|
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
|
|
|
DRILL HARD BONE 2.9MM
|
Facility
|
IP
|
$455.00
|
|
| Hospital Charge Code |
3004471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$263.67 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Aetna of WY Medicare |
$291.20
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$441.35
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$277.55
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$263.67
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$277.55
|
| Rate for Payer: United Healthcare Commercial |
$434.52
|
| Rate for Payer: United Healthcare Medicare |
$277.55
|
| Rate for Payer: WINHealth Partners Commercial |
$432.25
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
DRILL HARD BONE 2.9MM
|
Facility
|
OP
|
$455.00
|
|
| Hospital Charge Code |
3004471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$246.38 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Aetna of WY Medicare |
$300.30
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$441.35
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$259.35
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$246.38
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$259.35
|
| Rate for Payer: United Healthcare Commercial |
$434.52
|
| Rate for Payer: United Healthcare Medicare |
$259.35
|
| Rate for Payer: WINHealth Partners Commercial |
$445.90
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
DRILL LOCK 4.2X185MM STRYKER
|
Facility
|
IP
|
$525.21
|
|
| Hospital Charge Code |
3100689
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.36 |
| Max. Negotiated Rate |
$525.21 |
| 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 Commercial |
$501.58
|
| 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 LOCK 4.2X185MM STRYKER
|
Facility
|
OP
|
$525.21
|
|
| Hospital Charge Code |
3100689
|
|
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 LOCKING IMN 4.2 X 360MM
|
Facility
|
IP
|
$525.21
|
|
| Hospital Charge Code |
3100737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.36 |
| Max. Negotiated Rate |
$525.21 |
| 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 Commercial |
$501.58
|
| 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 LOCKING IMN 4.2 X 360MM
|
Facility
|
OP
|
$525.21
|
|
| Hospital Charge Code |
3100737
|
|
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 OVER QUICK RELEASE 2.7MM
|
Facility
|
IP
|
$948.54
|
|
| Hospital Charge Code |
3004707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$549.68 |
| Max. Negotiated Rate |
$948.54 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$929.57
|
| Rate for Payer: Aetna of WY Medicare |
$607.07
|
| Rate for Payer: Altius Commercial |
$910.60
|
| Rate for Payer: Beech Street Commercial |
$929.57
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$920.08
|
| Rate for Payer: Cash Price |
$663.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$920.08
|
| Rate for Payer: Cigna of WY Commercial |
$929.57
|
| Rate for Payer: Entrust Commercial |
$901.11
|
| Rate for Payer: First Choice Health Commercial |
$901.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$901.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$578.61
|
| Rate for Payer: HealthUtah PPO |
$948.54
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$920.08
|
| Rate for Payer: Multiplan Medicare/VA |
$549.68
|
| Rate for Payer: One Health Plan of WY PPO |
$929.57
|
| Rate for Payer: PacificSource Commercial |
$853.69
|
| Rate for Payer: PHCS PPO |
$929.57
|
| Rate for Payer: Three Rivers PPO |
$711.40
|
| Rate for Payer: TriWest Veterans Administration |
$578.61
|
| Rate for Payer: United Healthcare Commercial |
$905.86
|
| Rate for Payer: United Healthcare Medicare |
$578.61
|
| Rate for Payer: WINHealth Partners Commercial |
$901.11
|
| Rate for Payer: Wise Provider Network Commercial |
$901.11
|
|
|
DRILL OVER QUICK RELEASE 2.7MM
|
Facility
|
OP
|
$948.54
|
|
| Hospital Charge Code |
3004707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$513.63 |
| Max. Negotiated Rate |
$948.54 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$929.57
|
| Rate for Payer: Aetna of WY Medicare |
$626.04
|
| Rate for Payer: Altius Commercial |
$910.60
|
| Rate for Payer: Beech Street Commercial |
$929.57
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$920.08
|
| Rate for Payer: Cash Price |
$663.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$920.08
|
| Rate for Payer: Cigna of WY Commercial |
$929.57
|
| Rate for Payer: Entrust Commercial |
$901.11
|
| Rate for Payer: First Choice Health Commercial |
$901.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$901.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$540.67
|
| Rate for Payer: HealthUtah PPO |
$948.54
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$920.08
|
| Rate for Payer: Multiplan Medicare/VA |
$513.63
|
| Rate for Payer: One Health Plan of WY PPO |
$929.57
|
| Rate for Payer: PacificSource Commercial |
$853.69
|
| Rate for Payer: PHCS PPO |
$929.57
|
| Rate for Payer: Three Rivers PPO |
$711.40
|
| Rate for Payer: TriWest Veterans Administration |
$540.67
|
| Rate for Payer: United Healthcare Commercial |
$905.86
|
| Rate for Payer: United Healthcare Medicare |
$540.67
|
| Rate for Payer: WINHealth Partners Commercial |
$929.57
|
| Rate for Payer: Wise Provider Network Commercial |
$901.11
|
|
|
DRILL PERIPHERAL SCR 2.7MM
|
Facility
|
IP
|
$486.50
|
|
| Hospital Charge Code |
3002520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$281.93 |
| Max. Negotiated Rate |
$486.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$476.77
|
| Rate for Payer: Aetna of WY Medicare |
$311.36
|
| Rate for Payer: Altius Commercial |
$467.04
|
| Rate for Payer: Beech Street Commercial |
$476.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$471.90
|
| Rate for Payer: Cash Price |
$340.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$471.90
|
| Rate for Payer: Cigna of WY Commercial |
$476.77
|
| Rate for Payer: Entrust Commercial |
$462.18
|
| Rate for Payer: First Choice Health Commercial |
$462.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$462.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$296.76
|
| Rate for Payer: HealthUtah PPO |
$486.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$471.90
|
| Rate for Payer: Multiplan Medicare/VA |
$281.93
|
| Rate for Payer: One Health Plan of WY PPO |
$476.77
|
| Rate for Payer: PacificSource Commercial |
$437.85
|
| Rate for Payer: PHCS PPO |
$476.77
|
| Rate for Payer: Three Rivers PPO |
$364.88
|
| Rate for Payer: TriWest Veterans Administration |
$296.76
|
| Rate for Payer: United Healthcare Commercial |
$464.61
|
| Rate for Payer: United Healthcare Medicare |
$296.76
|
| Rate for Payer: WINHealth Partners Commercial |
$462.18
|
| Rate for Payer: Wise Provider Network Commercial |
$462.18
|
|
|
DRILL PERIPHERAL SCR 2.7MM
|
Facility
|
OP
|
$486.50
|
|
| Hospital Charge Code |
3002520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$263.44 |
| Max. Negotiated Rate |
$486.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$476.77
|
| Rate for Payer: Aetna of WY Medicare |
$321.09
|
| Rate for Payer: Altius Commercial |
$467.04
|
| Rate for Payer: Beech Street Commercial |
$476.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$471.90
|
| Rate for Payer: Cash Price |
$340.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$471.90
|
| Rate for Payer: Cigna of WY Commercial |
$476.77
|
| Rate for Payer: Entrust Commercial |
$462.18
|
| Rate for Payer: First Choice Health Commercial |
$462.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$462.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$277.30
|
| Rate for Payer: HealthUtah PPO |
$486.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$471.90
|
| Rate for Payer: Multiplan Medicare/VA |
$263.44
|
| Rate for Payer: One Health Plan of WY PPO |
$476.77
|
| Rate for Payer: PacificSource Commercial |
$437.85
|
| Rate for Payer: PHCS PPO |
$476.77
|
| Rate for Payer: Three Rivers PPO |
$364.88
|
| Rate for Payer: TriWest Veterans Administration |
$277.30
|
| Rate for Payer: United Healthcare Commercial |
$464.61
|
| Rate for Payer: United Healthcare Medicare |
$277.30
|
| Rate for Payer: WINHealth Partners Commercial |
$476.77
|
| Rate for Payer: Wise Provider Network Commercial |
$462.18
|
|
|
DRILL PIN, ACL TIGHTROPE 4MM
|
Facility
|
OP
|
$437.50
|
|
| Hospital Charge Code |
3001772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$236.91 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$428.75
|
| Rate for Payer: Aetna of WY Medicare |
$288.75
|
| Rate for Payer: Altius Commercial |
$420.00
|
| Rate for Payer: Beech Street Commercial |
$428.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$424.38
|
| Rate for Payer: Cash Price |
$306.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$424.38
|
| Rate for Payer: Cigna of WY Commercial |
$428.75
|
| Rate for Payer: Entrust Commercial |
$415.62
|
| Rate for Payer: First Choice Health Commercial |
$415.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$415.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$249.38
|
| Rate for Payer: HealthUtah PPO |
$437.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$424.38
|
| Rate for Payer: Multiplan Medicare/VA |
$236.91
|
| Rate for Payer: One Health Plan of WY PPO |
$428.75
|
| Rate for Payer: PacificSource Commercial |
$393.75
|
| Rate for Payer: PHCS PPO |
$428.75
|
| Rate for Payer: Three Rivers PPO |
$328.12
|
| Rate for Payer: TriWest Veterans Administration |
$249.38
|
| Rate for Payer: United Healthcare Commercial |
$417.81
|
| Rate for Payer: United Healthcare Medicare |
$249.38
|
| Rate for Payer: WINHealth Partners Commercial |
$428.75
|
| Rate for Payer: Wise Provider Network Commercial |
$415.62
|
|
|
DRILL PIN, ACL TIGHTROPE 4MM
|
Facility
|
IP
|
$437.50
|
|
| Hospital Charge Code |
3001772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.53 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$428.75
|
| Rate for Payer: Aetna of WY Medicare |
$280.00
|
| Rate for Payer: Altius Commercial |
$420.00
|
| Rate for Payer: Beech Street Commercial |
$428.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$424.38
|
| Rate for Payer: Cash Price |
$306.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$424.38
|
| Rate for Payer: Cigna of WY Commercial |
$428.75
|
| Rate for Payer: Entrust Commercial |
$415.62
|
| Rate for Payer: First Choice Health Commercial |
$415.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$415.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$266.88
|
| Rate for Payer: HealthUtah PPO |
$437.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$424.38
|
| Rate for Payer: Multiplan Medicare/VA |
$253.53
|
| Rate for Payer: One Health Plan of WY PPO |
$428.75
|
| Rate for Payer: PacificSource Commercial |
$393.75
|
| Rate for Payer: PHCS PPO |
$428.75
|
| Rate for Payer: Three Rivers PPO |
$328.12
|
| Rate for Payer: TriWest Veterans Administration |
$266.88
|
| Rate for Payer: United Healthcare Commercial |
$417.81
|
| Rate for Payer: United Healthcare Medicare |
$266.88
|
| Rate for Payer: WINHealth Partners Commercial |
$415.62
|
| Rate for Payer: Wise Provider Network Commercial |
$415.62
|
|
|
DRILL PROFILE MICRO CMP FT
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
3002294
|
|
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
|
|
|
DRILL PROFILE MICRO CMP FT
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
3002294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.24 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$514.50
|
| Rate for Payer: Aetna of WY Medicare |
$336.00
|
| 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 |
$320.25
|
| Rate for Payer: HealthUtah PPO |
$525.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$509.25
|
| Rate for Payer: Multiplan Medicare/VA |
$304.24
|
| 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 |
$320.25
|
| Rate for Payer: United Healthcare Commercial |
$501.38
|
| Rate for Payer: United Healthcare Medicare |
$320.25
|
| Rate for Payer: WINHealth Partners Commercial |
$498.75
|
| Rate for Payer: Wise Provider Network Commercial |
$498.75
|
|
|
DRILL PROFILE STD AR-8737-54
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
3002302
|
|
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
|
|
|
DRILL PROFILE STD AR-8737-54
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
3002302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.24 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$514.50
|
| Rate for Payer: Aetna of WY Medicare |
$336.00
|
| 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 |
$320.25
|
| Rate for Payer: HealthUtah PPO |
$525.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$509.25
|
| Rate for Payer: Multiplan Medicare/VA |
$304.24
|
| 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 |
$320.25
|
| Rate for Payer: United Healthcare Commercial |
$501.38
|
| Rate for Payer: United Healthcare Medicare |
$320.25
|
| Rate for Payer: WINHealth Partners Commercial |
$498.75
|
| Rate for Payer: Wise Provider Network Commercial |
$498.75
|
|
|
DRILL QUICK RELEASE 15/64
|
Facility
|
OP
|
$675.50
|
|
| Hospital Charge Code |
3002855
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$365.78 |
| Max. Negotiated Rate |
$675.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$661.99
|
| Rate for Payer: Aetna of WY Medicare |
$445.83
|
| Rate for Payer: Altius Commercial |
$648.48
|
| Rate for Payer: Beech Street Commercial |
$661.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$655.24
|
| Rate for Payer: Cash Price |
$472.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$655.24
|
| Rate for Payer: Cigna of WY Commercial |
$661.99
|
| Rate for Payer: Entrust Commercial |
$641.72
|
| Rate for Payer: First Choice Health Commercial |
$641.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$641.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$385.04
|
| Rate for Payer: HealthUtah PPO |
$675.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$655.24
|
| Rate for Payer: Multiplan Medicare/VA |
$365.78
|
| Rate for Payer: One Health Plan of WY PPO |
$661.99
|
| Rate for Payer: PacificSource Commercial |
$607.95
|
| Rate for Payer: PHCS PPO |
$661.99
|
| Rate for Payer: Three Rivers PPO |
$506.62
|
| Rate for Payer: TriWest Veterans Administration |
$385.04
|
| Rate for Payer: United Healthcare Commercial |
$645.10
|
| Rate for Payer: United Healthcare Medicare |
$385.04
|
| Rate for Payer: WINHealth Partners Commercial |
$661.99
|
| Rate for Payer: Wise Provider Network Commercial |
$641.72
|
|
|
DRILL QUICK RELEASE 15/64
|
Facility
|
IP
|
$675.50
|
|
| Hospital Charge Code |
3002855
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$391.45 |
| Max. Negotiated Rate |
$675.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$661.99
|
| Rate for Payer: Aetna of WY Medicare |
$432.32
|
| Rate for Payer: Altius Commercial |
$648.48
|
| Rate for Payer: Beech Street Commercial |
$661.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$655.24
|
| Rate for Payer: Cash Price |
$472.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$655.24
|
| Rate for Payer: Cigna of WY Commercial |
$661.99
|
| Rate for Payer: Entrust Commercial |
$641.72
|
| Rate for Payer: First Choice Health Commercial |
$641.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$641.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$412.06
|
| Rate for Payer: HealthUtah PPO |
$675.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$655.24
|
| Rate for Payer: Multiplan Medicare/VA |
$391.45
|
| Rate for Payer: One Health Plan of WY PPO |
$661.99
|
| Rate for Payer: PacificSource Commercial |
$607.95
|
| Rate for Payer: PHCS PPO |
$661.99
|
| Rate for Payer: Three Rivers PPO |
$506.62
|
| Rate for Payer: TriWest Veterans Administration |
$412.06
|
| Rate for Payer: United Healthcare Commercial |
$645.10
|
| Rate for Payer: United Healthcare Medicare |
$412.06
|
| Rate for Payer: WINHealth Partners Commercial |
$641.72
|
| Rate for Payer: Wise Provider Network Commercial |
$641.72
|
|
|
DRILL QUICK RELEASE 1.5MM HAND
|
Facility
|
IP
|
$717.50
|
|
| Hospital Charge Code |
3003259
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$415.79 |
| Max. Negotiated Rate |
$717.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$703.15
|
| Rate for Payer: Aetna of WY Medicare |
$459.20
|
| Rate for Payer: Altius Commercial |
$688.80
|
| Rate for Payer: Beech Street Commercial |
$703.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$695.98
|
| Rate for Payer: Cash Price |
$502.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$695.98
|
| Rate for Payer: Cigna of WY Commercial |
$703.15
|
| Rate for Payer: Entrust Commercial |
$681.62
|
| Rate for Payer: First Choice Health Commercial |
$681.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$681.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$437.68
|
| Rate for Payer: HealthUtah PPO |
$717.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$695.98
|
| Rate for Payer: Multiplan Medicare/VA |
$415.79
|
| Rate for Payer: One Health Plan of WY PPO |
$703.15
|
| Rate for Payer: PacificSource Commercial |
$645.75
|
| Rate for Payer: PHCS PPO |
$703.15
|
| Rate for Payer: Three Rivers PPO |
$538.12
|
| Rate for Payer: TriWest Veterans Administration |
$437.68
|
| Rate for Payer: United Healthcare Commercial |
$685.21
|
| Rate for Payer: United Healthcare Medicare |
$437.68
|
| Rate for Payer: WINHealth Partners Commercial |
$681.62
|
| Rate for Payer: Wise Provider Network Commercial |
$681.62
|
|
|
DRILL QUICK RELEASE 1.5MM HAND
|
Facility
|
OP
|
$717.50
|
|
| Hospital Charge Code |
3003259
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$388.53 |
| Max. Negotiated Rate |
$717.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$703.15
|
| Rate for Payer: Aetna of WY Medicare |
$473.55
|
| Rate for Payer: Altius Commercial |
$688.80
|
| Rate for Payer: Beech Street Commercial |
$703.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$695.98
|
| Rate for Payer: Cash Price |
$502.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$695.98
|
| Rate for Payer: Cigna of WY Commercial |
$703.15
|
| Rate for Payer: Entrust Commercial |
$681.62
|
| Rate for Payer: First Choice Health Commercial |
$681.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$681.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$408.98
|
| Rate for Payer: HealthUtah PPO |
$717.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$695.98
|
| Rate for Payer: Multiplan Medicare/VA |
$388.53
|
| Rate for Payer: One Health Plan of WY PPO |
$703.15
|
| Rate for Payer: PacificSource Commercial |
$645.75
|
| Rate for Payer: PHCS PPO |
$703.15
|
| Rate for Payer: Three Rivers PPO |
$538.12
|
| Rate for Payer: TriWest Veterans Administration |
$408.98
|
| Rate for Payer: United Healthcare Commercial |
$685.21
|
| Rate for Payer: United Healthcare Medicare |
$408.98
|
| Rate for Payer: WINHealth Partners Commercial |
$703.15
|
| Rate for Payer: Wise Provider Network Commercial |
$681.62
|
|
|
DRILL RADIAL PEG BIT PB100
|
Facility
|
OP
|
$367.50
|
|
| Hospital Charge Code |
3100672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.00 |
| Max. Negotiated Rate |
$367.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$360.15
|
| Rate for Payer: Aetna of WY Medicare |
$242.55
|
| Rate for Payer: Altius Commercial |
$352.80
|
| Rate for Payer: Beech Street Commercial |
$360.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$356.48
|
| Rate for Payer: Cash Price |
$257.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$356.48
|
| Rate for Payer: Cigna of WY Commercial |
$360.15
|
| Rate for Payer: Entrust Commercial |
$349.12
|
| Rate for Payer: First Choice Health Commercial |
$349.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$349.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$209.48
|
| Rate for Payer: HealthUtah PPO |
$367.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$356.48
|
| Rate for Payer: Multiplan Medicare/VA |
$199.00
|
| Rate for Payer: One Health Plan of WY PPO |
$360.15
|
| Rate for Payer: PacificSource Commercial |
$330.75
|
| Rate for Payer: PHCS PPO |
$360.15
|
| Rate for Payer: Three Rivers PPO |
$275.62
|
| Rate for Payer: TriWest Veterans Administration |
$209.48
|
| Rate for Payer: United Healthcare Commercial |
$350.96
|
| Rate for Payer: United Healthcare Medicare |
$209.48
|
| Rate for Payer: WINHealth Partners Commercial |
$360.15
|
| Rate for Payer: Wise Provider Network Commercial |
$349.12
|
|
|
DRILL RADIAL PEG BIT PB100
|
Facility
|
IP
|
$367.50
|
|
| Hospital Charge Code |
3100672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.97 |
| Max. Negotiated Rate |
$367.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$360.15
|
| Rate for Payer: Aetna of WY Medicare |
$235.20
|
| Rate for Payer: Altius Commercial |
$352.80
|
| Rate for Payer: Beech Street Commercial |
$360.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$356.48
|
| Rate for Payer: Cash Price |
$257.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$356.48
|
| Rate for Payer: Cigna of WY Commercial |
$360.15
|
| Rate for Payer: Entrust Commercial |
$349.12
|
| Rate for Payer: First Choice Health Commercial |
$349.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$349.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$224.18
|
| Rate for Payer: HealthUtah PPO |
$367.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$356.48
|
| Rate for Payer: Multiplan Medicare/VA |
$212.97
|
| Rate for Payer: One Health Plan of WY PPO |
$360.15
|
| Rate for Payer: PacificSource Commercial |
$330.75
|
| Rate for Payer: PHCS PPO |
$360.15
|
| Rate for Payer: Three Rivers PPO |
$275.62
|
| Rate for Payer: TriWest Veterans Administration |
$224.18
|
| Rate for Payer: United Healthcare Commercial |
$350.96
|
| Rate for Payer: United Healthcare Medicare |
$224.18
|
| Rate for Payer: WINHealth Partners Commercial |
$349.12
|
| Rate for Payer: Wise Provider Network Commercial |
$349.12
|
|
|
DRILL RELEASE 1.3MM OSTEO
|
Facility
|
OP
|
$1,452.50
|
|
| Hospital Charge Code |
3002380
|
|
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 RELEASE 1.3MM OSTEO
|
Facility
|
IP
|
$1,452.50
|
|
| Hospital Charge Code |
3002380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$841.72 |
| 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 |
$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 Commercial |
$1,387.14
|
| 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
|
|
