|
ENDOTRACH ORAL RAE 6.0 CUFFED
|
Facility
|
IP
|
$13.86
|
|
| Hospital Charge Code |
2500206
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.58
|
| Rate for Payer: Aetna of WY Medicare |
$8.87
|
| Rate for Payer: Altius Commercial |
$13.31
|
| Rate for Payer: Beech Street Commercial |
$13.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.44
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.44
|
| Rate for Payer: Cigna of WY Commercial |
$13.58
|
| Rate for Payer: Entrust Commercial |
$13.17
|
| Rate for Payer: First Choice Health Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.45
|
| Rate for Payer: HealthUtah PPO |
$13.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.44
|
| Rate for Payer: Multiplan Medicare/VA |
$8.03
|
| Rate for Payer: One Health Plan of WY PPO |
$13.58
|
| Rate for Payer: PacificSource Commercial |
$12.47
|
| Rate for Payer: PHCS PPO |
$13.58
|
| Rate for Payer: Three Rivers PPO |
$10.40
|
| Rate for Payer: TriWest Veterans Administration |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$13.24
|
| Rate for Payer: United Healthcare Medicare |
$8.45
|
| Rate for Payer: WINHealth Partners Commercial |
$13.17
|
| Rate for Payer: Wise Provider Network Commercial |
$13.17
|
|
|
ENDOTRACH ORAL RAE 6.0 CUFFED
|
Facility
|
OP
|
$13.86
|
|
| Hospital Charge Code |
2500206
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.58
|
| Rate for Payer: Aetna of WY Medicare |
$9.15
|
| Rate for Payer: Altius Commercial |
$13.31
|
| Rate for Payer: Beech Street Commercial |
$13.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.44
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.44
|
| Rate for Payer: Cigna of WY Commercial |
$13.58
|
| Rate for Payer: Entrust Commercial |
$13.17
|
| Rate for Payer: First Choice Health Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.90
|
| Rate for Payer: HealthUtah PPO |
$13.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.44
|
| Rate for Payer: Multiplan Medicare/VA |
$7.51
|
| Rate for Payer: One Health Plan of WY PPO |
$13.58
|
| Rate for Payer: PacificSource Commercial |
$12.47
|
| Rate for Payer: PHCS PPO |
$13.58
|
| Rate for Payer: Three Rivers PPO |
$10.40
|
| Rate for Payer: TriWest Veterans Administration |
$7.90
|
| Rate for Payer: United Healthcare Commercial |
$13.24
|
| Rate for Payer: United Healthcare Medicare |
$7.90
|
| Rate for Payer: WINHealth Partners Commercial |
$13.58
|
| Rate for Payer: Wise Provider Network Commercial |
$13.17
|
|
|
ENDOTRACH ORAL RAE 6.5 CUFFED
|
Facility
|
OP
|
$13.86
|
|
| Hospital Charge Code |
2500207
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.58
|
| Rate for Payer: Aetna of WY Medicare |
$9.15
|
| Rate for Payer: Altius Commercial |
$13.31
|
| Rate for Payer: Beech Street Commercial |
$13.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.44
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.44
|
| Rate for Payer: Cigna of WY Commercial |
$13.58
|
| Rate for Payer: Entrust Commercial |
$13.17
|
| Rate for Payer: First Choice Health Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.90
|
| Rate for Payer: HealthUtah PPO |
$13.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.44
|
| Rate for Payer: Multiplan Medicare/VA |
$7.51
|
| Rate for Payer: One Health Plan of WY PPO |
$13.58
|
| Rate for Payer: PacificSource Commercial |
$12.47
|
| Rate for Payer: PHCS PPO |
$13.58
|
| Rate for Payer: Three Rivers PPO |
$10.40
|
| Rate for Payer: TriWest Veterans Administration |
$7.90
|
| Rate for Payer: United Healthcare Commercial |
$13.24
|
| Rate for Payer: United Healthcare Medicare |
$7.90
|
| Rate for Payer: WINHealth Partners Commercial |
$13.58
|
| Rate for Payer: Wise Provider Network Commercial |
$13.17
|
|
|
ENDOTRACH ORAL RAE 6.5 CUFFED
|
Facility
|
IP
|
$13.86
|
|
| Hospital Charge Code |
2500207
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.58
|
| Rate for Payer: Aetna of WY Medicare |
$8.87
|
| Rate for Payer: Altius Commercial |
$13.31
|
| Rate for Payer: Beech Street Commercial |
$13.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.44
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.44
|
| Rate for Payer: Cigna of WY Commercial |
$13.58
|
| Rate for Payer: Entrust Commercial |
$13.17
|
| Rate for Payer: First Choice Health Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.45
|
| Rate for Payer: HealthUtah PPO |
$13.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.44
|
| Rate for Payer: Multiplan Medicare/VA |
$8.03
|
| Rate for Payer: One Health Plan of WY PPO |
$13.58
|
| Rate for Payer: PacificSource Commercial |
$12.47
|
| Rate for Payer: PHCS PPO |
$13.58
|
| Rate for Payer: Three Rivers PPO |
$10.40
|
| Rate for Payer: TriWest Veterans Administration |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$13.24
|
| Rate for Payer: United Healthcare Medicare |
$8.45
|
| Rate for Payer: WINHealth Partners Commercial |
$13.17
|
| Rate for Payer: Wise Provider Network Commercial |
$13.17
|
|
|
ENDOTRACH ORAL RAE 7.0 CUFFED
|
Facility
|
OP
|
$13.86
|
|
| Hospital Charge Code |
2500076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.58
|
| Rate for Payer: Aetna of WY Medicare |
$9.15
|
| Rate for Payer: Altius Commercial |
$13.31
|
| Rate for Payer: Beech Street Commercial |
$13.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.44
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.44
|
| Rate for Payer: Cigna of WY Commercial |
$13.58
|
| Rate for Payer: Entrust Commercial |
$13.17
|
| Rate for Payer: First Choice Health Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.90
|
| Rate for Payer: HealthUtah PPO |
$13.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.44
|
| Rate for Payer: Multiplan Medicare/VA |
$7.51
|
| Rate for Payer: One Health Plan of WY PPO |
$13.58
|
| Rate for Payer: PacificSource Commercial |
$12.47
|
| Rate for Payer: PHCS PPO |
$13.58
|
| Rate for Payer: Three Rivers PPO |
$10.40
|
| Rate for Payer: TriWest Veterans Administration |
$7.90
|
| Rate for Payer: United Healthcare Commercial |
$13.24
|
| Rate for Payer: United Healthcare Medicare |
$7.90
|
| Rate for Payer: WINHealth Partners Commercial |
$13.58
|
| Rate for Payer: Wise Provider Network Commercial |
$13.17
|
|
|
ENDOTRACH ORAL RAE 7.0 CUFFED
|
Facility
|
IP
|
$13.86
|
|
| Hospital Charge Code |
2500076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.58
|
| Rate for Payer: Aetna of WY Medicare |
$8.87
|
| Rate for Payer: Altius Commercial |
$13.31
|
| Rate for Payer: Beech Street Commercial |
$13.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.44
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.44
|
| Rate for Payer: Cigna of WY Commercial |
$13.58
|
| Rate for Payer: Entrust Commercial |
$13.17
|
| Rate for Payer: First Choice Health Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13.17
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.45
|
| Rate for Payer: HealthUtah PPO |
$13.86
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.44
|
| Rate for Payer: Multiplan Medicare/VA |
$8.03
|
| Rate for Payer: One Health Plan of WY PPO |
$13.58
|
| Rate for Payer: PacificSource Commercial |
$12.47
|
| Rate for Payer: PHCS PPO |
$13.58
|
| Rate for Payer: Three Rivers PPO |
$10.40
|
| Rate for Payer: TriWest Veterans Administration |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$13.24
|
| Rate for Payer: United Healthcare Medicare |
$8.45
|
| Rate for Payer: WINHealth Partners Commercial |
$13.17
|
| Rate for Payer: Wise Provider Network Commercial |
$13.17
|
|
|
ENDOTRACH REINFORCED TUBE 6.0
|
Facility
|
OP
|
$53.27
|
|
| Hospital Charge Code |
2500228
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.85 |
| Max. Negotiated Rate |
$53.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.20
|
| Rate for Payer: Aetna of WY Medicare |
$35.16
|
| Rate for Payer: Altius Commercial |
$51.14
|
| Rate for Payer: Beech Street Commercial |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$51.67
|
| Rate for Payer: Cash Price |
$37.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$51.67
|
| Rate for Payer: Cigna of WY Commercial |
$52.20
|
| Rate for Payer: Entrust Commercial |
$50.61
|
| Rate for Payer: First Choice Health Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$30.36
|
| Rate for Payer: HealthUtah PPO |
$53.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$51.67
|
| Rate for Payer: Multiplan Medicare/VA |
$28.85
|
| Rate for Payer: One Health Plan of WY PPO |
$52.20
|
| Rate for Payer: PacificSource Commercial |
$47.94
|
| Rate for Payer: PHCS PPO |
$52.20
|
| Rate for Payer: Three Rivers PPO |
$39.95
|
| Rate for Payer: TriWest Veterans Administration |
$30.36
|
| Rate for Payer: United Healthcare Commercial |
$50.87
|
| Rate for Payer: United Healthcare Medicare |
$30.36
|
| Rate for Payer: WINHealth Partners Commercial |
$52.20
|
| Rate for Payer: Wise Provider Network Commercial |
$50.61
|
|
|
ENDOTRACH REINFORCED TUBE 6.0
|
Facility
|
IP
|
$53.27
|
|
| Hospital Charge Code |
2500228
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.87 |
| Max. Negotiated Rate |
$53.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.20
|
| Rate for Payer: Aetna of WY Medicare |
$34.09
|
| Rate for Payer: Altius Commercial |
$51.14
|
| Rate for Payer: Beech Street Commercial |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$51.67
|
| Rate for Payer: Cash Price |
$37.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$51.67
|
| Rate for Payer: Cigna of WY Commercial |
$52.20
|
| Rate for Payer: Entrust Commercial |
$50.61
|
| Rate for Payer: First Choice Health Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.49
|
| Rate for Payer: HealthUtah PPO |
$53.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$51.67
|
| Rate for Payer: Multiplan Medicare/VA |
$30.87
|
| Rate for Payer: One Health Plan of WY PPO |
$52.20
|
| Rate for Payer: PacificSource Commercial |
$47.94
|
| Rate for Payer: PHCS PPO |
$52.20
|
| Rate for Payer: Three Rivers PPO |
$39.95
|
| Rate for Payer: TriWest Veterans Administration |
$32.49
|
| Rate for Payer: United Healthcare Commercial |
$50.87
|
| Rate for Payer: United Healthcare Medicare |
$32.49
|
| Rate for Payer: WINHealth Partners Commercial |
$50.61
|
| Rate for Payer: Wise Provider Network Commercial |
$50.61
|
|
|
ENDOTRACH REINFORCED TUBE 7.0
|
Facility
|
OP
|
$53.27
|
|
| Hospital Charge Code |
2500230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.85 |
| Max. Negotiated Rate |
$53.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.20
|
| Rate for Payer: Aetna of WY Medicare |
$35.16
|
| Rate for Payer: Altius Commercial |
$51.14
|
| Rate for Payer: Beech Street Commercial |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$51.67
|
| Rate for Payer: Cash Price |
$37.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$51.67
|
| Rate for Payer: Cigna of WY Commercial |
$52.20
|
| Rate for Payer: Entrust Commercial |
$50.61
|
| Rate for Payer: First Choice Health Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$30.36
|
| Rate for Payer: HealthUtah PPO |
$53.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$51.67
|
| Rate for Payer: Multiplan Medicare/VA |
$28.85
|
| Rate for Payer: One Health Plan of WY PPO |
$52.20
|
| Rate for Payer: PacificSource Commercial |
$47.94
|
| Rate for Payer: PHCS PPO |
$52.20
|
| Rate for Payer: Three Rivers PPO |
$39.95
|
| Rate for Payer: TriWest Veterans Administration |
$30.36
|
| Rate for Payer: United Healthcare Commercial |
$50.87
|
| Rate for Payer: United Healthcare Medicare |
$30.36
|
| Rate for Payer: WINHealth Partners Commercial |
$52.20
|
| Rate for Payer: Wise Provider Network Commercial |
$50.61
|
|
|
ENDOTRACH REINFORCED TUBE 7.0
|
Facility
|
IP
|
$53.27
|
|
| Hospital Charge Code |
2500230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.87 |
| Max. Negotiated Rate |
$53.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.20
|
| Rate for Payer: Aetna of WY Medicare |
$34.09
|
| Rate for Payer: Altius Commercial |
$51.14
|
| Rate for Payer: Beech Street Commercial |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$51.67
|
| Rate for Payer: Cash Price |
$37.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$51.67
|
| Rate for Payer: Cigna of WY Commercial |
$52.20
|
| Rate for Payer: Entrust Commercial |
$50.61
|
| Rate for Payer: First Choice Health Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$50.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.49
|
| Rate for Payer: HealthUtah PPO |
$53.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$51.67
|
| Rate for Payer: Multiplan Medicare/VA |
$30.87
|
| Rate for Payer: One Health Plan of WY PPO |
$52.20
|
| Rate for Payer: PacificSource Commercial |
$47.94
|
| Rate for Payer: PHCS PPO |
$52.20
|
| Rate for Payer: Three Rivers PPO |
$39.95
|
| Rate for Payer: TriWest Veterans Administration |
$32.49
|
| Rate for Payer: United Healthcare Commercial |
$50.87
|
| Rate for Payer: United Healthcare Medicare |
$32.49
|
| Rate for Payer: WINHealth Partners Commercial |
$50.61
|
| Rate for Payer: Wise Provider Network Commercial |
$50.61
|
|
|
ENDOTRACH TUBE CUFF 3.0
|
Facility
|
OP
|
$4.74
|
|
| Hospital Charge Code |
2500165
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$4.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.65
|
| Rate for Payer: Aetna of WY Medicare |
$3.13
|
| Rate for Payer: Altius Commercial |
$4.55
|
| Rate for Payer: Beech Street Commercial |
$4.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.60
|
| Rate for Payer: Cigna of WY Commercial |
$4.65
|
| Rate for Payer: Entrust Commercial |
$4.50
|
| Rate for Payer: First Choice Health Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.70
|
| Rate for Payer: HealthUtah PPO |
$4.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.60
|
| Rate for Payer: Multiplan Medicare/VA |
$2.57
|
| Rate for Payer: One Health Plan of WY PPO |
$4.65
|
| Rate for Payer: PacificSource Commercial |
$4.27
|
| Rate for Payer: PHCS PPO |
$4.65
|
| Rate for Payer: Three Rivers PPO |
$3.56
|
| Rate for Payer: TriWest Veterans Administration |
$2.70
|
| Rate for Payer: United Healthcare Commercial |
$4.53
|
| Rate for Payer: United Healthcare Medicare |
$2.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4.65
|
| Rate for Payer: Wise Provider Network Commercial |
$4.50
|
|
|
ENDOTRACH TUBE CUFF 3.0
|
Facility
|
IP
|
$4.74
|
|
| Hospital Charge Code |
2500165
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$4.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.65
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.55
|
| Rate for Payer: Beech Street Commercial |
$4.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.60
|
| Rate for Payer: Cigna of WY Commercial |
$4.65
|
| Rate for Payer: Entrust Commercial |
$4.50
|
| Rate for Payer: First Choice Health Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.60
|
| Rate for Payer: Multiplan Medicare/VA |
$2.75
|
| Rate for Payer: One Health Plan of WY PPO |
$4.65
|
| Rate for Payer: PacificSource Commercial |
$4.27
|
| Rate for Payer: PHCS PPO |
$4.65
|
| Rate for Payer: Three Rivers PPO |
$3.56
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.53
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.50
|
| Rate for Payer: Wise Provider Network Commercial |
$4.50
|
|
|
ENDOTRACH TUBE CUFF 3.5
|
Facility
|
OP
|
$4.73
|
|
| Hospital Charge Code |
2500166
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.12
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.70
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.56
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.70
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4.64
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 3.5
|
Facility
|
IP
|
$4.73
|
|
| Hospital Charge Code |
2500166
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.74
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.49
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 4.0
|
Facility
|
OP
|
$4.73
|
|
| Hospital Charge Code |
2500062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.12
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.70
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.56
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.70
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4.64
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 4.0
|
Facility
|
IP
|
$4.73
|
|
| Hospital Charge Code |
2500062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.74
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.49
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 4.5
|
Facility
|
OP
|
$4.73
|
|
| Hospital Charge Code |
2500087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.12
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.70
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.56
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.70
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4.64
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 4.5
|
Facility
|
IP
|
$4.73
|
|
| Hospital Charge Code |
2500087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.74
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.49
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 5.0
|
Facility
|
OP
|
$4.74
|
|
| Hospital Charge Code |
2500088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$4.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.65
|
| Rate for Payer: Aetna of WY Medicare |
$3.13
|
| Rate for Payer: Altius Commercial |
$4.55
|
| Rate for Payer: Beech Street Commercial |
$4.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.60
|
| Rate for Payer: Cigna of WY Commercial |
$4.65
|
| Rate for Payer: Entrust Commercial |
$4.50
|
| Rate for Payer: First Choice Health Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.70
|
| Rate for Payer: HealthUtah PPO |
$4.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.60
|
| Rate for Payer: Multiplan Medicare/VA |
$2.57
|
| Rate for Payer: One Health Plan of WY PPO |
$4.65
|
| Rate for Payer: PacificSource Commercial |
$4.27
|
| Rate for Payer: PHCS PPO |
$4.65
|
| Rate for Payer: Three Rivers PPO |
$3.56
|
| Rate for Payer: TriWest Veterans Administration |
$2.70
|
| Rate for Payer: United Healthcare Commercial |
$4.53
|
| Rate for Payer: United Healthcare Medicare |
$2.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4.65
|
| Rate for Payer: Wise Provider Network Commercial |
$4.50
|
|
|
ENDOTRACH TUBE CUFF 5.0
|
Facility
|
IP
|
$4.74
|
|
| Hospital Charge Code |
2500088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$4.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.65
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.55
|
| Rate for Payer: Beech Street Commercial |
$4.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.60
|
| Rate for Payer: Cigna of WY Commercial |
$4.65
|
| Rate for Payer: Entrust Commercial |
$4.50
|
| Rate for Payer: First Choice Health Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.60
|
| Rate for Payer: Multiplan Medicare/VA |
$2.75
|
| Rate for Payer: One Health Plan of WY PPO |
$4.65
|
| Rate for Payer: PacificSource Commercial |
$4.27
|
| Rate for Payer: PHCS PPO |
$4.65
|
| Rate for Payer: Three Rivers PPO |
$3.56
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.53
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.50
|
| Rate for Payer: Wise Provider Network Commercial |
$4.50
|
|
|
ENDOTRACH TUBE CUFF 5.5
|
Facility
|
IP
|
$4.74
|
|
| Hospital Charge Code |
2500089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$4.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.65
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.55
|
| Rate for Payer: Beech Street Commercial |
$4.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.60
|
| Rate for Payer: Cigna of WY Commercial |
$4.65
|
| Rate for Payer: Entrust Commercial |
$4.50
|
| Rate for Payer: First Choice Health Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.60
|
| Rate for Payer: Multiplan Medicare/VA |
$2.75
|
| Rate for Payer: One Health Plan of WY PPO |
$4.65
|
| Rate for Payer: PacificSource Commercial |
$4.27
|
| Rate for Payer: PHCS PPO |
$4.65
|
| Rate for Payer: Three Rivers PPO |
$3.56
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.53
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.50
|
| Rate for Payer: Wise Provider Network Commercial |
$4.50
|
|
|
ENDOTRACH TUBE CUFF 5.5
|
Facility
|
OP
|
$4.74
|
|
| Hospital Charge Code |
2500089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$4.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.65
|
| Rate for Payer: Aetna of WY Medicare |
$3.13
|
| Rate for Payer: Altius Commercial |
$4.55
|
| Rate for Payer: Beech Street Commercial |
$4.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.60
|
| Rate for Payer: Cigna of WY Commercial |
$4.65
|
| Rate for Payer: Entrust Commercial |
$4.50
|
| Rate for Payer: First Choice Health Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.70
|
| Rate for Payer: HealthUtah PPO |
$4.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.60
|
| Rate for Payer: Multiplan Medicare/VA |
$2.57
|
| Rate for Payer: One Health Plan of WY PPO |
$4.65
|
| Rate for Payer: PacificSource Commercial |
$4.27
|
| Rate for Payer: PHCS PPO |
$4.65
|
| Rate for Payer: Three Rivers PPO |
$3.56
|
| Rate for Payer: TriWest Veterans Administration |
$2.70
|
| Rate for Payer: United Healthcare Commercial |
$4.53
|
| Rate for Payer: United Healthcare Medicare |
$2.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4.65
|
| Rate for Payer: Wise Provider Network Commercial |
$4.50
|
|
|
ENDOTRACH TUBE CUFF 6.0
|
Facility
|
OP
|
$4.73
|
|
| Hospital Charge Code |
2500090
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.12
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.70
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.56
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.70
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.70
|
| Rate for Payer: WINHealth Partners Commercial |
$4.64
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 6.0
|
Facility
|
IP
|
$4.73
|
|
| Hospital Charge Code |
2500090
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.74
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.49
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
|
ENDOTRACH TUBE CUFF 6.5
|
Facility
|
IP
|
$4.73
|
|
| Hospital Charge Code |
2500091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.64
|
| Rate for Payer: Aetna of WY Medicare |
$3.03
|
| Rate for Payer: Altius Commercial |
$4.54
|
| Rate for Payer: Beech Street Commercial |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.59
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.59
|
| Rate for Payer: Cigna of WY Commercial |
$4.64
|
| Rate for Payer: Entrust Commercial |
$4.49
|
| Rate for Payer: First Choice Health Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.89
|
| Rate for Payer: HealthUtah PPO |
$4.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.59
|
| Rate for Payer: Multiplan Medicare/VA |
$2.74
|
| Rate for Payer: One Health Plan of WY PPO |
$4.64
|
| Rate for Payer: PacificSource Commercial |
$4.26
|
| Rate for Payer: PHCS PPO |
$4.64
|
| Rate for Payer: Three Rivers PPO |
$3.55
|
| Rate for Payer: TriWest Veterans Administration |
$2.89
|
| Rate for Payer: United Healthcare Commercial |
$4.52
|
| Rate for Payer: United Healthcare Medicare |
$2.89
|
| Rate for Payer: WINHealth Partners Commercial |
$4.49
|
| Rate for Payer: Wise Provider Network Commercial |
$4.49
|
|
