|
GUIDEWIRE .025X150CM VNUS
|
Facility
|
IP
|
$46.73
|
|
| Hospital Charge Code |
2650877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.08 |
| Max. Negotiated Rate |
$46.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$45.80
|
| Rate for Payer: Aetna of WY Medicare |
$29.91
|
| Rate for Payer: Altius Commercial |
$44.86
|
| Rate for Payer: Beech Street Commercial |
$45.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$45.33
|
| Rate for Payer: Cash Price |
$32.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$45.33
|
| Rate for Payer: Cigna of WY Commercial |
$45.80
|
| Rate for Payer: Entrust Commercial |
$44.39
|
| Rate for Payer: First Choice Health Commercial |
$44.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$44.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$28.51
|
| Rate for Payer: HealthUtah PPO |
$46.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$45.33
|
| Rate for Payer: Multiplan Medicare/VA |
$27.08
|
| Rate for Payer: One Health Plan of WY PPO |
$45.80
|
| Rate for Payer: PacificSource Commercial |
$42.06
|
| Rate for Payer: PHCS PPO |
$45.80
|
| Rate for Payer: Three Rivers PPO |
$35.05
|
| Rate for Payer: TriWest Veterans Administration |
$28.51
|
| Rate for Payer: United Healthcare Commercial |
$44.63
|
| Rate for Payer: United Healthcare Medicare |
$28.51
|
| Rate for Payer: WINHealth Partners Commercial |
$44.39
|
| Rate for Payer: Wise Provider Network Commercial |
$44.39
|
|
|
GUIDE WIRE .035X6" DOUBLE TROC
|
Facility
|
IP
|
$105.00
|
|
| Hospital Charge Code |
3004169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.85 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$102.90
|
| Rate for Payer: Aetna of WY Medicare |
$67.20
|
| Rate for Payer: Altius Commercial |
$100.80
|
| Rate for Payer: Beech Street Commercial |
$102.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$101.85
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$101.85
|
| Rate for Payer: Cigna of WY Commercial |
$102.90
|
| Rate for Payer: Entrust Commercial |
$99.75
|
| Rate for Payer: First Choice Health Commercial |
$99.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$99.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$64.05
|
| Rate for Payer: HealthUtah PPO |
$105.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$101.85
|
| Rate for Payer: Multiplan Medicare/VA |
$60.85
|
| Rate for Payer: One Health Plan of WY PPO |
$102.90
|
| Rate for Payer: PacificSource Commercial |
$94.50
|
| Rate for Payer: PHCS PPO |
$102.90
|
| Rate for Payer: Three Rivers PPO |
$78.75
|
| Rate for Payer: TriWest Veterans Administration |
$64.05
|
| Rate for Payer: United Healthcare Commercial |
$100.28
|
| Rate for Payer: United Healthcare Medicare |
$64.05
|
| Rate for Payer: WINHealth Partners Commercial |
$99.75
|
| Rate for Payer: Wise Provider Network Commercial |
$99.75
|
|
|
GUIDE WIRE .035X6" DOUBLE TROC
|
Facility
|
OP
|
$105.00
|
|
| Hospital Charge Code |
3004169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.86 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Beech Street Commercial |
$102.90
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$102.90
|
| Rate for Payer: Aetna of WY Medicare |
$69.30
|
| Rate for Payer: Altius Commercial |
$100.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$101.85
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$101.85
|
| Rate for Payer: Cigna of WY Commercial |
$102.90
|
| Rate for Payer: Entrust Commercial |
$99.75
|
| Rate for Payer: First Choice Health Commercial |
$99.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$99.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.85
|
| Rate for Payer: HealthUtah PPO |
$105.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$101.85
|
| Rate for Payer: Multiplan Medicare/VA |
$56.86
|
| Rate for Payer: One Health Plan of WY PPO |
$102.90
|
| Rate for Payer: PacificSource Commercial |
$94.50
|
| Rate for Payer: PHCS PPO |
$102.90
|
| Rate for Payer: Three Rivers PPO |
$78.75
|
| Rate for Payer: TriWest Veterans Administration |
$59.85
|
| Rate for Payer: United Healthcare Commercial |
$100.28
|
| Rate for Payer: United Healthcare Medicare |
$59.85
|
| Rate for Payer: WINHealth Partners Commercial |
$102.90
|
| Rate for Payer: Wise Provider Network Commercial |
$99.75
|
|
|
GUIDE WIRE .035X6" SINGLE TROC
|
Facility
|
IP
|
$98.00
|
|
| Hospital Charge Code |
3003346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.79 |
| Max. Negotiated Rate |
$98.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$96.04
|
| Rate for Payer: Aetna of WY Medicare |
$62.72
|
| Rate for Payer: Altius Commercial |
$94.08
|
| Rate for Payer: Beech Street Commercial |
$96.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$95.06
|
| Rate for Payer: Cash Price |
$68.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$95.06
|
| Rate for Payer: Cigna of WY Commercial |
$96.04
|
| Rate for Payer: Entrust Commercial |
$93.10
|
| Rate for Payer: First Choice Health Commercial |
$93.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$93.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.78
|
| Rate for Payer: HealthUtah PPO |
$98.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$95.06
|
| Rate for Payer: Multiplan Medicare/VA |
$56.79
|
| Rate for Payer: One Health Plan of WY PPO |
$96.04
|
| Rate for Payer: PacificSource Commercial |
$88.20
|
| Rate for Payer: PHCS PPO |
$96.04
|
| Rate for Payer: Three Rivers PPO |
$73.50
|
| Rate for Payer: TriWest Veterans Administration |
$59.78
|
| Rate for Payer: United Healthcare Commercial |
$93.59
|
| Rate for Payer: United Healthcare Medicare |
$59.78
|
| Rate for Payer: WINHealth Partners Commercial |
$93.10
|
| Rate for Payer: Wise Provider Network Commercial |
$93.10
|
|
|
GUIDE WIRE .035X6" SINGLE TROC
|
Facility
|
OP
|
$98.00
|
|
| Hospital Charge Code |
3003346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.07 |
| Max. Negotiated Rate |
$98.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$96.04
|
| Rate for Payer: Aetna of WY Medicare |
$64.68
|
| Rate for Payer: Altius Commercial |
$94.08
|
| Rate for Payer: Beech Street Commercial |
$96.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$95.06
|
| Rate for Payer: Cash Price |
$68.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$95.06
|
| Rate for Payer: Cigna of WY Commercial |
$96.04
|
| Rate for Payer: Entrust Commercial |
$93.10
|
| Rate for Payer: First Choice Health Commercial |
$93.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$93.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$55.86
|
| Rate for Payer: HealthUtah PPO |
$98.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$95.06
|
| Rate for Payer: Multiplan Medicare/VA |
$53.07
|
| Rate for Payer: One Health Plan of WY PPO |
$96.04
|
| Rate for Payer: PacificSource Commercial |
$88.20
|
| Rate for Payer: PHCS PPO |
$96.04
|
| Rate for Payer: Three Rivers PPO |
$73.50
|
| Rate for Payer: TriWest Veterans Administration |
$55.86
|
| Rate for Payer: United Healthcare Commercial |
$93.59
|
| Rate for Payer: United Healthcare Medicare |
$55.86
|
| Rate for Payer: WINHealth Partners Commercial |
$96.04
|
| Rate for Payer: Wise Provider Network Commercial |
$93.10
|
|
|
GUIDE WIRE .045" AR-8737-41
|
Facility
|
OP
|
$77.00
|
|
| Hospital Charge Code |
3002300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.70 |
| Max. Negotiated Rate |
$77.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$75.46
|
| Rate for Payer: Aetna of WY Medicare |
$50.82
|
| Rate for Payer: Altius Commercial |
$73.92
|
| Rate for Payer: Beech Street Commercial |
$75.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.69
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$74.69
|
| Rate for Payer: Cigna of WY Commercial |
$75.46
|
| Rate for Payer: Entrust Commercial |
$73.15
|
| Rate for Payer: First Choice Health Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.89
|
| Rate for Payer: HealthUtah PPO |
$77.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$74.69
|
| Rate for Payer: Multiplan Medicare/VA |
$41.70
|
| Rate for Payer: One Health Plan of WY PPO |
$75.46
|
| Rate for Payer: PacificSource Commercial |
$69.30
|
| Rate for Payer: PHCS PPO |
$75.46
|
| Rate for Payer: Three Rivers PPO |
$57.75
|
| Rate for Payer: TriWest Veterans Administration |
$43.89
|
| Rate for Payer: United Healthcare Commercial |
$73.54
|
| Rate for Payer: United Healthcare Medicare |
$43.89
|
| Rate for Payer: WINHealth Partners Commercial |
$75.46
|
| Rate for Payer: Wise Provider Network Commercial |
$73.15
|
|
|
GUIDE WIRE .045" AR-8737-41
|
Facility
|
IP
|
$77.00
|
|
| Hospital Charge Code |
3002300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.62 |
| Max. Negotiated Rate |
$77.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$75.46
|
| Rate for Payer: Aetna of WY Medicare |
$49.28
|
| Rate for Payer: Altius Commercial |
$73.92
|
| Rate for Payer: Beech Street Commercial |
$75.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.69
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$74.69
|
| Rate for Payer: Cigna of WY Commercial |
$75.46
|
| Rate for Payer: Entrust Commercial |
$73.15
|
| Rate for Payer: First Choice Health Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.97
|
| Rate for Payer: HealthUtah PPO |
$77.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$74.69
|
| Rate for Payer: Multiplan Medicare/VA |
$44.62
|
| Rate for Payer: One Health Plan of WY PPO |
$75.46
|
| Rate for Payer: PacificSource Commercial |
$69.30
|
| Rate for Payer: PHCS PPO |
$75.46
|
| Rate for Payer: Three Rivers PPO |
$57.75
|
| Rate for Payer: TriWest Veterans Administration |
$46.97
|
| Rate for Payer: United Healthcare Commercial |
$73.54
|
| Rate for Payer: United Healthcare Medicare |
$46.97
|
| Rate for Payer: WINHealth Partners Commercial |
$73.15
|
| Rate for Payer: Wise Provider Network Commercial |
$73.15
|
|
|
GUIDE WIRE .045X6" SS ACUMED
|
Facility
|
OP
|
$122.50
|
|
| Hospital Charge Code |
3002164
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.33 |
| Max. Negotiated Rate |
$122.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$120.05
|
| Rate for Payer: Aetna of WY Medicare |
$80.85
|
| Rate for Payer: Altius Commercial |
$117.60
|
| Rate for Payer: Beech Street Commercial |
$120.05
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$118.82
|
| Rate for Payer: Cash Price |
$85.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$118.82
|
| Rate for Payer: Cigna of WY Commercial |
$120.05
|
| Rate for Payer: Entrust Commercial |
$116.38
|
| Rate for Payer: First Choice Health Commercial |
$116.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$116.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$69.82
|
| Rate for Payer: HealthUtah PPO |
$122.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$118.82
|
| Rate for Payer: Multiplan Medicare/VA |
$66.33
|
| Rate for Payer: One Health Plan of WY PPO |
$120.05
|
| Rate for Payer: PacificSource Commercial |
$110.25
|
| Rate for Payer: PHCS PPO |
$120.05
|
| Rate for Payer: Three Rivers PPO |
$91.88
|
| Rate for Payer: TriWest Veterans Administration |
$69.82
|
| Rate for Payer: United Healthcare Commercial |
$116.99
|
| Rate for Payer: United Healthcare Medicare |
$69.82
|
| Rate for Payer: WINHealth Partners Commercial |
$120.05
|
| Rate for Payer: Wise Provider Network Commercial |
$116.38
|
|
|
GUIDE WIRE .045X6" SS ACUMED
|
Facility
|
IP
|
$122.50
|
|
| Hospital Charge Code |
3002164
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.99 |
| Max. Negotiated Rate |
$122.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$120.05
|
| Rate for Payer: Aetna of WY Medicare |
$78.40
|
| Rate for Payer: Altius Commercial |
$117.60
|
| Rate for Payer: Beech Street Commercial |
$120.05
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$118.82
|
| Rate for Payer: Cash Price |
$85.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$118.82
|
| Rate for Payer: Cigna of WY Commercial |
$120.05
|
| Rate for Payer: Entrust Commercial |
$116.38
|
| Rate for Payer: First Choice Health Commercial |
$116.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$116.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$74.72
|
| Rate for Payer: HealthUtah PPO |
$122.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$118.82
|
| Rate for Payer: Multiplan Medicare/VA |
$70.99
|
| Rate for Payer: One Health Plan of WY PPO |
$120.05
|
| Rate for Payer: PacificSource Commercial |
$110.25
|
| Rate for Payer: PHCS PPO |
$120.05
|
| Rate for Payer: Three Rivers PPO |
$91.88
|
| Rate for Payer: TriWest Veterans Administration |
$74.72
|
| Rate for Payer: United Healthcare Commercial |
$116.99
|
| Rate for Payer: United Healthcare Medicare |
$74.72
|
| Rate for Payer: WINHealth Partners Commercial |
$116.38
|
| Rate for Payer: Wise Provider Network Commercial |
$116.38
|
|
|
GUIDE WIRE .054 X 7" ACUTRAK 2
|
Facility
|
IP
|
$84.00
|
|
| Hospital Charge Code |
3002483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.68 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.32
|
| Rate for Payer: Aetna of WY Medicare |
$53.76
|
| Rate for Payer: Altius Commercial |
$80.64
|
| Rate for Payer: Beech Street Commercial |
$82.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.48
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.48
|
| Rate for Payer: Cigna of WY Commercial |
$82.32
|
| Rate for Payer: Entrust Commercial |
$79.80
|
| Rate for Payer: First Choice Health Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.24
|
| Rate for Payer: HealthUtah PPO |
$84.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.48
|
| Rate for Payer: Multiplan Medicare/VA |
$48.68
|
| Rate for Payer: One Health Plan of WY PPO |
$82.32
|
| Rate for Payer: PacificSource Commercial |
$75.60
|
| Rate for Payer: PHCS PPO |
$82.32
|
| Rate for Payer: Three Rivers PPO |
$63.00
|
| Rate for Payer: TriWest Veterans Administration |
$51.24
|
| Rate for Payer: United Healthcare Commercial |
$80.22
|
| Rate for Payer: United Healthcare Medicare |
$51.24
|
| Rate for Payer: WINHealth Partners Commercial |
$79.80
|
| Rate for Payer: Wise Provider Network Commercial |
$79.80
|
|
|
GUIDE WIRE .054 X 7" ACUTRAK 2
|
Facility
|
OP
|
$84.00
|
|
| Hospital Charge Code |
3002483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.49 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.32
|
| Rate for Payer: Aetna of WY Medicare |
$55.44
|
| Rate for Payer: Altius Commercial |
$80.64
|
| Rate for Payer: Beech Street Commercial |
$82.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.48
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.48
|
| Rate for Payer: Cigna of WY Commercial |
$82.32
|
| Rate for Payer: Entrust Commercial |
$79.80
|
| Rate for Payer: First Choice Health Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$47.88
|
| Rate for Payer: HealthUtah PPO |
$84.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.48
|
| Rate for Payer: Multiplan Medicare/VA |
$45.49
|
| Rate for Payer: One Health Plan of WY PPO |
$82.32
|
| Rate for Payer: PacificSource Commercial |
$75.60
|
| Rate for Payer: PHCS PPO |
$82.32
|
| Rate for Payer: Three Rivers PPO |
$63.00
|
| Rate for Payer: TriWest Veterans Administration |
$47.88
|
| Rate for Payer: United Healthcare Commercial |
$80.22
|
| Rate for Payer: United Healthcare Medicare |
$47.88
|
| Rate for Payer: WINHealth Partners Commercial |
$82.32
|
| Rate for Payer: Wise Provider Network Commercial |
$79.80
|
|
|
GUIDE WIRE .062 W/TROCAR TIP
|
Facility
|
IP
|
$52.50
|
|
| Hospital Charge Code |
3002445
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$51.45
|
| Rate for Payer: Aetna of WY Medicare |
$33.60
|
| Rate for Payer: Altius Commercial |
$50.40
|
| Rate for Payer: Beech Street Commercial |
$51.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$50.92
|
| Rate for Payer: Cash Price |
$36.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$50.92
|
| Rate for Payer: Cigna of WY Commercial |
$51.45
|
| Rate for Payer: Entrust Commercial |
$49.88
|
| Rate for Payer: First Choice Health Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.02
|
| Rate for Payer: HealthUtah PPO |
$52.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$50.92
|
| Rate for Payer: Multiplan Medicare/VA |
$30.42
|
| Rate for Payer: One Health Plan of WY PPO |
$51.45
|
| Rate for Payer: PacificSource Commercial |
$47.25
|
| Rate for Payer: PHCS PPO |
$51.45
|
| Rate for Payer: Three Rivers PPO |
$39.38
|
| Rate for Payer: TriWest Veterans Administration |
$32.02
|
| Rate for Payer: United Healthcare Commercial |
$50.14
|
| Rate for Payer: United Healthcare Medicare |
$32.02
|
| Rate for Payer: WINHealth Partners Commercial |
$49.88
|
| Rate for Payer: Wise Provider Network Commercial |
$49.88
|
|
|
GUIDE WIRE .062 W/TROCAR TIP
|
Facility
|
OP
|
$52.50
|
|
| Hospital Charge Code |
3002445
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$51.45
|
| Rate for Payer: Aetna of WY Medicare |
$34.65
|
| Rate for Payer: Altius Commercial |
$50.40
|
| Rate for Payer: Beech Street Commercial |
$51.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$50.92
|
| Rate for Payer: Cash Price |
$36.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$50.92
|
| Rate for Payer: Cigna of WY Commercial |
$51.45
|
| Rate for Payer: Entrust Commercial |
$49.88
|
| Rate for Payer: First Choice Health Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.92
|
| Rate for Payer: HealthUtah PPO |
$52.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$50.92
|
| Rate for Payer: Multiplan Medicare/VA |
$28.43
|
| Rate for Payer: One Health Plan of WY PPO |
$51.45
|
| Rate for Payer: PacificSource Commercial |
$47.25
|
| Rate for Payer: PHCS PPO |
$51.45
|
| Rate for Payer: Three Rivers PPO |
$39.38
|
| Rate for Payer: TriWest Veterans Administration |
$29.92
|
| Rate for Payer: United Healthcare Commercial |
$50.14
|
| Rate for Payer: United Healthcare Medicare |
$29.92
|
| Rate for Payer: WINHealth Partners Commercial |
$51.45
|
| Rate for Payer: Wise Provider Network Commercial |
$49.88
|
|
|
GUIDEWIRE .062X6" AR-8941-6
|
Facility
|
IP
|
$140.00
|
|
| Hospital Charge Code |
3003298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.13 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Aetna of WY Medicare |
$89.60
|
| 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 |
$135.80
|
| 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 |
$85.40
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$81.13
|
| 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 |
$85.40
|
| Rate for Payer: United Healthcare Commercial |
$133.70
|
| Rate for Payer: United Healthcare Medicare |
$85.40
|
| Rate for Payer: WINHealth Partners Commercial |
$133.00
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
GUIDEWIRE .062X6" AR-8941-6
|
Facility
|
OP
|
$140.00
|
|
| Hospital Charge Code |
3003298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.81 |
| 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 Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$135.80
|
| 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 |
$79.80
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$75.81
|
| 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 |
$79.80
|
| Rate for Payer: United Healthcare Commercial |
$133.70
|
| Rate for Payer: United Healthcare Medicare |
$79.80
|
| Rate for Payer: WINHealth Partners Commercial |
$137.20
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
GUIDEWIRE .062X7" AR-8941-7
|
Facility
|
IP
|
$140.00
|
|
| Hospital Charge Code |
3003299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.13 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Aetna of WY Medicare |
$89.60
|
| 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 |
$135.80
|
| 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 |
$85.40
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$81.13
|
| 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 |
$85.40
|
| Rate for Payer: United Healthcare Commercial |
$133.70
|
| Rate for Payer: United Healthcare Medicare |
$85.40
|
| Rate for Payer: WINHealth Partners Commercial |
$133.00
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
GUIDEWIRE .062X7" AR-8941-7
|
Facility
|
OP
|
$140.00
|
|
| Hospital Charge Code |
3003299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.81 |
| 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 Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$135.80
|
| 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 |
$79.80
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$75.81
|
| 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 |
$79.80
|
| Rate for Payer: United Healthcare Commercial |
$133.70
|
| Rate for Payer: United Healthcare Medicare |
$79.80
|
| Rate for Payer: WINHealth Partners Commercial |
$137.20
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
GUIDE WIRE .062 X 8" 24416
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
3003989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$224.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$213.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$202.82
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$213.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$213.50
|
| Rate for Payer: WINHealth Partners Commercial |
$332.50
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
GUIDE WIRE .062 X 8" 24416
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
3003989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$231.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$199.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$189.52
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$199.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$199.50
|
| Rate for Payer: WINHealth Partners Commercial |
$343.00
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
GUIDE WIRE .062X9.25 ACUTRAK 2
|
Facility
|
IP
|
$91.00
|
|
| Hospital Charge Code |
3003495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.73 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Aetna of WY Medicare |
$58.24
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$88.27
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$55.51
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$52.73
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$55.51
|
| Rate for Payer: United Healthcare Commercial |
$86.90
|
| Rate for Payer: United Healthcare Medicare |
$55.51
|
| Rate for Payer: WINHealth Partners Commercial |
$86.45
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
GUIDE WIRE .062X9.25 ACUTRAK 2
|
Facility
|
OP
|
$91.00
|
|
| Hospital Charge Code |
3003495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.28 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: United Healthcare Commercial |
$86.90
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Aetna of WY Medicare |
$60.06
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$88.27
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.87
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$49.28
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$51.87
|
| Rate for Payer: United Healthcare Medicare |
$51.87
|
| Rate for Payer: WINHealth Partners Commercial |
$89.18
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
GUIDE WIRE .094X8 W/TROCAR
|
Facility
|
OP
|
$52.50
|
|
| Hospital Charge Code |
3002446
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$51.45
|
| Rate for Payer: Aetna of WY Medicare |
$34.65
|
| Rate for Payer: Altius Commercial |
$50.40
|
| Rate for Payer: Beech Street Commercial |
$51.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$50.92
|
| Rate for Payer: Cash Price |
$36.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$50.92
|
| Rate for Payer: Cigna of WY Commercial |
$51.45
|
| Rate for Payer: Entrust Commercial |
$49.88
|
| Rate for Payer: First Choice Health Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.92
|
| Rate for Payer: HealthUtah PPO |
$52.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$50.92
|
| Rate for Payer: Multiplan Medicare/VA |
$28.43
|
| Rate for Payer: One Health Plan of WY PPO |
$51.45
|
| Rate for Payer: PacificSource Commercial |
$47.25
|
| Rate for Payer: PHCS PPO |
$51.45
|
| Rate for Payer: Three Rivers PPO |
$39.38
|
| Rate for Payer: TriWest Veterans Administration |
$29.92
|
| Rate for Payer: United Healthcare Commercial |
$50.14
|
| Rate for Payer: United Healthcare Medicare |
$29.92
|
| Rate for Payer: WINHealth Partners Commercial |
$51.45
|
| Rate for Payer: Wise Provider Network Commercial |
$49.88
|
|
|
GUIDE WIRE .094X8 W/TROCAR
|
Facility
|
IP
|
$52.50
|
|
| Hospital Charge Code |
3002446
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$51.45
|
| Rate for Payer: Aetna of WY Medicare |
$33.60
|
| Rate for Payer: Altius Commercial |
$50.40
|
| Rate for Payer: Beech Street Commercial |
$51.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$50.92
|
| Rate for Payer: Cash Price |
$36.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$50.92
|
| Rate for Payer: Cigna of WY Commercial |
$51.45
|
| Rate for Payer: Entrust Commercial |
$49.88
|
| Rate for Payer: First Choice Health Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$49.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.02
|
| Rate for Payer: HealthUtah PPO |
$52.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$50.92
|
| Rate for Payer: Multiplan Medicare/VA |
$30.42
|
| Rate for Payer: One Health Plan of WY PPO |
$51.45
|
| Rate for Payer: PacificSource Commercial |
$47.25
|
| Rate for Payer: PHCS PPO |
$51.45
|
| Rate for Payer: Three Rivers PPO |
$39.38
|
| Rate for Payer: TriWest Veterans Administration |
$32.02
|
| Rate for Payer: United Healthcare Commercial |
$50.14
|
| Rate for Payer: United Healthcare Medicare |
$32.02
|
| Rate for Payer: WINHealth Partners Commercial |
$49.88
|
| Rate for Payer: Wise Provider Network Commercial |
$49.88
|
|
|
GUIDEWIRE 1.2 X 100 ASNIS
|
Facility
|
OP
|
$84.00
|
|
| Hospital Charge Code |
3100209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.49 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.32
|
| Rate for Payer: Aetna of WY Medicare |
$55.44
|
| Rate for Payer: Altius Commercial |
$80.64
|
| Rate for Payer: Beech Street Commercial |
$82.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.48
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.48
|
| Rate for Payer: Cigna of WY Commercial |
$82.32
|
| Rate for Payer: Entrust Commercial |
$79.80
|
| Rate for Payer: First Choice Health Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$47.88
|
| Rate for Payer: HealthUtah PPO |
$84.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.48
|
| Rate for Payer: Multiplan Medicare/VA |
$45.49
|
| Rate for Payer: One Health Plan of WY PPO |
$82.32
|
| Rate for Payer: PacificSource Commercial |
$75.60
|
| Rate for Payer: PHCS PPO |
$82.32
|
| Rate for Payer: Three Rivers PPO |
$63.00
|
| Rate for Payer: TriWest Veterans Administration |
$47.88
|
| Rate for Payer: United Healthcare Commercial |
$80.22
|
| Rate for Payer: United Healthcare Medicare |
$47.88
|
| Rate for Payer: WINHealth Partners Commercial |
$82.32
|
| Rate for Payer: Wise Provider Network Commercial |
$79.80
|
|
|
GUIDEWIRE 1.2 X 100 ASNIS
|
Facility
|
IP
|
$84.00
|
|
| Hospital Charge Code |
3100209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$48.68 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.32
|
| Rate for Payer: Aetna of WY Medicare |
$53.76
|
| Rate for Payer: Altius Commercial |
$80.64
|
| Rate for Payer: Beech Street Commercial |
$82.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.48
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.48
|
| Rate for Payer: Cigna of WY Commercial |
$82.32
|
| Rate for Payer: Entrust Commercial |
$79.80
|
| Rate for Payer: First Choice Health Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.24
|
| Rate for Payer: HealthUtah PPO |
$84.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.48
|
| Rate for Payer: Multiplan Medicare/VA |
$48.68
|
| Rate for Payer: One Health Plan of WY PPO |
$82.32
|
| Rate for Payer: PacificSource Commercial |
$75.60
|
| Rate for Payer: PHCS PPO |
$82.32
|
| Rate for Payer: Three Rivers PPO |
$63.00
|
| Rate for Payer: TriWest Veterans Administration |
$51.24
|
| Rate for Payer: United Healthcare Commercial |
$80.22
|
| Rate for Payer: United Healthcare Medicare |
$51.24
|
| Rate for Payer: WINHealth Partners Commercial |
$79.80
|
| Rate for Payer: Wise Provider Network Commercial |
$79.80
|
|
