer: PHCS PPO |
$513.27
|
| Rate for Payer: Three Rivers PPO |
$392.80
|
| Rate for Payer: TriWest Veterans Administration |
$319.48
|
| Rate for Payer: United Healthcare Commercial |
$500.17
|
| Rate for Payer: United Healthcare Medicare |
$319.48
|
| Rate for Payer: WINHealth Partners Commercial |
$497.55
|
| Rate for Payer: Wise Provider Network Commercial |
$497.55
|
|
|
DRILL COUNTERBORE SHORT IMN 5.5 X 185MM
|
Facility
|
OP
|
$523.74
|
|
| Hospital Charge Code |
3100738
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$283.61 |
| Max. Negotiated Rate |
$523.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$513.27
|
| Rate for Payer: Aetna of WY Medicare |
$345.67
|
| Rate for Payer: Altius Commercial |
$502.79
|
| Rate for Payer: Beech Street Commercial |
$513.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$508.03
|
| Rate for Payer: Cash Price |
$366.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$508.03
|
| Rate for Payer: Cigna of WY Commercial |
$513.27
|
| Rate for Payer: Entrust Commercial |
$497.55
|
| Rate for Payer: First Choice Health Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$298.53
|
| Rate for Payer: HealthUtah PPO |
$523.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$508.03
|
| Rate for Payer: Multiplan Medicare/VA |
$283.61
|
| Rate for Payer: One Health Plan of WY PPO |
$513.27
|
| Rate for Payer: PacificSource Commercial |
$471.37
|
| Rate for Payer: PHCS PPO |
$513.27
|
| Rate for Payer: Three Rivers PPO |
$392.80
|
| Rate for Payer: TriWest Veterans Administration |
$298.53
|
| Rate for Payer: United Healthcare Commercial |
$500.17
|
| Rate for Payer: United Healthcare Medicare |
$298.53
|
| Rate for Payer: WINHealth Partners Commercial |
$513.27
|
| Rate for Payer: Wise Provider Network Commercial |
$497.55
|
|
|
DRILL FEMUR 4.9MM CALIBRATED
|
Facility
|
OP
|
$1,440.60
|
|
| Hospital Charge Code |
3002777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.08 |
| Max. Negotiated Rate |
$1,440.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,411.79
|
| Rate for Payer: Aetna of WY Medicare |
$950.80
|
| Rate for Payer: Altius Commercial |
$1,382.98
|
| Rate for Payer: Beech Street Commercial |
$1,411.79
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,397.38
|
| Rate for Payer: Cash Price |
$1,008.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,397.38
|
| Rate for Payer: Cigna of WY Commercial |
$1,411.79
|
| Rate for Payer: Entrust Commercial |
$1,368.57
|
| Rate for Payer: First Choice Health Commercial |
$1,368.57
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,368.57
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$821.14
|
| Rate for Payer: HealthUtah PPO |
$1,440.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,397.38
|
| Rate for Payer: Multiplan Medicare/VA |
$780.08
|
| Rate for Payer: One Health Plan of WY PPO |
$1,411.79
|
| Rate for Payer: PacificSource Commercial |
$1,296.54
|
| Rate for Payer: PHCS PPO |
$1,411.79
|
| Rate for Payer: Three Rivers PPO |
$1,080.45
|
| Rate for Payer: TriWest Veterans Administration |
$821.14
|
| Rate for Payer: United Healthcare Commercial |
$1,375.77
|
| Rate for Payer: United Healthcare Medicare |
$821.14
|
| Rate for Payer: WINHealth Partners Commercial |
$1,411.79
|
| Rate for Payer: Wise Provider Network Commercial |
$1,368.57
|
|
|
DRILL FEMUR 4.9MM CALIBRATED
|
Facility
|
IP
|
$1,440.60
|
|
| Hospital Charge Code |
3002777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$834.83 |
| Max. Negotiated Rate |
$1,440.60 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,411.79
|
| Rate for Payer: Aetna of WY Medicare |
$921.98
|
| Rate for Payer: Altius Commercial |
$1,382.98
|
| Rate for Payer: Beech Street Commercial |
$1,411.79
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,397.38
|
| Rate for Payer: Cash Price |
$1,008.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,397.38
|
| Rate for Payer: Cigna of WY Commercial |
$1,411.79
|
| Rate for Payer: Entrust Commercial |
$1,368.57
|
| Rate for Payer: First Choice Health Commercial |
$1,368.57
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,368.57
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$878.77
|
| Rate for Payer: HealthUtah PPO |
$1,440.60
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,397.38
|
| Rate for Payer: Multiplan Medicare/VA |
$834.83
|
| Rate for Payer: One Health Plan of WY PPO |
$1,411.79
|
| Rate for Payer: PacificSource Commercial |
$1,296.54
|
| Rate for Payer: PHCS PPO |
$1,411.79
|
| Rate for Payer: Three Rivers PPO |
$1,080.45
|
| Rate for Payer: TriWest Veterans Administration |
$878.77
|
| Rate for Payer: United Healthcare Commercial |
$1,375.77
|
| Rate for Payer: United Healthcare Medicare |
$878.77
|
| Rate for Payer: WINHealth Partners Commercial |
$1,368.57
|
| Rate for Payer: Wise Provider Network Commercial |
$1,368.57
|
|
|
DRILL FRAG-LOC 2.5 MM ACUMED
|
Facility
|
IP
|
$1,172.50
|
|
| Hospital Charge Code |
3003457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$679.46 |
| Max. Negotiated Rate |
$1,172.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,149.05
|
| Rate for Payer: Aetna of WY Medicare |
$750.40
|
| Rate for Payer: Altius Commercial |
$1,125.60
|
| Rate for Payer: Beech Street Commercial |
$1,149.05
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,137.32
|
| Rate for Payer: Cash Price |
$820.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,137.32
|
| Rate for Payer: Cigna of WY Commercial |
$1,149.05
|
| Rate for Payer: Entrust Commercial |
$1,113.88
|
| Rate for Payer: First Choice Health Commercial |
$1,113.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,113.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$715.22
|
| Rate for Payer: HealthUtah PPO |
$1,172.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,137.32
|
| Rate for Payer: Multiplan Medicare/VA |
$679.46
|
| Rate for Payer: One Health Plan of WY PPO |
$1,149.05
|
| Rate for Payer: PacificSource Commercial |
$1,055.25
|
| Rate for Payer: PHCS PPO |
$1,149.05
|
| Rate for Payer: Three Rivers PPO |
$879.38
|
| Rate for Payer: TriWest Veterans Administration |
$715.22
|
| Rate for Payer: United Healthcare Commercial |
$1,119.74
|
| Rate for Payer: United Healthcare Medicare |
$715.22
|
| Rate for Payer: WINHealth Partners Commercial |
$1,113.88
|
| Rate for Payer: Wise Provider Network Commercial |
$1,113.88
|
|
|
DRILL FRAG-LOC 2.5 MM ACUMED
|
Facility
|
OP
|
$1,172.50
|
|
| Hospital Charge Code |
3003457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$634.91 |
| Max. Negotiated Rate |
$1,172.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,149.05
|
| Rate for Payer: Aetna of WY Medicare |
$773.85
|
| Rate for Payer: Altius Commercial |
$1,125.60
|
| Rate for Payer: Beech Street Commercial |
$1,149.05
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,137.32
|
| Rate for Payer: Cash Price |
$820.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,137.32
|
| Rate for Payer: Cigna of WY Commercial |
$1,149.05
|
| Rate for Payer: Entrust Commercial |
$1,113.88
|
| Rate for Payer: First Choice Health Commercial |
$1,113.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,113.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$668.32
|
| Rate for Payer: HealthUtah PPO |
$1,172.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,137.32
|
| Rate for Payer: Multiplan Medicare/VA |
$634.91
|
| Rate for Payer: One Health Plan of WY PPO |
$1,149.05
|
| Rate for Payer: PacificSource Commercial |
$1,055.25
|
| Rate for Payer: PHCS PPO |
$1,149.05
|
| Rate for Payer: Three Rivers PPO |
$879.38
|
| Rate for Payer: TriWest Veterans Administration |
$668.32
|
| Rate for Payer: United Healthcare Commercial |
$1,119.74
|
| Rate for Payer: United Healthcare Medicare |
$668.32
|
| Rate for Payer: WINHealth Partners Commercial |
$1,149.05
|
| Rate for Payer: Wise Provider Network Commercial |
$1,113.88
|
|
|
DRILL FREEHAND 4.2 X 130MM
|
Facility
|
IP
|
$568.40
|
|
| Hospital Charge Code |
3100712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$329.39 |
| Max. Negotiated Rate |
$568.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$557.03
|
| Rate for Payer: Aetna of WY Medicare |
$363.78
|
| Rate for Payer: Altius Commercial |
$545.66
|
| Rate for Payer: Beech Street Commercial |
$557.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$551.35
|
| Rate for Payer: Cash Price |
$397.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$551.35
|
| Rate for Payer: Cigna of WY Commercial |
$557.03
|
| Rate for Payer: Entrust Commercial |
$539.98
|
| Rate for Payer: First Choice Health Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$346.72
|
| Rate for Payer: HealthUtah PPO |
$568.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$551.35
|
| Rate for Payer: Multiplan Medicare/VA |
$329.39
|
| Rate for Payer: One Health Plan of WY PPO |
$557.03
|
| Rate for Payer: PacificSource Commercial |
$511.56
|
| Rate for Payer: PHCS PPO |
$557.03
|
| Rate for Payer: Three Rivers PPO |
$426.30
|
| Rate for Payer: TriWest Veterans Administration |
$346.72
|
| Rate for Payer: United Healthcare Commercial |
$542.82
|
| Rate for Payer: United Healthcare Medicare |
$346.72
|
| Rate for Payer: WINHealth Partners Commercial |
$539.98
|
| Rate for Payer: Wise Provider Network Commercial |
$539.98
|
|
|
DRILL FREEHAND 4.2 X 130MM
|
Facility
|
OP
|
$568.40
|
|
| Hospital Charge Code |
3100712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$568.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$557.03
|
| Rate for Payer: Aetna of WY Medicare |
$375.14
|
| Rate for Payer: Altius Commercial |
$545.66
|
| Rate for Payer: Beech Street Commercial |
$557.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$551.35
|
| Rate for Payer: Cash Price |
$397.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$551.35
|
| Rate for Payer: Cigna of WY Commercial |
$557.03
|
| Rate for Payer: Entrust Commercial |
$539.98
|
| Rate for Payer: First Choice Health Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$323.99
|
| Rate for Payer: HealthUtah PPO |
$568.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$551.35
|
| Rate for Payer: Multiplan Medicare/VA |
$307.79
|
| Rate for Payer: One Health Plan of WY PPO |
$557.03
|
| Rate for Payer: PacificSource Commercial |
$511.56
|
| Rate for Payer: PHCS PPO |
$557.03
|
| Rate for Payer: Three Rivers PPO |
$426.30
|
| Rate for Payer: TriWest Veterans Administration |
$323.99
|
| Rate for Payer: United Healthcare Commercial |
$542.82
|
| Rate for Payer: United Healthcare Medicare |
$323.99
|
| Rate for Payer: WINHealth Partners Commercial |
$557.03
|
| Rate for Payer: Wise Provider Network Commercial |
$539.98
|
|
|
DRILL FREEHAND 4.2X185 STRYKER
|
Facility
|
OP
|
$523.74
|
|
| Hospital Charge Code |
3100690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$283.61 |
| Max. Negotiated Rate |
$523.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$513.27
|
| Rate for Payer: Aetna of WY Medicare |
$345.67
|
| Rate for Payer: Altius Commercial |
$502.79
|
| Rate for Payer: Beech Street Commercial |
$513.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$508.03
|
| Rate for Payer: Cash Price |
$366.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$508.03
|
| Rate for Payer: Cigna of WY Commercial |
$513.27
|
| Rate for Payer: Entrust Commercial |
$497.55
|
| Rate for Payer: First Choice Health Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$298.53
|
| Rate for Payer: HealthUtah PPO |
$523.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$508.03
|
| Rate for Payer: Multiplan Medicare/VA |
$283.61
|
| Rate for Payer: One Health Plan of WY PPO |
$513.27
|
| Rate for Payer: PacificSource Commercial |
$471.37
|
| Rate for Payer: PHCS PPO |
$513.27
|
| Rate for Payer: Three Rivers PPO |
$392.80
|
| Rate for Payer: TriWest Veterans Administration |
$298.53
|
| Rate for Payer: United Healthcare Commercial |
$500.17
|
| Rate for Payer: United Healthcare Medicare |
$298.53
|
| Rate for Payer: WINHealth Partners Commercial |
$513.27
|
| Rate for Payer: Wise Provider Network Commercial |
$497.55
|
|
|
DRILL FREEHAND 4.2X185 STRYKER
|
Facility
|
IP
|
$523.74
|
|
| Hospital Charge Code |
3100690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.51 |
| Max. Negotiated Rate |
$523.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$513.27
|
| Rate for Payer: Aetna of WY Medicare |
$335.19
|
| Rate for Payer: Altius Commercial |
$502.79
|
| Rate for Payer: Beech Street Commercial |
$513.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$508.03
|
| Rate for Payer: Cash Price |
$366.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$508.03
|
| Rate for Payer: Cigna of WY Commercial |
$513.27
|
| Rate for Payer: Entrust Commercial |
$497.55
|
| Rate for Payer: First Choice Health Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$497.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$319.48
|
| Rate for Payer: HealthUtah PPO |
$523.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$508.03
|
| Rate for Payer: Multiplan Medicare/VA |
$303.51
|
| Rate for Payer: One Health Plan of WY PPO |
$513.27
|
| Rate for Payer: PacificSource Commercial |
$471.37
|
| Rate for Payer: PHCS PPO |
$513.27
|
| Rate for Payer: Three Rivers PPO |
$392.80
|
| Rate for Payer: TriWest Veterans Administration |
$319.48
|
| Rate for Payer: United Healthcare Commercial |
$500.17
|
| Rate for Payer: United Healthcare Medicare |
$319.48
|
| Rate for Payer: WINHealth Partners Commercial |
$497.55
|
| Rate for Payer: Wise Provider Network Commercial |
$497.55
|
|
|
DRILL FREEHAND IMN 4.2 X 130MM
|
Facility
|
IP
|
$568.40
|
|
| Hospital Charge Code |
3100736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$329.39 |
| Max. Negotiated Rate |
$568.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$557.03
|
| Rate for Payer: Aetna of WY Medicare |
$363.78
|
| Rate for Payer: Altius Commercial |
$545.66
|
| Rate for Payer: Beech Street Commercial |
$557.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$551.35
|
| Rate for Payer: Cash Price |
$397.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$551.35
|
| Rate for Payer: Cigna of WY Commercial |
$557.03
|
| Rate for Payer: Entrust Commercial |
$539.98
|
| Rate for Payer: First Choice Health Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$346.72
|
| Rate for Payer: HealthUtah PPO |
$568.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$551.35
|
| Rate for Payer: Multiplan Medicare/VA |
$329.39
|
| Rate for Payer: One Health Plan of WY PPO |
$557.03
|
| Rate for Payer: PacificSource Commercial |
$511.56
|
| Rate for Payer: PHCS PPO |
$557.03
|
| Rate for Payer: Three Rivers PPO |
$426.30
|
| Rate for Payer: TriWest Veterans Administration |
$346.72
|
| Rate for Payer: United Healthcare Commercial |
$542.82
|
| Rate for Payer: United Healthcare Medicare |
$346.72
|
| Rate for Payer: WINHealth Partners Commercial |
$539.98
|
| Rate for Payer: Wise Provider Network Commercial |
$539.98
|
|
|
DRILL FREEHAND IMN 4.2 X 130MM
|
Facility
|
OP
|
$568.40
|
|
| Hospital Charge Code |
3100736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$568.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$557.03
|
| Rate for Payer: Aetna of WY Medicare |
$375.14
|
| Rate for Payer: Altius Commercial |
$545.66
|
| Rate for Payer: Beech Street Commercial |
$557.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$551.35
|
| Rate for Payer: Cash Price |
$397.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$551.35
|
| Rate for Payer: Cigna of WY Commercial |
$557.03
|
| Rate for Payer: Entrust Commercial |
$539.98
|
| Rate for Payer: First Choice Health Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$539.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$323.99
|
| Rate for Payer: HealthUtah PPO |
$568.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$551.35
|
| Rate for Payer: Multiplan Medicare/VA |
$307.79
|
| Rate for Payer: One Health Plan of WY PPO |
$557.03
|
| Rate for Payer: PacificSource Commercial |
$511.56
|
| Rate for Payer: PHCS PPO |
$557.03
|
| Rate for Payer: Three Rivers PPO |
$426.30
|
| Rate for Payer: TriWest Veterans Administration |
$323.99
|
| Rate for Payer: United Healthcare Commercial |
$542.82
|
| Rate for Payer: United Healthcare Medicare |
$323.99
|
| Rate for Payer: WINHealth Partners Commercial |
$557.03
|
| Rate for Payer: Wise Provider Network Commercial |
$539.98
|
|
|
DRILL FUS QUICK RELEASE 2.0 MM
|
Facility
|
OP
|
$1,452.50
|
|
| Hospital Charge Code |
3003830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$786.53 |
| Max. Negotiated Rate |
$1,452.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,423.45
|
| Rate for Payer: Aetna of WY Medicare |
$958.65
|
| Rate for Payer: Altius Commercial |
$1,394.40
|
| Rate for Payer: Beech Street Commercial |
$1,423.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,408.92
|
| Rate for Payer: Cash Price |
$1,016.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,408.92
|
| Rate for Payer: Cigna of WY Commercial |
$1,423.45
|
| Rate for Payer: Entrust Commercial |
$1,379.88
|
| Rate for Payer: First Choice Health Commercial |
$1,379.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,379.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$827.92
|
| Rate for Payer: HealthUtah PPO |
$1,452.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,408.92
|
| Rate for Payer: Multiplan Medicare/VA |
$786.53
|
| Rate for Payer: One Health Plan of WY PPO |
$1,423.45
|
| Rate for Payer: PacificSource Commercial |
$1,307.25
|
| Rate for Payer: PHCS PPO |
$1,423.45
|
| Rate for Payer: Three Rivers PPO |
$1,089.38
|
| Rate for Payer: TriWest Veterans Administration |
$827.92
|
| Rate for Payer: United Healthcare Commercial |
$1,387.14
|
| Rate for Payer: United Healthcare Medicare |
$827.92
|
| Rate for Payer: WINHealth Partners Commercial |
$1,423.45
|
| Rate for Payer: Wise Provider Network Commercial |
$1,379.88
|
|
|
DRILL FUS QUICK RELEASE 2.0 MM
|
Facility
|
IP
|
$1,452.50
|
|
| Hospital Charge Code |
3003830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$841.72 |
| Max. Negotiated Rate |
$1,452.50 |
| Rate for Payer: United Healthcare Commercial |
$1,387.14
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,423.45
|
| Rate for Payer: Aetna of WY Medicare |
$929.60
|
| Rate for Payer: Altius Commercial |
$1,394.40
|
| Rate for Payer: Beech Street Commercial |
$1,423.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,408.92
|
| Rate for Payer: Cash Price |
$1,016.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,408.92
|
| Rate for Payer: Cigna of WY Commercial |
$1,423.45
|
| Rate for Payer: Entrust Commercial |
$1,379.88
|
| Rate for Payer: First Choice Health Commercial |
$1,379.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,379.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$886.02
|
| Rate for Payer: HealthUtah PPO |
$1,452.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,408.92
|
| Rate for Payer: Multiplan Medicare/VA |
$841.72
|
| Rate for Payer: One Health Plan of WY PPO |
$1,423.45
|
| Rate for Payer: PacificSource Commercial |
$1,307.25
|
| Rate for Payer: PHCS PPO |
$1,423.45
|
| Rate for Payer: Three Rivers PPO |
$1,089.38
|
| Rate for Payer: TriWest Veterans Administration |
$886.02
|
| Rate for Payer: United Healthcare Medicare |
$886.02
|
| Rate for Payer: WINHealth Partners Commercial |
$1,379.88
|
| Rate for Payer: Wise Provider Network Commercial |
$1,379.88
|
|
|
DRILL GUIDE 2.8MM HEXALOBE LOCK 6-65MM
|
Facility
|
IP
|
$2,492.00
|
|
| Hospital Charge Code |
3004656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,444.11 |
| Max. Negotiated Rate |
$2,492.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,442.16
|
| Rate for Payer: Aetna of WY Medicare |
$1,594.88
|
| Rate for Payer: Altius Commercial |
$2,392.32
|
| Rate for Payer: Beech Street Commercial |
$2,442.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,417.24
|
| Rate for Payer: Cash Price |
$1,744.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,417.24
|
| Rate for Payer: Cigna of WY Commercial |
$2,442.16
|
| Rate for Payer: Entrust Commercial |
$2,367.40
|
| Rate for Payer: First Choice Health Commercial |
$2,367.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,367.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,520.12
|
| Rate for Payer: HealthUtah PPO |
$2,492.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,417.24
|
| Rate for Payer: Multiplan Medicare/VA |
$1,444.11
|
| Rate for Payer: One Health Plan of WY PPO |
$2,442.16
|
| Rate for Payer: PacificSource Commercial |
$2,242.80
|
| Rate for Payer: PHCS PPO |
$2,442.16
|
| Rate for Payer: Three Rivers PPO |
$1,869.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,520.12
|
| Rate for Payer: United Healthcare Commercial |
$2,379.86
|
| Rate for Payer: United Healthcare Medicare |
$1,520.12
|
| Rate for Payer: WINHealth Partners Commercial |
$2,367.40
|
| Rate for Payer: Wise Provider Network Commercial |
$2,367.40
|
|
|
DRILL GUIDE 2.8MM HEXALOBE LOCK 6-65MM
|
Facility
|
OP
|
$2,492.00
|
|
| Hospital Charge Code |
3004656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,349.42 |
| Max. Negotiated Rate |
$2,492.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,442.16
|
| Rate for Payer: Aetna of WY Medicare |
$1,644.72
|
| Rate for Payer: Altius Commercial |
$2,392.32
|
| Rate for Payer: Beech Street Commercial |
$2,442.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,417.24
|
| Rate for Payer: Cash Price |
$1,744.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,417.24
|
| Rate for Payer: Cigna of WY Commercial |
$2,442.16
|
| Rate for Payer: Entrust Commercial |
$2,367.40
|
| Rate for Payer: First Choice Health Commercial |
$2,367.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,367.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,420.44
|
| Rate for Payer: HealthUtah PPO |
$2,492.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,417.24
|
| Rate for Payer: Multiplan Medicare/VA |
$1,349.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,442.16
|
| Rate for Payer: PacificSource Commercial |
$2,242.80
|
| Rate for Payer: PHCS PPO |
$2,442.16
|
| Rate for Payer: Three Rivers PPO |
$1,869.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,420.44
|
| Rate for Payer: United Healthcare Commercial |
$2,379.86
|
| Rate for Payer: United Healthcare Medicare |
$1,420.44
|
| Rate for Payer: WINHealth Partners Commercial |
$2,442.16
|
| Rate for Payer: Wise Provider Network Commercial |
$2,367.40
|
|
|
DRILL GUIDE DT .062" ACUMED
|
Facility
|
OP
|
$91.00
|
|
| Hospital Charge Code |
3002905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.28 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Aetna of WY Medicare |
$60.06
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$88.27
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.87
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$49.28
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$51.87
|
| Rate for Payer: United Healthcare Commercial |
$86.90
|
| Rate for Payer: United Healthcare Medicare |
$51.87
|
| Rate for Payer: WINHealth Partners Commercial |
$89.18
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
DRILL GUIDE DT .062" ACUMED
|
Facility
|
IP
|
$91.00
|
|
| Hospital Charge Code |
3002905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.73 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: United Healthcare Commercial |
$86.90
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Aetna of WY Medicare |
$58.24
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$88.27
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$55.51
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$52.73
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$55.51
|
| Rate for Payer: United Healthcare Medicare |
$55.51
|
| Rate for Payer: WINHealth Partners Commercial |
$86.45
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
DRILL GUIDE QUATTRO 2.9MM
|
Facility
|
OP
|
$2,125.20
|
|
| Hospital Charge Code |
3004555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,150.80 |
| Max. Negotiated Rate |
$2,125.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,082.70
|
| Rate for Payer: Aetna of WY Medicare |
$1,402.63
|
| Rate for Payer: Altius Commercial |
$2,040.19
|
| Rate for Payer: Beech Street Commercial |
$2,082.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,061.44
|
| Rate for Payer: Cash Price |
$1,487.64
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,061.44
|
| Rate for Payer: Cigna of WY Commercial |
$2,082.70
|
| Rate for Payer: Entrust Commercial |
$2,018.94
|
| Rate for Payer: First Choice Health Commercial |
$2,018.94
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,018.94
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,211.36
|
| Rate for Payer: HealthUtah PPO |
$2,125.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,061.44
|
| Rate for Payer: Multiplan Medicare/VA |
$1,150.80
|
| Rate for Payer: One Health Plan of WY PPO |
$2,082.70
|
| Rate for Payer: PacificSource Commercial |
$1,912.68
|
| Rate for Payer: PHCS PPO |
$2,082.70
|
| Rate for Payer: Three Rivers PPO |
$1,593.90
|
| Rate for Payer: TriWest Veterans Administration |
$1,211.36
|
| Rate for Payer: United Healthcare Commercial |
$2,029.57
|
| Rate for Payer: United Healthcare Medicare |
$1,211.36
|
| Rate for Payer: WINHealth Partners Commercial |
$2,082.70
|
| Rate for Payer: Wise Provider Network Commercial |
$2,018.94
|
|
|
DRILL GUIDE QUATTRO 2.9MM
|
Facility
|
IP
|
$2,125.20
|
|
| Hospital Charge Code |
3004555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,231.55 |
| Max. Negotiated Rate |
$2,125.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,082.70
|
| Rate for Payer: Aetna of WY Medicare |
$1,360.13
|
| Rate for Payer: Altius Commercial |
$2,040.19
|
| Rate for Payer: Beech Street Commercial |
$2,082.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,061.44
|
| Rate for Payer: Cash Price |
$1,487.64
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,061.44
|
| Rate for Payer: Cigna of WY Commercial |
$2,082.70
|
| Rate for Payer: Entrust Commercial |
$2,018.94
|
| Rate for Payer: First Choice Health Commercial |
$2,018.94
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,018.94
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,296.37
|
| Rate for Payer: HealthUtah PPO |
$2,125.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,061.44
|
| Rate for Payer: Multiplan Medicare/VA |
$1,231.55
|
| Rate for Payer: One Health Plan of WY PPO |
$2,082.70
|
| Rate for Payer: PacificSource Commercial |
$1,912.68
|
| Rate for Payer: PHCS PPO |
$2,082.70
|
| Rate for Payer: Three Rivers PPO |
$1,593.90
|
| Rate for Payer: TriWest Veterans Administration |
$1,296.37
|
| Rate for Payer: United Healthcare Commercial |
$2,029.57
|
| Rate for Payer: United Healthcare Medicare |
$1,296.37
|
| Rate for Payer: WINHealth Partners Commercial |
$2,018.94
|
| Rate for Payer: Wise Provider Network Commercial |
$2,018.94
|
|
|
DRILL GUIDE RE-USE
|
Facility
|
OP
|
$505.75
|
|
| Hospital Charge Code |
3100351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$273.86 |
| Max. Negotiated Rate |
$505.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$495.64
|
| Rate for Payer: Aetna of WY Medicare |
$333.80
|
| Rate for Payer: Altius Commercial |
$485.52
|
| Rate for Payer: Beech Street Commercial |
$495.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$490.58
|
| Rate for Payer: Cash Price |
$354.02
|
| Rate for Payer: ChoiceCare Network Commercial |
$490.58
|
| Rate for Payer: Cigna of WY Commercial |
$495.64
|
| Rate for Payer: Entrust Commercial |
$480.46
|
| Rate for Payer: First Choice Health Commercial |
$480.46
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$480.46
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$288.28
|
| Rate for Payer: HealthUtah PPO |
$505.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$490.58
|
| Rate for Payer: Multiplan Medicare/VA |
$273.86
|
| Rate for Payer: One Health Plan of WY PPO |
$495.64
|
| Rate for Payer: PacificSource Commercial |
$455.18
|
| Rate for Payer: PHCS PPO |
$495.64
|
| Rate for Payer: Three Rivers PPO |
$379.31
|
| Rate for Payer: TriWest Veterans Administration |
$288.28
|
| Rate for Payer: United Healthcare Commercial |
$482.99
|
| Rate for Payer: United Healthcare Medicare |
$288.28
|
| Rate for Payer: WINHealth Partners Commercial |
$495.64
|
| Rate for Payer: Wise Provider Network Commercial |
$480.46
|
|
|
DRILL GUIDE RE-USE
|
Facility
|
IP
|
$505.75
|
|
| Hospital Charge Code |
3100351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$293.08 |
| Max. Negotiated Rate |
$505.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$495.64
|
| Rate for Payer: Aetna of WY Medicare |
$323.68
|
| Rate for Payer: Altius Commercial |
$485.52
|
| Rate for Payer: Beech Street Commercial |
$495.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$490.58
|
| Rate for Payer: Cash Price |
$354.02
|
| Rate for Payer: ChoiceCare Network Commercial |
$490.58
|
| Rate for Payer: Cigna of WY Commercial |
$495.64
|
| Rate for Payer: Entrust Commercial |
$480.46
|
| Rate for Payer: First Choice Health Commercial |
$480.46
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$480.46
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$308.51
|
| Rate for Payer: HealthUtah PPO |
$505.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$490.58
|
| Rate for Payer: Multiplan Medicare/VA |
$293.08
|
| Rate for Payer: One Health Plan of WY PPO |
$495.64
|
| Rate for Payer: PacificSource Commercial |
$455.18
|
| Rate for Payer: PHCS PPO |
$495.64
|
| Rate for Payer: Three Rivers PPO |
$379.31
|
| Rate for Payer: TriWest Veterans Administration |
$308.51
|
| Rate for Payer: United Healthcare Commercial |
$482.99
|
| Rate for Payer: United Healthcare Medicare |
$308.51
|
| Rate for Payer: WINHealth Partners Commercial |
$480.46
|
| Rate for Payer: Wise Provider Network Commercial |
$480.46
|
|
|
DRILL HARD BONE 2.9 ANCHOR
|
Facility
|
OP
|
$546.00
|
|
| Hospital Charge Code |
3003581
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$295.66 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$535.08
|
| Rate for Payer: Aetna of WY Medicare |
$360.36
|
| Rate for Payer: Altius Commercial |
$524.16
|
| Rate for Payer: Beech Street Commercial |
$535.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$529.62
|
| Rate for Payer: Cash Price |
$382.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$529.62
|
| Rate for Payer: Cigna of WY Commercial |
$535.08
|
| Rate for Payer: Entrust Commercial |
$518.70
|
| Rate for Payer: First Choice Health Commercial |
$518.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$518.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$311.22
|
| Rate for Payer: HealthUtah PPO |
$546.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$529.62
|
| Rate for Payer: Multiplan Medicare/VA |
$295.66
|
| Rate for Payer: One Health Plan of WY PPO |
$535.08
|
| Rate for Payer: PacificSource Commercial |
$491.40
|
| Rate for Payer: PHCS PPO |
$535.08
|
| Rate for Payer: Three Rivers PPO |
$409.50
|
| Rate for Payer: TriWest Veterans Administration |
$311.22
|
| Rate for Payer: United Healthcare Commercial |
$521.43
|
| Rate for Payer: United Healthcare Medicare |
$311.22
|
| Rate for Payer: WINHealth Partners Commercial |
$535.08
|
| Rate for Payer: Wise Provider Network Commercial |
$518.70
|
|
