|
HC ASSAY OF BLOOD LIPOPROTEIN,LDL CHOLEST - LDL CHOLESTEROL DIRECT
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
HCPCS 83721
|
| Hospital Charge Code |
3018372101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$88.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$86.40
|
| Rate for Payer: Altius Commercial |
$86.40
|
| Rate for Payer: Beech Street Commercial |
$88.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$73.89
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$87.30
|
| Rate for Payer: Cigna of WY Commercial |
$88.20
|
| Rate for Payer: Entrust Commercial |
$85.50
|
| Rate for Payer: First Choice Health Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.40
|
| Rate for Payer: HealthUtah PPO |
$90.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$87.30
|
| Rate for Payer: Multiplan Medicare/VA |
$56.43
|
| Rate for Payer: One Health Plan of WY PPO |
$88.20
|
| Rate for Payer: PacificSource Commercial |
$81.00
|
| Rate for Payer: PHCS PPO |
$88.20
|
| Rate for Payer: Three Rivers PPO |
$67.50
|
| Rate for Payer: TriWest Veterans Administration |
$59.40
|
| Rate for Payer: United Healthcare Commercial |
$78.30
|
| Rate for Payer: United Healthcare Medicare |
$59.40
|
| Rate for Payer: WINHealth Partners Commercial |
$85.50
|
| Rate for Payer: Wise Provider Network Commercial |
$85.50
|
|
|
HC ASSAY OF BLOOD LIPOPROTEIN,LDL CHOLEST - LDL CHOLESTEROL DIRECT
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
HCPCS 83721
|
| Hospital Charge Code |
3018372101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$88.20
|
| Rate for Payer: Aetna of WY Medicare |
$59.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$86.40
|
| Rate for Payer: Altius Commercial |
$86.40
|
| Rate for Payer: Beech Street Commercial |
$88.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$73.89
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$87.30
|
| Rate for Payer: Cigna of WY Commercial |
$88.20
|
| Rate for Payer: Entrust Commercial |
$85.50
|
| Rate for Payer: First Choice Health Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.20
|
| Rate for Payer: HealthUtah PPO |
$90.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$87.30
|
| Rate for Payer: Multiplan Medicare/VA |
$49.59
|
| Rate for Payer: One Health Plan of WY PPO |
$88.20
|
| Rate for Payer: PacificSource Commercial |
$81.00
|
| Rate for Payer: PHCS PPO |
$88.20
|
| Rate for Payer: Three Rivers PPO |
$67.50
|
| Rate for Payer: TriWest Veterans Administration |
$52.20
|
| Rate for Payer: United Healthcare Commercial |
$78.30
|
| Rate for Payer: United Healthcare Medicare |
$52.20
|
| Rate for Payer: WINHealth Partners Commercial |
$88.20
|
| Rate for Payer: Wise Provider Network Commercial |
$85.50
|
|
|
HC ASSAY OF BLOOD OSMOLALITY - OSMOLALITY
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
HCPCS 83930
|
| Hospital Charge Code |
3018393001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.34 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.10
|
| Rate for Payer: Aetna of WY Medicare |
$62.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$91.20
|
| Rate for Payer: Altius Commercial |
$91.20
|
| Rate for Payer: Beech Street Commercial |
$93.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$66.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.15
|
| Rate for Payer: Cigna of WY Commercial |
$93.10
|
| Rate for Payer: Entrust Commercial |
$90.25
|
| Rate for Payer: First Choice Health Commercial |
$90.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$55.10
|
| Rate for Payer: HealthUtah PPO |
$95.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.15
|
| Rate for Payer: Multiplan Medicare/VA |
$52.34
|
| Rate for Payer: One Health Plan of WY PPO |
$93.10
|
| Rate for Payer: PacificSource Commercial |
$85.50
|
| Rate for Payer: PHCS PPO |
$93.10
|
| Rate for Payer: Three Rivers PPO |
$71.25
|
| Rate for Payer: TriWest Veterans Administration |
$55.10
|
| Rate for Payer: United Healthcare Commercial |
$82.65
|
| Rate for Payer: United Healthcare Medicare |
$55.10
|
| Rate for Payer: WINHealth Partners Commercial |
$93.10
|
| Rate for Payer: Wise Provider Network Commercial |
$90.25
|
|
|
HC ASSAY OF BLOOD OSMOLALITY - OSMOLALITY
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
HCPCS 83930
|
| Hospital Charge Code |
3018393001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.56 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$91.20
|
| Rate for Payer: Altius Commercial |
$91.20
|
| Rate for Payer: Beech Street Commercial |
$93.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$66.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.15
|
| Rate for Payer: Cigna of WY Commercial |
$93.10
|
| Rate for Payer: Entrust Commercial |
$90.25
|
| Rate for Payer: First Choice Health Commercial |
$90.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$62.70
|
| Rate for Payer: HealthUtah PPO |
$95.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.15
|
| Rate for Payer: Multiplan Medicare/VA |
$59.56
|
| Rate for Payer: One Health Plan of WY PPO |
$93.10
|
| Rate for Payer: PacificSource Commercial |
$85.50
|
| Rate for Payer: PHCS PPO |
$93.10
|
| Rate for Payer: Three Rivers PPO |
$71.25
|
| Rate for Payer: TriWest Veterans Administration |
$62.70
|
| Rate for Payer: United Healthcare Commercial |
$82.65
|
| Rate for Payer: United Healthcare Medicare |
$62.70
|
| Rate for Payer: WINHealth Partners Commercial |
$90.25
|
| Rate for Payer: Wise Provider Network Commercial |
$90.25
|
|
|
HC ASSAY OF BLOOD PKU - PHENYLALANINE
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
HCPCS 84030
|
| Hospital Charge Code |
3018403001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.48 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$53.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$52.80
|
| Rate for Payer: Altius Commercial |
$52.80
|
| Rate for Payer: Beech Street Commercial |
$53.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$45.16
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$53.35
|
| Rate for Payer: Cigna of WY Commercial |
$53.90
|
| Rate for Payer: Entrust Commercial |
$52.25
|
| Rate for Payer: First Choice Health Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$36.30
|
| Rate for Payer: HealthUtah PPO |
$55.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$53.35
|
| Rate for Payer: Multiplan Medicare/VA |
$34.48
|
| Rate for Payer: One Health Plan of WY PPO |
$53.90
|
| Rate for Payer: PacificSource Commercial |
$49.50
|
| Rate for Payer: PHCS PPO |
$53.90
|
| Rate for Payer: Three Rivers PPO |
$41.25
|
| Rate for Payer: TriWest Veterans Administration |
$36.30
|
| Rate for Payer: United Healthcare Commercial |
$47.85
|
| Rate for Payer: United Healthcare Medicare |
$36.30
|
| Rate for Payer: WINHealth Partners Commercial |
$52.25
|
| Rate for Payer: Wise Provider Network Commercial |
$52.25
|
|
|
HC ASSAY OF BLOOD PKU - PHENYLALANINE
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
HCPCS 84030
|
| Hospital Charge Code |
3018403001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.30 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$53.90
|
| Rate for Payer: Aetna of WY Medicare |
$36.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$52.80
|
| Rate for Payer: Altius Commercial |
$52.80
|
| Rate for Payer: Beech Street Commercial |
$53.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$45.16
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$53.35
|
| Rate for Payer: Cigna of WY Commercial |
$53.90
|
| Rate for Payer: Entrust Commercial |
$52.25
|
| Rate for Payer: First Choice Health Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.90
|
| Rate for Payer: HealthUtah PPO |
$55.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$53.35
|
| Rate for Payer: Multiplan Medicare/VA |
$30.30
|
| Rate for Payer: One Health Plan of WY PPO |
$53.90
|
| Rate for Payer: PacificSource Commercial |
$49.50
|
| Rate for Payer: PHCS PPO |
$53.90
|
| Rate for Payer: Three Rivers PPO |
$41.25
|
| Rate for Payer: TriWest Veterans Administration |
$31.90
|
| Rate for Payer: United Healthcare Commercial |
$47.85
|
| Rate for Payer: United Healthcare Medicare |
$31.90
|
| Rate for Payer: WINHealth Partners Commercial |
$53.90
|
| Rate for Payer: Wise Provider Network Commercial |
$52.25
|
|
|
HC ASSAY OF BUPRENORPHINE
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 80348
|
| Hospital Charge Code |
3018034801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$303.05 |
| Max. Negotiated Rate |
$550.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$539.00
|
| Rate for Payer: Aetna of WY Medicare |
$363.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$528.00
|
| Rate for Payer: Altius Commercial |
$528.00
|
| Rate for Payer: Beech Street Commercial |
$539.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$451.55
|
| Rate for Payer: Cash Price |
$385.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$533.50
|
| Rate for Payer: Cigna of WY Commercial |
$539.00
|
| Rate for Payer: Entrust Commercial |
$522.50
|
| Rate for Payer: First Choice Health Commercial |
$522.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$522.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$319.00
|
| Rate for Payer: HealthUtah PPO |
$550.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$533.50
|
| Rate for Payer: Multiplan Medicare/VA |
$303.05
|
| Rate for Payer: One Health Plan of WY PPO |
$539.00
|
| Rate for Payer: PacificSource Commercial |
$495.00
|
| Rate for Payer: PHCS PPO |
$539.00
|
| Rate for Payer: Three Rivers PPO |
$412.50
|
| Rate for Payer: TriWest Veterans Administration |
$319.00
|
| Rate for Payer: United Healthcare Commercial |
$478.50
|
| Rate for Payer: United Healthcare Medicare |
$319.00
|
| Rate for Payer: WINHealth Partners Commercial |
$539.00
|
| Rate for Payer: Wise Provider Network Commercial |
$522.50
|
|
|
HC ASSAY OF BUPRENORPHINE
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 80348
|
| Hospital Charge Code |
3018034801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$344.85 |
| Max. Negotiated Rate |
$550.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$539.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$528.00
|
| Rate for Payer: Altius Commercial |
$528.00
|
| Rate for Payer: Beech Street Commercial |
$539.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$451.55
|
| Rate for Payer: Cash Price |
$385.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$533.50
|
| Rate for Payer: Cigna of WY Commercial |
$539.00
|
| Rate for Payer: Entrust Commercial |
$522.50
|
| Rate for Payer: First Choice Health Commercial |
$522.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$522.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$363.00
|
| Rate for Payer: HealthUtah PPO |
$550.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$533.50
|
| Rate for Payer: Multiplan Medicare/VA |
$344.85
|
| Rate for Payer: One Health Plan of WY PPO |
$539.00
|
| Rate for Payer: PacificSource Commercial |
$495.00
|
| Rate for Payer: PHCS PPO |
$539.00
|
| Rate for Payer: Three Rivers PPO |
$412.50
|
| Rate for Payer: TriWest Veterans Administration |
$363.00
|
| Rate for Payer: United Healthcare Commercial |
$478.50
|
| Rate for Payer: United Healthcare Medicare |
$363.00
|
| Rate for Payer: WINHealth Partners Commercial |
$522.50
|
| Rate for Payer: Wise Provider Network Commercial |
$522.50
|
|
|
HC ASSAY OF BUPROPION
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
HCPCS 80338
|
| Hospital Charge Code |
3018033801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$194.37 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$303.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$297.60
|
| Rate for Payer: Altius Commercial |
$297.60
|
| Rate for Payer: Beech Street Commercial |
$303.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$254.51
|
| Rate for Payer: Cash Price |
$217.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$300.70
|
| Rate for Payer: Cigna of WY Commercial |
$303.80
|
| Rate for Payer: Entrust Commercial |
$294.50
|
| Rate for Payer: First Choice Health Commercial |
$294.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$294.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$204.60
|
| Rate for Payer: HealthUtah PPO |
$310.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$300.70
|
| Rate for Payer: Multiplan Medicare/VA |
$194.37
|
| Rate for Payer: One Health Plan of WY PPO |
$303.80
|
| Rate for Payer: PacificSource Commercial |
$279.00
|
| Rate for Payer: PHCS PPO |
$303.80
|
| Rate for Payer: Three Rivers PPO |
$232.50
|
| Rate for Payer: TriWest Veterans Administration |
$204.60
|
| Rate for Payer: United Healthcare Commercial |
$269.70
|
| Rate for Payer: United Healthcare Medicare |
$204.60
|
| Rate for Payer: WINHealth Partners Commercial |
$294.50
|
| Rate for Payer: Wise Provider Network Commercial |
$294.50
|
|
|
HC ASSAY OF BUPROPION
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
HCPCS 80338
|
| Hospital Charge Code |
3018033801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$170.81 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$303.80
|
| Rate for Payer: Aetna of WY Medicare |
$204.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$297.60
|
| Rate for Payer: Altius Commercial |
$297.60
|
| Rate for Payer: Beech Street Commercial |
$303.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$254.51
|
| Rate for Payer: Cash Price |
$217.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$300.70
|
| Rate for Payer: Cigna of WY Commercial |
$303.80
|
| Rate for Payer: Entrust Commercial |
$294.50
|
| Rate for Payer: First Choice Health Commercial |
$294.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$294.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$179.80
|
| Rate for Payer: HealthUtah PPO |
$310.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$300.70
|
| Rate for Payer: Multiplan Medicare/VA |
$170.81
|
| Rate for Payer: One Health Plan of WY PPO |
$303.80
|
| Rate for Payer: PacificSource Commercial |
$279.00
|
| Rate for Payer: PHCS PPO |
$303.80
|
| Rate for Payer: Three Rivers PPO |
$232.50
|
| Rate for Payer: TriWest Veterans Administration |
$179.80
|
| Rate for Payer: United Healthcare Commercial |
$269.70
|
| Rate for Payer: United Healthcare Medicare |
$179.80
|
| Rate for Payer: WINHealth Partners Commercial |
$303.80
|
| Rate for Payer: Wise Provider Network Commercial |
$294.50
|
|
|
HC ASSAY OF CADMIUM - CADMIUM PLASMA
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
HCPCS 82300
|
| Hospital Charge Code |
3018230003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.78 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$134.40
|
| Rate for Payer: Altius Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.94
|
| Rate for Payer: Cash Price |
$98.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$135.80
|
| Rate for Payer: Cigna of WY Commercial |
$137.20
|
| Rate for Payer: Entrust Commercial |
$133.00
|
| Rate for Payer: First Choice Health Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$92.40
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$87.78
|
| Rate for Payer: One Health Plan of WY PPO |
$137.20
|
| Rate for Payer: PacificSource Commercial |
$126.00
|
| Rate for Payer: PHCS PPO |
$137.20
|
| Rate for Payer: Three Rivers PPO |
$105.00
|
| Rate for Payer: TriWest Veterans Administration |
$92.40
|
| Rate for Payer: United Healthcare Commercial |
$121.80
|
| Rate for Payer: United Healthcare Medicare |
$92.40
|
| Rate for Payer: WINHealth Partners Commercial |
$133.00
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
HC ASSAY OF CADMIUM - CADMIUM PLASMA
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
HCPCS 82300
|
| Hospital Charge Code |
3018230003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.14 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Aetna of WY Medicare |
$92.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$134.40
|
| Rate for Payer: Altius Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.94
|
| Rate for Payer: Cash Price |
$98.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$135.80
|
| Rate for Payer: Cigna of WY Commercial |
$137.20
|
| Rate for Payer: Entrust Commercial |
$133.00
|
| Rate for Payer: First Choice Health Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$81.20
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$77.14
|
| Rate for Payer: One Health Plan of WY PPO |
$137.20
|
| Rate for Payer: PacificSource Commercial |
$126.00
|
| Rate for Payer: PHCS PPO |
$137.20
|
| Rate for Payer: Three Rivers PPO |
$105.00
|
| Rate for Payer: TriWest Veterans Administration |
$81.20
|
| Rate for Payer: United Healthcare Commercial |
$121.80
|
| Rate for Payer: United Healthcare Medicare |
$81.20
|
| Rate for Payer: WINHealth Partners Commercial |
$137.20
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
HC ASSAY OF CADMIUM - CADMIUM RANDOM URINE
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
HCPCS 82300
|
| Hospital Charge Code |
3018230002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.78 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$134.40
|
| Rate for Payer: Altius Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.94
|
| Rate for Payer: Cash Price |
$98.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$135.80
|
| Rate for Payer: Cigna of WY Commercial |
$137.20
|
| Rate for Payer: Entrust Commercial |
$133.00
|
| Rate for Payer: First Choice Health Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$92.40
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$87.78
|
| Rate for Payer: One Health Plan of WY PPO |
$137.20
|
| Rate for Payer: PacificSource Commercial |
$126.00
|
| Rate for Payer: PHCS PPO |
$137.20
|
| Rate for Payer: Three Rivers PPO |
$105.00
|
| Rate for Payer: TriWest Veterans Administration |
$92.40
|
| Rate for Payer: United Healthcare Commercial |
$121.80
|
| Rate for Payer: United Healthcare Medicare |
$92.40
|
| Rate for Payer: WINHealth Partners Commercial |
$133.00
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
HC ASSAY OF CADMIUM - CADMIUM RANDOM URINE
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
HCPCS 82300
|
| Hospital Charge Code |
3018230002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.14 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Aetna of WY Medicare |
$92.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$134.40
|
| Rate for Payer: Altius Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.94
|
| Rate for Payer: Cash Price |
$98.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$135.80
|
| Rate for Payer: Cigna of WY Commercial |
$137.20
|
| Rate for Payer: Entrust Commercial |
$133.00
|
| Rate for Payer: First Choice Health Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$81.20
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$77.14
|
| Rate for Payer: One Health Plan of WY PPO |
$137.20
|
| Rate for Payer: PacificSource Commercial |
$126.00
|
| Rate for Payer: PHCS PPO |
$137.20
|
| Rate for Payer: Three Rivers PPO |
$105.00
|
| Rate for Payer: TriWest Veterans Administration |
$81.20
|
| Rate for Payer: United Healthcare Commercial |
$121.80
|
| Rate for Payer: United Healthcare Medicare |
$81.20
|
| Rate for Payer: WINHealth Partners Commercial |
$137.20
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
HC ASSAY OF CALCITONIN - CALCITONIN
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
HCPCS 82308
|
| Hospital Charge Code |
3018230801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$109.72 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$171.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$168.00
|
| Rate for Payer: Altius Commercial |
$168.00
|
| Rate for Payer: Beech Street Commercial |
$171.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$143.68
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$169.75
|
| Rate for Payer: Cigna of WY Commercial |
$171.50
|
| Rate for Payer: Entrust Commercial |
$166.25
|
| Rate for Payer: First Choice Health Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$115.50
|
| Rate for Payer: HealthUtah PPO |
$175.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$169.75
|
| Rate for Payer: Multiplan Medicare/VA |
$109.72
|
| Rate for Payer: One Health Plan of WY PPO |
$171.50
|
| Rate for Payer: PacificSource Commercial |
$157.50
|
| Rate for Payer: PHCS PPO |
$171.50
|
| Rate for Payer: Three Rivers PPO |
$131.25
|
| Rate for Payer: TriWest Veterans Administration |
$115.50
|
| Rate for Payer: United Healthcare Commercial |
$152.25
|
| Rate for Payer: United Healthcare Medicare |
$115.50
|
| Rate for Payer: WINHealth Partners Commercial |
$166.25
|
| Rate for Payer: Wise Provider Network Commercial |
$166.25
|
|
|
HC ASSAY OF CALCITONIN - CALCITONIN
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
HCPCS 82308
|
| Hospital Charge Code |
3018230801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$96.42 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$171.50
|
| Rate for Payer: Aetna of WY Medicare |
$115.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$168.00
|
| Rate for Payer: Altius Commercial |
$168.00
|
| Rate for Payer: Beech Street Commercial |
$171.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$143.68
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$169.75
|
| Rate for Payer: Cigna of WY Commercial |
$171.50
|
| Rate for Payer: Entrust Commercial |
$166.25
|
| Rate for Payer: First Choice Health Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$101.50
|
| Rate for Payer: HealthUtah PPO |
$175.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$169.75
|
| Rate for Payer: Multiplan Medicare/VA |
$96.42
|
| Rate for Payer: One Health Plan of WY PPO |
$171.50
|
| Rate for Payer: PacificSource Commercial |
$157.50
|
| Rate for Payer: PHCS PPO |
$171.50
|
| Rate for Payer: Three Rivers PPO |
$131.25
|
| Rate for Payer: TriWest Veterans Administration |
$101.50
|
| Rate for Payer: United Healthcare Commercial |
$152.25
|
| Rate for Payer: United Healthcare Medicare |
$101.50
|
| Rate for Payer: WINHealth Partners Commercial |
$171.50
|
| Rate for Payer: Wise Provider Network Commercial |
$166.25
|
|
|
HC ASSAY OF CALCIUM IN URINE - CALCIUM RANDOM URINE
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
HCPCS 82340
|
| Hospital Charge Code |
3018234001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.08 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$78.40
|
| Rate for Payer: Aetna of WY Medicare |
$52.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$76.80
|
| Rate for Payer: Altius Commercial |
$76.80
|
| Rate for Payer: Beech Street Commercial |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$65.68
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$77.60
|
| Rate for Payer: Cigna of WY Commercial |
$78.40
|
| Rate for Payer: Entrust Commercial |
$76.00
|
| Rate for Payer: First Choice Health Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.40
|
| Rate for Payer: HealthUtah PPO |
$80.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$77.60
|
| Rate for Payer: Multiplan Medicare/VA |
$44.08
|
| Rate for Payer: One Health Plan of WY PPO |
$78.40
|
| Rate for Payer: PacificSource Commercial |
$72.00
|
| Rate for Payer: PHCS PPO |
$78.40
|
| Rate for Payer: Three Rivers PPO |
$60.00
|
| Rate for Payer: TriWest Veterans Administration |
$46.40
|
| Rate for Payer: United Healthcare Commercial |
$69.60
|
| Rate for Payer: United Healthcare Medicare |
$46.40
|
| Rate for Payer: WINHealth Partners Commercial |
$78.40
|
| Rate for Payer: Wise Provider Network Commercial |
$76.00
|
|
|
HC ASSAY OF CALCIUM IN URINE - CALCIUM RANDOM URINE
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
HCPCS 82340
|
| Hospital Charge Code |
3018234001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.16 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$78.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$76.80
|
| Rate for Payer: Altius Commercial |
$76.80
|
| Rate for Payer: Beech Street Commercial |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$65.68
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$77.60
|
| Rate for Payer: Cigna of WY Commercial |
$78.40
|
| Rate for Payer: Entrust Commercial |
$76.00
|
| Rate for Payer: First Choice Health Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.80
|
| Rate for Payer: HealthUtah PPO |
$80.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$77.60
|
| Rate for Payer: Multiplan Medicare/VA |
$50.16
|
| Rate for Payer: One Health Plan of WY PPO |
$78.40
|
| Rate for Payer: PacificSource Commercial |
$72.00
|
| Rate for Payer: PHCS PPO |
$78.40
|
| Rate for Payer: Three Rivers PPO |
$60.00
|
| Rate for Payer: TriWest Veterans Administration |
$52.80
|
| Rate for Payer: United Healthcare Commercial |
$69.60
|
| Rate for Payer: United Healthcare Medicare |
$52.80
|
| Rate for Payer: WINHealth Partners Commercial |
$76.00
|
| Rate for Payer: Wise Provider Network Commercial |
$76.00
|
|
|
HC ASSAY OF CALCIUM IN URINE - CALCIUM TIMED URINE
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
HCPCS 82340
|
| Hospital Charge Code |
3018234002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.08 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$78.40
|
| Rate for Payer: Aetna of WY Medicare |
$52.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$76.80
|
| Rate for Payer: Altius Commercial |
$76.80
|
| Rate for Payer: Beech Street Commercial |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$65.68
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$77.60
|
| Rate for Payer: Cigna of WY Commercial |
$78.40
|
| Rate for Payer: Entrust Commercial |
$76.00
|
| Rate for Payer: First Choice Health Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.40
|
| Rate for Payer: HealthUtah PPO |
$80.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$77.60
|
| Rate for Payer: Multiplan Medicare/VA |
$44.08
|
| Rate for Payer: One Health Plan of WY PPO |
$78.40
|
| Rate for Payer: PacificSource Commercial |
$72.00
|
| Rate for Payer: PHCS PPO |
$78.40
|
| Rate for Payer: Three Rivers PPO |
$60.00
|
| Rate for Payer: TriWest Veterans Administration |
$46.40
|
| Rate for Payer: United Healthcare Commercial |
$69.60
|
| Rate for Payer: United Healthcare Medicare |
$46.40
|
| Rate for Payer: WINHealth Partners Commercial |
$78.40
|
| Rate for Payer: Wise Provider Network Commercial |
$76.00
|
|
|
HC ASSAY OF CALCIUM IN URINE - CALCIUM TIMED URINE
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
HCPCS 82340
|
| Hospital Charge Code |
3018234002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.16 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$78.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$76.80
|
| Rate for Payer: Altius Commercial |
$76.80
|
| Rate for Payer: Beech Street Commercial |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$65.68
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$77.60
|
| Rate for Payer: Cigna of WY Commercial |
$78.40
|
| Rate for Payer: Entrust Commercial |
$76.00
|
| Rate for Payer: First Choice Health Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$76.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.80
|
| Rate for Payer: HealthUtah PPO |
$80.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$77.60
|
| Rate for Payer: Multiplan Medicare/VA |
$50.16
|
| Rate for Payer: One Health Plan of WY PPO |
$78.40
|
| Rate for Payer: PacificSource Commercial |
$72.00
|
| Rate for Payer: PHCS PPO |
$78.40
|
| Rate for Payer: Three Rivers PPO |
$60.00
|
| Rate for Payer: TriWest Veterans Administration |
$52.80
|
| Rate for Payer: United Healthcare Commercial |
$69.60
|
| Rate for Payer: United Healthcare Medicare |
$52.80
|
| Rate for Payer: WINHealth Partners Commercial |
$76.00
|
| Rate for Payer: Wise Provider Network Commercial |
$76.00
|
|
|
HC ASSAY OF CALCIUM, IONIZED - CALCIUM IONIZED
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS 82330
|
| Hospital Charge Code |
3018233001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$132.30
|
| Rate for Payer: Aetna of WY Medicare |
$89.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$129.60
|
| Rate for Payer: Altius Commercial |
$129.60
|
| Rate for Payer: Beech Street Commercial |
$132.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$110.84
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$130.95
|
| Rate for Payer: Cigna of WY Commercial |
$132.30
|
| Rate for Payer: Entrust Commercial |
$128.25
|
| Rate for Payer: First Choice Health Commercial |
$128.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$128.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.30
|
| Rate for Payer: HealthUtah PPO |
$135.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$130.95
|
| Rate for Payer: Multiplan Medicare/VA |
$74.38
|
| Rate for Payer: One Health Plan of WY PPO |
$132.30
|
| Rate for Payer: PacificSource Commercial |
$121.50
|
| Rate for Payer: PHCS PPO |
$132.30
|
| Rate for Payer: Three Rivers PPO |
$101.25
|
| Rate for Payer: TriWest Veterans Administration |
$78.30
|
| Rate for Payer: United Healthcare Commercial |
$117.45
|
| Rate for Payer: United Healthcare Medicare |
$78.30
|
| Rate for Payer: WINHealth Partners Commercial |
$132.30
|
| Rate for Payer: Wise Provider Network Commercial |
$128.25
|
|
|
HC ASSAY OF CALCIUM, IONIZED - CALCIUM IONIZED
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS 82330
|
| Hospital Charge Code |
3018233001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.64 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$132.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$129.60
|
| Rate for Payer: Altius Commercial |
$129.60
|
| Rate for Payer: Beech Street Commercial |
$132.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$110.84
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$130.95
|
| Rate for Payer: Cigna of WY Commercial |
$132.30
|
| Rate for Payer: Entrust Commercial |
$128.25
|
| Rate for Payer: First Choice Health Commercial |
$128.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$128.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$89.10
|
| Rate for Payer: HealthUtah PPO |
$135.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$130.95
|
| Rate for Payer: Multiplan Medicare/VA |
$84.64
|
| Rate for Payer: One Health Plan of WY PPO |
$132.30
|
| Rate for Payer: PacificSource Commercial |
$121.50
|
| Rate for Payer: PHCS PPO |
$132.30
|
| Rate for Payer: Three Rivers PPO |
$101.25
|
| Rate for Payer: TriWest Veterans Administration |
$89.10
|
| Rate for Payer: United Healthcare Commercial |
$117.45
|
| Rate for Payer: United Healthcare Medicare |
$89.10
|
| Rate for Payer: WINHealth Partners Commercial |
$128.25
|
| Rate for Payer: Wise Provider Network Commercial |
$128.25
|
|
|
HC ASSAY OF CALCIUM, TOTAL - CALCIUM
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
HCPCS 82310
|
| Hospital Charge Code |
3018231001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$88.20
|
| Rate for Payer: Aetna of WY Medicare |
$59.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$86.40
|
| Rate for Payer: Altius Commercial |
$86.40
|
| Rate for Payer: Beech Street Commercial |
$88.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$73.89
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$87.30
|
| Rate for Payer: Cigna of WY Commercial |
$88.20
|
| Rate for Payer: Entrust Commercial |
$85.50
|
| Rate for Payer: First Choice Health Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.20
|
| Rate for Payer: HealthUtah PPO |
$90.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$87.30
|
| Rate for Payer: Multiplan Medicare/VA |
$49.59
|
| Rate for Payer: One Health Plan of WY PPO |
$88.20
|
| Rate for Payer: PacificSource Commercial |
$81.00
|
| Rate for Payer: PHCS PPO |
$88.20
|
| Rate for Payer: Three Rivers PPO |
$67.50
|
| Rate for Payer: TriWest Veterans Administration |
$52.20
|
| Rate for Payer: United Healthcare Commercial |
$78.30
|
| Rate for Payer: United Healthcare Medicare |
$52.20
|
| Rate for Payer: WINHealth Partners Commercial |
$88.20
|
| Rate for Payer: Wise Provider Network Commercial |
$85.50
|
|
|
HC ASSAY OF CALCIUM, TOTAL - CALCIUM
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
HCPCS 82310
|
| Hospital Charge Code |
3018231001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$88.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$86.40
|
| Rate for Payer: Altius Commercial |
$86.40
|
| Rate for Payer: Beech Street Commercial |
$88.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$73.89
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$87.30
|
| Rate for Payer: Cigna of WY Commercial |
$88.20
|
| Rate for Payer: Entrust Commercial |
$85.50
|
| Rate for Payer: First Choice Health Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.40
|
| Rate for Payer: HealthUtah PPO |
$90.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$87.30
|
| Rate for Payer: Multiplan Medicare/VA |
$56.43
|
| Rate for Payer: One Health Plan of WY PPO |
$88.20
|
| Rate for Payer: PacificSource Commercial |
$81.00
|
| Rate for Payer: PHCS PPO |
$88.20
|
| Rate for Payer: Three Rivers PPO |
$67.50
|
| Rate for Payer: TriWest Veterans Administration |
$59.40
|
| Rate for Payer: United Healthcare Commercial |
$78.30
|
| Rate for Payer: United Healthcare Medicare |
$59.40
|
| Rate for Payer: WINHealth Partners Commercial |
$85.50
|
| Rate for Payer: Wise Provider Network Commercial |
$85.50
|
|
|
HC ASSAY OF CALPROTECTIN FECAL
|
Facility
|
OP
|
$330.00
|
|
|
Service Code
|
HCPCS 83993
|
| Hospital Charge Code |
3018399301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$181.83 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$323.40
|
| Rate for Payer: Aetna of WY Medicare |
$217.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$316.80
|
| Rate for Payer: Altius Commercial |
$316.80
|
| Rate for Payer: Beech Street Commercial |
$323.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$270.93
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$320.10
|
| Rate for Payer: Cigna of WY Commercial |
$323.40
|
| Rate for Payer: Entrust Commercial |
$313.50
|
| Rate for Payer: First Choice Health Commercial |
$313.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$313.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$191.40
|
| Rate for Payer: HealthUtah PPO |
$330.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$320.10
|
| Rate for Payer: Multiplan Medicare/VA |
$181.83
|
| Rate for Payer: One Health Plan of WY PPO |
$323.40
|
| Rate for Payer: PacificSource Commercial |
$297.00
|
| Rate for Payer: PHCS PPO |
$323.40
|
| Rate for Payer: Three Rivers PPO |
$247.50
|
| Rate for Payer: TriWest Veterans Administration |
$191.40
|
| Rate for Payer: United Healthcare Commercial |
$287.10
|
| Rate for Payer: United Healthcare Medicare |
$191.40
|
| Rate for Payer: WINHealth Partners Commercial |
$323.40
|
| Rate for Payer: Wise Provider Network Commercial |
$313.50
|
|
