|
FEMOR NAIL 09X280MM 1825-0928S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100610
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X300MM 1825-0930S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X300MM 1825-0930S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X320MM 1825-0932S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100612
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X320MM 1825-0932S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100612
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X340MM 1825-0934S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X340MM 1825-0934S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X360MM 1825-0936S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100614
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X360MM 1825-0936S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100614
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X380MM 1825-0938S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100615
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X380MM 1825-0938S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100615
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X400MM 1825-0940S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100616
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X400MM 1825-0940S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100616
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X420MM 1825-0942S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100617
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 09X420MM 1825-0942S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100617
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X280MM 1825-1028S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100618
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X280MM 1825-1028S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100618
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X300MM 1825-1030S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X300MM 1825-1030S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X320MM 1825-1032S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X320MM 1825-1032S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X340MM 1825-1034S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X340MM 1825-1034S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X360MM 1825-1036S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,482.95
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,366.56
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,248.23
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,366.56
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,366.56
|
| Rate for Payer: WINHealth Partners Commercial |
$3,685.63
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
|
FEMOR NAIL 10X360MM 1825-1036S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.81 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,802.02
|
| Rate for Payer: Aetna of WY Medicare |
$2,560.54
|
| Rate for Payer: Altius Commercial |
$3,724.43
|
| Rate for Payer: Beech Street Commercial |
$3,802.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,763.22
|
| Rate for Payer: Cash Price |
$2,715.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,763.22
|
| Rate for Payer: Cigna of WY Commercial |
$3,802.02
|
| Rate for Payer: Entrust Commercial |
$3,685.63
|
| Rate for Payer: First Choice Health Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,685.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,211.38
|
| Rate for Payer: HealthUtah PPO |
$3,879.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,763.22
|
| Rate for Payer: Multiplan Medicare/VA |
$2,100.81
|
| Rate for Payer: One Health Plan of WY PPO |
$3,802.02
|
| Rate for Payer: PacificSource Commercial |
$3,491.65
|
| Rate for Payer: PHCS PPO |
$3,802.02
|
| Rate for Payer: Three Rivers PPO |
$2,909.71
|
| Rate for Payer: TriWest Veterans Administration |
$2,211.38
|
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| Rate for Payer: United Healthcare Medicare |
$2,211.38
|
| Rate for Payer: WINHealth Partners Commercial |
$3,802.02
|
| Rate for Payer: Wise Provider Network Commercial |
$3,685.63
|
|
