|
HC ASSAY OF PROGESTERONE 17-D - 17-HYDROXYPROGESTERONE
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
HCPCS 83498
|
| Hospital Charge Code |
3018349801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$101.80 |
| Max. Negotiated Rate |
$188.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$184.24
|
| Rate for Payer: Aetna of WY Medicare |
$124.08
|
| Rate for Payer: Altius Commercial |
$180.48
|
| Rate for Payer: Beech Street Commercial |
$184.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$182.36
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$182.36
|
| Rate for Payer: Cigna of WY Commercial |
$184.24
|
| Rate for Payer: Entrust Commercial |
$178.60
|
| Rate for Payer: First Choice Health Commercial |
$178.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$178.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$107.16
|
| Rate for Payer: HealthUtah PPO |
$188.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$182.36
|
| Rate for Payer: Multiplan Medicare/VA |
$101.80
|
| Rate for Payer: One Health Plan of WY PPO |
$184.24
|
| Rate for Payer: PacificSource Commercial |
$169.20
|
| Rate for Payer: PHCS PPO |
$184.24
|
| Rate for Payer: Three Rivers PPO |
$141.00
|
| Rate for Payer: TriWest Veterans Administration |
$107.16
|
| Rate for Payer: United Healthcare Commercial |
$179.54
|
| Rate for Payer: United Healthcare Medicare |
$107.16
|
| Rate for Payer: WINHealth Partners Commercial |
$184.24
|
| Rate for Payer: Wise Provider Network Commercial |
$178.60
|
|
|
HC ASSAY OF PROGESTERONE 17-D - 17-HYDROXYPROGESTERONE
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
HCPCS 83498
|
| Hospital Charge Code |
3018349801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.95 |
| Max. Negotiated Rate |
$188.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$184.24
|
| Rate for Payer: Aetna of WY Medicare |
$120.32
|
| Rate for Payer: Altius Commercial |
$180.48
|
| Rate for Payer: Beech Street Commercial |
$184.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$182.36
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$182.36
|
| Rate for Payer: Cigna of WY Commercial |
$184.24
|
| Rate for Payer: Entrust Commercial |
$178.60
|
| Rate for Payer: First Choice Health Commercial |
$178.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$178.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$114.68
|
| Rate for Payer: HealthUtah PPO |
$188.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$182.36
|
| Rate for Payer: Multiplan Medicare/VA |
$108.95
|
| Rate for Payer: One Health Plan of WY PPO |
$184.24
|
| Rate for Payer: PacificSource Commercial |
$169.20
|
| Rate for Payer: PHCS PPO |
$184.24
|
| Rate for Payer: Three Rivers PPO |
$141.00
|
| Rate for Payer: TriWest Veterans Administration |
$114.68
|
| Rate for Payer: United Healthcare Commercial |
$179.54
|
| Rate for Payer: United Healthcare Medicare |
$114.68
|
| Rate for Payer: WINHealth Partners Commercial |
$178.60
|
| Rate for Payer: Wise Provider Network Commercial |
$178.60
|
|
|
HC ASSAY OF PROGESTERONE - PROGESTERONE
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
HCPCS 84144
|
| Hospital Charge Code |
3018414401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$132.13 |
| Max. Negotiated Rate |
$244.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$239.12
|
| Rate for Payer: Aetna of WY Medicare |
$161.04
|
| Rate for Payer: Altius Commercial |
$234.24
|
| Rate for Payer: Beech Street Commercial |
$239.12
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$236.68
|
| Rate for Payer: Cash Price |
$170.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$236.68
|
| Rate for Payer: Cigna of WY Commercial |
$239.12
|
| Rate for Payer: Entrust Commercial |
$231.80
|
| Rate for Payer: First Choice Health Commercial |
$231.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$231.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$139.08
|
| Rate for Payer: HealthUtah PPO |
$244.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$236.68
|
| Rate for Payer: Multiplan Medicare/VA |
$132.13
|
| Rate for Payer: One Health Plan of WY PPO |
$239.12
|
| Rate for Payer: PacificSource Commercial |
$219.60
|
| Rate for Payer: PHCS PPO |
$239.12
|
| Rate for Payer: Three Rivers PPO |
$183.00
|
| Rate for Payer: TriWest Veterans Administration |
$139.08
|
| Rate for Payer: United Healthcare Commercial |
$233.02
|
| Rate for Payer: United Healthcare Medicare |
$139.08
|
| Rate for Payer: WINHealth Partners Commercial |
$239.12
|
| Rate for Payer: Wise Provider Network Commercial |
$231.80
|
|
|
HC ASSAY OF PROGESTERONE - PROGESTERONE
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
HCPCS 84144
|
| Hospital Charge Code |
3018414401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$141.40 |
| Max. Negotiated Rate |
$244.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$239.12
|
| Rate for Payer: Aetna of WY Medicare |
$156.16
|
| Rate for Payer: Altius Commercial |
$234.24
|
| Rate for Payer: Beech Street Commercial |
$239.12
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$236.68
|
| Rate for Payer: Cash Price |
$170.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$236.68
|
| Rate for Payer: Cigna of WY Commercial |
$239.12
|
| Rate for Payer: Entrust Commercial |
$231.80
|
| Rate for Payer: First Choice Health Commercial |
$231.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$231.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$148.84
|
| Rate for Payer: HealthUtah PPO |
$244.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$236.68
|
| Rate for Payer: Multiplan Medicare/VA |
$141.40
|
| Rate for Payer: One Health Plan of WY PPO |
$239.12
|
| Rate for Payer: PacificSource Commercial |
$219.60
|
| Rate for Payer: PHCS PPO |
$239.12
|
| Rate for Payer: Three Rivers PPO |
$183.00
|
| Rate for Payer: TriWest Veterans Administration |
$148.84
|
| Rate for Payer: United Healthcare Commercial |
$233.02
|
| Rate for Payer: United Healthcare Medicare |
$148.84
|
| Rate for Payer: WINHealth Partners Commercial |
$231.80
|
| Rate for Payer: Wise Provider Network Commercial |
$231.80
|
|
|
HC ASSAY OF PROINSULIN - PROINSULIN
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
HCPCS 84206
|
| Hospital Charge Code |
3018420601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$124.54 |
| Max. Negotiated Rate |
$230.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$225.40
|
| Rate for Payer: Aetna of WY Medicare |
$151.80
|
| Rate for Payer: Altius Commercial |
$220.80
|
| Rate for Payer: Beech Street Commercial |
$225.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$223.10
|
| Rate for Payer: Cash Price |
$161.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$223.10
|
| Rate for Payer: Cigna of WY Commercial |
$225.40
|
| Rate for Payer: Entrust Commercial |
$218.50
|
| Rate for Payer: First Choice Health Commercial |
$218.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$218.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$131.10
|
| Rate for Payer: HealthUtah PPO |
$230.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$223.10
|
| Rate for Payer: Multiplan Medicare/VA |
$124.54
|
| Rate for Payer: One Health Plan of WY PPO |
$225.40
|
| Rate for Payer: PacificSource Commercial |
$207.00
|
| Rate for Payer: PHCS PPO |
$225.40
|
| Rate for Payer: Three Rivers PPO |
$172.50
|
| Rate for Payer: TriWest Veterans Administration |
$131.10
|
| Rate for Payer: United Healthcare Commercial |
$219.65
|
| Rate for Payer: United Healthcare Medicare |
$131.10
|
| Rate for Payer: WINHealth Partners Commercial |
$225.40
|
| Rate for Payer: Wise Provider Network Commercial |
$218.50
|
|
|
HC ASSAY OF PROINSULIN - PROINSULIN
|
Facility
|
IP
|
$230.00
|
|
|
Service Code
|
HCPCS 84206
|
| Hospital Charge Code |
3018420601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$133.28 |
| Max. Negotiated Rate |
$230.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$225.40
|
| Rate for Payer: Aetna of WY Medicare |
$147.20
|
| Rate for Payer: Altius Commercial |
$220.80
|
| Rate for Payer: Beech Street Commercial |
$225.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$223.10
|
| Rate for Payer: Cash Price |
$161.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$223.10
|
| Rate for Payer: Cigna of WY Commercial |
$225.40
|
| Rate for Payer: Entrust Commercial |
$218.50
|
| Rate for Payer: First Choice Health Commercial |
$218.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$218.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$140.30
|
| Rate for Payer: HealthUtah PPO |
$230.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$223.10
|
| Rate for Payer: Multiplan Medicare/VA |
$133.28
|
| Rate for Payer: One Health Plan of WY PPO |
$225.40
|
| Rate for Payer: PacificSource Commercial |
$207.00
|
| Rate for Payer: PHCS PPO |
$225.40
|
| Rate for Payer: Three Rivers PPO |
$172.50
|
| Rate for Payer: TriWest Veterans Administration |
$140.30
|
| Rate for Payer: United Healthcare Commercial |
$219.65
|
| Rate for Payer: United Healthcare Medicare |
$140.30
|
| Rate for Payer: WINHealth Partners Commercial |
$218.50
|
| Rate for Payer: Wise Provider Network Commercial |
$218.50
|
|
|
HC ASSAY OF PROLACTIN - PROLACTIN
|
Facility
|
OP
|
$118.00
|
|
|
Service Code
|
HCPCS 84146
|
| Hospital Charge Code |
3018414601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$118.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$115.64
|
| Rate for Payer: Aetna of WY Medicare |
$77.88
|
| Rate for Payer: Altius Commercial |
$113.28
|
| Rate for Payer: Beech Street Commercial |
$115.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.46
|
| Rate for Payer: Cash Price |
$82.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$114.46
|
| Rate for Payer: Cigna of WY Commercial |
$115.64
|
| Rate for Payer: Entrust Commercial |
$112.10
|
| Rate for Payer: First Choice Health Commercial |
$112.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$112.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$67.26
|
| Rate for Payer: HealthUtah PPO |
$118.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$114.46
|
| Rate for Payer: Multiplan Medicare/VA |
$63.90
|
| Rate for Payer: One Health Plan of WY PPO |
$115.64
|
| Rate for Payer: PacificSource Commercial |
$106.20
|
| Rate for Payer: PHCS PPO |
$115.64
|
| Rate for Payer: Three Rivers PPO |
$88.50
|
| Rate for Payer: TriWest Veterans Administration |
$67.26
|
| Rate for Payer: United Healthcare Commercial |
$112.69
|
| Rate for Payer: United Healthcare Medicare |
$67.26
|
| Rate for Payer: WINHealth Partners Commercial |
$115.64
|
| Rate for Payer: Wise Provider Network Commercial |
$112.10
|
|
|
HC ASSAY OF PROLACTIN - PROLACTIN
|
Facility
|
IP
|
$118.00
|
|
|
Service Code
|
HCPCS 84146
|
| Hospital Charge Code |
3018414601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.38 |
| Max. Negotiated Rate |
$118.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$115.64
|
| Rate for Payer: Aetna of WY Medicare |
$75.52
|
| Rate for Payer: Altius Commercial |
$113.28
|
| Rate for Payer: Beech Street Commercial |
$115.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.46
|
| Rate for Payer: Cash Price |
$82.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$114.46
|
| Rate for Payer: Cigna of WY Commercial |
$115.64
|
| Rate for Payer: Entrust Commercial |
$112.10
|
| Rate for Payer: First Choice Health Commercial |
$112.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$112.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$71.98
|
| Rate for Payer: HealthUtah PPO |
$118.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$114.46
|
| Rate for Payer: Multiplan Medicare/VA |
$68.38
|
| Rate for Payer: One Health Plan of WY PPO |
$115.64
|
| Rate for Payer: PacificSource Commercial |
$106.20
|
| Rate for Payer: PHCS PPO |
$115.64
|
| Rate for Payer: Three Rivers PPO |
$88.50
|
| Rate for Payer: TriWest Veterans Administration |
$71.98
|
| Rate for Payer: United Healthcare Commercial |
$112.69
|
| Rate for Payer: United Healthcare Medicare |
$71.98
|
| Rate for Payer: WINHealth Partners Commercial |
$112.10
|
| Rate for Payer: Wise Provider Network Commercial |
$112.10
|
|
|
HC ASSAY OF PROSTAGLANDIN - PROSTAGLANDIN E2, URINE
|
Facility
|
OP
|
$361.00
|
|
|
Service Code
|
HCPCS 84150
|
| Hospital Charge Code |
3018415002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$195.48 |
| Max. Negotiated Rate |
$361.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$353.78
|
| Rate for Payer: Aetna of WY Medicare |
$238.26
|
| Rate for Payer: Altius Commercial |
$346.56
|
| Rate for Payer: Beech Street Commercial |
$353.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$350.17
|
| Rate for Payer: Cash Price |
$252.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$350.17
|
| Rate for Payer: Cigna of WY Commercial |
$353.78
|
| Rate for Payer: Entrust Commercial |
$342.95
|
| Rate for Payer: First Choice Health Commercial |
$342.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$342.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$205.77
|
| Rate for Payer: HealthUtah PPO |
$361.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$350.17
|
| Rate for Payer: Multiplan Medicare/VA |
$195.48
|
| Rate for Payer: One Health Plan of WY PPO |
$353.78
|
| Rate for Payer: PacificSource Commercial |
$324.90
|
| Rate for Payer: PHCS PPO |
$353.78
|
| Rate for Payer: Three Rivers PPO |
$270.75
|
| Rate for Payer: TriWest Veterans Administration |
$205.77
|
| Rate for Payer: United Healthcare Commercial |
$344.76
|
| Rate for Payer: United Healthcare Medicare |
$205.77
|
| Rate for Payer: WINHealth Partners Commercial |
$353.78
|
| Rate for Payer: Wise Provider Network Commercial |
$342.95
|
|
|
HC ASSAY OF PROSTAGLANDIN - PROSTAGLANDIN E2, URINE
|
Facility
|
IP
|
$361.00
|
|
|
Service Code
|
HCPCS 84150
|
| Hospital Charge Code |
3018415002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$209.20 |
| Max. Negotiated Rate |
$361.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$353.78
|
| Rate for Payer: Aetna of WY Medicare |
$231.04
|
| Rate for Payer: Altius Commercial |
$346.56
|
| Rate for Payer: Beech Street Commercial |
$353.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$350.17
|
| Rate for Payer: Cash Price |
$252.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$350.17
|
| Rate for Payer: Cigna of WY Commercial |
$353.78
|
| Rate for Payer: Entrust Commercial |
$342.95
|
| Rate for Payer: First Choice Health Commercial |
$342.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$342.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$220.21
|
| Rate for Payer: HealthUtah PPO |
$361.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$350.17
|
| Rate for Payer: Multiplan Medicare/VA |
$209.20
|
| Rate for Payer: One Health Plan of WY PPO |
$353.78
|
| Rate for Payer: PacificSource Commercial |
$324.90
|
| Rate for Payer: PHCS PPO |
$353.78
|
| Rate for Payer: Three Rivers PPO |
$270.75
|
| Rate for Payer: TriWest Veterans Administration |
$220.21
|
| Rate for Payer: United Healthcare Commercial |
$344.76
|
| Rate for Payer: United Healthcare Medicare |
$220.21
|
| Rate for Payer: WINHealth Partners Commercial |
$342.95
|
| Rate for Payer: Wise Provider Network Commercial |
$342.95
|
|
|
HC ASSAY OF PYRUVATE - PYRUVIC ACID
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
HCPCS 84210
|
| Hospital Charge Code |
3018421001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.73 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Aetna of WY Medicare |
$58.24
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$88.27
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$55.51
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$52.73
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$55.51
|
| Rate for Payer: United Healthcare Commercial |
$86.90
|
| Rate for Payer: United Healthcare Medicare |
$55.51
|
| Rate for Payer: WINHealth Partners Commercial |
$86.45
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
HC ASSAY OF PYRUVATE - PYRUVIC ACID
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
HCPCS 84210
|
| Hospital Charge Code |
3018421001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.28 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$89.18
|
| Rate for Payer: Aetna of WY Medicare |
$60.06
|
| Rate for Payer: Altius Commercial |
$87.36
|
| Rate for Payer: Beech Street Commercial |
$89.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$88.27
|
| Rate for Payer: Cash Price |
$63.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$88.27
|
| Rate for Payer: Cigna of WY Commercial |
$89.18
|
| Rate for Payer: Entrust Commercial |
$86.45
|
| Rate for Payer: First Choice Health Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$86.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.87
|
| Rate for Payer: HealthUtah PPO |
$91.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$88.27
|
| Rate for Payer: Multiplan Medicare/VA |
$49.28
|
| Rate for Payer: One Health Plan of WY PPO |
$89.18
|
| Rate for Payer: PacificSource Commercial |
$81.90
|
| Rate for Payer: PHCS PPO |
$89.18
|
| Rate for Payer: Three Rivers PPO |
$68.25
|
| Rate for Payer: TriWest Veterans Administration |
$51.87
|
| Rate for Payer: United Healthcare Commercial |
$86.90
|
| Rate for Payer: United Healthcare Medicare |
$51.87
|
| Rate for Payer: WINHealth Partners Commercial |
$89.18
|
| Rate for Payer: Wise Provider Network Commercial |
$86.45
|
|
|
HC ASSAY OF QUINIDINE - QUINIDINE LEVEL
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
HCPCS 80194
|
| Hospital Charge Code |
3018019401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.77 |
| Max. Negotiated Rate |
$127.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$124.46
|
| Rate for Payer: Aetna of WY Medicare |
$83.82
|
| Rate for Payer: Altius Commercial |
$121.92
|
| Rate for Payer: Beech Street Commercial |
$124.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$123.19
|
| Rate for Payer: Cash Price |
$88.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$123.19
|
| Rate for Payer: Cigna of WY Commercial |
$124.46
|
| Rate for Payer: Entrust Commercial |
$120.65
|
| Rate for Payer: First Choice Health Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$72.39
|
| Rate for Payer: HealthUtah PPO |
$127.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$123.19
|
| Rate for Payer: Multiplan Medicare/VA |
$68.77
|
| Rate for Payer: One Health Plan of WY PPO |
$124.46
|
| Rate for Payer: PacificSource Commercial |
$114.30
|
| Rate for Payer: PHCS PPO |
$124.46
|
| Rate for Payer: Three Rivers PPO |
$95.25
|
| Rate for Payer: TriWest Veterans Administration |
$72.39
|
| Rate for Payer: United Healthcare Commercial |
$121.28
|
| Rate for Payer: United Healthcare Medicare |
$72.39
|
| Rate for Payer: WINHealth Partners Commercial |
$124.46
|
| Rate for Payer: Wise Provider Network Commercial |
$120.65
|
|
|
HC ASSAY OF QUINIDINE - QUINIDINE LEVEL
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
HCPCS 80194
|
| Hospital Charge Code |
3018019401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$127.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$124.46
|
| Rate for Payer: Aetna of WY Medicare |
$81.28
|
| Rate for Payer: Altius Commercial |
$121.92
|
| Rate for Payer: Beech Street Commercial |
$124.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$123.19
|
| Rate for Payer: Cash Price |
$88.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$123.19
|
| Rate for Payer: Cigna of WY Commercial |
$124.46
|
| Rate for Payer: Entrust Commercial |
$120.65
|
| Rate for Payer: First Choice Health Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$120.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$77.47
|
| Rate for Payer: HealthUtah PPO |
$127.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$123.19
|
| Rate for Payer: Multiplan Medicare/VA |
$73.60
|
| Rate for Payer: One Health Plan of WY PPO |
$124.46
|
| Rate for Payer: PacificSource Commercial |
$114.30
|
| Rate for Payer: PHCS PPO |
$124.46
|
| Rate for Payer: Three Rivers PPO |
$95.25
|
| Rate for Payer: TriWest Veterans Administration |
$77.47
|
| Rate for Payer: United Healthcare Commercial |
$121.28
|
| Rate for Payer: United Healthcare Medicare |
$77.47
|
| Rate for Payer: WINHealth Partners Commercial |
$120.65
|
| Rate for Payer: Wise Provider Network Commercial |
$120.65
|
|
|
HC ASSAY OF RENIN - RENIN DIRECT ASSAY
|
Facility
|
IP
|
$223.00
|
|
|
Service Code
|
HCPCS 84244
|
| Hospital Charge Code |
3018424401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$129.23 |
| Max. Negotiated Rate |
$223.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$218.54
|
| Rate for Payer: Aetna of WY Medicare |
$142.72
|
| Rate for Payer: Altius Commercial |
$214.08
|
| Rate for Payer: Beech Street Commercial |
$218.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$216.31
|
| Rate for Payer: Cash Price |
$156.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$216.31
|
| Rate for Payer: Cigna of WY Commercial |
$218.54
|
| Rate for Payer: Entrust Commercial |
$211.85
|
| Rate for Payer: First Choice Health Commercial |
$211.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$211.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$136.03
|
| Rate for Payer: HealthUtah PPO |
$223.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$216.31
|
| Rate for Payer: Multiplan Medicare/VA |
$129.23
|
| Rate for Payer: One Health Plan of WY PPO |
$218.54
|
| Rate for Payer: PacificSource Commercial |
$200.70
|
| Rate for Payer: PHCS PPO |
$218.54
|
| Rate for Payer: Three Rivers PPO |
$167.25
|
| Rate for Payer: TriWest Veterans Administration |
$136.03
|
| Rate for Payer: United Healthcare Commercial |
$212.96
|
| Rate for Payer: United Healthcare Medicare |
$136.03
|
| Rate for Payer: WINHealth Partners Commercial |
$211.85
|
| Rate for Payer: Wise Provider Network Commercial |
$211.85
|
|
|
HC ASSAY OF RENIN - RENIN DIRECT ASSAY
|
Facility
|
OP
|
$223.00
|
|
|
Service Code
|
HCPCS 84244
|
| Hospital Charge Code |
3018424401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$120.75 |
| Max. Negotiated Rate |
$223.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$218.54
|
| Rate for Payer: Aetna of WY Medicare |
$147.18
|
| Rate for Payer: Altius Commercial |
$214.08
|
| Rate for Payer: Beech Street Commercial |
$218.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$216.31
|
| Rate for Payer: Cash Price |
$156.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$216.31
|
| Rate for Payer: Cigna of WY Commercial |
$218.54
|
| Rate for Payer: Entrust Commercial |
$211.85
|
| Rate for Payer: First Choice Health Commercial |
$211.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$211.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$127.11
|
| Rate for Payer: HealthUtah PPO |
$223.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$216.31
|
| Rate for Payer: Multiplan Medicare/VA |
$120.75
|
| Rate for Payer: One Health Plan of WY PPO |
$218.54
|
| Rate for Payer: PacificSource Commercial |
$200.70
|
| Rate for Payer: PHCS PPO |
$218.54
|
| Rate for Payer: Three Rivers PPO |
$167.25
|
| Rate for Payer: TriWest Veterans Administration |
$127.11
|
| Rate for Payer: United Healthcare Commercial |
$212.96
|
| Rate for Payer: United Healthcare Medicare |
$127.11
|
| Rate for Payer: WINHealth Partners Commercial |
$218.54
|
| Rate for Payer: Wise Provider Network Commercial |
$211.85
|
|
|
HC ASSAY OF SALICYLATE
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
HCPCS 80179
|
| Hospital Charge Code |
3018017901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$83.30
|
| Rate for Payer: Aetna of WY Medicare |
$56.10
|
| Rate for Payer: Altius Commercial |
$81.60
|
| Rate for Payer: Beech Street Commercial |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$82.45
|
| Rate for Payer: Cash Price |
$59.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$82.45
|
| Rate for Payer: Cigna of WY Commercial |
$83.30
|
| Rate for Payer: Entrust Commercial |
$80.75
|
| Rate for Payer: First Choice Health Commercial |
$80.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$80.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$48.45
|
| Rate for Payer: HealthUtah PPO |
$85.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$82.45
|
| Rate for Payer: Multiplan Medicare/VA |
$46.03
|
| Rate for Payer: One Health Plan of WY PPO |
$83.30
|
| Rate for Payer: PacificSource Commercial |
$76.50
|
| Rate for Payer: PHCS PPO |
$83.30
|
| Rate for Payer: Three Rivers PPO |
$63.75
|
| Rate for Payer: TriWest Veterans Administration |
$48.45
|
| Rate for Payer: United Healthcare Commercial |
$81.18
|
| Rate for Payer: United Healthcare Medicare |
$48.45
|
| Rate for Payer: WINHealth Partners Commercial |
$83.30
|
| Rate for Payer: Wise Provider Network Commercial |
$80.75
|
|
|
HC ASSAY OF SALICYLATE
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
HCPCS 80179
|
| Hospital Charge Code |
3018017901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.26 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$83.30
|
| Rate for Payer: Aetna of WY Medicare |
$54.40
|
| Rate for Payer: Altius Commercial |
$81.60
|
| Rate for Payer: Beech Street Commercial |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$82.45
|
| Rate for Payer: Cash Price |
$59.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$82.45
|
| Rate for Payer: Cigna of WY Commercial |
$83.30
|
| Rate for Payer: Entrust Commercial |
$80.75
|
| Rate for Payer: First Choice Health Commercial |
$80.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$80.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.85
|
| Rate for Payer: HealthUtah PPO |
$85.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$82.45
|
| Rate for Payer: Multiplan Medicare/VA |
$49.26
|
| Rate for Payer: One Health Plan of WY PPO |
$83.30
|
| Rate for Payer: PacificSource Commercial |
$76.50
|
| Rate for Payer: PHCS PPO |
$83.30
|
| Rate for Payer: Three Rivers PPO |
$63.75
|
| Rate for Payer: TriWest Veterans Administration |
$51.85
|
| Rate for Payer: United Healthcare Commercial |
$81.18
|
| Rate for Payer: United Healthcare Medicare |
$51.85
|
| Rate for Payer: WINHealth Partners Commercial |
$80.75
|
| Rate for Payer: Wise Provider Network Commercial |
$80.75
|
|
|
HC ASSAY OF SELENIUM - SELENIUM SERUM
|
Facility
|
OP
|
$176.00
|
|
|
Service Code
|
HCPCS 84255
|
| Hospital Charge Code |
3018425501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$95.30 |
| Max. Negotiated Rate |
$176.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$172.48
|
| Rate for Payer: Aetna of WY Medicare |
$116.16
|
| Rate for Payer: Altius Commercial |
$168.96
|
| Rate for Payer: Beech Street Commercial |
$172.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$170.72
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$170.72
|
| Rate for Payer: Cigna of WY Commercial |
$172.48
|
| Rate for Payer: Entrust Commercial |
$167.20
|
| Rate for Payer: First Choice Health Commercial |
$167.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$167.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.32
|
| Rate for Payer: HealthUtah PPO |
$176.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$170.72
|
| Rate for Payer: Multiplan Medicare/VA |
$95.30
|
| Rate for Payer: One Health Plan of WY PPO |
$172.48
|
| Rate for Payer: PacificSource Commercial |
$158.40
|
| Rate for Payer: PHCS PPO |
$172.48
|
| Rate for Payer: Three Rivers PPO |
$132.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.32
|
| Rate for Payer: United Healthcare Commercial |
$168.08
|
| Rate for Payer: United Healthcare Medicare |
$100.32
|
| Rate for Payer: WINHealth Partners Commercial |
$172.48
|
| Rate for Payer: Wise Provider Network Commercial |
$167.20
|
|
|
HC ASSAY OF SELENIUM - SELENIUM SERUM
|
Facility
|
IP
|
$176.00
|
|
|
Service Code
|
HCPCS 84255
|
| Hospital Charge Code |
3018425501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$101.99 |
| Max. Negotiated Rate |
$176.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$172.48
|
| Rate for Payer: Aetna of WY Medicare |
$112.64
|
| Rate for Payer: Altius Commercial |
$168.96
|
| Rate for Payer: Beech Street Commercial |
$172.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$170.72
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$170.72
|
| Rate for Payer: Cigna of WY Commercial |
$172.48
|
| Rate for Payer: Entrust Commercial |
$167.20
|
| Rate for Payer: First Choice Health Commercial |
$167.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$167.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$107.36
|
| Rate for Payer: HealthUtah PPO |
$176.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$170.72
|
| Rate for Payer: Multiplan Medicare/VA |
$101.99
|
| Rate for Payer: One Health Plan of WY PPO |
$172.48
|
| Rate for Payer: PacificSource Commercial |
$158.40
|
| Rate for Payer: PHCS PPO |
$172.48
|
| Rate for Payer: Three Rivers PPO |
$132.00
|
| Rate for Payer: TriWest Veterans Administration |
$107.36
|
| Rate for Payer: United Healthcare Commercial |
$168.08
|
| Rate for Payer: United Healthcare Medicare |
$107.36
|
| Rate for Payer: WINHealth Partners Commercial |
$167.20
|
| Rate for Payer: Wise Provider Network Commercial |
$167.20
|
|
|
HC ASSAY OF SEROTONIN - SEROTONIN SERUM
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
HCPCS 84260
|
| Hospital Charge Code |
3018426001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$145.12 |
| Max. Negotiated Rate |
$268.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$262.64
|
| Rate for Payer: Aetna of WY Medicare |
$176.88
|
| Rate for Payer: Altius Commercial |
$257.28
|
| Rate for Payer: Beech Street Commercial |
$262.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$259.96
|
| Rate for Payer: Cash Price |
$187.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$259.96
|
| Rate for Payer: Cigna of WY Commercial |
$262.64
|
| Rate for Payer: Entrust Commercial |
$254.60
|
| Rate for Payer: First Choice Health Commercial |
$254.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$254.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$152.76
|
| Rate for Payer: HealthUtah PPO |
$268.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$259.96
|
| Rate for Payer: Multiplan Medicare/VA |
$145.12
|
| Rate for Payer: One Health Plan of WY PPO |
$262.64
|
| Rate for Payer: PacificSource Commercial |
$241.20
|
| Rate for Payer: PHCS PPO |
$262.64
|
| Rate for Payer: Three Rivers PPO |
$201.00
|
| Rate for Payer: TriWest Veterans Administration |
$152.76
|
| Rate for Payer: United Healthcare Commercial |
$255.94
|
| Rate for Payer: United Healthcare Medicare |
$152.76
|
| Rate for Payer: WINHealth Partners Commercial |
$262.64
|
| Rate for Payer: Wise Provider Network Commercial |
$254.60
|
|
|
HC ASSAY OF SEROTONIN - SEROTONIN SERUM
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
HCPCS 84260
|
| Hospital Charge Code |
3018426001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$155.31 |
| Max. Negotiated Rate |
$268.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$262.64
|
| Rate for Payer: Aetna of WY Medicare |
$171.52
|
| Rate for Payer: Altius Commercial |
$257.28
|
| Rate for Payer: Beech Street Commercial |
$262.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$259.96
|
| Rate for Payer: Cash Price |
$187.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$259.96
|
| Rate for Payer: Cigna of WY Commercial |
$262.64
|
| Rate for Payer: Entrust Commercial |
$254.60
|
| Rate for Payer: First Choice Health Commercial |
$254.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$254.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.48
|
| Rate for Payer: HealthUtah PPO |
$268.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$259.96
|
| Rate for Payer: Multiplan Medicare/VA |
$155.31
|
| Rate for Payer: One Health Plan of WY PPO |
$262.64
|
| Rate for Payer: PacificSource Commercial |
$241.20
|
| Rate for Payer: PHCS PPO |
$262.64
|
| Rate for Payer: Three Rivers PPO |
$201.00
|
| Rate for Payer: TriWest Veterans Administration |
$163.48
|
| Rate for Payer: United Healthcare Commercial |
$255.94
|
| Rate for Payer: United Healthcare Medicare |
$163.48
|
| Rate for Payer: WINHealth Partners Commercial |
$254.60
|
| Rate for Payer: Wise Provider Network Commercial |
$254.60
|
|
|
HC ASSAY OF SERUM ALBUMIN - ALBUMIN
|
Facility
|
IP
|
$48.00
|
|
|
Service Code
|
HCPCS 82040
|
| Hospital Charge Code |
3018204001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.82 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.04
|
| Rate for Payer: Aetna of WY Medicare |
$30.72
|
| Rate for Payer: Altius Commercial |
$46.08
|
| Rate for Payer: Beech Street Commercial |
$47.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.56
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.56
|
| Rate for Payer: Cigna of WY Commercial |
$47.04
|
| Rate for Payer: Entrust Commercial |
$45.60
|
| Rate for Payer: First Choice Health Commercial |
$45.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.28
|
| Rate for Payer: HealthUtah PPO |
$48.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.56
|
| Rate for Payer: Multiplan Medicare/VA |
$27.82
|
| Rate for Payer: One Health Plan of WY PPO |
$47.04
|
| Rate for Payer: PacificSource Commercial |
$43.20
|
| Rate for Payer: PHCS PPO |
$47.04
|
| Rate for Payer: Three Rivers PPO |
$36.00
|
| Rate for Payer: TriWest Veterans Administration |
$29.28
|
| Rate for Payer: United Healthcare Commercial |
$45.84
|
| Rate for Payer: United Healthcare Medicare |
$29.28
|
| Rate for Payer: WINHealth Partners Commercial |
$45.60
|
| Rate for Payer: Wise Provider Network Commercial |
$45.60
|
|
|
HC ASSAY OF SERUM ALBUMIN - ALBUMIN
|
Facility
|
OP
|
$48.00
|
|
|
Service Code
|
HCPCS 82040
|
| Hospital Charge Code |
3018204001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.04
|
| Rate for Payer: Aetna of WY Medicare |
$31.68
|
| Rate for Payer: Altius Commercial |
$46.08
|
| Rate for Payer: Beech Street Commercial |
$47.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.56
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.56
|
| Rate for Payer: Cigna of WY Commercial |
$47.04
|
| Rate for Payer: Entrust Commercial |
$45.60
|
| Rate for Payer: First Choice Health Commercial |
$45.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.36
|
| Rate for Payer: HealthUtah PPO |
$48.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.56
|
| Rate for Payer: Multiplan Medicare/VA |
$25.99
|
| Rate for Payer: One Health Plan of WY PPO |
$47.04
|
| Rate for Payer: PacificSource Commercial |
$43.20
|
| Rate for Payer: PHCS PPO |
$47.04
|
| Rate for Payer: Three Rivers PPO |
$36.00
|
| Rate for Payer: TriWest Veterans Administration |
$27.36
|
| Rate for Payer: United Healthcare Commercial |
$45.84
|
| Rate for Payer: United Healthcare Medicare |
$27.36
|
| Rate for Payer: WINHealth Partners Commercial |
$47.04
|
| Rate for Payer: Wise Provider Network Commercial |
$45.60
|
|
|
HC ASSAY OF SERUM POTASSIUM - POTASSIUM
|
Facility
|
OP
|
$92.00
|
|
|
Service Code
|
HCPCS 84132
|
| Hospital Charge Code |
3018413201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.82 |
| Max. Negotiated Rate |
$92.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$90.16
|
| Rate for Payer: Aetna of WY Medicare |
$60.72
|
| Rate for Payer: Altius Commercial |
$88.32
|
| Rate for Payer: Beech Street Commercial |
$90.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$89.24
|
| Rate for Payer: Cash Price |
$64.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$89.24
|
| Rate for Payer: Cigna of WY Commercial |
$90.16
|
| Rate for Payer: Entrust Commercial |
$87.40
|
| Rate for Payer: First Choice Health Commercial |
$87.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$87.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$52.44
|
| Rate for Payer: HealthUtah PPO |
$92.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$89.24
|
| Rate for Payer: Multiplan Medicare/VA |
$49.82
|
| Rate for Payer: One Health Plan of WY PPO |
$90.16
|
| Rate for Payer: PacificSource Commercial |
$82.80
|
| Rate for Payer: PHCS PPO |
$90.16
|
| Rate for Payer: Three Rivers PPO |
$69.00
|
| Rate for Payer: TriWest Veterans Administration |
$52.44
|
| Rate for Payer: United Healthcare Commercial |
$87.86
|
| Rate for Payer: United Healthcare Medicare |
$52.44
|
| Rate for Payer: WINHealth Partners Commercial |
$90.16
|
| Rate for Payer: Wise Provider Network Commercial |
$87.40
|
|
