|
HC ASSAY OF TOBRAMYCIN - TOBRAMYCIN PEAK
|
Facility
|
IP
|
$139.00
|
|
|
Service Code
|
HCPCS 80200
|
| Hospital Charge Code |
3018020001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.55 |
| Max. Negotiated Rate |
$139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$136.22
|
| Rate for Payer: Aetna of WY Medicare |
$88.96
|
| Rate for Payer: Altius Commercial |
$133.44
|
| Rate for Payer: Beech Street Commercial |
$136.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.83
|
| Rate for Payer: Cash Price |
$97.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.83
|
| Rate for Payer: Cigna of WY Commercial |
$136.22
|
| Rate for Payer: Entrust Commercial |
$132.05
|
| Rate for Payer: First Choice Health Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$84.79
|
| Rate for Payer: HealthUtah PPO |
$139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.83
|
| Rate for Payer: Multiplan Medicare/VA |
$80.55
|
| Rate for Payer: One Health Plan of WY PPO |
$136.22
|
| Rate for Payer: PacificSource Commercial |
$125.10
|
| Rate for Payer: PHCS PPO |
$136.22
|
| Rate for Payer: Three Rivers PPO |
$104.25
|
| Rate for Payer: TriWest Veterans Administration |
$84.79
|
| Rate for Payer: United Healthcare Commercial |
$132.74
|
| Rate for Payer: United Healthcare Medicare |
$84.79
|
| Rate for Payer: WINHealth Partners Commercial |
$132.05
|
| Rate for Payer: Wise Provider Network Commercial |
$132.05
|
|
|
HC ASSAY OF TOBRAMYCIN - TOBRAMYCIN PEAK
|
Facility
|
OP
|
$139.00
|
|
|
Service Code
|
HCPCS 80200
|
| Hospital Charge Code |
3018020001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.27 |
| Max. Negotiated Rate |
$139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$136.22
|
| Rate for Payer: Aetna of WY Medicare |
$91.74
|
| Rate for Payer: Altius Commercial |
$133.44
|
| Rate for Payer: Beech Street Commercial |
$136.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.83
|
| Rate for Payer: Cash Price |
$97.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.83
|
| Rate for Payer: Cigna of WY Commercial |
$136.22
|
| Rate for Payer: Entrust Commercial |
$132.05
|
| Rate for Payer: First Choice Health Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$79.23
|
| Rate for Payer: HealthUtah PPO |
$139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.83
|
| Rate for Payer: Multiplan Medicare/VA |
$75.27
|
| Rate for Payer: One Health Plan of WY PPO |
$136.22
|
| Rate for Payer: PacificSource Commercial |
$125.10
|
| Rate for Payer: PHCS PPO |
$136.22
|
| Rate for Payer: Three Rivers PPO |
$104.25
|
| Rate for Payer: TriWest Veterans Administration |
$79.23
|
| Rate for Payer: United Healthcare Commercial |
$132.74
|
| Rate for Payer: United Healthcare Medicare |
$79.23
|
| Rate for Payer: WINHealth Partners Commercial |
$136.22
|
| Rate for Payer: Wise Provider Network Commercial |
$132.05
|
|
|
HC ASSAY OF TOBRAMYCIN - TOBRAMYCIN RANDOM
|
Facility
|
IP
|
$139.00
|
|
|
Service Code
|
HCPCS 80200
|
| Hospital Charge Code |
3018020002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.55 |
| Max. Negotiated Rate |
$139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$136.22
|
| Rate for Payer: Aetna of WY Medicare |
$88.96
|
| Rate for Payer: Altius Commercial |
$133.44
|
| Rate for Payer: Beech Street Commercial |
$136.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.83
|
| Rate for Payer: Cash Price |
$97.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.83
|
| Rate for Payer: Cigna of WY Commercial |
$136.22
|
| Rate for Payer: Entrust Commercial |
$132.05
|
| Rate for Payer: First Choice Health Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$84.79
|
| Rate for Payer: HealthUtah PPO |
$139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.83
|
| Rate for Payer: Multiplan Medicare/VA |
$80.55
|
| Rate for Payer: One Health Plan of WY PPO |
$136.22
|
| Rate for Payer: PacificSource Commercial |
$125.10
|
| Rate for Payer: PHCS PPO |
$136.22
|
| Rate for Payer: Three Rivers PPO |
$104.25
|
| Rate for Payer: TriWest Veterans Administration |
$84.79
|
| Rate for Payer: United Healthcare Commercial |
$132.74
|
| Rate for Payer: United Healthcare Medicare |
$84.79
|
| Rate for Payer: WINHealth Partners Commercial |
$132.05
|
| Rate for Payer: Wise Provider Network Commercial |
$132.05
|
|
|
HC ASSAY OF TOBRAMYCIN - TOBRAMYCIN RANDOM
|
Facility
|
OP
|
$139.00
|
|
|
Service Code
|
HCPCS 80200
|
| Hospital Charge Code |
3018020002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.27 |
| Max. Negotiated Rate |
$139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$136.22
|
| Rate for Payer: Aetna of WY Medicare |
$91.74
|
| Rate for Payer: Altius Commercial |
$133.44
|
| Rate for Payer: Beech Street Commercial |
$136.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.83
|
| Rate for Payer: Cash Price |
$97.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.83
|
| Rate for Payer: Cigna of WY Commercial |
$136.22
|
| Rate for Payer: Entrust Commercial |
$132.05
|
| Rate for Payer: First Choice Health Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$132.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$79.23
|
| Rate for Payer: HealthUtah PPO |
$139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.83
|
| Rate for Payer: Multiplan Medicare/VA |
$75.27
|
| Rate for Payer: One Health Plan of WY PPO |
$136.22
|
| Rate for Payer: PacificSource Commercial |
$125.10
|
| Rate for Payer: PHCS PPO |
$136.22
|
| Rate for Payer: Three Rivers PPO |
$104.25
|
| Rate for Payer: TriWest Veterans Administration |
$79.23
|
| Rate for Payer: United Healthcare Commercial |
$132.74
|
| Rate for Payer: United Healthcare Medicare |
$79.23
|
| Rate for Payer: WINHealth Partners Commercial |
$136.22
|
| Rate for Payer: Wise Provider Network Commercial |
$132.05
|
|
|
HC ASSAY OF TOPIRAMATE - TOPIRAMATE LEVEL
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
HCPCS 80201
|
| Hospital Charge Code |
3018020101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.72 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: United Healthcare Commercial |
$154.71
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$158.76
|
| Rate for Payer: Aetna of WY Medicare |
$106.92
|
| Rate for Payer: Altius Commercial |
$155.52
|
| Rate for Payer: Beech Street Commercial |
$158.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$157.14
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$157.14
|
| Rate for Payer: Cigna of WY Commercial |
$158.76
|
| Rate for Payer: Entrust Commercial |
$153.90
|
| Rate for Payer: First Choice Health Commercial |
$153.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$153.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$92.34
|
| Rate for Payer: HealthUtah PPO |
$162.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$157.14
|
| Rate for Payer: Multiplan Medicare/VA |
$87.72
|
| Rate for Payer: One Health Plan of WY PPO |
$158.76
|
| Rate for Payer: PacificSource Commercial |
$145.80
|
| Rate for Payer: PHCS PPO |
$158.76
|
| Rate for Payer: Three Rivers PPO |
$121.50
|
| Rate for Payer: TriWest Veterans Administration |
$92.34
|
| Rate for Payer: United Healthcare Medicare |
$92.34
|
| Rate for Payer: WINHealth Partners Commercial |
$158.76
|
| Rate for Payer: Wise Provider Network Commercial |
$153.90
|
|
|
HC ASSAY OF TOPIRAMATE - TOPIRAMATE LEVEL
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
HCPCS 80201
|
| Hospital Charge Code |
3018020101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.88 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$158.76
|
| Rate for Payer: Aetna of WY Medicare |
$103.68
|
| Rate for Payer: Altius Commercial |
$155.52
|
| Rate for Payer: Beech Street Commercial |
$158.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$157.14
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$157.14
|
| Rate for Payer: Cigna of WY Commercial |
$158.76
|
| Rate for Payer: Entrust Commercial |
$153.90
|
| Rate for Payer: First Choice Health Commercial |
$153.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$153.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$98.82
|
| Rate for Payer: HealthUtah PPO |
$162.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$157.14
|
| Rate for Payer: Multiplan Medicare/VA |
$93.88
|
| Rate for Payer: One Health Plan of WY PPO |
$158.76
|
| Rate for Payer: PacificSource Commercial |
$145.80
|
| Rate for Payer: PHCS PPO |
$158.76
|
| Rate for Payer: Three Rivers PPO |
$121.50
|
| Rate for Payer: TriWest Veterans Administration |
$98.82
|
| Rate for Payer: United Healthcare Commercial |
$154.71
|
| Rate for Payer: United Healthcare Medicare |
$98.82
|
| Rate for Payer: WINHealth Partners Commercial |
$153.90
|
| Rate for Payer: Wise Provider Network Commercial |
$153.90
|
|
|
HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE
|
Facility
|
OP
|
$118.00
|
|
|
Service Code
|
HCPCS 84403
|
| Hospital Charge Code |
3018440301
|
|
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 TOTAL TESTOSTERONE - TESTOSTERONE
|
Facility
|
IP
|
$118.00
|
|
|
Service Code
|
HCPCS 84403
|
| Hospital Charge Code |
3018440301
|
|
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 TOTAL THYROXINE - T4 (THYROID HORMONE)
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
HCPCS 84436
|
| Hospital Charge Code |
3018443601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.24 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$76.44
|
| Rate for Payer: Aetna of WY Medicare |
$51.48
|
| Rate for Payer: Altius Commercial |
$74.88
|
| Rate for Payer: Beech Street Commercial |
$76.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$75.66
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$75.66
|
| Rate for Payer: Cigna of WY Commercial |
$76.44
|
| Rate for Payer: Entrust Commercial |
$74.10
|
| Rate for Payer: First Choice Health Commercial |
$74.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$74.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.46
|
| Rate for Payer: HealthUtah PPO |
$78.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$75.66
|
| Rate for Payer: Multiplan Medicare/VA |
$42.24
|
| Rate for Payer: One Health Plan of WY PPO |
$76.44
|
| Rate for Payer: PacificSource Commercial |
$70.20
|
| Rate for Payer: PHCS PPO |
$76.44
|
| Rate for Payer: Three Rivers PPO |
$58.50
|
| Rate for Payer: TriWest Veterans Administration |
$44.46
|
| Rate for Payer: United Healthcare Commercial |
$74.49
|
| Rate for Payer: United Healthcare Medicare |
$44.46
|
| Rate for Payer: WINHealth Partners Commercial |
$76.44
|
| Rate for Payer: Wise Provider Network Commercial |
$74.10
|
|
|
HC ASSAY OF TOTAL THYROXINE - T4 (THYROID HORMONE)
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
HCPCS 84436
|
| Hospital Charge Code |
3018443601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.20 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$76.44
|
| Rate for Payer: Aetna of WY Medicare |
$49.92
|
| Rate for Payer: Altius Commercial |
$74.88
|
| Rate for Payer: Beech Street Commercial |
$76.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$75.66
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$75.66
|
| Rate for Payer: Cigna of WY Commercial |
$76.44
|
| Rate for Payer: Entrust Commercial |
$74.10
|
| Rate for Payer: First Choice Health Commercial |
$74.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$74.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$47.58
|
| Rate for Payer: HealthUtah PPO |
$78.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$75.66
|
| Rate for Payer: Multiplan Medicare/VA |
$45.20
|
| Rate for Payer: One Health Plan of WY PPO |
$76.44
|
| Rate for Payer: PacificSource Commercial |
$70.20
|
| Rate for Payer: PHCS PPO |
$76.44
|
| Rate for Payer: Three Rivers PPO |
$58.50
|
| Rate for Payer: TriWest Veterans Administration |
$47.58
|
| Rate for Payer: United Healthcare Commercial |
$74.49
|
| Rate for Payer: United Healthcare Medicare |
$47.58
|
| Rate for Payer: WINHealth Partners Commercial |
$74.10
|
| Rate for Payer: Wise Provider Network Commercial |
$74.10
|
|
|
HC ASSAY OF TRANSFERRIN - TRANSFERRIN
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 84466
|
| Hospital Charge Code |
3018446601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.70 |
| Max. Negotiated Rate |
$77.00 |
| Rate for Payer: United Healthcare Commercial |
$73.54
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$75.46
|
| Rate for Payer: Aetna of WY Medicare |
$50.82
|
| Rate for Payer: Altius Commercial |
$73.92
|
| Rate for Payer: Beech Street Commercial |
$75.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.69
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$74.69
|
| Rate for Payer: Cigna of WY Commercial |
$75.46
|
| Rate for Payer: Entrust Commercial |
$73.15
|
| Rate for Payer: First Choice Health Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.89
|
| Rate for Payer: HealthUtah PPO |
$77.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$74.69
|
| Rate for Payer: Multiplan Medicare/VA |
$41.70
|
| Rate for Payer: One Health Plan of WY PPO |
$75.46
|
| Rate for Payer: PacificSource Commercial |
$69.30
|
| Rate for Payer: PHCS PPO |
$75.46
|
| Rate for Payer: Three Rivers PPO |
$57.75
|
| Rate for Payer: TriWest Veterans Administration |
$43.89
|
| Rate for Payer: United Healthcare Medicare |
$43.89
|
| Rate for Payer: WINHealth Partners Commercial |
$75.46
|
| Rate for Payer: Wise Provider Network Commercial |
$73.15
|
|
|
HC ASSAY OF TRANSFERRIN - TRANSFERRIN
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS 84466
|
| Hospital Charge Code |
3018446601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.62 |
| Max. Negotiated Rate |
$77.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$75.46
|
| Rate for Payer: Aetna of WY Medicare |
$49.28
|
| Rate for Payer: Altius Commercial |
$73.92
|
| Rate for Payer: Beech Street Commercial |
$75.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.69
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$74.69
|
| Rate for Payer: Cigna of WY Commercial |
$75.46
|
| Rate for Payer: Entrust Commercial |
$73.15
|
| Rate for Payer: First Choice Health Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.97
|
| Rate for Payer: HealthUtah PPO |
$77.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$74.69
|
| Rate for Payer: Multiplan Medicare/VA |
$44.62
|
| Rate for Payer: One Health Plan of WY PPO |
$75.46
|
| Rate for Payer: PacificSource Commercial |
$69.30
|
| Rate for Payer: PHCS PPO |
$75.46
|
| Rate for Payer: Three Rivers PPO |
$57.75
|
| Rate for Payer: TriWest Veterans Administration |
$46.97
|
| Rate for Payer: United Healthcare Commercial |
$73.54
|
| Rate for Payer: United Healthcare Medicare |
$46.97
|
| Rate for Payer: WINHealth Partners Commercial |
$73.15
|
| Rate for Payer: Wise Provider Network Commercial |
$73.15
|
|
|
HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
HCPCS 84478
|
| Hospital Charge Code |
3018447801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.53 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$48.02
|
| Rate for Payer: Aetna of WY Medicare |
$32.34
|
| Rate for Payer: Altius Commercial |
$47.04
|
| Rate for Payer: Beech Street Commercial |
$48.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$47.53
|
| Rate for Payer: Cash Price |
$34.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$47.53
|
| Rate for Payer: Cigna of WY Commercial |
$48.02
|
| Rate for Payer: Entrust Commercial |
$46.55
|
| Rate for Payer: First Choice Health Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.93
|
| Rate for Payer: HealthUtah PPO |
$49.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$47.53
|
| Rate for Payer: Multiplan Medicare/VA |
$26.53
|
| Rate for Payer: One Health Plan of WY PPO |
$48.02
|
| Rate for Payer: PacificSource Commercial |
$44.10
|
| Rate for Payer: PHCS PPO |
$48.02
|
| Rate for Payer: Three Rivers PPO |
$36.75
|
| Rate for Payer: TriWest Veterans Administration |
$27.93
|
| Rate for Payer: United Healthcare Commercial |
$46.80
|
| Rate for Payer: United Healthcare Medicare |
$27.93
|
| Rate for Payer: WINHealth Partners Commercial |
$48.02
|
| Rate for Payer: Wise Provider Network Commercial |
$46.55
|
|
|
HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
HCPCS 84478
|
| Hospital Charge Code |
3018447801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$48.02
|
| Rate for Payer: Aetna of WY Medicare |
$31.36
|
| Rate for Payer: Altius Commercial |
$47.04
|
| Rate for Payer: Beech Street Commercial |
$48.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$47.53
|
| Rate for Payer: Cash Price |
$34.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$47.53
|
| Rate for Payer: Cigna of WY Commercial |
$48.02
|
| Rate for Payer: Entrust Commercial |
$46.55
|
| Rate for Payer: First Choice Health Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.89
|
| Rate for Payer: HealthUtah PPO |
$49.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$47.53
|
| Rate for Payer: Multiplan Medicare/VA |
$28.40
|
| Rate for Payer: One Health Plan of WY PPO |
$48.02
|
| Rate for Payer: PacificSource Commercial |
$44.10
|
| Rate for Payer: PHCS PPO |
$48.02
|
| Rate for Payer: Three Rivers PPO |
$36.75
|
| Rate for Payer: TriWest Veterans Administration |
$29.89
|
| Rate for Payer: United Healthcare Commercial |
$46.80
|
| Rate for Payer: United Healthcare Medicare |
$29.89
|
| Rate for Payer: WINHealth Partners Commercial |
$46.55
|
| Rate for Payer: Wise Provider Network Commercial |
$46.55
|
|
|
HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES BODY FLUID
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 84478
|
| Hospital Charge Code |
3018447802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.18 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.20
|
| Rate for Payer: Aetna of WY Medicare |
$25.60
|
| Rate for Payer: Altius Commercial |
$38.40
|
| Rate for Payer: Beech Street Commercial |
$39.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$38.80
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$38.80
|
| Rate for Payer: Cigna of WY Commercial |
$39.20
|
| Rate for Payer: Entrust Commercial |
$38.00
|
| Rate for Payer: First Choice Health Commercial |
$38.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.40
|
| Rate for Payer: HealthUtah PPO |
$40.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$38.80
|
| Rate for Payer: Multiplan Medicare/VA |
$23.18
|
| Rate for Payer: One Health Plan of WY PPO |
$39.20
|
| Rate for Payer: PacificSource Commercial |
$36.00
|
| Rate for Payer: PHCS PPO |
$39.20
|
| Rate for Payer: Three Rivers PPO |
$30.00
|
| Rate for Payer: TriWest Veterans Administration |
$24.40
|
| Rate for Payer: United Healthcare Commercial |
$38.20
|
| Rate for Payer: United Healthcare Medicare |
$24.40
|
| Rate for Payer: WINHealth Partners Commercial |
$38.00
|
| Rate for Payer: Wise Provider Network Commercial |
$38.00
|
|
|
HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES BODY FLUID
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 84478
|
| Hospital Charge Code |
3018447802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.66 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$39.20
|
| Rate for Payer: Aetna of WY Medicare |
$26.40
|
| Rate for Payer: Altius Commercial |
$38.40
|
| Rate for Payer: Beech Street Commercial |
$39.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$38.80
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$38.80
|
| Rate for Payer: Cigna of WY Commercial |
$39.20
|
| Rate for Payer: Entrust Commercial |
$38.00
|
| Rate for Payer: First Choice Health Commercial |
$38.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$38.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$22.80
|
| Rate for Payer: HealthUtah PPO |
$40.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$38.80
|
| Rate for Payer: Multiplan Medicare/VA |
$21.66
|
| Rate for Payer: One Health Plan of WY PPO |
$39.20
|
| Rate for Payer: PacificSource Commercial |
$36.00
|
| Rate for Payer: PHCS PPO |
$39.20
|
| Rate for Payer: Three Rivers PPO |
$30.00
|
| Rate for Payer: TriWest Veterans Administration |
$22.80
|
| Rate for Payer: United Healthcare Commercial |
$38.20
|
| Rate for Payer: United Healthcare Medicare |
$22.80
|
| Rate for Payer: WINHealth Partners Commercial |
$39.20
|
| Rate for Payer: Wise Provider Network Commercial |
$38.00
|
|
|
HC ASSAY OF TROPONIN, QUANT - TROPONIN I
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
HCPCS 84484
|
| Hospital Charge Code |
3018448402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$155.95 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$282.24
|
| Rate for Payer: Aetna of WY Medicare |
$190.08
|
| Rate for Payer: Altius Commercial |
$276.48
|
| Rate for Payer: Beech Street Commercial |
$282.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$279.36
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$279.36
|
| Rate for Payer: Cigna of WY Commercial |
$282.24
|
| Rate for Payer: Entrust Commercial |
$273.60
|
| Rate for Payer: First Choice Health Commercial |
$273.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$273.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$164.16
|
| Rate for Payer: HealthUtah PPO |
$288.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$279.36
|
| Rate for Payer: Multiplan Medicare/VA |
$155.95
|
| Rate for Payer: One Health Plan of WY PPO |
$282.24
|
| Rate for Payer: PacificSource Commercial |
$259.20
|
| Rate for Payer: PHCS PPO |
$282.24
|
| Rate for Payer: Three Rivers PPO |
$216.00
|
| Rate for Payer: TriWest Veterans Administration |
$164.16
|
| Rate for Payer: United Healthcare Commercial |
$275.04
|
| Rate for Payer: United Healthcare Medicare |
$164.16
|
| Rate for Payer: WINHealth Partners Commercial |
$282.24
|
| Rate for Payer: Wise Provider Network Commercial |
$273.60
|
|
|
HC ASSAY OF TROPONIN, QUANT - TROPONIN I
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
HCPCS 84484
|
| Hospital Charge Code |
3018448402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$166.90 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$282.24
|
| Rate for Payer: Aetna of WY Medicare |
$184.32
|
| Rate for Payer: Altius Commercial |
$276.48
|
| Rate for Payer: Beech Street Commercial |
$282.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$279.36
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$279.36
|
| Rate for Payer: Cigna of WY Commercial |
$282.24
|
| Rate for Payer: Entrust Commercial |
$273.60
|
| Rate for Payer: First Choice Health Commercial |
$273.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$273.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$175.68
|
| Rate for Payer: HealthUtah PPO |
$288.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$279.36
|
| Rate for Payer: Multiplan Medicare/VA |
$166.90
|
| Rate for Payer: One Health Plan of WY PPO |
$282.24
|
| Rate for Payer: PacificSource Commercial |
$259.20
|
| Rate for Payer: PHCS PPO |
$282.24
|
| Rate for Payer: Three Rivers PPO |
$216.00
|
| Rate for Payer: TriWest Veterans Administration |
$175.68
|
| Rate for Payer: United Healthcare Commercial |
$275.04
|
| Rate for Payer: United Healthcare Medicare |
$175.68
|
| Rate for Payer: WINHealth Partners Commercial |
$273.60
|
| Rate for Payer: Wise Provider Network Commercial |
$273.60
|
|
|
HC ASSAY OF URIC ACID, BLOOD, OTHER SOURCE - URIC ACID BODY FLUID
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
3018456002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$66.64
|
| Rate for Payer: Aetna of WY Medicare |
$43.52
|
| Rate for Payer: Altius Commercial |
$65.28
|
| Rate for Payer: Beech Street Commercial |
$66.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$65.96
|
| Rate for Payer: Cash Price |
$47.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$65.96
|
| Rate for Payer: Cigna of WY Commercial |
$66.64
|
| Rate for Payer: Entrust Commercial |
$64.60
|
| Rate for Payer: First Choice Health Commercial |
$64.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$64.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.48
|
| Rate for Payer: HealthUtah PPO |
$68.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$65.96
|
| Rate for Payer: Multiplan Medicare/VA |
$39.41
|
| Rate for Payer: One Health Plan of WY PPO |
$66.64
|
| Rate for Payer: PacificSource Commercial |
$61.20
|
| Rate for Payer: PHCS PPO |
$66.64
|
| Rate for Payer: Three Rivers PPO |
$51.00
|
| Rate for Payer: TriWest Veterans Administration |
$41.48
|
| Rate for Payer: United Healthcare Commercial |
$64.94
|
| Rate for Payer: United Healthcare Medicare |
$41.48
|
| Rate for Payer: WINHealth Partners Commercial |
$64.60
|
| Rate for Payer: Wise Provider Network Commercial |
$64.60
|
|
|
HC ASSAY OF URIC ACID, BLOOD, OTHER SOURCE - URIC ACID BODY FLUID
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
3018456002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.82 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$66.64
|
| Rate for Payer: Aetna of WY Medicare |
$44.88
|
| Rate for Payer: Altius Commercial |
$65.28
|
| Rate for Payer: Beech Street Commercial |
$66.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$65.96
|
| Rate for Payer: Cash Price |
$47.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$65.96
|
| Rate for Payer: Cigna of WY Commercial |
$66.64
|
| Rate for Payer: Entrust Commercial |
$64.60
|
| Rate for Payer: First Choice Health Commercial |
$64.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$64.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$38.76
|
| Rate for Payer: HealthUtah PPO |
$68.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$65.96
|
| Rate for Payer: Multiplan Medicare/VA |
$36.82
|
| Rate for Payer: One Health Plan of WY PPO |
$66.64
|
| Rate for Payer: PacificSource Commercial |
$61.20
|
| Rate for Payer: PHCS PPO |
$66.64
|
| Rate for Payer: Three Rivers PPO |
$51.00
|
| Rate for Payer: TriWest Veterans Administration |
$38.76
|
| Rate for Payer: United Healthcare Commercial |
$64.94
|
| Rate for Payer: United Healthcare Medicare |
$38.76
|
| Rate for Payer: WINHealth Partners Commercial |
$66.64
|
| Rate for Payer: Wise Provider Network Commercial |
$64.60
|
|
|
HC ASSAY OF URIC ACID, BLOOD, OTHER SOURCE - URIC ACID, URINE, 24 HOUR
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
3018456003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.45 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$46.06
|
| Rate for Payer: Aetna of WY Medicare |
$31.02
|
| Rate for Payer: Altius Commercial |
$45.12
|
| Rate for Payer: Beech Street Commercial |
$46.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$45.59
|
| Rate for Payer: Cash Price |
$32.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$45.59
|
| Rate for Payer: Cigna of WY Commercial |
$46.06
|
| Rate for Payer: Entrust Commercial |
$44.65
|
| Rate for Payer: First Choice Health Commercial |
$44.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$44.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.79
|
| Rate for Payer: HealthUtah PPO |
$47.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$45.59
|
| Rate for Payer: Multiplan Medicare/VA |
$25.45
|
| Rate for Payer: One Health Plan of WY PPO |
$46.06
|
| Rate for Payer: PacificSource Commercial |
$42.30
|
| Rate for Payer: PHCS PPO |
$46.06
|
| Rate for Payer: Three Rivers PPO |
$35.25
|
| Rate for Payer: TriWest Veterans Administration |
$26.79
|
| Rate for Payer: United Healthcare Commercial |
$44.88
|
| Rate for Payer: United Healthcare Medicare |
$26.79
|
| Rate for Payer: WINHealth Partners Commercial |
$46.06
|
| Rate for Payer: Wise Provider Network Commercial |
$44.65
|
|
|
HC ASSAY OF URIC ACID, BLOOD, OTHER SOURCE - URIC ACID, URINE, 24 HOUR
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
3018456003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.24 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$46.06
|
| Rate for Payer: Aetna of WY Medicare |
$30.08
|
| Rate for Payer: Altius Commercial |
$45.12
|
| Rate for Payer: Beech Street Commercial |
$46.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$45.59
|
| Rate for Payer: Cash Price |
$32.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$45.59
|
| Rate for Payer: Cigna of WY Commercial |
$46.06
|
| Rate for Payer: Entrust Commercial |
$44.65
|
| Rate for Payer: First Choice Health Commercial |
$44.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$44.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$28.67
|
| Rate for Payer: HealthUtah PPO |
$47.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$45.59
|
| Rate for Payer: Multiplan Medicare/VA |
$27.24
|
| Rate for Payer: One Health Plan of WY PPO |
$46.06
|
| Rate for Payer: PacificSource Commercial |
$42.30
|
| Rate for Payer: PHCS PPO |
$46.06
|
| Rate for Payer: Three Rivers PPO |
$35.25
|
| Rate for Payer: TriWest Veterans Administration |
$28.67
|
| Rate for Payer: United Healthcare Commercial |
$44.88
|
| Rate for Payer: United Healthcare Medicare |
$28.67
|
| Rate for Payer: WINHealth Partners Commercial |
$44.65
|
| Rate for Payer: Wise Provider Network Commercial |
$44.65
|
|
|
HC ASSAY OF URIC ACID, BLOOD - URIC ACID
|
Facility
|
IP
|
$63.00
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
3018455001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.51 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$61.74
|
| Rate for Payer: Aetna of WY Medicare |
$40.32
|
| Rate for Payer: Altius Commercial |
$60.48
|
| Rate for Payer: Beech Street Commercial |
$61.74
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$61.11
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$61.11
|
| Rate for Payer: Cigna of WY Commercial |
$61.74
|
| Rate for Payer: Entrust Commercial |
$59.85
|
| Rate for Payer: First Choice Health Commercial |
$59.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$59.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$38.43
|
| Rate for Payer: HealthUtah PPO |
$63.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$61.11
|
| Rate for Payer: Multiplan Medicare/VA |
$36.51
|
| Rate for Payer: One Health Plan of WY PPO |
$61.74
|
| Rate for Payer: PacificSource Commercial |
$56.70
|
| Rate for Payer: PHCS PPO |
$61.74
|
| Rate for Payer: Three Rivers PPO |
$47.25
|
| Rate for Payer: TriWest Veterans Administration |
$38.43
|
| Rate for Payer: United Healthcare Commercial |
$60.16
|
| Rate for Payer: United Healthcare Medicare |
$38.43
|
| Rate for Payer: WINHealth Partners Commercial |
$59.85
|
| Rate for Payer: Wise Provider Network Commercial |
$59.85
|
|
|
HC ASSAY OF URIC ACID, BLOOD - URIC ACID
|
Facility
|
OP
|
$63.00
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
3018455001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.11 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$61.74
|
| Rate for Payer: Aetna of WY Medicare |
$41.58
|
| Rate for Payer: Altius Commercial |
$60.48
|
| Rate for Payer: Beech Street Commercial |
$61.74
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$61.11
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$61.11
|
| Rate for Payer: Cigna of WY Commercial |
$61.74
|
| Rate for Payer: Entrust Commercial |
$59.85
|
| Rate for Payer: First Choice Health Commercial |
$59.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$59.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$35.91
|
| Rate for Payer: HealthUtah PPO |
$63.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$61.11
|
| Rate for Payer: Multiplan Medicare/VA |
$34.11
|
| Rate for Payer: One Health Plan of WY PPO |
$61.74
|
| Rate for Payer: PacificSource Commercial |
$56.70
|
| Rate for Payer: PHCS PPO |
$61.74
|
| Rate for Payer: Three Rivers PPO |
$47.25
|
| Rate for Payer: TriWest Veterans Administration |
$35.91
|
| Rate for Payer: United Healthcare Commercial |
$60.16
|
| Rate for Payer: United Healthcare Medicare |
$35.91
|
| Rate for Payer: WINHealth Partners Commercial |
$61.74
|
| Rate for Payer: Wise Provider Network Commercial |
$59.85
|
|
|
HC ASSAY OF URINE CHLORIDE
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
HCPCS 82436
|
| Hospital Charge Code |
3018243603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.62 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$49.98
|
| Rate for Payer: Aetna of WY Medicare |
$33.66
|
| Rate for Payer: Altius Commercial |
$48.96
|
| Rate for Payer: Beech Street Commercial |
$49.98
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$49.47
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.47
|
| Rate for Payer: Cigna of WY Commercial |
$49.98
|
| Rate for Payer: Entrust Commercial |
$48.45
|
| Rate for Payer: First Choice Health Commercial |
$48.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.07
|
| Rate for Payer: HealthUtah PPO |
$51.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.47
|
| Rate for Payer: Multiplan Medicare/VA |
$27.62
|
| Rate for Payer: One Health Plan of WY PPO |
$49.98
|
| Rate for Payer: PacificSource Commercial |
$45.90
|
| Rate for Payer: PHCS PPO |
$49.98
|
| Rate for Payer: Three Rivers PPO |
$38.25
|
| Rate for Payer: TriWest Veterans Administration |
$29.07
|
| Rate for Payer: United Healthcare Commercial |
$48.70
|
| Rate for Payer: United Healthcare Medicare |
$29.07
|
| Rate for Payer: WINHealth Partners Commercial |
$49.98
|
| Rate for Payer: Wise Provider Network Commercial |
$48.45
|
|
