|
ANKLE STAR STERILE INSTRUMENTS
|
Facility
|
IP
|
$5,544.00
|
|
| Hospital Charge Code |
3002742
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,212.75 |
| Max. Negotiated Rate |
$5,544.00 |
| Rate for Payer: Three Rivers PPO |
$4,158.00
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,433.12
|
| Rate for Payer: Aetna of WY Medicare |
$3,548.16
|
| Rate for Payer: Altius Commercial |
$5,322.24
|
| Rate for Payer: Beech Street Commercial |
$5,433.12
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5,377.68
|
| Rate for Payer: Cash Price |
$3,880.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,377.68
|
| Rate for Payer: Cigna of WY Commercial |
$5,433.12
|
| Rate for Payer: Entrust Commercial |
$5,266.80
|
| Rate for Payer: First Choice Health Commercial |
$5,266.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,266.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3,381.84
|
| Rate for Payer: HealthUtah PPO |
$5,544.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,377.68
|
| Rate for Payer: Multiplan Medicare/VA |
$3,212.75
|
| Rate for Payer: One Health Plan of WY PPO |
$5,433.12
|
| Rate for Payer: PacificSource Commercial |
$4,989.60
|
| Rate for Payer: PHCS PPO |
$5,433.12
|
| Rate for Payer: TriWest Veterans Administration |
$3,381.84
|
| Rate for Payer: United Healthcare Commercial |
$5,294.52
|
| Rate for Payer: United Healthcare Medicare |
$3,381.84
|
| Rate for Payer: WINHealth Partners Commercial |
$5,266.80
|
| Rate for Payer: Wise Provider Network Commercial |
$5,266.80
|
|
|
ANKLE STAR TALAR RT SMALL
|
Facility
|
OP
|
$25,987.50
|
|
| Hospital Charge Code |
3002741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14,072.23 |
| Max. Negotiated Rate |
$25,987.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$25,467.75
|
| Rate for Payer: Aetna of WY Medicare |
$17,151.75
|
| Rate for Payer: Altius Commercial |
$24,948.00
|
| Rate for Payer: Beech Street Commercial |
$25,467.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$25,207.88
|
| Rate for Payer: Cash Price |
$18,191.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$25,207.88
|
| Rate for Payer: Cigna of WY Commercial |
$25,467.75
|
| Rate for Payer: Entrust Commercial |
$24,688.12
|
| Rate for Payer: First Choice Health Commercial |
$24,688.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$24,688.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14,812.88
|
| Rate for Payer: HealthUtah PPO |
$25,987.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$25,207.88
|
| Rate for Payer: Multiplan Medicare/VA |
$14,072.23
|
| Rate for Payer: One Health Plan of WY PPO |
$25,467.75
|
| Rate for Payer: PacificSource Commercial |
$23,388.75
|
| Rate for Payer: PHCS PPO |
$25,467.75
|
| Rate for Payer: Three Rivers PPO |
$19,490.62
|
| Rate for Payer: TriWest Veterans Administration |
$14,812.88
|
| Rate for Payer: United Healthcare Commercial |
$24,818.06
|
| Rate for Payer: United Healthcare Medicare |
$14,812.88
|
| Rate for Payer: WINHealth Partners Commercial |
$25,467.75
|
| Rate for Payer: Wise Provider Network Commercial |
$24,688.12
|
|
|
ANKLE STAR TALAR RT SMALL
|
Facility
|
IP
|
$25,987.50
|
|
| Hospital Charge Code |
3002741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,059.76 |
| Max. Negotiated Rate |
$25,987.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$25,467.75
|
| Rate for Payer: Aetna of WY Medicare |
$16,632.00
|
| Rate for Payer: Altius Commercial |
$24,948.00
|
| Rate for Payer: Beech Street Commercial |
$25,467.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$25,207.88
|
| Rate for Payer: Cash Price |
$18,191.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$25,207.88
|
| Rate for Payer: Cigna of WY Commercial |
$25,467.75
|
| Rate for Payer: Entrust Commercial |
$24,688.12
|
| Rate for Payer: First Choice Health Commercial |
$24,688.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$24,688.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$15,852.38
|
| Rate for Payer: HealthUtah PPO |
$25,987.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$25,207.88
|
| Rate for Payer: Multiplan Medicare/VA |
$15,059.76
|
| Rate for Payer: One Health Plan of WY PPO |
$25,467.75
|
| Rate for Payer: PacificSource Commercial |
$23,388.75
|
| Rate for Payer: PHCS PPO |
$25,467.75
|
| Rate for Payer: Three Rivers PPO |
$19,490.62
|
| Rate for Payer: TriWest Veterans Administration |
$15,852.38
|
| Rate for Payer: United Healthcare Commercial |
$24,818.06
|
| Rate for Payer: United Healthcare Medicare |
$15,852.38
|
| Rate for Payer: WINHealth Partners Commercial |
$24,688.12
|
| Rate for Payer: Wise Provider Network Commercial |
$24,688.12
|
|
|
ANKLE STAR TIBIAL MEDIUM
|
Facility
|
OP
|
$23,453.50
|
|
| Hospital Charge Code |
3002739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,700.07 |
| Max. Negotiated Rate |
$23,453.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22,984.43
|
| Rate for Payer: Aetna of WY Medicare |
$15,479.31
|
| Rate for Payer: Altius Commercial |
$22,515.36
|
| Rate for Payer: Beech Street Commercial |
$22,984.43
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22,749.90
|
| Rate for Payer: Cash Price |
$16,417.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$22,749.90
|
| Rate for Payer: Cigna of WY Commercial |
$22,984.43
|
| Rate for Payer: Entrust Commercial |
$22,280.82
|
| Rate for Payer: First Choice Health Commercial |
$22,280.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$22,280.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13,368.50
|
| Rate for Payer: HealthUtah PPO |
$23,453.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$22,749.90
|
| Rate for Payer: Multiplan Medicare/VA |
$12,700.07
|
| Rate for Payer: One Health Plan of WY PPO |
$22,984.43
|
| Rate for Payer: PacificSource Commercial |
$21,108.15
|
| Rate for Payer: PHCS PPO |
$22,984.43
|
| Rate for Payer: Three Rivers PPO |
$17,590.12
|
| Rate for Payer: TriWest Veterans Administration |
$13,368.50
|
| Rate for Payer: United Healthcare Commercial |
$22,398.09
|
| Rate for Payer: United Healthcare Medicare |
$13,368.50
|
| Rate for Payer: WINHealth Partners Commercial |
$22,984.43
|
| Rate for Payer: Wise Provider Network Commercial |
$22,280.82
|
|
|
ANKLE STAR TIBIAL MEDIUM
|
Facility
|
IP
|
$23,453.50
|
|
| Hospital Charge Code |
3002739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,591.30 |
| Max. Negotiated Rate |
$23,453.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22,984.43
|
| Rate for Payer: Aetna of WY Medicare |
$15,010.24
|
| Rate for Payer: Altius Commercial |
$22,515.36
|
| Rate for Payer: Beech Street Commercial |
$22,984.43
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22,749.90
|
| Rate for Payer: Cash Price |
$16,417.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$22,749.90
|
| Rate for Payer: Cigna of WY Commercial |
$22,984.43
|
| Rate for Payer: Entrust Commercial |
$22,280.82
|
| Rate for Payer: First Choice Health Commercial |
$22,280.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$22,280.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14,306.64
|
| Rate for Payer: HealthUtah PPO |
$23,453.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$22,749.90
|
| Rate for Payer: Multiplan Medicare/VA |
$13,591.30
|
| Rate for Payer: One Health Plan of WY PPO |
$22,984.43
|
| Rate for Payer: PacificSource Commercial |
$21,108.15
|
| Rate for Payer: PHCS PPO |
$22,984.43
|
| Rate for Payer: Three Rivers PPO |
$17,590.12
|
| Rate for Payer: TriWest Veterans Administration |
$14,306.64
|
| Rate for Payer: United Healthcare Commercial |
$22,398.09
|
| Rate for Payer: United Healthcare Medicare |
$14,306.64
|
| Rate for Payer: WINHealth Partners Commercial |
$22,280.82
|
| Rate for Payer: Wise Provider Network Commercial |
$22,280.82
|
|
|
ANKLE STIRRUP PLUS BLK 97007
|
Facility
|
OP
|
$40.32
|
|
| Hospital Charge Code |
2200081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.51
|
| Rate for Payer: Aetna of WY Medicare |
$26.61
|
| Rate for Payer: Altius Commercial |
$38.71
|
| Rate for Payer: Beech Street Commercial |
$39.51
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.11
|
| Rate for Payer: Cash Price |
$28.22
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.11
|
| Rate for Payer: Cigna of WY Commercial |
$39.51
|
| Rate for Payer: Entrust Commercial |
$38.30
|
| Rate for Payer: First Choice Health Commercial |
$38.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$22.98
|
| Rate for Payer: HealthUtah PPO |
$40.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.11
|
| Rate for Payer: Multiplan Medicare/VA |
$21.83
|
| Rate for Payer: One Health Plan of WY PPO |
$39.51
|
| Rate for Payer: PacificSource Commercial |
$36.29
|
| Rate for Payer: PHCS PPO |
$39.51
|
| Rate for Payer: Three Rivers PPO |
$30.24
|
| Rate for Payer: TriWest Veterans Administration |
$22.98
|
| Rate for Payer: United Healthcare Commercial |
$38.51
|
| Rate for Payer: United Healthcare Medicare |
$22.98
|
| Rate for Payer: WINHealth Partners Commercial |
$39.51
|
| Rate for Payer: Wise Provider Network Commercial |
$38.30
|
|
|
ANKLE STIRRUP PLUS BLK 97007
|
Facility
|
IP
|
$40.32
|
|
| Hospital Charge Code |
2200081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.37 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.51
|
| Rate for Payer: Aetna of WY Medicare |
$25.80
|
| Rate for Payer: Altius Commercial |
$38.71
|
| Rate for Payer: Beech Street Commercial |
$39.51
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.11
|
| Rate for Payer: Cash Price |
$28.22
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.11
|
| Rate for Payer: Cigna of WY Commercial |
$39.51
|
| Rate for Payer: Entrust Commercial |
$38.30
|
| Rate for Payer: First Choice Health Commercial |
$38.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.60
|
| Rate for Payer: HealthUtah PPO |
$40.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.11
|
| Rate for Payer: Multiplan Medicare/VA |
$23.37
|
| Rate for Payer: One Health Plan of WY PPO |
$39.51
|
| Rate for Payer: PacificSource Commercial |
$36.29
|
| Rate for Payer: PHCS PPO |
$39.51
|
| Rate for Payer: Three Rivers PPO |
$30.24
|
| Rate for Payer: TriWest Veterans Administration |
$24.60
|
| Rate for Payer: United Healthcare Commercial |
$38.51
|
| Rate for Payer: United Healthcare Medicare |
$24.60
|
| Rate for Payer: WINHealth Partners Commercial |
$38.30
|
| Rate for Payer: Wise Provider Network Commercial |
$38.30
|
|
|
ANKLE/WRIST WEIGHT 5LB DELUXE
|
Facility
|
IP
|
$40.77
|
|
| Hospital Charge Code |
2900040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.63 |
| Max. Negotiated Rate |
$40.77 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.95
|
| Rate for Payer: Aetna of WY Medicare |
$26.09
|
| Rate for Payer: Altius Commercial |
$39.14
|
| Rate for Payer: Beech Street Commercial |
$39.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.55
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.55
|
| Rate for Payer: Cigna of WY Commercial |
$39.95
|
| Rate for Payer: Entrust Commercial |
$38.73
|
| Rate for Payer: First Choice Health Commercial |
$38.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.87
|
| Rate for Payer: HealthUtah PPO |
$40.77
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.55
|
| Rate for Payer: Multiplan Medicare/VA |
$23.63
|
| Rate for Payer: One Health Plan of WY PPO |
$39.95
|
| Rate for Payer: PacificSource Commercial |
$36.69
|
| Rate for Payer: PHCS PPO |
$39.95
|
| Rate for Payer: Three Rivers PPO |
$30.58
|
| Rate for Payer: TriWest Veterans Administration |
$24.87
|
| Rate for Payer: United Healthcare Commercial |
$38.94
|
| Rate for Payer: United Healthcare Medicare |
$24.87
|
| Rate for Payer: WINHealth Partners Commercial |
$38.73
|
| Rate for Payer: Wise Provider Network Commercial |
$38.73
|
|
|
ANKLE/WRIST WEIGHT 5LB DELUXE
|
Facility
|
OP
|
$40.77
|
|
| Hospital Charge Code |
2900040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.08 |
| Max. Negotiated Rate |
$40.77 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.95
|
| Rate for Payer: Aetna of WY Medicare |
$26.91
|
| Rate for Payer: Altius Commercial |
$39.14
|
| Rate for Payer: Beech Street Commercial |
$39.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.55
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.55
|
| Rate for Payer: Cigna of WY Commercial |
$39.95
|
| Rate for Payer: Entrust Commercial |
$38.73
|
| Rate for Payer: First Choice Health Commercial |
$38.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.24
|
| Rate for Payer: HealthUtah PPO |
$40.77
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.55
|
| Rate for Payer: Multiplan Medicare/VA |
$22.08
|
| Rate for Payer: One Health Plan of WY PPO |
$39.95
|
| Rate for Payer: PacificSource Commercial |
$36.69
|
| Rate for Payer: PHCS PPO |
$39.95
|
| Rate for Payer: Three Rivers PPO |
$30.58
|
| Rate for Payer: TriWest Veterans Administration |
$23.24
|
| Rate for Payer: United Healthcare Commercial |
$38.94
|
| Rate for Payer: United Healthcare Medicare |
$23.24
|
| Rate for Payer: WINHealth Partners Commercial |
$39.95
|
| Rate for Payer: Wise Provider Network Commercial |
$38.73
|
|
|
ANKL KLASY XS LT BLK 79-81482
|
Facility
|
OP
|
$45.85
|
|
| Hospital Charge Code |
2200122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.93
|
| Rate for Payer: Aetna of WY Medicare |
$30.26
|
| Rate for Payer: Altius Commercial |
$44.02
|
| Rate for Payer: Beech Street Commercial |
$44.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$44.47
|
| Rate for Payer: Cash Price |
$32.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.47
|
| Rate for Payer: Cigna of WY Commercial |
$44.93
|
| Rate for Payer: Entrust Commercial |
$43.56
|
| Rate for Payer: First Choice Health Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.13
|
| Rate for Payer: HealthUtah PPO |
$45.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.47
|
| Rate for Payer: Multiplan Medicare/VA |
$24.83
|
| Rate for Payer: One Health Plan of WY PPO |
$44.93
|
| Rate for Payer: PacificSource Commercial |
$41.26
|
| Rate for Payer: PHCS PPO |
$44.93
|
| Rate for Payer: Three Rivers PPO |
$34.39
|
| Rate for Payer: TriWest Veterans Administration |
$26.13
|
| Rate for Payer: United Healthcare Commercial |
$43.79
|
| Rate for Payer: United Healthcare Medicare |
$26.13
|
| Rate for Payer: WINHealth Partners Commercial |
$44.93
|
| Rate for Payer: Wise Provider Network Commercial |
$43.56
|
|
|
ANKL KLASY XS LT BLK 79-81482
|
Facility
|
IP
|
$45.85
|
|
| Hospital Charge Code |
2200122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.93
|
| Rate for Payer: Aetna of WY Medicare |
$29.34
|
| Rate for Payer: Altius Commercial |
$44.02
|
| Rate for Payer: Beech Street Commercial |
$44.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$44.47
|
| Rate for Payer: Cash Price |
$32.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.47
|
| Rate for Payer: Cigna of WY Commercial |
$44.93
|
| Rate for Payer: Entrust Commercial |
$43.56
|
| Rate for Payer: First Choice Health Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.97
|
| Rate for Payer: HealthUtah PPO |
$45.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.47
|
| Rate for Payer: Multiplan Medicare/VA |
$26.57
|
| Rate for Payer: One Health Plan of WY PPO |
$44.93
|
| Rate for Payer: PacificSource Commercial |
$41.26
|
| Rate for Payer: PHCS PPO |
$44.93
|
| Rate for Payer: Three Rivers PPO |
$34.39
|
| Rate for Payer: TriWest Veterans Administration |
$27.97
|
| Rate for Payer: United Healthcare Commercial |
$43.79
|
| Rate for Payer: United Healthcare Medicare |
$27.97
|
| Rate for Payer: WINHealth Partners Commercial |
$43.56
|
| Rate for Payer: Wise Provider Network Commercial |
$43.56
|
|
|
ANKL KLASY XXS LT 79-81421
|
Facility
|
OP
|
$45.85
|
|
| Hospital Charge Code |
2200129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.93
|
| Rate for Payer: Aetna of WY Medicare |
$30.26
|
| Rate for Payer: Altius Commercial |
$44.02
|
| Rate for Payer: Beech Street Commercial |
$44.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$44.47
|
| Rate for Payer: Cash Price |
$32.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.47
|
| Rate for Payer: Cigna of WY Commercial |
$44.93
|
| Rate for Payer: Entrust Commercial |
$43.56
|
| Rate for Payer: First Choice Health Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.13
|
| Rate for Payer: HealthUtah PPO |
$45.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.47
|
| Rate for Payer: Multiplan Medicare/VA |
$24.83
|
| Rate for Payer: One Health Plan of WY PPO |
$44.93
|
| Rate for Payer: PacificSource Commercial |
$41.26
|
| Rate for Payer: PHCS PPO |
$44.93
|
| Rate for Payer: Three Rivers PPO |
$34.39
|
| Rate for Payer: TriWest Veterans Administration |
$26.13
|
| Rate for Payer: United Healthcare Commercial |
$43.79
|
| Rate for Payer: United Healthcare Medicare |
$26.13
|
| Rate for Payer: WINHealth Partners Commercial |
$44.93
|
| Rate for Payer: Wise Provider Network Commercial |
$43.56
|
|
|
ANKL KLASY XXS LT 79-81421
|
Facility
|
IP
|
$45.85
|
|
| Hospital Charge Code |
2200129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.93
|
| Rate for Payer: Aetna of WY Medicare |
$29.34
|
| Rate for Payer: Altius Commercial |
$44.02
|
| Rate for Payer: Beech Street Commercial |
$44.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$44.47
|
| Rate for Payer: Cash Price |
$32.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.47
|
| Rate for Payer: Cigna of WY Commercial |
$44.93
|
| Rate for Payer: Entrust Commercial |
$43.56
|
| Rate for Payer: First Choice Health Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.97
|
| Rate for Payer: HealthUtah PPO |
$45.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.47
|
| Rate for Payer: Multiplan Medicare/VA |
$26.57
|
| Rate for Payer: One Health Plan of WY PPO |
$44.93
|
| Rate for Payer: PacificSource Commercial |
$41.26
|
| Rate for Payer: PHCS PPO |
$44.93
|
| Rate for Payer: Three Rivers PPO |
$34.39
|
| Rate for Payer: TriWest Veterans Administration |
$27.97
|
| Rate for Payer: United Healthcare Commercial |
$43.79
|
| Rate for Payer: United Healthcare Medicare |
$27.97
|
| Rate for Payer: WINHealth Partners Commercial |
$43.56
|
| Rate for Payer: Wise Provider Network Commercial |
$43.56
|
|
|
ANKL KLASY XXS RT 79-81411
|
Facility
|
OP
|
$45.85
|
|
| Hospital Charge Code |
2200130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.93
|
| Rate for Payer: Aetna of WY Medicare |
$30.26
|
| Rate for Payer: Altius Commercial |
$44.02
|
| Rate for Payer: Beech Street Commercial |
$44.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$44.47
|
| Rate for Payer: Cash Price |
$32.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.47
|
| Rate for Payer: Cigna of WY Commercial |
$44.93
|
| Rate for Payer: Entrust Commercial |
$43.56
|
| Rate for Payer: First Choice Health Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.13
|
| Rate for Payer: HealthUtah PPO |
$45.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.47
|
| Rate for Payer: Multiplan Medicare/VA |
$24.83
|
| Rate for Payer: One Health Plan of WY PPO |
$44.93
|
| Rate for Payer: PacificSource Commercial |
$41.26
|
| Rate for Payer: PHCS PPO |
$44.93
|
| Rate for Payer: Three Rivers PPO |
$34.39
|
| Rate for Payer: TriWest Veterans Administration |
$26.13
|
| Rate for Payer: United Healthcare Commercial |
$43.79
|
| Rate for Payer: United Healthcare Medicare |
$26.13
|
| Rate for Payer: WINHealth Partners Commercial |
$44.93
|
| Rate for Payer: Wise Provider Network Commercial |
$43.56
|
|
|
ANKL KLASY XXS RT 79-81411
|
Facility
|
IP
|
$45.85
|
|
| Hospital Charge Code |
2200130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.93
|
| Rate for Payer: Aetna of WY Medicare |
$29.34
|
| Rate for Payer: Altius Commercial |
$44.02
|
| Rate for Payer: Beech Street Commercial |
$44.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$44.47
|
| Rate for Payer: Cash Price |
$32.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.47
|
| Rate for Payer: Cigna of WY Commercial |
$44.93
|
| Rate for Payer: Entrust Commercial |
$43.56
|
| Rate for Payer: First Choice Health Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.97
|
| Rate for Payer: HealthUtah PPO |
$45.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.47
|
| Rate for Payer: Multiplan Medicare/VA |
$26.57
|
| Rate for Payer: One Health Plan of WY PPO |
$44.93
|
| Rate for Payer: PacificSource Commercial |
$41.26
|
| Rate for Payer: PHCS PPO |
$44.93
|
| Rate for Payer: Three Rivers PPO |
$34.39
|
| Rate for Payer: TriWest Veterans Administration |
$27.97
|
| Rate for Payer: United Healthcare Commercial |
$43.79
|
| Rate for Payer: United Healthcare Medicare |
$27.97
|
| Rate for Payer: WINHealth Partners Commercial |
$43.56
|
| Rate for Payer: Wise Provider Network Commercial |
$43.56
|
|
|
ANK SYNDESMOSIS ZIPTIGHT SS
|
Facility
|
IP
|
$2,442.48
|
|
| Hospital Charge Code |
3003531
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,415.42 |
| Max. Negotiated Rate |
$2,442.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,393.63
|
| Rate for Payer: Aetna of WY Medicare |
$1,563.19
|
| Rate for Payer: Altius Commercial |
$2,344.78
|
| Rate for Payer: Beech Street Commercial |
$2,393.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,369.21
|
| Rate for Payer: Cash Price |
$1,709.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,369.21
|
| Rate for Payer: Cigna of WY Commercial |
$2,393.63
|
| Rate for Payer: Entrust Commercial |
$2,320.36
|
| Rate for Payer: First Choice Health Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,489.91
|
| Rate for Payer: HealthUtah PPO |
$2,442.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,369.21
|
| Rate for Payer: Multiplan Medicare/VA |
$1,415.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,393.63
|
| Rate for Payer: PacificSource Commercial |
$2,198.23
|
| Rate for Payer: PHCS PPO |
$2,393.63
|
| Rate for Payer: Three Rivers PPO |
$1,831.86
|
| Rate for Payer: TriWest Veterans Administration |
$1,489.91
|
| Rate for Payer: United Healthcare Commercial |
$2,332.57
|
| Rate for Payer: United Healthcare Medicare |
$1,489.91
|
| Rate for Payer: WINHealth Partners Commercial |
$2,320.36
|
| Rate for Payer: Wise Provider Network Commercial |
$2,320.36
|
|
|
ANK SYNDESMOSIS ZIPTIGHT SS
|
Facility
|
OP
|
$2,442.48
|
|
| Hospital Charge Code |
3003531
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,322.60 |
| Max. Negotiated Rate |
$2,442.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,393.63
|
| Rate for Payer: Aetna of WY Medicare |
$1,612.04
|
| Rate for Payer: Altius Commercial |
$2,344.78
|
| Rate for Payer: Beech Street Commercial |
$2,393.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,369.21
|
| Rate for Payer: Cash Price |
$1,709.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,369.21
|
| Rate for Payer: Cigna of WY Commercial |
$2,393.63
|
| Rate for Payer: Entrust Commercial |
$2,320.36
|
| Rate for Payer: First Choice Health Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,392.21
|
| Rate for Payer: HealthUtah PPO |
$2,442.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,369.21
|
| Rate for Payer: Multiplan Medicare/VA |
$1,322.60
|
| Rate for Payer: One Health Plan of WY PPO |
$2,393.63
|
| Rate for Payer: PacificSource Commercial |
$2,198.23
|
| Rate for Payer: PHCS PPO |
$2,393.63
|
| Rate for Payer: Three Rivers PPO |
$1,831.86
|
| Rate for Payer: TriWest Veterans Administration |
$1,392.21
|
| Rate for Payer: United Healthcare Commercial |
$2,332.57
|
| Rate for Payer: United Healthcare Medicare |
$1,392.21
|
| Rate for Payer: WINHealth Partners Commercial |
$2,393.63
|
| Rate for Payer: Wise Provider Network Commercial |
$2,320.36
|
|
|
ANK SYNDESMOSIS ZIPTIGHT TITAN
|
Facility
|
OP
|
$2,442.48
|
|
| Hospital Charge Code |
3003663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,322.60 |
| Max. Negotiated Rate |
$2,442.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,393.63
|
| Rate for Payer: Aetna of WY Medicare |
$1,612.04
|
| Rate for Payer: Altius Commercial |
$2,344.78
|
| Rate for Payer: Beech Street Commercial |
$2,393.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,369.21
|
| Rate for Payer: Cash Price |
$1,709.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,369.21
|
| Rate for Payer: Cigna of WY Commercial |
$2,393.63
|
| Rate for Payer: Entrust Commercial |
$2,320.36
|
| Rate for Payer: First Choice Health Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,392.21
|
| Rate for Payer: HealthUtah PPO |
$2,442.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,369.21
|
| Rate for Payer: Multiplan Medicare/VA |
$1,322.60
|
| Rate for Payer: One Health Plan of WY PPO |
$2,393.63
|
| Rate for Payer: PacificSource Commercial |
$2,198.23
|
| Rate for Payer: PHCS PPO |
$2,393.63
|
| Rate for Payer: Three Rivers PPO |
$1,831.86
|
| Rate for Payer: TriWest Veterans Administration |
$1,392.21
|
| Rate for Payer: United Healthcare Commercial |
$2,332.57
|
| Rate for Payer: United Healthcare Medicare |
$1,392.21
|
| Rate for Payer: WINHealth Partners Commercial |
$2,393.63
|
| Rate for Payer: Wise Provider Network Commercial |
$2,320.36
|
|
|
ANK SYNDESMOSIS ZIPTIGHT TITAN
|
Facility
|
IP
|
$2,442.48
|
|
| Hospital Charge Code |
3003663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,415.42 |
| Max. Negotiated Rate |
$2,442.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,393.63
|
| Rate for Payer: Aetna of WY Medicare |
$1,563.19
|
| Rate for Payer: Altius Commercial |
$2,344.78
|
| Rate for Payer: Beech Street Commercial |
$2,393.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,369.21
|
| Rate for Payer: Cash Price |
$1,709.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,369.21
|
| Rate for Payer: Cigna of WY Commercial |
$2,393.63
|
| Rate for Payer: Entrust Commercial |
$2,320.36
|
| Rate for Payer: First Choice Health Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,320.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,489.91
|
| Rate for Payer: HealthUtah PPO |
$2,442.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,369.21
|
| Rate for Payer: Multiplan Medicare/VA |
$1,415.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,393.63
|
| Rate for Payer: PacificSource Commercial |
$2,198.23
|
| Rate for Payer: PHCS PPO |
$2,393.63
|
| Rate for Payer: Three Rivers PPO |
$1,831.86
|
| Rate for Payer: TriWest Veterans Administration |
$1,489.91
|
| Rate for Payer: United Healthcare Commercial |
$2,332.57
|
| Rate for Payer: United Healthcare Medicare |
$1,489.91
|
| Rate for Payer: WINHealth Partners Commercial |
$2,320.36
|
| Rate for Payer: Wise Provider Network Commercial |
$2,320.36
|
|
|
ANNUAL ALCOHOL SCREEN 15 MIN
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS G0442
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$41.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$40.18
|
| Rate for Payer: Aetna of WY Medicare |
$8.76
|
| Rate for Payer: Beech Street Commercial |
$38.95
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.77
|
| Rate for Payer: Cigna of WY Commercial |
$40.18
|
| Rate for Payer: First Choice Health Commercial |
$36.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.76
|
| Rate for Payer: HealthUtah PPO |
$41.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.77
|
| Rate for Payer: Multiplan Medicare/VA |
$7.45
|
| Rate for Payer: One Health Plan of WY PPO |
$40.18
|
| Rate for Payer: PacificSource Commercial |
$36.90
|
| Rate for Payer: PHCS PPO |
$38.95
|
| Rate for Payer: Three Rivers PPO |
$30.75
|
| Rate for Payer: TriWest Veterans Administration |
$8.76
|
| Rate for Payer: United Healthcare Commercial |
$38.95
|
| Rate for Payer: WINHealth Partners Commercial |
$38.95
|
|
|
ANOSCOPE DISP 82420
|
Facility
|
IP
|
$3.93
|
|
| Hospital Charge Code |
2400224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$3.93 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.85
|
| Rate for Payer: Aetna of WY Medicare |
$2.52
|
| Rate for Payer: Altius Commercial |
$3.77
|
| Rate for Payer: Beech Street Commercial |
$3.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.81
|
| Rate for Payer: Cash Price |
$2.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.81
|
| Rate for Payer: Cigna of WY Commercial |
$3.85
|
| Rate for Payer: Entrust Commercial |
$3.73
|
| Rate for Payer: First Choice Health Commercial |
$3.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.40
|
| Rate for Payer: HealthUtah PPO |
$3.93
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.81
|
| Rate for Payer: Multiplan Medicare/VA |
$2.28
|
| Rate for Payer: One Health Plan of WY PPO |
$3.85
|
| Rate for Payer: PacificSource Commercial |
$3.54
|
| Rate for Payer: PHCS PPO |
$3.85
|
| Rate for Payer: Three Rivers PPO |
$2.95
|
| Rate for Payer: TriWest Veterans Administration |
$2.40
|
| Rate for Payer: United Healthcare Commercial |
$3.75
|
| Rate for Payer: United Healthcare Medicare |
$2.40
|
| Rate for Payer: WINHealth Partners Commercial |
$3.73
|
| Rate for Payer: Wise Provider Network Commercial |
$3.73
|
|
|
ANOSCOPE DISP 82420
|
Facility
|
OP
|
$3.93
|
|
| Hospital Charge Code |
2400224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$3.93 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.85
|
| Rate for Payer: Aetna of WY Medicare |
$2.59
|
| Rate for Payer: Altius Commercial |
$3.77
|
| Rate for Payer: Beech Street Commercial |
$3.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.81
|
| Rate for Payer: Cash Price |
$2.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.81
|
| Rate for Payer: Cigna of WY Commercial |
$3.85
|
| Rate for Payer: Entrust Commercial |
$3.73
|
| Rate for Payer: First Choice Health Commercial |
$3.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.24
|
| Rate for Payer: HealthUtah PPO |
$3.93
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.81
|
| Rate for Payer: Multiplan Medicare/VA |
$2.13
|
| Rate for Payer: One Health Plan of WY PPO |
$3.85
|
| Rate for Payer: PacificSource Commercial |
$3.54
|
| Rate for Payer: PHCS PPO |
$3.85
|
| Rate for Payer: Three Rivers PPO |
$2.95
|
| Rate for Payer: TriWest Veterans Administration |
$2.24
|
| Rate for Payer: United Healthcare Commercial |
$3.75
|
| Rate for Payer: United Healthcare Medicare |
$2.24
|
| Rate for Payer: WINHealth Partners Commercial |
$3.85
|
| Rate for Payer: Wise Provider Network Commercial |
$3.73
|
|
|
ANOSCOPY ABLATION LESION
|
Professional
|
Both
|
$3,252.00
|
|
|
Service Code
|
HCPCS 46615
|
| Min. Negotiated Rate |
$73.90 |
| Max. Negotiated Rate |
$3,252.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,186.96
|
| Rate for Payer: Aetna of WY Medicare |
$86.94
|
| Rate for Payer: Beech Street Commercial |
$3,089.40
|
| Rate for Payer: Cash Price |
$2,276.40
|
| Rate for Payer: Cash Price |
$2,276.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,154.44
|
| Rate for Payer: Cigna of WY Commercial |
$3,186.96
|
| Rate for Payer: First Choice Health Commercial |
$2,926.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,089.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$86.94
|
| Rate for Payer: HealthUtah PPO |
$3,252.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,154.44
|
| Rate for Payer: Multiplan Medicare/VA |
$73.90
|
| Rate for Payer: One Health Plan of WY PPO |
$3,186.96
|
| Rate for Payer: PacificSource Commercial |
$2,926.80
|
| Rate for Payer: PHCS PPO |
$3,089.40
|
| Rate for Payer: Three Rivers PPO |
$2,439.00
|
| Rate for Payer: TriWest Veterans Administration |
$86.94
|
| Rate for Payer: United Healthcare Commercial |
$3,089.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2,764.20
|
|
|
ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 46600
|
| Min. Negotiated Rate |
$33.86 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$175.42
|
| Rate for Payer: Aetna of WY Medicare |
$39.83
|
| Rate for Payer: Beech Street Commercial |
$170.05
|
| Rate for Payer: Cash Price |
$125.30
|
| Rate for Payer: Cash Price |
$125.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$173.63
|
| Rate for Payer: Cigna of WY Commercial |
$175.42
|
| Rate for Payer: First Choice Health Commercial |
$161.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$170.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.83
|
| Rate for Payer: HealthUtah PPO |
$179.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$173.63
|
| Rate for Payer: Multiplan Medicare/VA |
$33.86
|
| Rate for Payer: One Health Plan of WY PPO |
$175.42
|
| Rate for Payer: PacificSource Commercial |
$161.10
|
| Rate for Payer: PHCS PPO |
$170.05
|
| Rate for Payer: Three Rivers PPO |
$134.25
|
| Rate for Payer: TriWest Veterans Administration |
$39.83
|
| Rate for Payer: United Healthcare Commercial |
$170.05
|
| Rate for Payer: WINHealth Partners Commercial |
$152.15
|
|
|
ANOSCOPY W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 46606
|
| Min. Negotiated Rate |
$61.38 |
| Max. Negotiated Rate |
$2,509.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,458.82
|
| Rate for Payer: Aetna of WY Medicare |
$72.21
|
| Rate for Payer: Beech Street Commercial |
$2,383.55
|
| Rate for Payer: Cash Price |
$1,756.30
|
| Rate for Payer: Cash Price |
$1,756.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,433.73
|
| Rate for Payer: Cigna of WY Commercial |
$2,458.82
|
| Rate for Payer: First Choice Health Commercial |
$2,258.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,383.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$72.21
|
| Rate for Payer: HealthUtah PPO |
$2,509.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,433.73
|
| Rate for Payer: Multiplan Medicare/VA |
$61.38
|
| Rate for Payer: One Health Plan of WY PPO |
$2,458.82
|
| Rate for Payer: PacificSource Commercial |
$2,258.10
|
| Rate for Payer: PHCS PPO |
$2,383.55
|
| Rate for Payer: Three Rivers PPO |
$1,881.75
|
| Rate for Payer: TriWest Veterans Administration |
$72.21
|
| Rate for Payer: United Healthcare Commercial |
$2,383.55
|
| Rate for Payer: WINHealth Partners Commercial |
$2,132.65
|
|
