|
ENDOTRACH TUBE RAE UC 3.5
|
Facility
|
IP
|
$8.05
|
|
| Hospital Charge Code |
2500080
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.89
|
| Rate for Payer: Aetna of WY Medicare |
$5.15
|
| Rate for Payer: Altius Commercial |
$7.73
|
| Rate for Payer: Beech Street Commercial |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.81
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.81
|
| Rate for Payer: Cigna of WY Commercial |
$7.89
|
| Rate for Payer: Entrust Commercial |
$7.65
|
| Rate for Payer: First Choice Health Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.91
|
| Rate for Payer: HealthUtah PPO |
$8.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.81
|
| Rate for Payer: Multiplan Medicare/VA |
$4.66
|
| Rate for Payer: One Health Plan of WY PPO |
$7.89
|
| Rate for Payer: PacificSource Commercial |
$7.24
|
| Rate for Payer: PHCS PPO |
$7.89
|
| Rate for Payer: Three Rivers PPO |
$6.04
|
| Rate for Payer: TriWest Veterans Administration |
$4.91
|
| Rate for Payer: United Healthcare Commercial |
$7.69
|
| Rate for Payer: United Healthcare Medicare |
$4.91
|
| Rate for Payer: WINHealth Partners Commercial |
$7.65
|
| Rate for Payer: Wise Provider Network Commercial |
$7.65
|
|
|
ENDOTRACH TUBE RAE UC 3.5
|
Facility
|
OP
|
$8.05
|
|
| Hospital Charge Code |
2500080
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.89
|
| Rate for Payer: Aetna of WY Medicare |
$5.31
|
| Rate for Payer: Altius Commercial |
$7.73
|
| Rate for Payer: Beech Street Commercial |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.81
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.81
|
| Rate for Payer: Cigna of WY Commercial |
$7.89
|
| Rate for Payer: Entrust Commercial |
$7.65
|
| Rate for Payer: First Choice Health Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.59
|
| Rate for Payer: HealthUtah PPO |
$8.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.81
|
| Rate for Payer: Multiplan Medicare/VA |
$4.36
|
| Rate for Payer: One Health Plan of WY PPO |
$7.89
|
| Rate for Payer: PacificSource Commercial |
$7.24
|
| Rate for Payer: PHCS PPO |
$7.89
|
| Rate for Payer: Three Rivers PPO |
$6.04
|
| Rate for Payer: TriWest Veterans Administration |
$4.59
|
| Rate for Payer: United Healthcare Commercial |
$7.69
|
| Rate for Payer: United Healthcare Medicare |
$4.59
|
| Rate for Payer: WINHealth Partners Commercial |
$7.89
|
| Rate for Payer: Wise Provider Network Commercial |
$7.65
|
|
|
ENDOTRACHTUBE RAE UC 4.0
|
Facility
|
OP
|
$8.05
|
|
| Hospital Charge Code |
2500081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.89
|
| Rate for Payer: Aetna of WY Medicare |
$5.31
|
| Rate for Payer: Altius Commercial |
$7.73
|
| Rate for Payer: Beech Street Commercial |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.81
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.81
|
| Rate for Payer: Cigna of WY Commercial |
$7.89
|
| Rate for Payer: Entrust Commercial |
$7.65
|
| Rate for Payer: First Choice Health Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.59
|
| Rate for Payer: HealthUtah PPO |
$8.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.81
|
| Rate for Payer: Multiplan Medicare/VA |
$4.36
|
| Rate for Payer: One Health Plan of WY PPO |
$7.89
|
| Rate for Payer: PacificSource Commercial |
$7.24
|
| Rate for Payer: PHCS PPO |
$7.89
|
| Rate for Payer: Three Rivers PPO |
$6.04
|
| Rate for Payer: TriWest Veterans Administration |
$4.59
|
| Rate for Payer: United Healthcare Commercial |
$7.69
|
| Rate for Payer: United Healthcare Medicare |
$4.59
|
| Rate for Payer: WINHealth Partners Commercial |
$7.89
|
| Rate for Payer: Wise Provider Network Commercial |
$7.65
|
|
|
ENDOTRACHTUBE RAE UC 4.0
|
Facility
|
IP
|
$8.05
|
|
| Hospital Charge Code |
2500081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.89
|
| Rate for Payer: Aetna of WY Medicare |
$5.15
|
| Rate for Payer: Altius Commercial |
$7.73
|
| Rate for Payer: Beech Street Commercial |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.81
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.81
|
| Rate for Payer: Cigna of WY Commercial |
$7.89
|
| Rate for Payer: Entrust Commercial |
$7.65
|
| Rate for Payer: First Choice Health Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.91
|
| Rate for Payer: HealthUtah PPO |
$8.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.81
|
| Rate for Payer: Multiplan Medicare/VA |
$4.66
|
| Rate for Payer: One Health Plan of WY PPO |
$7.89
|
| Rate for Payer: PacificSource Commercial |
$7.24
|
| Rate for Payer: PHCS PPO |
$7.89
|
| Rate for Payer: Three Rivers PPO |
$6.04
|
| Rate for Payer: TriWest Veterans Administration |
$4.91
|
| Rate for Payer: United Healthcare Commercial |
$7.69
|
| Rate for Payer: United Healthcare Medicare |
$4.91
|
| Rate for Payer: WINHealth Partners Commercial |
$7.65
|
| Rate for Payer: Wise Provider Network Commercial |
$7.65
|
|
|
ENDOTRACH TUBE RAE UC 5.5
|
Facility
|
IP
|
$7.68
|
|
| Hospital Charge Code |
2500084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.53
|
| Rate for Payer: Aetna of WY Medicare |
$4.92
|
| Rate for Payer: Altius Commercial |
$7.37
|
| Rate for Payer: Beech Street Commercial |
$7.53
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.45
|
| Rate for Payer: Cash Price |
$5.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.45
|
| Rate for Payer: Cigna of WY Commercial |
$7.53
|
| Rate for Payer: Entrust Commercial |
$7.30
|
| Rate for Payer: First Choice Health Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.68
|
| Rate for Payer: HealthUtah PPO |
$7.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.45
|
| Rate for Payer: Multiplan Medicare/VA |
$4.45
|
| Rate for Payer: One Health Plan of WY PPO |
$7.53
|
| Rate for Payer: PacificSource Commercial |
$6.91
|
| Rate for Payer: PHCS PPO |
$7.53
|
| Rate for Payer: Three Rivers PPO |
$5.76
|
| Rate for Payer: TriWest Veterans Administration |
$4.68
|
| Rate for Payer: United Healthcare Commercial |
$7.33
|
| Rate for Payer: United Healthcare Medicare |
$4.68
|
| Rate for Payer: WINHealth Partners Commercial |
$7.30
|
| Rate for Payer: Wise Provider Network Commercial |
$7.30
|
|
|
ENDOTRACH TUBE RAE UC 5.5
|
Facility
|
OP
|
$7.68
|
|
| Hospital Charge Code |
2500084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.53
|
| Rate for Payer: Aetna of WY Medicare |
$5.07
|
| Rate for Payer: Altius Commercial |
$7.37
|
| Rate for Payer: Beech Street Commercial |
$7.53
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.45
|
| Rate for Payer: Cash Price |
$5.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.45
|
| Rate for Payer: Cigna of WY Commercial |
$7.53
|
| Rate for Payer: Entrust Commercial |
$7.30
|
| Rate for Payer: First Choice Health Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.38
|
| Rate for Payer: HealthUtah PPO |
$7.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.45
|
| Rate for Payer: Multiplan Medicare/VA |
$4.16
|
| Rate for Payer: One Health Plan of WY PPO |
$7.53
|
| Rate for Payer: PacificSource Commercial |
$6.91
|
| Rate for Payer: PHCS PPO |
$7.53
|
| Rate for Payer: Three Rivers PPO |
$5.76
|
| Rate for Payer: TriWest Veterans Administration |
$4.38
|
| Rate for Payer: United Healthcare Commercial |
$7.33
|
| Rate for Payer: United Healthcare Medicare |
$4.38
|
| Rate for Payer: WINHealth Partners Commercial |
$7.53
|
| Rate for Payer: Wise Provider Network Commercial |
$7.30
|
|
|
ENDOTRACH TUBE RAE UC 6.0
|
Facility
|
OP
|
$7.68
|
|
| Hospital Charge Code |
2500085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: United Healthcare Commercial |
$7.33
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.53
|
| Rate for Payer: Aetna of WY Medicare |
$5.07
|
| Rate for Payer: Altius Commercial |
$7.37
|
| Rate for Payer: Beech Street Commercial |
$7.53
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.45
|
| Rate for Payer: Cash Price |
$5.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.45
|
| Rate for Payer: Cigna of WY Commercial |
$7.53
|
| Rate for Payer: Entrust Commercial |
$7.30
|
| Rate for Payer: First Choice Health Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.38
|
| Rate for Payer: HealthUtah PPO |
$7.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.45
|
| Rate for Payer: Multiplan Medicare/VA |
$4.16
|
| Rate for Payer: One Health Plan of WY PPO |
$7.53
|
| Rate for Payer: PacificSource Commercial |
$6.91
|
| Rate for Payer: PHCS PPO |
$7.53
|
| Rate for Payer: Three Rivers PPO |
$5.76
|
| Rate for Payer: TriWest Veterans Administration |
$4.38
|
| Rate for Payer: United Healthcare Medicare |
$4.38
|
| Rate for Payer: WINHealth Partners Commercial |
$7.53
|
| Rate for Payer: Wise Provider Network Commercial |
$7.30
|
|
|
ENDOTRACH TUBE RAE UC 6.0
|
Facility
|
IP
|
$7.68
|
|
| Hospital Charge Code |
2500085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.53
|
| Rate for Payer: Aetna of WY Medicare |
$4.92
|
| Rate for Payer: Altius Commercial |
$7.37
|
| Rate for Payer: Beech Street Commercial |
$7.53
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.45
|
| Rate for Payer: Cash Price |
$5.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.45
|
| Rate for Payer: Cigna of WY Commercial |
$7.53
|
| Rate for Payer: Entrust Commercial |
$7.30
|
| Rate for Payer: First Choice Health Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.68
|
| Rate for Payer: HealthUtah PPO |
$7.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.45
|
| Rate for Payer: Multiplan Medicare/VA |
$4.45
|
| Rate for Payer: One Health Plan of WY PPO |
$7.53
|
| Rate for Payer: PacificSource Commercial |
$6.91
|
| Rate for Payer: PHCS PPO |
$7.53
|
| Rate for Payer: Three Rivers PPO |
$5.76
|
| Rate for Payer: TriWest Veterans Administration |
$4.68
|
| Rate for Payer: United Healthcare Commercial |
$7.33
|
| Rate for Payer: United Healthcare Medicare |
$4.68
|
| Rate for Payer: WINHealth Partners Commercial |
$7.30
|
| Rate for Payer: Wise Provider Network Commercial |
$7.30
|
|
|
ENDOTRACH TUBE RAE UC 7.0
|
Facility
|
IP
|
$8.05
|
|
| Hospital Charge Code |
2500086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.89
|
| Rate for Payer: Aetna of WY Medicare |
$5.15
|
| Rate for Payer: Altius Commercial |
$7.73
|
| Rate for Payer: Beech Street Commercial |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.81
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.81
|
| Rate for Payer: Cigna of WY Commercial |
$7.89
|
| Rate for Payer: Entrust Commercial |
$7.65
|
| Rate for Payer: First Choice Health Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.91
|
| Rate for Payer: HealthUtah PPO |
$8.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.81
|
| Rate for Payer: Multiplan Medicare/VA |
$4.66
|
| Rate for Payer: One Health Plan of WY PPO |
$7.89
|
| Rate for Payer: PacificSource Commercial |
$7.24
|
| Rate for Payer: PHCS PPO |
$7.89
|
| Rate for Payer: Three Rivers PPO |
$6.04
|
| Rate for Payer: TriWest Veterans Administration |
$4.91
|
| Rate for Payer: United Healthcare Commercial |
$7.69
|
| Rate for Payer: United Healthcare Medicare |
$4.91
|
| Rate for Payer: WINHealth Partners Commercial |
$7.65
|
| Rate for Payer: Wise Provider Network Commercial |
$7.65
|
|
|
ENDOTRACH TUBE RAE UC 7.0
|
Facility
|
OP
|
$8.05
|
|
| Hospital Charge Code |
2500086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.89
|
| Rate for Payer: Aetna of WY Medicare |
$5.31
|
| Rate for Payer: Altius Commercial |
$7.73
|
| Rate for Payer: Beech Street Commercial |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.81
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.81
|
| Rate for Payer: Cigna of WY Commercial |
$7.89
|
| Rate for Payer: Entrust Commercial |
$7.65
|
| Rate for Payer: First Choice Health Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.59
|
| Rate for Payer: HealthUtah PPO |
$8.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.81
|
| Rate for Payer: Multiplan Medicare/VA |
$4.36
|
| Rate for Payer: One Health Plan of WY PPO |
$7.89
|
| Rate for Payer: PacificSource Commercial |
$7.24
|
| Rate for Payer: PHCS PPO |
$7.89
|
| Rate for Payer: Three Rivers PPO |
$6.04
|
| Rate for Payer: TriWest Veterans Administration |
$4.59
|
| Rate for Payer: United Healthcare Commercial |
$7.69
|
| Rate for Payer: United Healthcare Medicare |
$4.59
|
| Rate for Payer: WINHealth Partners Commercial |
$7.89
|
| Rate for Payer: Wise Provider Network Commercial |
$7.65
|
|
|
ENDOTRACH TUBE UC 2.0
|
Facility
|
OP
|
$3.92
|
|
| Hospital Charge Code |
2500168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.84
|
| Rate for Payer: Aetna of WY Medicare |
$2.59
|
| Rate for Payer: Altius Commercial |
$3.76
|
| Rate for Payer: Beech Street Commercial |
$3.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.80
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.80
|
| Rate for Payer: Cigna of WY Commercial |
$3.84
|
| Rate for Payer: Entrust Commercial |
$3.72
|
| Rate for Payer: First Choice Health Commercial |
$3.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.23
|
| Rate for Payer: HealthUtah PPO |
$3.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.80
|
| Rate for Payer: Multiplan Medicare/VA |
$2.12
|
| Rate for Payer: One Health Plan of WY PPO |
$3.84
|
| Rate for Payer: PacificSource Commercial |
$3.53
|
| Rate for Payer: PHCS PPO |
$3.84
|
| Rate for Payer: Three Rivers PPO |
$2.94
|
| Rate for Payer: TriWest Veterans Administration |
$2.23
|
| Rate for Payer: United Healthcare Commercial |
$3.74
|
| Rate for Payer: United Healthcare Medicare |
$2.23
|
| Rate for Payer: WINHealth Partners Commercial |
$3.84
|
| Rate for Payer: Wise Provider Network Commercial |
$3.72
|
|
|
ENDOTRACH TUBE UC 2.0
|
Facility
|
IP
|
$3.92
|
|
| Hospital Charge Code |
2500168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.84
|
| Rate for Payer: Aetna of WY Medicare |
$2.51
|
| Rate for Payer: Altius Commercial |
$3.76
|
| Rate for Payer: Beech Street Commercial |
$3.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.80
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.80
|
| Rate for Payer: Cigna of WY Commercial |
$3.84
|
| Rate for Payer: Entrust Commercial |
$3.72
|
| Rate for Payer: First Choice Health Commercial |
$3.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.39
|
| Rate for Payer: HealthUtah PPO |
$3.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.80
|
| Rate for Payer: Multiplan Medicare/VA |
$2.27
|
| Rate for Payer: One Health Plan of WY PPO |
$3.84
|
| Rate for Payer: PacificSource Commercial |
$3.53
|
| Rate for Payer: PHCS PPO |
$3.84
|
| Rate for Payer: Three Rivers PPO |
$2.94
|
| Rate for Payer: TriWest Veterans Administration |
$2.39
|
| Rate for Payer: United Healthcare Commercial |
$3.74
|
| Rate for Payer: United Healthcare Medicare |
$2.39
|
| Rate for Payer: WINHealth Partners Commercial |
$3.72
|
| Rate for Payer: Wise Provider Network Commercial |
$3.72
|
|
|
ENDOTRACH TUBE UC 2.5
|
Facility
|
OP
|
$3.90
|
|
| Hospital Charge Code |
2500097
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.57
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.22
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.11
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.22
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3.82
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 2.5
|
Facility
|
IP
|
$3.90
|
|
| Hospital Charge Code |
2500097
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.50
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.38
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.26
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.38
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3.70
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 3.0
|
Facility
|
OP
|
$3.90
|
|
| Hospital Charge Code |
2500098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.57
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.22
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.11
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.22
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3.82
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 3.0
|
Facility
|
IP
|
$3.90
|
|
| Hospital Charge Code |
2500098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.50
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.38
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.26
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.38
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3.70
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 3.5
|
Facility
|
IP
|
$3.90
|
|
| Hospital Charge Code |
2500099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.50
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.38
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.26
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.38
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3.70
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 3.5
|
Facility
|
OP
|
$3.90
|
|
| Hospital Charge Code |
2500099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.57
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.22
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.11
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.22
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3.82
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 4.0
|
Facility
|
IP
|
$3.90
|
|
| Hospital Charge Code |
2500100
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.50
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.38
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.26
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.38
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3.70
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 4.0
|
Facility
|
OP
|
$3.90
|
|
| Hospital Charge Code |
2500100
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.57
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.22
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.11
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.22
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3.82
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 4.5
|
Facility
|
IP
|
$3.90
|
|
| Hospital Charge Code |
2500101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.50
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.38
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.26
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.38
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3.70
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 4.5
|
Facility
|
OP
|
$3.90
|
|
| Hospital Charge Code |
2500101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.57
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.22
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.11
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.22
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3.82
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 5.0
|
Facility
|
OP
|
$3.90
|
|
| Hospital Charge Code |
2500102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.57
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.22
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.11
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.22
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3.82
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 5.0
|
Facility
|
IP
|
$3.90
|
|
| Hospital Charge Code |
2500102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.50
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.38
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.26
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.38
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3.70
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
|
ENDOTRACH TUBE UC 5.5
|
Facility
|
OP
|
$3.90
|
|
| Hospital Charge Code |
2500103
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.82
|
| Rate for Payer: Aetna of WY Medicare |
$2.57
|
| Rate for Payer: Altius Commercial |
$3.74
|
| Rate for Payer: Beech Street Commercial |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.78
|
| Rate for Payer: Cigna of WY Commercial |
$3.82
|
| Rate for Payer: Entrust Commercial |
$3.70
|
| Rate for Payer: First Choice Health Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.22
|
| Rate for Payer: HealthUtah PPO |
$3.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.78
|
| Rate for Payer: Multiplan Medicare/VA |
$2.11
|
| Rate for Payer: One Health Plan of WY PPO |
$3.82
|
| Rate for Payer: PacificSource Commercial |
$3.51
|
| Rate for Payer: PHCS PPO |
$3.82
|
| Rate for Payer: Three Rivers PPO |
$2.92
|
| Rate for Payer: TriWest Veterans Administration |
$2.22
|
| Rate for Payer: United Healthcare Commercial |
$3.72
|
| Rate for Payer: United Healthcare Medicare |
$2.22
|
| Rate for Payer: WINHealth Partners Commercial |
$3.82
|
| Rate for Payer: Wise Provider Network Commercial |
$3.70
|
|
