|
HC ASSAY OF METANEPHRINES - METANEPHRINES 24HR URINE
|
Facility
|
OP
|
$238.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
3018383501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$128.88 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$233.24
|
| Rate for Payer: Aetna of WY Medicare |
$157.08
|
| Rate for Payer: Altius Commercial |
$228.48
|
| Rate for Payer: Beech Street Commercial |
$233.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$230.86
|
| Rate for Payer: Cash Price |
$166.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$230.86
|
| Rate for Payer: Cigna of WY Commercial |
$233.24
|
| Rate for Payer: Entrust Commercial |
$226.10
|
| Rate for Payer: First Choice Health Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$135.66
|
| Rate for Payer: HealthUtah PPO |
$238.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$230.86
|
| Rate for Payer: Multiplan Medicare/VA |
$128.88
|
| Rate for Payer: One Health Plan of WY PPO |
$233.24
|
| Rate for Payer: PacificSource Commercial |
$214.20
|
| Rate for Payer: PHCS PPO |
$233.24
|
| Rate for Payer: Three Rivers PPO |
$178.50
|
| Rate for Payer: TriWest Veterans Administration |
$135.66
|
| Rate for Payer: United Healthcare Commercial |
$227.29
|
| Rate for Payer: United Healthcare Medicare |
$135.66
|
| Rate for Payer: WINHealth Partners Commercial |
$233.24
|
| Rate for Payer: Wise Provider Network Commercial |
$226.10
|
|
|
HC ASSAY OF METANEPHRINES - METANEPHRINES 24HR URINE
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
3018383501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$137.92 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: United Healthcare Commercial |
$227.29
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$233.24
|
| Rate for Payer: Aetna of WY Medicare |
$152.32
|
| Rate for Payer: Altius Commercial |
$228.48
|
| Rate for Payer: Beech Street Commercial |
$233.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$230.86
|
| Rate for Payer: Cash Price |
$166.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$230.86
|
| Rate for Payer: Cigna of WY Commercial |
$233.24
|
| Rate for Payer: Entrust Commercial |
$226.10
|
| Rate for Payer: First Choice Health Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.18
|
| Rate for Payer: HealthUtah PPO |
$238.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$230.86
|
| Rate for Payer: Multiplan Medicare/VA |
$137.92
|
| Rate for Payer: One Health Plan of WY PPO |
$233.24
|
| Rate for Payer: PacificSource Commercial |
$214.20
|
| Rate for Payer: PHCS PPO |
$233.24
|
| Rate for Payer: Three Rivers PPO |
$178.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.18
|
| Rate for Payer: United Healthcare Medicare |
$145.18
|
| Rate for Payer: WINHealth Partners Commercial |
$226.10
|
| Rate for Payer: Wise Provider Network Commercial |
$226.10
|
|
|
HC ASSAY OF METANEPHRINES - METANEPHRINES PLASMA
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
3018383502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.16 |
| Max. Negotiated Rate |
$197.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$193.06
|
| Rate for Payer: Aetna of WY Medicare |
$126.08
|
| Rate for Payer: Altius Commercial |
$189.12
|
| Rate for Payer: Beech Street Commercial |
$193.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$191.09
|
| Rate for Payer: Cash Price |
$137.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$191.09
|
| Rate for Payer: Cigna of WY Commercial |
$193.06
|
| Rate for Payer: Entrust Commercial |
$187.15
|
| Rate for Payer: First Choice Health Commercial |
$187.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$187.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$120.17
|
| Rate for Payer: HealthUtah PPO |
$197.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$191.09
|
| Rate for Payer: Multiplan Medicare/VA |
$114.16
|
| Rate for Payer: One Health Plan of WY PPO |
$193.06
|
| Rate for Payer: PacificSource Commercial |
$177.30
|
| Rate for Payer: PHCS PPO |
$193.06
|
| Rate for Payer: Three Rivers PPO |
$147.75
|
| Rate for Payer: TriWest Veterans Administration |
$120.17
|
| Rate for Payer: United Healthcare Commercial |
$188.14
|
| Rate for Payer: United Healthcare Medicare |
$120.17
|
| Rate for Payer: WINHealth Partners Commercial |
$187.15
|
| Rate for Payer: Wise Provider Network Commercial |
$187.15
|
|
|
HC ASSAY OF METANEPHRINES - METANEPHRINES PLASMA
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
3018383502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$106.68 |
| Max. Negotiated Rate |
$197.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$193.06
|
| Rate for Payer: Aetna of WY Medicare |
$130.02
|
| Rate for Payer: Altius Commercial |
$189.12
|
| Rate for Payer: Beech Street Commercial |
$193.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$191.09
|
| Rate for Payer: Cash Price |
$137.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$191.09
|
| Rate for Payer: Cigna of WY Commercial |
$193.06
|
| Rate for Payer: Entrust Commercial |
$187.15
|
| Rate for Payer: First Choice Health Commercial |
$187.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$187.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$112.29
|
| Rate for Payer: HealthUtah PPO |
$197.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$191.09
|
| Rate for Payer: Multiplan Medicare/VA |
$106.68
|
| Rate for Payer: One Health Plan of WY PPO |
$193.06
|
| Rate for Payer: PacificSource Commercial |
$177.30
|
| Rate for Payer: PHCS PPO |
$193.06
|
| Rate for Payer: Three Rivers PPO |
$147.75
|
| Rate for Payer: TriWest Veterans Administration |
$112.29
|
| Rate for Payer: United Healthcare Commercial |
$188.14
|
| Rate for Payer: United Healthcare Medicare |
$112.29
|
| Rate for Payer: WINHealth Partners Commercial |
$193.06
|
| Rate for Payer: Wise Provider Network Commercial |
$187.15
|
|
|
HC ASSAY OF MYOGLOBIN - MYOGLOBIN SERUM
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
HCPCS 83874
|
| Hospital Charge Code |
3018387401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.57 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$84.28
|
| Rate for Payer: Aetna of WY Medicare |
$56.76
|
| Rate for Payer: Altius Commercial |
$82.56
|
| Rate for Payer: Beech Street Commercial |
$84.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$83.42
|
| Rate for Payer: Cash Price |
$60.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$83.42
|
| Rate for Payer: Cigna of WY Commercial |
$84.28
|
| Rate for Payer: Entrust Commercial |
$81.70
|
| Rate for Payer: First Choice Health Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$49.02
|
| Rate for Payer: HealthUtah PPO |
$86.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$83.42
|
| Rate for Payer: Multiplan Medicare/VA |
$46.57
|
| Rate for Payer: One Health Plan of WY PPO |
$84.28
|
| Rate for Payer: PacificSource Commercial |
$77.40
|
| Rate for Payer: PHCS PPO |
$84.28
|
| Rate for Payer: Three Rivers PPO |
$64.50
|
| Rate for Payer: TriWest Veterans Administration |
$49.02
|
| Rate for Payer: United Healthcare Commercial |
$82.13
|
| Rate for Payer: United Healthcare Medicare |
$49.02
|
| Rate for Payer: WINHealth Partners Commercial |
$84.28
|
| Rate for Payer: Wise Provider Network Commercial |
$81.70
|
|
|
HC ASSAY OF MYOGLOBIN - MYOGLOBIN SERUM
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
HCPCS 83874
|
| Hospital Charge Code |
3018387401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.84 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$84.28
|
| Rate for Payer: Aetna of WY Medicare |
$55.04
|
| Rate for Payer: Altius Commercial |
$82.56
|
| Rate for Payer: Beech Street Commercial |
$84.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$83.42
|
| Rate for Payer: Cash Price |
$60.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$83.42
|
| Rate for Payer: Cigna of WY Commercial |
$84.28
|
| Rate for Payer: Entrust Commercial |
$81.70
|
| Rate for Payer: First Choice Health Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.46
|
| Rate for Payer: HealthUtah PPO |
$86.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$83.42
|
| Rate for Payer: Multiplan Medicare/VA |
$49.84
|
| Rate for Payer: One Health Plan of WY PPO |
$84.28
|
| Rate for Payer: PacificSource Commercial |
$77.40
|
| Rate for Payer: PHCS PPO |
$84.28
|
| Rate for Payer: Three Rivers PPO |
$64.50
|
| Rate for Payer: TriWest Veterans Administration |
$52.46
|
| Rate for Payer: United Healthcare Commercial |
$82.13
|
| Rate for Payer: United Healthcare Medicare |
$52.46
|
| Rate for Payer: WINHealth Partners Commercial |
$81.70
|
| Rate for Payer: Wise Provider Network Commercial |
$81.70
|
|
|
HC ASSAY OF MYOGLOBIN - MYOGLOBIN URINE QUANTITATIVE
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
HCPCS 83874
|
| Hospital Charge Code |
3018387402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.57 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$84.28
|
| Rate for Payer: Aetna of WY Medicare |
$56.76
|
| Rate for Payer: Altius Commercial |
$82.56
|
| Rate for Payer: Beech Street Commercial |
$84.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$83.42
|
| Rate for Payer: Cash Price |
$60.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$83.42
|
| Rate for Payer: Cigna of WY Commercial |
$84.28
|
| Rate for Payer: Entrust Commercial |
$81.70
|
| Rate for Payer: First Choice Health Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$49.02
|
| Rate for Payer: HealthUtah PPO |
$86.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$83.42
|
| Rate for Payer: Multiplan Medicare/VA |
$46.57
|
| Rate for Payer: One Health Plan of WY PPO |
$84.28
|
| Rate for Payer: PacificSource Commercial |
$77.40
|
| Rate for Payer: PHCS PPO |
$84.28
|
| Rate for Payer: Three Rivers PPO |
$64.50
|
| Rate for Payer: TriWest Veterans Administration |
$49.02
|
| Rate for Payer: United Healthcare Commercial |
$82.13
|
| Rate for Payer: United Healthcare Medicare |
$49.02
|
| Rate for Payer: WINHealth Partners Commercial |
$84.28
|
| Rate for Payer: Wise Provider Network Commercial |
$81.70
|
|
|
HC ASSAY OF MYOGLOBIN - MYOGLOBIN URINE QUANTITATIVE
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
HCPCS 83874
|
| Hospital Charge Code |
3018387402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.84 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$84.28
|
| Rate for Payer: Aetna of WY Medicare |
$55.04
|
| Rate for Payer: Altius Commercial |
$82.56
|
| Rate for Payer: Beech Street Commercial |
$84.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$83.42
|
| Rate for Payer: Cash Price |
$60.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$83.42
|
| Rate for Payer: Cigna of WY Commercial |
$84.28
|
| Rate for Payer: Entrust Commercial |
$81.70
|
| Rate for Payer: First Choice Health Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$81.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.46
|
| Rate for Payer: HealthUtah PPO |
$86.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$83.42
|
| Rate for Payer: Multiplan Medicare/VA |
$49.84
|
| Rate for Payer: One Health Plan of WY PPO |
$84.28
|
| Rate for Payer: PacificSource Commercial |
$77.40
|
| Rate for Payer: PHCS PPO |
$84.28
|
| Rate for Payer: Three Rivers PPO |
$64.50
|
| Rate for Payer: TriWest Veterans Administration |
$52.46
|
| Rate for Payer: United Healthcare Commercial |
$82.13
|
| Rate for Payer: United Healthcare Medicare |
$52.46
|
| Rate for Payer: WINHealth Partners Commercial |
$81.70
|
| Rate for Payer: Wise Provider Network Commercial |
$81.70
|
|
|
HC ASSAY OF NEURONTIN/GABAPENTIN
|
Facility
|
IP
|
$187.00
|
|
|
Service Code
|
HCPCS 80171
|
| Hospital Charge Code |
3018017101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.37 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$183.26
|
| Rate for Payer: Aetna of WY Medicare |
$119.68
|
| Rate for Payer: Altius Commercial |
$179.52
|
| Rate for Payer: Beech Street Commercial |
$183.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$181.39
|
| Rate for Payer: Cash Price |
$130.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$181.39
|
| Rate for Payer: Cigna of WY Commercial |
$183.26
|
| Rate for Payer: Entrust Commercial |
$177.65
|
| Rate for Payer: First Choice Health Commercial |
$177.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$177.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$114.07
|
| Rate for Payer: HealthUtah PPO |
$187.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$181.39
|
| Rate for Payer: Multiplan Medicare/VA |
$108.37
|
| Rate for Payer: One Health Plan of WY PPO |
$183.26
|
| Rate for Payer: PacificSource Commercial |
$168.30
|
| Rate for Payer: PHCS PPO |
$183.26
|
| Rate for Payer: Three Rivers PPO |
$140.25
|
| Rate for Payer: TriWest Veterans Administration |
$114.07
|
| Rate for Payer: United Healthcare Commercial |
$178.58
|
| Rate for Payer: United Healthcare Medicare |
$114.07
|
| Rate for Payer: WINHealth Partners Commercial |
$177.65
|
| Rate for Payer: Wise Provider Network Commercial |
$177.65
|
|
|
HC ASSAY OF NEURONTIN/GABAPENTIN
|
Facility
|
OP
|
$187.00
|
|
|
Service Code
|
HCPCS 80171
|
| Hospital Charge Code |
3018017101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$101.26 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$183.26
|
| Rate for Payer: Aetna of WY Medicare |
$123.42
|
| Rate for Payer: Altius Commercial |
$179.52
|
| Rate for Payer: Beech Street Commercial |
$183.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$181.39
|
| Rate for Payer: Cash Price |
$130.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$181.39
|
| Rate for Payer: Cigna of WY Commercial |
$183.26
|
| Rate for Payer: Entrust Commercial |
$177.65
|
| Rate for Payer: First Choice Health Commercial |
$177.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$177.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$106.59
|
| Rate for Payer: HealthUtah PPO |
$187.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$181.39
|
| Rate for Payer: Multiplan Medicare/VA |
$101.26
|
| Rate for Payer: One Health Plan of WY PPO |
$183.26
|
| Rate for Payer: PacificSource Commercial |
$168.30
|
| Rate for Payer: PHCS PPO |
$183.26
|
| Rate for Payer: Three Rivers PPO |
$140.25
|
| Rate for Payer: TriWest Veterans Administration |
$106.59
|
| Rate for Payer: United Healthcare Commercial |
$178.58
|
| Rate for Payer: United Healthcare Medicare |
$106.59
|
| Rate for Payer: WINHealth Partners Commercial |
$183.26
|
| Rate for Payer: Wise Provider Network Commercial |
$177.65
|
|
|
HC ASSAY OF NICKEL
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
HCPCS 83885
|
| Hospital Charge Code |
3018388502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.26 |
| Max. Negotiated Rate |
$211.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$206.78
|
| Rate for Payer: Aetna of WY Medicare |
$139.26
|
| Rate for Payer: Altius Commercial |
$202.56
|
| Rate for Payer: Beech Street Commercial |
$206.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$204.67
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$204.67
|
| Rate for Payer: Cigna of WY Commercial |
$206.78
|
| Rate for Payer: Entrust Commercial |
$200.45
|
| Rate for Payer: First Choice Health Commercial |
$200.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$200.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$120.27
|
| Rate for Payer: HealthUtah PPO |
$211.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$204.67
|
| Rate for Payer: Multiplan Medicare/VA |
$114.26
|
| Rate for Payer: One Health Plan of WY PPO |
$206.78
|
| Rate for Payer: PacificSource Commercial |
$189.90
|
| Rate for Payer: PHCS PPO |
$206.78
|
| Rate for Payer: Three Rivers PPO |
$158.25
|
| Rate for Payer: TriWest Veterans Administration |
$120.27
|
| Rate for Payer: United Healthcare Commercial |
$201.50
|
| Rate for Payer: United Healthcare Medicare |
$120.27
|
| Rate for Payer: WINHealth Partners Commercial |
$206.78
|
| Rate for Payer: Wise Provider Network Commercial |
$200.45
|
|
|
HC ASSAY OF NICKEL
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
HCPCS 83885
|
| Hospital Charge Code |
3018388502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$122.27 |
| Max. Negotiated Rate |
$211.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$206.78
|
| Rate for Payer: Aetna of WY Medicare |
$135.04
|
| Rate for Payer: Altius Commercial |
$202.56
|
| Rate for Payer: Beech Street Commercial |
$206.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$204.67
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$204.67
|
| Rate for Payer: Cigna of WY Commercial |
$206.78
|
| Rate for Payer: Entrust Commercial |
$200.45
|
| Rate for Payer: First Choice Health Commercial |
$200.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$200.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$128.71
|
| Rate for Payer: HealthUtah PPO |
$211.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$204.67
|
| Rate for Payer: Multiplan Medicare/VA |
$122.27
|
| Rate for Payer: One Health Plan of WY PPO |
$206.78
|
| Rate for Payer: PacificSource Commercial |
$189.90
|
| Rate for Payer: PHCS PPO |
$206.78
|
| Rate for Payer: Three Rivers PPO |
$158.25
|
| Rate for Payer: TriWest Veterans Administration |
$128.71
|
| Rate for Payer: United Healthcare Commercial |
$201.50
|
| Rate for Payer: United Healthcare Medicare |
$128.71
|
| Rate for Payer: WINHealth Partners Commercial |
$200.45
|
| Rate for Payer: Wise Provider Network Commercial |
$200.45
|
|
|
HC ASSAY OF NUCLEAR MATRIX PROTEIN 22 (NMP22)
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
HCPCS 86386
|
| Hospital Charge Code |
3008638601
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.22 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$147.00
|
| Rate for Payer: Aetna of WY Medicare |
$99.00
|
| Rate for Payer: Altius Commercial |
$144.00
|
| Rate for Payer: Beech Street Commercial |
$147.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$145.50
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$145.50
|
| Rate for Payer: Cigna of WY Commercial |
$147.00
|
| Rate for Payer: Entrust Commercial |
$142.50
|
| Rate for Payer: First Choice Health Commercial |
$142.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$142.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$85.50
|
| Rate for Payer: HealthUtah PPO |
$150.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$145.50
|
| Rate for Payer: Multiplan Medicare/VA |
$81.22
|
| Rate for Payer: One Health Plan of WY PPO |
$147.00
|
| Rate for Payer: PacificSource Commercial |
$135.00
|
| Rate for Payer: PHCS PPO |
$147.00
|
| Rate for Payer: Three Rivers PPO |
$112.50
|
| Rate for Payer: TriWest Veterans Administration |
$85.50
|
| Rate for Payer: United Healthcare Commercial |
$143.25
|
| Rate for Payer: United Healthcare Medicare |
$85.50
|
| Rate for Payer: WINHealth Partners Commercial |
$147.00
|
| Rate for Payer: Wise Provider Network Commercial |
$142.50
|
|
|
HC ASSAY OF NUCLEAR MATRIX PROTEIN 22 (NMP22)
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
HCPCS 86386
|
| Hospital Charge Code |
3008638601
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$86.92 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$147.00
|
| Rate for Payer: Aetna of WY Medicare |
$96.00
|
| Rate for Payer: Altius Commercial |
$144.00
|
| Rate for Payer: Beech Street Commercial |
$147.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$145.50
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$145.50
|
| Rate for Payer: Cigna of WY Commercial |
$147.00
|
| Rate for Payer: Entrust Commercial |
$142.50
|
| Rate for Payer: First Choice Health Commercial |
$142.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$142.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$91.50
|
| Rate for Payer: HealthUtah PPO |
$150.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$145.50
|
| Rate for Payer: Multiplan Medicare/VA |
$86.92
|
| Rate for Payer: One Health Plan of WY PPO |
$147.00
|
| Rate for Payer: PacificSource Commercial |
$135.00
|
| Rate for Payer: PHCS PPO |
$147.00
|
| Rate for Payer: Three Rivers PPO |
$112.50
|
| Rate for Payer: TriWest Veterans Administration |
$91.50
|
| Rate for Payer: United Healthcare Commercial |
$143.25
|
| Rate for Payer: United Healthcare Medicare |
$91.50
|
| Rate for Payer: WINHealth Partners Commercial |
$142.50
|
| Rate for Payer: Wise Provider Network Commercial |
$142.50
|
|
|
HC ASSAY OF OSTEOCALCIN - OSTEOCALCIN
|
Facility
|
OP
|
$258.00
|
|
|
Service Code
|
HCPCS 83937
|
| Hospital Charge Code |
3018393701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$139.71 |
| Max. Negotiated Rate |
$258.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$252.84
|
| Rate for Payer: Aetna of WY Medicare |
$170.28
|
| Rate for Payer: Altius Commercial |
$247.68
|
| Rate for Payer: Beech Street Commercial |
$252.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$250.26
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$250.26
|
| Rate for Payer: Cigna of WY Commercial |
$252.84
|
| Rate for Payer: Entrust Commercial |
$245.10
|
| Rate for Payer: First Choice Health Commercial |
$245.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$245.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$147.06
|
| Rate for Payer: HealthUtah PPO |
$258.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$250.26
|
| Rate for Payer: Multiplan Medicare/VA |
$139.71
|
| Rate for Payer: One Health Plan of WY PPO |
$252.84
|
| Rate for Payer: PacificSource Commercial |
$232.20
|
| Rate for Payer: PHCS PPO |
$252.84
|
| Rate for Payer: Three Rivers PPO |
$193.50
|
| Rate for Payer: TriWest Veterans Administration |
$147.06
|
| Rate for Payer: United Healthcare Commercial |
$246.39
|
| Rate for Payer: United Healthcare Medicare |
$147.06
|
| Rate for Payer: WINHealth Partners Commercial |
$252.84
|
| Rate for Payer: Wise Provider Network Commercial |
$245.10
|
|
|
HC ASSAY OF OSTEOCALCIN - OSTEOCALCIN
|
Facility
|
IP
|
$258.00
|
|
|
Service Code
|
HCPCS 83937
|
| Hospital Charge Code |
3018393701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$258.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$252.84
|
| Rate for Payer: Aetna of WY Medicare |
$165.12
|
| Rate for Payer: Altius Commercial |
$247.68
|
| Rate for Payer: Beech Street Commercial |
$252.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$250.26
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$250.26
|
| Rate for Payer: Cigna of WY Commercial |
$252.84
|
| Rate for Payer: Entrust Commercial |
$245.10
|
| Rate for Payer: First Choice Health Commercial |
$245.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$245.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$157.38
|
| Rate for Payer: HealthUtah PPO |
$258.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$250.26
|
| Rate for Payer: Multiplan Medicare/VA |
$149.51
|
| Rate for Payer: One Health Plan of WY PPO |
$252.84
|
| Rate for Payer: PacificSource Commercial |
$232.20
|
| Rate for Payer: PHCS PPO |
$252.84
|
| Rate for Payer: Three Rivers PPO |
$193.50
|
| Rate for Payer: TriWest Veterans Administration |
$157.38
|
| Rate for Payer: United Healthcare Commercial |
$246.39
|
| Rate for Payer: United Healthcare Medicare |
$157.38
|
| Rate for Payer: WINHealth Partners Commercial |
$245.10
|
| Rate for Payer: Wise Provider Network Commercial |
$245.10
|
|
|
HC ASSAY OF OTHER SOURCE ALBUMIN - ALBUMIN
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
HCPCS 82042
|
| Hospital Charge Code |
3018204204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.06 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$111.72
|
| Rate for Payer: Aetna of WY Medicare |
$72.96
|
| Rate for Payer: Altius Commercial |
$109.44
|
| Rate for Payer: Beech Street Commercial |
$111.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$110.58
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$110.58
|
| Rate for Payer: Cigna of WY Commercial |
$111.72
|
| Rate for Payer: Entrust Commercial |
$108.30
|
| Rate for Payer: First Choice Health Commercial |
$108.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$108.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$69.54
|
| Rate for Payer: HealthUtah PPO |
$114.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$110.58
|
| Rate for Payer: Multiplan Medicare/VA |
$66.06
|
| Rate for Payer: One Health Plan of WY PPO |
$111.72
|
| Rate for Payer: PacificSource Commercial |
$102.60
|
| Rate for Payer: PHCS PPO |
$111.72
|
| Rate for Payer: Three Rivers PPO |
$85.50
|
| Rate for Payer: TriWest Veterans Administration |
$69.54
|
| Rate for Payer: United Healthcare Commercial |
$108.87
|
| Rate for Payer: United Healthcare Medicare |
$69.54
|
| Rate for Payer: WINHealth Partners Commercial |
$108.30
|
| Rate for Payer: Wise Provider Network Commercial |
$108.30
|
|
|
HC ASSAY OF OTHER SOURCE ALBUMIN - ALBUMIN
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
HCPCS 82042
|
| Hospital Charge Code |
3018204204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.73 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$111.72
|
| Rate for Payer: Aetna of WY Medicare |
$75.24
|
| Rate for Payer: Altius Commercial |
$109.44
|
| Rate for Payer: Beech Street Commercial |
$111.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$110.58
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$110.58
|
| Rate for Payer: Cigna of WY Commercial |
$111.72
|
| Rate for Payer: Entrust Commercial |
$108.30
|
| Rate for Payer: First Choice Health Commercial |
$108.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$108.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$64.98
|
| Rate for Payer: HealthUtah PPO |
$114.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$110.58
|
| Rate for Payer: Multiplan Medicare/VA |
$61.73
|
| Rate for Payer: One Health Plan of WY PPO |
$111.72
|
| Rate for Payer: PacificSource Commercial |
$102.60
|
| Rate for Payer: PHCS PPO |
$111.72
|
| Rate for Payer: Three Rivers PPO |
$85.50
|
| Rate for Payer: TriWest Veterans Administration |
$64.98
|
| Rate for Payer: United Healthcare Commercial |
$108.87
|
| Rate for Payer: United Healthcare Medicare |
$64.98
|
| Rate for Payer: WINHealth Partners Commercial |
$111.72
|
| Rate for Payer: Wise Provider Network Commercial |
$108.30
|
|
|
HC ASSAY OF OXALATE - OXALATE 24HR URINE
|
Facility
|
IP
|
$257.00
|
|
|
Service Code
|
HCPCS 83945
|
| Hospital Charge Code |
3018394501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.93 |
| Max. Negotiated Rate |
$257.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$251.86
|
| Rate for Payer: Aetna of WY Medicare |
$164.48
|
| Rate for Payer: Altius Commercial |
$246.72
|
| Rate for Payer: Beech Street Commercial |
$251.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$249.29
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$249.29
|
| Rate for Payer: Cigna of WY Commercial |
$251.86
|
| Rate for Payer: Entrust Commercial |
$244.15
|
| Rate for Payer: First Choice Health Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$156.77
|
| Rate for Payer: HealthUtah PPO |
$257.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$249.29
|
| Rate for Payer: Multiplan Medicare/VA |
$148.93
|
| Rate for Payer: One Health Plan of WY PPO |
$251.86
|
| Rate for Payer: PacificSource Commercial |
$231.30
|
| Rate for Payer: PHCS PPO |
$251.86
|
| Rate for Payer: Three Rivers PPO |
$192.75
|
| Rate for Payer: TriWest Veterans Administration |
$156.77
|
| Rate for Payer: United Healthcare Commercial |
$245.44
|
| Rate for Payer: United Healthcare Medicare |
$156.77
|
| Rate for Payer: WINHealth Partners Commercial |
$244.15
|
| Rate for Payer: Wise Provider Network Commercial |
$244.15
|
|
|
HC ASSAY OF OXALATE - OXALATE 24HR URINE
|
Facility
|
OP
|
$257.00
|
|
|
Service Code
|
HCPCS 83945
|
| Hospital Charge Code |
3018394501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$139.17 |
| Max. Negotiated Rate |
$257.00 |
| Rate for Payer: United Healthcare Commercial |
$245.44
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$251.86
|
| Rate for Payer: Aetna of WY Medicare |
$169.62
|
| Rate for Payer: Altius Commercial |
$246.72
|
| Rate for Payer: Beech Street Commercial |
$251.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$249.29
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$249.29
|
| Rate for Payer: Cigna of WY Commercial |
$251.86
|
| Rate for Payer: Entrust Commercial |
$244.15
|
| Rate for Payer: First Choice Health Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$146.49
|
| Rate for Payer: HealthUtah PPO |
$257.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$249.29
|
| Rate for Payer: Multiplan Medicare/VA |
$139.17
|
| Rate for Payer: One Health Plan of WY PPO |
$251.86
|
| Rate for Payer: PacificSource Commercial |
$231.30
|
| Rate for Payer: PHCS PPO |
$251.86
|
| Rate for Payer: Three Rivers PPO |
$192.75
|
| Rate for Payer: TriWest Veterans Administration |
$146.49
|
| Rate for Payer: United Healthcare Medicare |
$146.49
|
| Rate for Payer: WINHealth Partners Commercial |
$251.86
|
| Rate for Payer: Wise Provider Network Commercial |
$244.15
|
|
|
HC ASSAY OF OXALATE - OXALATE SERUM
|
Facility
|
IP
|
$257.00
|
|
|
Service Code
|
HCPCS 83945
|
| Hospital Charge Code |
3018394502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.93 |
| Max. Negotiated Rate |
$257.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$251.86
|
| Rate for Payer: Aetna of WY Medicare |
$164.48
|
| Rate for Payer: Altius Commercial |
$246.72
|
| Rate for Payer: Beech Street Commercial |
$251.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$249.29
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$249.29
|
| Rate for Payer: Cigna of WY Commercial |
$251.86
|
| Rate for Payer: Entrust Commercial |
$244.15
|
| Rate for Payer: First Choice Health Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$156.77
|
| Rate for Payer: HealthUtah PPO |
$257.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$249.29
|
| Rate for Payer: Multiplan Medicare/VA |
$148.93
|
| Rate for Payer: One Health Plan of WY PPO |
$251.86
|
| Rate for Payer: PacificSource Commercial |
$231.30
|
| Rate for Payer: PHCS PPO |
$251.86
|
| Rate for Payer: Three Rivers PPO |
$192.75
|
| Rate for Payer: TriWest Veterans Administration |
$156.77
|
| Rate for Payer: United Healthcare Commercial |
$245.44
|
| Rate for Payer: United Healthcare Medicare |
$156.77
|
| Rate for Payer: WINHealth Partners Commercial |
$244.15
|
| Rate for Payer: Wise Provider Network Commercial |
$244.15
|
|
|
HC ASSAY OF OXALATE - OXALATE SERUM
|
Facility
|
OP
|
$257.00
|
|
|
Service Code
|
HCPCS 83945
|
| Hospital Charge Code |
3018394502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$139.17 |
| Max. Negotiated Rate |
$257.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$251.86
|
| Rate for Payer: Aetna of WY Medicare |
$169.62
|
| Rate for Payer: Altius Commercial |
$246.72
|
| Rate for Payer: Beech Street Commercial |
$251.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$249.29
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$249.29
|
| Rate for Payer: Cigna of WY Commercial |
$251.86
|
| Rate for Payer: Entrust Commercial |
$244.15
|
| Rate for Payer: First Choice Health Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$244.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$146.49
|
| Rate for Payer: HealthUtah PPO |
$257.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$249.29
|
| Rate for Payer: Multiplan Medicare/VA |
$139.17
|
| Rate for Payer: One Health Plan of WY PPO |
$251.86
|
| Rate for Payer: PacificSource Commercial |
$231.30
|
| Rate for Payer: PHCS PPO |
$251.86
|
| Rate for Payer: Three Rivers PPO |
$192.75
|
| Rate for Payer: TriWest Veterans Administration |
$146.49
|
| Rate for Payer: United Healthcare Commercial |
$245.44
|
| Rate for Payer: United Healthcare Medicare |
$146.49
|
| Rate for Payer: WINHealth Partners Commercial |
$251.86
|
| Rate for Payer: Wise Provider Network Commercial |
$244.15
|
|
|
HC ASSAY OF OXALATE - OXALATE URINE
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
HCPCS 83945
|
| Hospital Charge Code |
3078394501
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$116.48 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$196.98
|
| Rate for Payer: Aetna of WY Medicare |
$128.64
|
| Rate for Payer: Altius Commercial |
$192.96
|
| Rate for Payer: Beech Street Commercial |
$196.98
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$194.97
|
| Rate for Payer: Cash Price |
$140.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$194.97
|
| Rate for Payer: Cigna of WY Commercial |
$196.98
|
| Rate for Payer: Entrust Commercial |
$190.95
|
| Rate for Payer: First Choice Health Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$122.61
|
| Rate for Payer: HealthUtah PPO |
$201.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$194.97
|
| Rate for Payer: Multiplan Medicare/VA |
$116.48
|
| Rate for Payer: One Health Plan of WY PPO |
$196.98
|
| Rate for Payer: PacificSource Commercial |
$180.90
|
| Rate for Payer: PHCS PPO |
$196.98
|
| Rate for Payer: Three Rivers PPO |
$150.75
|
| Rate for Payer: TriWest Veterans Administration |
$122.61
|
| Rate for Payer: United Healthcare Commercial |
$191.96
|
| Rate for Payer: United Healthcare Medicare |
$122.61
|
| Rate for Payer: WINHealth Partners Commercial |
$190.95
|
| Rate for Payer: Wise Provider Network Commercial |
$190.95
|
|
|
HC ASSAY OF OXALATE - OXALATE URINE
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
HCPCS 83945
|
| Hospital Charge Code |
3078394501
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$108.84 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$196.98
|
| Rate for Payer: Aetna of WY Medicare |
$132.66
|
| Rate for Payer: Altius Commercial |
$192.96
|
| Rate for Payer: Beech Street Commercial |
$196.98
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$194.97
|
| Rate for Payer: Cash Price |
$140.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$194.97
|
| Rate for Payer: Cigna of WY Commercial |
$196.98
|
| Rate for Payer: Entrust Commercial |
$190.95
|
| Rate for Payer: First Choice Health Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$114.57
|
| Rate for Payer: HealthUtah PPO |
$201.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$194.97
|
| Rate for Payer: Multiplan Medicare/VA |
$108.84
|
| Rate for Payer: One Health Plan of WY PPO |
$196.98
|
| Rate for Payer: PacificSource Commercial |
$180.90
|
| Rate for Payer: PHCS PPO |
$196.98
|
| Rate for Payer: Three Rivers PPO |
$150.75
|
| Rate for Payer: TriWest Veterans Administration |
$114.57
|
| Rate for Payer: United Healthcare Commercial |
$191.96
|
| Rate for Payer: United Healthcare Medicare |
$114.57
|
| Rate for Payer: WINHealth Partners Commercial |
$196.98
|
| Rate for Payer: Wise Provider Network Commercial |
$190.95
|
|
|
HC ASSAY OF PARATHORMONE - PTH INTACT
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS 83970
|
| Hospital Charge Code |
3018397001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$141.33 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$255.78
|
| Rate for Payer: Aetna of WY Medicare |
$172.26
|
| Rate for Payer: Altius Commercial |
$250.56
|
| Rate for Payer: Beech Street Commercial |
$255.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$253.17
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$253.17
|
| Rate for Payer: Cigna of WY Commercial |
$255.78
|
| Rate for Payer: Entrust Commercial |
$247.95
|
| Rate for Payer: First Choice Health Commercial |
$247.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$247.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$148.77
|
| Rate for Payer: HealthUtah PPO |
$261.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$253.17
|
| Rate for Payer: Multiplan Medicare/VA |
$141.33
|
| Rate for Payer: One Health Plan of WY PPO |
$255.78
|
| Rate for Payer: PacificSource Commercial |
$234.90
|
| Rate for Payer: PHCS PPO |
$255.78
|
| Rate for Payer: Three Rivers PPO |
$195.75
|
| Rate for Payer: TriWest Veterans Administration |
$148.77
|
| Rate for Payer: United Healthcare Commercial |
$249.26
|
| Rate for Payer: United Healthcare Medicare |
$148.77
|
| Rate for Payer: WINHealth Partners Commercial |
$255.78
|
| Rate for Payer: Wise Provider Network Commercial |
$247.95
|
|
