|
GUIDEWIRE 1.35MM DUAL TROCAR
|
Facility
|
IP
|
$143.50
|
|
| Hospital Charge Code |
3004175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.16 |
| Max. Negotiated Rate |
$143.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$140.63
|
| Rate for Payer: Aetna of WY Medicare |
$91.84
|
| Rate for Payer: Altius Commercial |
$137.76
|
| Rate for Payer: Beech Street Commercial |
$140.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$139.20
|
| Rate for Payer: Cash Price |
$100.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$139.20
|
| Rate for Payer: Cigna of WY Commercial |
$140.63
|
| Rate for Payer: Entrust Commercial |
$136.32
|
| Rate for Payer: First Choice Health Commercial |
$136.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$136.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$87.54
|
| Rate for Payer: HealthUtah PPO |
$143.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$139.20
|
| Rate for Payer: Multiplan Medicare/VA |
$83.16
|
| Rate for Payer: One Health Plan of WY PPO |
$140.63
|
| Rate for Payer: PacificSource Commercial |
$129.15
|
| Rate for Payer: PHCS PPO |
$140.63
|
| Rate for Payer: Three Rivers PPO |
$107.62
|
| Rate for Payer: TriWest Veterans Administration |
$87.54
|
| Rate for Payer: United Healthcare Commercial |
$137.04
|
| Rate for Payer: United Healthcare Medicare |
$87.54
|
| Rate for Payer: WINHealth Partners Commercial |
$136.32
|
| Rate for Payer: Wise Provider Network Commercial |
$136.32
|
|
|
GUIDEWIRE 1.35MM DUAL TROCAR
|
Facility
|
OP
|
$143.50
|
|
| Hospital Charge Code |
3004175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.71 |
| Max. Negotiated Rate |
$143.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$140.63
|
| Rate for Payer: Aetna of WY Medicare |
$94.71
|
| Rate for Payer: Altius Commercial |
$137.76
|
| Rate for Payer: Beech Street Commercial |
$140.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$139.20
|
| Rate for Payer: Cash Price |
$100.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$139.20
|
| Rate for Payer: Cigna of WY Commercial |
$140.63
|
| Rate for Payer: Entrust Commercial |
$136.32
|
| Rate for Payer: First Choice Health Commercial |
$136.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$136.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$81.80
|
| Rate for Payer: HealthUtah PPO |
$143.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$139.20
|
| Rate for Payer: Multiplan Medicare/VA |
$77.71
|
| Rate for Payer: One Health Plan of WY PPO |
$140.63
|
| Rate for Payer: PacificSource Commercial |
$129.15
|
| Rate for Payer: PHCS PPO |
$140.63
|
| Rate for Payer: Three Rivers PPO |
$107.62
|
| Rate for Payer: TriWest Veterans Administration |
$81.80
|
| Rate for Payer: United Healthcare Commercial |
$137.04
|
| Rate for Payer: United Healthcare Medicare |
$81.80
|
| Rate for Payer: WINHealth Partners Commercial |
$140.63
|
| Rate for Payer: Wise Provider Network Commercial |
$136.32
|
|
|
GUIDE WIRE 1.3MM ACUMED
|
Facility
|
OP
|
$73.50
|
|
| Hospital Charge Code |
3003665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: United Healthcare Commercial |
$70.19
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$72.03
|
| Rate for Payer: Aetna of WY Medicare |
$48.51
|
| Rate for Payer: Altius Commercial |
$70.56
|
| Rate for Payer: Beech Street Commercial |
$72.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.30
|
| Rate for Payer: Cash Price |
$51.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$71.30
|
| Rate for Payer: Cigna of WY Commercial |
$72.03
|
| Rate for Payer: Entrust Commercial |
$69.82
|
| Rate for Payer: First Choice Health Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.90
|
| Rate for Payer: HealthUtah PPO |
$73.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$71.30
|
| Rate for Payer: Multiplan Medicare/VA |
$39.80
|
| Rate for Payer: One Health Plan of WY PPO |
$72.03
|
| Rate for Payer: PacificSource Commercial |
$66.15
|
| Rate for Payer: PHCS PPO |
$72.03
|
| Rate for Payer: Three Rivers PPO |
$55.12
|
| Rate for Payer: TriWest Veterans Administration |
$41.90
|
| Rate for Payer: United Healthcare Medicare |
$41.90
|
| Rate for Payer: WINHealth Partners Commercial |
$72.03
|
| Rate for Payer: Wise Provider Network Commercial |
$69.82
|
|
|
GUIDE WIRE 1.3MM ACUMED
|
Facility
|
IP
|
$73.50
|
|
| Hospital Charge Code |
3003665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.59 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$72.03
|
| Rate for Payer: Aetna of WY Medicare |
$47.04
|
| Rate for Payer: Altius Commercial |
$70.56
|
| Rate for Payer: Beech Street Commercial |
$72.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.30
|
| Rate for Payer: Cash Price |
$51.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$71.30
|
| Rate for Payer: Cigna of WY Commercial |
$72.03
|
| Rate for Payer: Entrust Commercial |
$69.82
|
| Rate for Payer: First Choice Health Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.84
|
| Rate for Payer: HealthUtah PPO |
$73.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$71.30
|
| Rate for Payer: Multiplan Medicare/VA |
$42.59
|
| Rate for Payer: One Health Plan of WY PPO |
$72.03
|
| Rate for Payer: PacificSource Commercial |
$66.15
|
| Rate for Payer: PHCS PPO |
$72.03
|
| Rate for Payer: Three Rivers PPO |
$55.12
|
| Rate for Payer: TriWest Veterans Administration |
$44.84
|
| Rate for Payer: United Healthcare Commercial |
$70.19
|
| Rate for Payer: United Healthcare Medicare |
$44.84
|
| Rate for Payer: WINHealth Partners Commercial |
$69.82
|
| Rate for Payer: Wise Provider Network Commercial |
$69.82
|
|
|
GUIDE WIRE 1.4 ASNIS
|
Facility
|
IP
|
$82.32
|
|
| Hospital Charge Code |
3150168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.70 |
| Max. Negotiated Rate |
$82.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$80.67
|
| Rate for Payer: Aetna of WY Medicare |
$52.68
|
| Rate for Payer: Altius Commercial |
$79.03
|
| Rate for Payer: Beech Street Commercial |
$80.67
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$79.85
|
| Rate for Payer: Cash Price |
$57.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$79.85
|
| Rate for Payer: Cigna of WY Commercial |
$80.67
|
| Rate for Payer: Entrust Commercial |
$78.20
|
| Rate for Payer: First Choice Health Commercial |
$78.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$78.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.22
|
| Rate for Payer: HealthUtah PPO |
$82.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$79.85
|
| Rate for Payer: Multiplan Medicare/VA |
$47.70
|
| Rate for Payer: One Health Plan of WY PPO |
$80.67
|
| Rate for Payer: PacificSource Commercial |
$74.09
|
| Rate for Payer: PHCS PPO |
$80.67
|
| Rate for Payer: Three Rivers PPO |
$61.74
|
| Rate for Payer: TriWest Veterans Administration |
$50.22
|
| Rate for Payer: United Healthcare Commercial |
$78.62
|
| Rate for Payer: United Healthcare Medicare |
$50.22
|
| Rate for Payer: WINHealth Partners Commercial |
$78.20
|
| Rate for Payer: Wise Provider Network Commercial |
$78.20
|
|
|
GUIDE WIRE 1.4 ASNIS
|
Facility
|
OP
|
$82.32
|
|
| Hospital Charge Code |
3150168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.58 |
| Max. Negotiated Rate |
$82.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$80.67
|
| Rate for Payer: Aetna of WY Medicare |
$54.33
|
| Rate for Payer: Altius Commercial |
$79.03
|
| Rate for Payer: Beech Street Commercial |
$80.67
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$79.85
|
| Rate for Payer: Cash Price |
$57.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$79.85
|
| Rate for Payer: Cigna of WY Commercial |
$80.67
|
| Rate for Payer: Entrust Commercial |
$78.20
|
| Rate for Payer: First Choice Health Commercial |
$78.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$78.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.92
|
| Rate for Payer: HealthUtah PPO |
$82.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$79.85
|
| Rate for Payer: Multiplan Medicare/VA |
$44.58
|
| Rate for Payer: One Health Plan of WY PPO |
$80.67
|
| Rate for Payer: PacificSource Commercial |
$74.09
|
| Rate for Payer: PHCS PPO |
$80.67
|
| Rate for Payer: Three Rivers PPO |
$61.74
|
| Rate for Payer: TriWest Veterans Administration |
$46.92
|
| Rate for Payer: United Healthcare Commercial |
$78.62
|
| Rate for Payer: United Healthcare Medicare |
$46.92
|
| Rate for Payer: WINHealth Partners Commercial |
$80.67
|
| Rate for Payer: Wise Provider Network Commercial |
$78.20
|
|
|
GUIDE WIRE 1.6MM EXTREMITY
|
Facility
|
IP
|
$73.50
|
|
| Hospital Charge Code |
3004106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.59 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$72.03
|
| Rate for Payer: Aetna of WY Medicare |
$47.04
|
| Rate for Payer: Altius Commercial |
$70.56
|
| Rate for Payer: Beech Street Commercial |
$72.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.30
|
| Rate for Payer: Cash Price |
$51.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$71.30
|
| Rate for Payer: Cigna of WY Commercial |
$72.03
|
| Rate for Payer: Entrust Commercial |
$69.82
|
| Rate for Payer: First Choice Health Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.84
|
| Rate for Payer: HealthUtah PPO |
$73.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$71.30
|
| Rate for Payer: Multiplan Medicare/VA |
$42.59
|
| Rate for Payer: One Health Plan of WY PPO |
$72.03
|
| Rate for Payer: PacificSource Commercial |
$66.15
|
| Rate for Payer: PHCS PPO |
$72.03
|
| Rate for Payer: Three Rivers PPO |
$55.12
|
| Rate for Payer: TriWest Veterans Administration |
$44.84
|
| Rate for Payer: United Healthcare Commercial |
$70.19
|
| Rate for Payer: United Healthcare Medicare |
$44.84
|
| Rate for Payer: WINHealth Partners Commercial |
$69.82
|
| Rate for Payer: Wise Provider Network Commercial |
$69.82
|
|
|
GUIDE WIRE 1.6MM EXTREMITY
|
Facility
|
OP
|
$73.50
|
|
| Hospital Charge Code |
3004106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$72.03
|
| Rate for Payer: Aetna of WY Medicare |
$48.51
|
| Rate for Payer: Altius Commercial |
$70.56
|
| Rate for Payer: Beech Street Commercial |
$72.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.30
|
| Rate for Payer: Cash Price |
$51.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$71.30
|
| Rate for Payer: Cigna of WY Commercial |
$72.03
|
| Rate for Payer: Entrust Commercial |
$69.82
|
| Rate for Payer: First Choice Health Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.90
|
| Rate for Payer: HealthUtah PPO |
$73.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$71.30
|
| Rate for Payer: Multiplan Medicare/VA |
$39.80
|
| Rate for Payer: One Health Plan of WY PPO |
$72.03
|
| Rate for Payer: PacificSource Commercial |
$66.15
|
| Rate for Payer: PHCS PPO |
$72.03
|
| Rate for Payer: Three Rivers PPO |
$55.12
|
| Rate for Payer: TriWest Veterans Administration |
$41.90
|
| Rate for Payer: United Healthcare Commercial |
$70.19
|
| Rate for Payer: United Healthcare Medicare |
$41.90
|
| Rate for Payer: WINHealth Partners Commercial |
$72.03
|
| Rate for Payer: Wise Provider Network Commercial |
$69.82
|
|
|
GUIDE WIRE 2.5X800MM BALL T2
|
Facility
|
IP
|
$468.72
|
|
| Hospital Charge Code |
3100538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$271.62 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$459.35
|
| Rate for Payer: Aetna of WY Medicare |
$299.98
|
| Rate for Payer: Altius Commercial |
$449.97
|
| Rate for Payer: Beech Street Commercial |
$459.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$454.66
|
| Rate for Payer: Cash Price |
$328.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$454.66
|
| Rate for Payer: Cigna of WY Commercial |
$459.35
|
| Rate for Payer: Entrust Commercial |
$445.28
|
| Rate for Payer: First Choice Health Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$285.92
|
| Rate for Payer: HealthUtah PPO |
$468.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$454.66
|
| Rate for Payer: Multiplan Medicare/VA |
$271.62
|
| Rate for Payer: One Health Plan of WY PPO |
$459.35
|
| Rate for Payer: PacificSource Commercial |
$421.85
|
| Rate for Payer: PHCS PPO |
$459.35
|
| Rate for Payer: Three Rivers PPO |
$351.54
|
| Rate for Payer: TriWest Veterans Administration |
$285.92
|
| Rate for Payer: United Healthcare Commercial |
$447.63
|
| Rate for Payer: United Healthcare Medicare |
$285.92
|
| Rate for Payer: WINHealth Partners Commercial |
$445.28
|
| Rate for Payer: Wise Provider Network Commercial |
$445.28
|
|
|
GUIDE WIRE 2.5X800MM BALL T2
|
Facility
|
OP
|
$468.72
|
|
| Hospital Charge Code |
3100538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$253.81 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$459.35
|
| Rate for Payer: Aetna of WY Medicare |
$309.36
|
| Rate for Payer: Altius Commercial |
$449.97
|
| Rate for Payer: Beech Street Commercial |
$459.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$454.66
|
| Rate for Payer: Cash Price |
$328.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$454.66
|
| Rate for Payer: Cigna of WY Commercial |
$459.35
|
| Rate for Payer: Entrust Commercial |
$445.28
|
| Rate for Payer: First Choice Health Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$267.17
|
| Rate for Payer: HealthUtah PPO |
$468.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$454.66
|
| Rate for Payer: Multiplan Medicare/VA |
$253.81
|
| Rate for Payer: One Health Plan of WY PPO |
$459.35
|
| Rate for Payer: PacificSource Commercial |
$421.85
|
| Rate for Payer: PHCS PPO |
$459.35
|
| Rate for Payer: Three Rivers PPO |
$351.54
|
| Rate for Payer: TriWest Veterans Administration |
$267.17
|
| Rate for Payer: United Healthcare Commercial |
$447.63
|
| Rate for Payer: United Healthcare Medicare |
$267.17
|
| Rate for Payer: WINHealth Partners Commercial |
$459.35
|
| Rate for Payer: Wise Provider Network Commercial |
$445.28
|
|
|
GUIDEWIRE 2.8 MM STRYKER
|
Facility
|
IP
|
$81.90
|
|
| Hospital Charge Code |
3001780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.46 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$80.26
|
| Rate for Payer: Aetna of WY Medicare |
$52.42
|
| Rate for Payer: Altius Commercial |
$78.62
|
| Rate for Payer: Beech Street Commercial |
$80.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$79.44
|
| Rate for Payer: Cash Price |
$57.33
|
| Rate for Payer: ChoiceCare Network Commercial |
$79.44
|
| Rate for Payer: Cigna of WY Commercial |
$80.26
|
| Rate for Payer: Entrust Commercial |
$77.80
|
| Rate for Payer: First Choice Health Commercial |
$77.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$77.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$49.96
|
| Rate for Payer: HealthUtah PPO |
$81.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$79.44
|
| Rate for Payer: Multiplan Medicare/VA |
$47.46
|
| Rate for Payer: One Health Plan of WY PPO |
$80.26
|
| Rate for Payer: PacificSource Commercial |
$73.71
|
| Rate for Payer: PHCS PPO |
$80.26
|
| Rate for Payer: Three Rivers PPO |
$61.42
|
| Rate for Payer: TriWest Veterans Administration |
$49.96
|
| Rate for Payer: United Healthcare Commercial |
$78.21
|
| Rate for Payer: United Healthcare Medicare |
$49.96
|
| Rate for Payer: WINHealth Partners Commercial |
$77.80
|
| Rate for Payer: Wise Provider Network Commercial |
$77.80
|
|
|
GUIDEWIRE 2.8 MM STRYKER
|
Facility
|
OP
|
$81.90
|
|
| Hospital Charge Code |
3001780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.35 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$80.26
|
| Rate for Payer: Aetna of WY Medicare |
$54.05
|
| Rate for Payer: Altius Commercial |
$78.62
|
| Rate for Payer: Beech Street Commercial |
$80.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$79.44
|
| Rate for Payer: Cash Price |
$57.33
|
| Rate for Payer: ChoiceCare Network Commercial |
$79.44
|
| Rate for Payer: Cigna of WY Commercial |
$80.26
|
| Rate for Payer: Entrust Commercial |
$77.80
|
| Rate for Payer: First Choice Health Commercial |
$77.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$77.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.68
|
| Rate for Payer: HealthUtah PPO |
$81.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$79.44
|
| Rate for Payer: Multiplan Medicare/VA |
$44.35
|
| Rate for Payer: One Health Plan of WY PPO |
$80.26
|
| Rate for Payer: PacificSource Commercial |
$73.71
|
| Rate for Payer: PHCS PPO |
$80.26
|
| Rate for Payer: Three Rivers PPO |
$61.42
|
| Rate for Payer: TriWest Veterans Administration |
$46.68
|
| Rate for Payer: United Healthcare Commercial |
$78.21
|
| Rate for Payer: United Healthcare Medicare |
$46.68
|
| Rate for Payer: WINHealth Partners Commercial |
$80.26
|
| Rate for Payer: Wise Provider Network Commercial |
$77.80
|
|
|
GUIDE WIRE 2MM X 9" ST
|
Facility
|
OP
|
$126.00
|
|
| Hospital Charge Code |
3003996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.23 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$123.48
|
| Rate for Payer: Aetna of WY Medicare |
$83.16
|
| Rate for Payer: Altius Commercial |
$120.96
|
| Rate for Payer: Beech Street Commercial |
$123.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$122.22
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$122.22
|
| Rate for Payer: Cigna of WY Commercial |
$123.48
|
| Rate for Payer: Entrust Commercial |
$119.70
|
| Rate for Payer: First Choice Health Commercial |
$119.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$119.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$71.82
|
| Rate for Payer: HealthUtah PPO |
$126.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$122.22
|
| Rate for Payer: Multiplan Medicare/VA |
$68.23
|
| Rate for Payer: One Health Plan of WY PPO |
$123.48
|
| Rate for Payer: PacificSource Commercial |
$113.40
|
| Rate for Payer: PHCS PPO |
$123.48
|
| Rate for Payer: Three Rivers PPO |
$94.50
|
| Rate for Payer: TriWest Veterans Administration |
$71.82
|
| Rate for Payer: United Healthcare Commercial |
$120.33
|
| Rate for Payer: United Healthcare Medicare |
$71.82
|
| Rate for Payer: WINHealth Partners Commercial |
$123.48
|
| Rate for Payer: Wise Provider Network Commercial |
$119.70
|
|
|
GUIDE WIRE 2MM X 9" ST
|
Facility
|
IP
|
$126.00
|
|
| Hospital Charge Code |
3003996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.02 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$123.48
|
| Rate for Payer: Aetna of WY Medicare |
$80.64
|
| Rate for Payer: Altius Commercial |
$120.96
|
| Rate for Payer: Beech Street Commercial |
$123.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$122.22
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$122.22
|
| Rate for Payer: Cigna of WY Commercial |
$123.48
|
| Rate for Payer: Entrust Commercial |
$119.70
|
| Rate for Payer: First Choice Health Commercial |
$119.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$119.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$76.86
|
| Rate for Payer: HealthUtah PPO |
$126.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$122.22
|
| Rate for Payer: Multiplan Medicare/VA |
$73.02
|
| Rate for Payer: One Health Plan of WY PPO |
$123.48
|
| Rate for Payer: PacificSource Commercial |
$113.40
|
| Rate for Payer: PHCS PPO |
$123.48
|
| Rate for Payer: Three Rivers PPO |
$94.50
|
| Rate for Payer: TriWest Veterans Administration |
$76.86
|
| Rate for Payer: United Healthcare Commercial |
$120.33
|
| Rate for Payer: United Healthcare Medicare |
$76.86
|
| Rate for Payer: WINHealth Partners Commercial |
$119.70
|
| Rate for Payer: Wise Provider Network Commercial |
$119.70
|
|
|
GUIDE WIRE 2X800MM SMOOTH T2
|
Facility
|
OP
|
$468.72
|
|
| Hospital Charge Code |
3100537
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.81 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$459.35
|
| Rate for Payer: Aetna of WY Medicare |
$309.36
|
| Rate for Payer: Altius Commercial |
$449.97
|
| Rate for Payer: Beech Street Commercial |
$459.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$454.66
|
| Rate for Payer: Cash Price |
$328.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$454.66
|
| Rate for Payer: Cigna of WY Commercial |
$459.35
|
| Rate for Payer: Entrust Commercial |
$445.28
|
| Rate for Payer: First Choice Health Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$267.17
|
| Rate for Payer: HealthUtah PPO |
$468.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$454.66
|
| Rate for Payer: Multiplan Medicare/VA |
$253.81
|
| Rate for Payer: One Health Plan of WY PPO |
$459.35
|
| Rate for Payer: PacificSource Commercial |
$421.85
|
| Rate for Payer: PHCS PPO |
$459.35
|
| Rate for Payer: Three Rivers PPO |
$351.54
|
| Rate for Payer: TriWest Veterans Administration |
$267.17
|
| Rate for Payer: United Healthcare Commercial |
$447.63
|
| Rate for Payer: United Healthcare Medicare |
$267.17
|
| Rate for Payer: WINHealth Partners Commercial |
$459.35
|
| Rate for Payer: Wise Provider Network Commercial |
$445.28
|
|
|
GUIDE WIRE 2X800MM SMOOTH T2
|
Facility
|
IP
|
$468.72
|
|
| Hospital Charge Code |
3100537
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$271.62 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$459.35
|
| Rate for Payer: Aetna of WY Medicare |
$299.98
|
| Rate for Payer: Altius Commercial |
$449.97
|
| Rate for Payer: Beech Street Commercial |
$459.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$454.66
|
| Rate for Payer: Cash Price |
$328.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$454.66
|
| Rate for Payer: Cigna of WY Commercial |
$459.35
|
| Rate for Payer: Entrust Commercial |
$445.28
|
| Rate for Payer: First Choice Health Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$445.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$285.92
|
| Rate for Payer: HealthUtah PPO |
$468.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$454.66
|
| Rate for Payer: Multiplan Medicare/VA |
$271.62
|
| Rate for Payer: One Health Plan of WY PPO |
$459.35
|
| Rate for Payer: PacificSource Commercial |
$421.85
|
| Rate for Payer: PHCS PPO |
$459.35
|
| Rate for Payer: Three Rivers PPO |
$351.54
|
| Rate for Payer: TriWest Veterans Administration |
$285.92
|
| Rate for Payer: United Healthcare Commercial |
$447.63
|
| Rate for Payer: United Healthcare Medicare |
$285.92
|
| Rate for Payer: WINHealth Partners Commercial |
$445.28
|
| Rate for Payer: Wise Provider Network Commercial |
$445.28
|
|
|
GUIDE WIRE 3.2X300MM THREADED
|
Facility
|
OP
|
$123.69
|
|
| Hospital Charge Code |
3000218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.98 |
| Max. Negotiated Rate |
$123.69 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$121.22
|
| Rate for Payer: Aetna of WY Medicare |
$81.64
|
| Rate for Payer: Altius Commercial |
$118.74
|
| Rate for Payer: Beech Street Commercial |
$121.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$119.98
|
| Rate for Payer: Cash Price |
$86.58
|
| Rate for Payer: ChoiceCare Network Commercial |
$119.98
|
| Rate for Payer: Cigna of WY Commercial |
$121.22
|
| Rate for Payer: Entrust Commercial |
$117.51
|
| Rate for Payer: First Choice Health Commercial |
$117.51
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$117.51
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$70.50
|
| Rate for Payer: HealthUtah PPO |
$123.69
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$119.98
|
| Rate for Payer: Multiplan Medicare/VA |
$66.98
|
| Rate for Payer: One Health Plan of WY PPO |
$121.22
|
| Rate for Payer: PacificSource Commercial |
$111.32
|
| Rate for Payer: PHCS PPO |
$121.22
|
| Rate for Payer: Three Rivers PPO |
$92.77
|
| Rate for Payer: TriWest Veterans Administration |
$70.50
|
| Rate for Payer: United Healthcare Commercial |
$118.12
|
| Rate for Payer: United Healthcare Medicare |
$70.50
|
| Rate for Payer: WINHealth Partners Commercial |
$121.22
|
| Rate for Payer: Wise Provider Network Commercial |
$117.51
|
|
|
GUIDE WIRE 3.2X300MM THREADED
|
Facility
|
IP
|
$123.69
|
|
| Hospital Charge Code |
3000218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.68 |
| Max. Negotiated Rate |
$123.69 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$121.22
|
| Rate for Payer: Aetna of WY Medicare |
$79.16
|
| Rate for Payer: Altius Commercial |
$118.74
|
| Rate for Payer: Beech Street Commercial |
$121.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$119.98
|
| Rate for Payer: Cash Price |
$86.58
|
| Rate for Payer: ChoiceCare Network Commercial |
$119.98
|
| Rate for Payer: Cigna of WY Commercial |
$121.22
|
| Rate for Payer: Entrust Commercial |
$117.51
|
| Rate for Payer: First Choice Health Commercial |
$117.51
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$117.51
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$75.45
|
| Rate for Payer: HealthUtah PPO |
$123.69
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$119.98
|
| Rate for Payer: Multiplan Medicare/VA |
$71.68
|
| Rate for Payer: One Health Plan of WY PPO |
$121.22
|
| Rate for Payer: PacificSource Commercial |
$111.32
|
| Rate for Payer: PHCS PPO |
$121.22
|
| Rate for Payer: Three Rivers PPO |
$92.77
|
| Rate for Payer: TriWest Veterans Administration |
$75.45
|
| Rate for Payer: United Healthcare Commercial |
$118.12
|
| Rate for Payer: United Healthcare Medicare |
$75.45
|
| Rate for Payer: WINHealth Partners Commercial |
$117.51
|
| Rate for Payer: Wise Provider Network Commercial |
$117.51
|
|
|
GUIDE WIRE 3X1000MM 1806-0085
|
Facility
|
IP
|
$489.44
|
|
| Hospital Charge Code |
3100026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$283.63 |
| Max. Negotiated Rate |
$489.44 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$479.65
|
| Rate for Payer: Aetna of WY Medicare |
$313.24
|
| Rate for Payer: Altius Commercial |
$469.86
|
| Rate for Payer: Beech Street Commercial |
$479.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$474.76
|
| Rate for Payer: Cash Price |
$342.61
|
| Rate for Payer: ChoiceCare Network Commercial |
$474.76
|
| Rate for Payer: Cigna of WY Commercial |
$479.65
|
| Rate for Payer: Entrust Commercial |
$464.97
|
| Rate for Payer: First Choice Health Commercial |
$464.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$464.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$298.56
|
| Rate for Payer: HealthUtah PPO |
$489.44
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$474.76
|
| Rate for Payer: Multiplan Medicare/VA |
$283.63
|
| Rate for Payer: One Health Plan of WY PPO |
$479.65
|
| Rate for Payer: PacificSource Commercial |
$440.50
|
| Rate for Payer: PHCS PPO |
$479.65
|
| Rate for Payer: Three Rivers PPO |
$367.08
|
| Rate for Payer: TriWest Veterans Administration |
$298.56
|
| Rate for Payer: United Healthcare Commercial |
$467.42
|
| Rate for Payer: United Healthcare Medicare |
$298.56
|
| Rate for Payer: WINHealth Partners Commercial |
$464.97
|
| Rate for Payer: Wise Provider Network Commercial |
$464.97
|
|
|
GUIDE WIRE 3X1000MM 1806-0085
|
Facility
|
OP
|
$489.44
|
|
| Hospital Charge Code |
3100026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$265.03 |
| Max. Negotiated Rate |
$489.44 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$479.65
|
| Rate for Payer: Aetna of WY Medicare |
$323.03
|
| Rate for Payer: Altius Commercial |
$469.86
|
| Rate for Payer: Beech Street Commercial |
$479.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$474.76
|
| Rate for Payer: Cash Price |
$342.61
|
| Rate for Payer: ChoiceCare Network Commercial |
$474.76
|
| Rate for Payer: Cigna of WY Commercial |
$479.65
|
| Rate for Payer: Entrust Commercial |
$464.97
|
| Rate for Payer: First Choice Health Commercial |
$464.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$464.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$278.98
|
| Rate for Payer: HealthUtah PPO |
$489.44
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$474.76
|
| Rate for Payer: Multiplan Medicare/VA |
$265.03
|
| Rate for Payer: One Health Plan of WY PPO |
$479.65
|
| Rate for Payer: PacificSource Commercial |
$440.50
|
| Rate for Payer: PHCS PPO |
$479.65
|
| Rate for Payer: Three Rivers PPO |
$367.08
|
| Rate for Payer: TriWest Veterans Administration |
$278.98
|
| Rate for Payer: United Healthcare Commercial |
$467.42
|
| Rate for Payer: United Healthcare Medicare |
$278.98
|
| Rate for Payer: WINHealth Partners Commercial |
$479.65
|
| Rate for Payer: Wise Provider Network Commercial |
$464.97
|
|
|
GUIDE WIRE 3X800 MM 1806-0080
|
Facility
|
IP
|
$468.16
|
|
| Hospital Charge Code |
3100027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$271.30 |
| Max. Negotiated Rate |
$468.16 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$458.80
|
| Rate for Payer: Aetna of WY Medicare |
$299.62
|
| Rate for Payer: Altius Commercial |
$449.43
|
| Rate for Payer: Beech Street Commercial |
$458.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$454.12
|
| Rate for Payer: Cash Price |
$327.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$454.12
|
| Rate for Payer: Cigna of WY Commercial |
$458.80
|
| Rate for Payer: Entrust Commercial |
$444.75
|
| Rate for Payer: First Choice Health Commercial |
$444.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$444.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$285.58
|
| Rate for Payer: HealthUtah PPO |
$468.16
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$454.12
|
| Rate for Payer: Multiplan Medicare/VA |
$271.30
|
| Rate for Payer: One Health Plan of WY PPO |
$458.80
|
| Rate for Payer: PacificSource Commercial |
$421.34
|
| Rate for Payer: PHCS PPO |
$458.80
|
| Rate for Payer: Three Rivers PPO |
$351.12
|
| Rate for Payer: TriWest Veterans Administration |
$285.58
|
| Rate for Payer: United Healthcare Commercial |
$447.09
|
| Rate for Payer: United Healthcare Medicare |
$285.58
|
| Rate for Payer: WINHealth Partners Commercial |
$444.75
|
| Rate for Payer: Wise Provider Network Commercial |
$444.75
|
|
|
GUIDE WIRE 3X800 MM 1806-0080
|
Facility
|
OP
|
$468.16
|
|
| Hospital Charge Code |
3100027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.51 |
| Max. Negotiated Rate |
$468.16 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$458.80
|
| Rate for Payer: Aetna of WY Medicare |
$308.99
|
| Rate for Payer: Altius Commercial |
$449.43
|
| Rate for Payer: Beech Street Commercial |
$458.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$454.12
|
| Rate for Payer: Cash Price |
$327.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$454.12
|
| Rate for Payer: Cigna of WY Commercial |
$458.80
|
| Rate for Payer: Entrust Commercial |
$444.75
|
| Rate for Payer: First Choice Health Commercial |
$444.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$444.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$266.85
|
| Rate for Payer: HealthUtah PPO |
$468.16
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$454.12
|
| Rate for Payer: Multiplan Medicare/VA |
$253.51
|
| Rate for Payer: One Health Plan of WY PPO |
$458.80
|
| Rate for Payer: PacificSource Commercial |
$421.34
|
| Rate for Payer: PHCS PPO |
$458.80
|
| Rate for Payer: Three Rivers PPO |
$351.12
|
| Rate for Payer: TriWest Veterans Administration |
$266.85
|
| Rate for Payer: United Healthcare Commercial |
$447.09
|
| Rate for Payer: United Healthcare Medicare |
$266.85
|
| Rate for Payer: WINHealth Partners Commercial |
$458.80
|
| Rate for Payer: Wise Provider Network Commercial |
$444.75
|
|
|
GUIDEWIRE 4 BIOCOMPRESSION SCR
|
Facility
|
IP
|
$28.63
|
|
| Hospital Charge Code |
3004098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$28.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$28.06
|
| Rate for Payer: Aetna of WY Medicare |
$18.32
|
| Rate for Payer: Altius Commercial |
$27.48
|
| Rate for Payer: Beech Street Commercial |
$28.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.77
|
| Rate for Payer: Cash Price |
$20.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.77
|
| Rate for Payer: Cigna of WY Commercial |
$28.06
|
| Rate for Payer: Entrust Commercial |
$27.20
|
| Rate for Payer: First Choice Health Commercial |
$27.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$17.46
|
| Rate for Payer: HealthUtah PPO |
$28.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.77
|
| Rate for Payer: Multiplan Medicare/VA |
$16.59
|
| Rate for Payer: One Health Plan of WY PPO |
$28.06
|
| Rate for Payer: PacificSource Commercial |
$25.77
|
| Rate for Payer: PHCS PPO |
$28.06
|
| Rate for Payer: Three Rivers PPO |
$21.47
|
| Rate for Payer: TriWest Veterans Administration |
$17.46
|
| Rate for Payer: United Healthcare Commercial |
$27.34
|
| Rate for Payer: United Healthcare Medicare |
$17.46
|
| Rate for Payer: WINHealth Partners Commercial |
$27.20
|
| Rate for Payer: Wise Provider Network Commercial |
$27.20
|
|
|
GUIDEWIRE 4 BIOCOMPRESSION SCR
|
Facility
|
OP
|
$28.63
|
|
| Hospital Charge Code |
3004098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$28.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$28.06
|
| Rate for Payer: Aetna of WY Medicare |
$18.90
|
| Rate for Payer: Altius Commercial |
$27.48
|
| Rate for Payer: Beech Street Commercial |
$28.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.77
|
| Rate for Payer: Cash Price |
$20.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.77
|
| Rate for Payer: Cigna of WY Commercial |
$28.06
|
| Rate for Payer: Entrust Commercial |
$27.20
|
| Rate for Payer: First Choice Health Commercial |
$27.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.32
|
| Rate for Payer: HealthUtah PPO |
$28.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.77
|
| Rate for Payer: Multiplan Medicare/VA |
$15.50
|
| Rate for Payer: One Health Plan of WY PPO |
$28.06
|
| Rate for Payer: PacificSource Commercial |
$25.77
|
| Rate for Payer: PHCS PPO |
$28.06
|
| Rate for Payer: Three Rivers PPO |
$21.47
|
| Rate for Payer: TriWest Veterans Administration |
$16.32
|
| Rate for Payer: United Healthcare Commercial |
$27.34
|
| Rate for Payer: United Healthcare Medicare |
$16.32
|
| Rate for Payer: WINHealth Partners Commercial |
$28.06
|
| Rate for Payer: Wise Provider Network Commercial |
$27.20
|
|
|
GUIDE WIRE .86MM TROCAR TIP
|
Facility
|
IP
|
$77.00
|
|
| Hospital Charge Code |
3002293
|
|
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
|
|
