|
FEMOR NAIL 10X380MM 1825-1038S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100468
|
|
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 10X380MM 1825-1038S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100468
|
|
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 10X400MM 1825-1040S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100620
|
|
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 10X400MM 1825-1040S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100620
|
|
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 10X420MM 1825-1042S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100469
|
|
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 10X420MM 1825-1042S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100469
|
|
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 10X440MM 1825-1044S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100470
|
|
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 10X440MM 1825-1044S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100470
|
|
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 11X280MM 1825-1128S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100471
|
|
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 11X280MM 1825-1128S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100471
|
|
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 11X300MM 1825-1130S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100472
|
|
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 11X300MM 1825-1130S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100472
|
|
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 11X320MM 1825-1132S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100473
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,248.23 |
| Max. Negotiated Rate |
$3,879.61 |
| Rate for Payer: United Healthcare Commercial |
$3,705.03
|
| 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 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 11X320MM 1825-1132S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100473
|
|
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 11X340MM 1825-1134S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100474
|
|
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 11X340MM 1825-1134S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100474
|
|
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 11X360MM 1825-1136S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100475
|
|
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 11X360MM 1825-1136S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100475
|
|
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 11X380MM 1825-1138S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100476
|
|
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 11X380MM 1825-1138S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100476
|
|
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 11X400MM 1825-1140S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100400
|
|
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 11X400MM 1825-1140S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100400
|
|
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 11X420MM 1825-1142S
|
Facility
|
IP
|
$3,879.61
|
|
| Hospital Charge Code |
3100477
|
|
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 11X420MM 1825-1142S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100477
|
|
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 11X440MM 1825-1144S
|
Facility
|
OP
|
$3,879.61
|
|
| Hospital Charge Code |
3100478
|
|
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
|
|
