|
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
|
|
|
HC ASSAY OF URINE CHLORIDE - CHLORIDE URINE RANDOM
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
HCPCS 82436
|
| Hospital Charge Code |
3018243601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$49.98
|
| Rate for Payer: Aetna of WY Medicare |
$32.64
|
| 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 |
$31.11
|
| Rate for Payer: HealthUtah PPO |
$51.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.47
|
| Rate for Payer: Multiplan Medicare/VA |
$29.55
|
| 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 |
$31.11
|
| Rate for Payer: United Healthcare Commercial |
$48.70
|
| Rate for Payer: United Healthcare Medicare |
$31.11
|
| Rate for Payer: WINHealth Partners Commercial |
$48.45
|
| Rate for Payer: Wise Provider Network Commercial |
$48.45
|
|
|
HC ASSAY OF URINE CHLORIDE - CHLORIDE URINE RANDOM
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
HCPCS 82436
|
| Hospital Charge Code |
3018243601
|
|
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
|
|
|
HC ASSAY OF URINE CREATININE - CREATININE RANDOM URINE
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3018257001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.59 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$105.84
|
| Rate for Payer: Aetna of WY Medicare |
$69.12
|
| Rate for Payer: Altius Commercial |
$103.68
|
| Rate for Payer: Beech Street Commercial |
$105.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$104.76
|
| Rate for Payer: Cigna of WY Commercial |
$105.84
|
| Rate for Payer: Entrust Commercial |
$102.60
|
| Rate for Payer: First Choice Health Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$65.88
|
| Rate for Payer: HealthUtah PPO |
$108.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$104.76
|
| Rate for Payer: Multiplan Medicare/VA |
$62.59
|
| Rate for Payer: One Health Plan of WY PPO |
$105.84
|
| Rate for Payer: PacificSource Commercial |
$97.20
|
| Rate for Payer: PHCS PPO |
$105.84
|
| Rate for Payer: Three Rivers PPO |
$81.00
|
| Rate for Payer: TriWest Veterans Administration |
$65.88
|
| Rate for Payer: United Healthcare Commercial |
$103.14
|
| Rate for Payer: United Healthcare Medicare |
$65.88
|
| Rate for Payer: WINHealth Partners Commercial |
$102.60
|
| Rate for Payer: Wise Provider Network Commercial |
$102.60
|
|
|
HC ASSAY OF URINE CREATININE - CREATININE RANDOM URINE
|
Facility
|
OP
|
$108.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3018257001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.48 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$105.84
|
| Rate for Payer: Aetna of WY Medicare |
$71.28
|
| Rate for Payer: Altius Commercial |
$103.68
|
| Rate for Payer: Beech Street Commercial |
$105.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$104.76
|
| Rate for Payer: Cigna of WY Commercial |
$105.84
|
| Rate for Payer: Entrust Commercial |
$102.60
|
| Rate for Payer: First Choice Health Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$61.56
|
| Rate for Payer: HealthUtah PPO |
$108.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$104.76
|
| Rate for Payer: Multiplan Medicare/VA |
$58.48
|
| Rate for Payer: One Health Plan of WY PPO |
$105.84
|
| Rate for Payer: PacificSource Commercial |
$97.20
|
| Rate for Payer: PHCS PPO |
$105.84
|
| Rate for Payer: Three Rivers PPO |
$81.00
|
| Rate for Payer: TriWest Veterans Administration |
$61.56
|
| Rate for Payer: United Healthcare Commercial |
$103.14
|
| Rate for Payer: United Healthcare Medicare |
$61.56
|
| Rate for Payer: WINHealth Partners Commercial |
$105.84
|
| Rate for Payer: Wise Provider Network Commercial |
$102.60
|
|
|
HC ASSAY OF URINE CREATININE - CREATININE, URINE, 24 HOUR
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3018257004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.59 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$105.84
|
| Rate for Payer: Aetna of WY Medicare |
$69.12
|
| Rate for Payer: Altius Commercial |
$103.68
|
| Rate for Payer: Beech Street Commercial |
$105.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$104.76
|
| Rate for Payer: Cigna of WY Commercial |
$105.84
|
| Rate for Payer: Entrust Commercial |
$102.60
|
| Rate for Payer: First Choice Health Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$65.88
|
| Rate for Payer: HealthUtah PPO |
$108.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$104.76
|
| Rate for Payer: Multiplan Medicare/VA |
$62.59
|
| Rate for Payer: One Health Plan of WY PPO |
$105.84
|
| Rate for Payer: PacificSource Commercial |
$97.20
|
| Rate for Payer: PHCS PPO |
$105.84
|
| Rate for Payer: Three Rivers PPO |
$81.00
|
| Rate for Payer: TriWest Veterans Administration |
$65.88
|
| Rate for Payer: United Healthcare Commercial |
$103.14
|
| Rate for Payer: United Healthcare Medicare |
$65.88
|
| Rate for Payer: WINHealth Partners Commercial |
$102.60
|
| Rate for Payer: Wise Provider Network Commercial |
$102.60
|
|
|
HC ASSAY OF URINE CREATININE - CREATININE, URINE, 24 HOUR
|
Facility
|
OP
|
$108.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3018257004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.48 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$105.84
|
| Rate for Payer: Aetna of WY Medicare |
$71.28
|
| Rate for Payer: Altius Commercial |
$103.68
|
| Rate for Payer: Beech Street Commercial |
$105.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$104.76
|
| Rate for Payer: Cigna of WY Commercial |
$105.84
|
| Rate for Payer: Entrust Commercial |
$102.60
|
| Rate for Payer: First Choice Health Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$61.56
|
| Rate for Payer: HealthUtah PPO |
$108.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$104.76
|
| Rate for Payer: Multiplan Medicare/VA |
$58.48
|
| Rate for Payer: One Health Plan of WY PPO |
$105.84
|
| Rate for Payer: PacificSource Commercial |
$97.20
|
| Rate for Payer: PHCS PPO |
$105.84
|
| Rate for Payer: Three Rivers PPO |
$81.00
|
| Rate for Payer: TriWest Veterans Administration |
$61.56
|
| Rate for Payer: United Healthcare Commercial |
$103.14
|
| Rate for Payer: United Healthcare Medicare |
$61.56
|
| Rate for Payer: WINHealth Partners Commercial |
$105.84
|
| Rate for Payer: Wise Provider Network Commercial |
$102.60
|
|
|
HC ASSAY OF URINE CREATININE - POCT CREATININE
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3018257003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.59 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$105.84
|
| Rate for Payer: Aetna of WY Medicare |
$69.12
|
| Rate for Payer: Altius Commercial |
$103.68
|
| Rate for Payer: Beech Street Commercial |
$105.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$104.76
|
| Rate for Payer: Cigna of WY Commercial |
$105.84
|
| Rate for Payer: Entrust Commercial |
$102.60
|
| Rate for Payer: First Choice Health Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$65.88
|
| Rate for Payer: HealthUtah PPO |
$108.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$104.76
|
| Rate for Payer: Multiplan Medicare/VA |
$62.59
|
| Rate for Payer: One Health Plan of WY PPO |
$105.84
|
| Rate for Payer: PacificSource Commercial |
$97.20
|
| Rate for Payer: PHCS PPO |
$105.84
|
| Rate for Payer: Three Rivers PPO |
$81.00
|
| Rate for Payer: TriWest Veterans Administration |
$65.88
|
| Rate for Payer: United Healthcare Commercial |
$103.14
|
| Rate for Payer: United Healthcare Medicare |
$65.88
|
| Rate for Payer: WINHealth Partners Commercial |
$102.60
|
| Rate for Payer: Wise Provider Network Commercial |
$102.60
|
|
|
HC ASSAY OF URINE CREATININE - POCT CREATININE
|
Facility
|
OP
|
$108.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3018257003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.48 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$105.84
|
| Rate for Payer: Aetna of WY Medicare |
$71.28
|
| Rate for Payer: Altius Commercial |
$103.68
|
| Rate for Payer: Beech Street Commercial |
$105.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$104.76
|
| Rate for Payer: Cigna of WY Commercial |
$105.84
|
| Rate for Payer: Entrust Commercial |
$102.60
|
| Rate for Payer: First Choice Health Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$102.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$61.56
|
| Rate for Payer: HealthUtah PPO |
$108.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$104.76
|
| Rate for Payer: Multiplan Medicare/VA |
$58.48
|
| Rate for Payer: One Health Plan of WY PPO |
$105.84
|
| Rate for Payer: PacificSource Commercial |
$97.20
|
| Rate for Payer: PHCS PPO |
$105.84
|
| Rate for Payer: Three Rivers PPO |
$81.00
|
| Rate for Payer: TriWest Veterans Administration |
$61.56
|
| Rate for Payer: United Healthcare Commercial |
$103.14
|
| Rate for Payer: United Healthcare Medicare |
$61.56
|
| Rate for Payer: WINHealth Partners Commercial |
$105.84
|
| Rate for Payer: Wise Provider Network Commercial |
$102.60
|
|
|
HC ASSAY OF URINE OSMOLALITY - OSMOLALITY URINE
|
Facility
|
IP
|
$138.00
|
|
|
Service Code
|
HCPCS 83935
|
| Hospital Charge Code |
3018393501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.97 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.24
|
| Rate for Payer: Aetna of WY Medicare |
$88.32
|
| Rate for Payer: Altius Commercial |
$132.48
|
| Rate for Payer: Beech Street Commercial |
$135.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$133.86
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$133.86
|
| Rate for Payer: Cigna of WY Commercial |
$135.24
|
| Rate for Payer: Entrust Commercial |
$131.10
|
| Rate for Payer: First Choice Health Commercial |
$131.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$84.18
|
| Rate for Payer: HealthUtah PPO |
$138.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$133.86
|
| Rate for Payer: Multiplan Medicare/VA |
$79.97
|
| Rate for Payer: One Health Plan of WY PPO |
$135.24
|
| Rate for Payer: PacificSource Commercial |
$124.20
|
| Rate for Payer: PHCS PPO |
$135.24
|
| Rate for Payer: Three Rivers PPO |
$103.50
|
| Rate for Payer: TriWest Veterans Administration |
$84.18
|
| Rate for Payer: United Healthcare Commercial |
$131.79
|
| Rate for Payer: United Healthcare Medicare |
$84.18
|
| Rate for Payer: WINHealth Partners Commercial |
$131.10
|
| Rate for Payer: Wise Provider Network Commercial |
$131.10
|
|
|
HC ASSAY OF URINE OSMOLALITY - OSMOLALITY URINE
|
Facility
|
OP
|
$138.00
|
|
|
Service Code
|
HCPCS 83935
|
| Hospital Charge Code |
3018393501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.73 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.24
|
| Rate for Payer: Aetna of WY Medicare |
$91.08
|
| Rate for Payer: Altius Commercial |
$132.48
|
| Rate for Payer: Beech Street Commercial |
$135.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$133.86
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$133.86
|
| Rate for Payer: Cigna of WY Commercial |
$135.24
|
| Rate for Payer: Entrust Commercial |
$131.10
|
| Rate for Payer: First Choice Health Commercial |
$131.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.66
|
| Rate for Payer: HealthUtah PPO |
$138.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$133.86
|
| Rate for Payer: Multiplan Medicare/VA |
$74.73
|
| Rate for Payer: One Health Plan of WY PPO |
$135.24
|
| Rate for Payer: PacificSource Commercial |
$124.20
|
| Rate for Payer: PHCS PPO |
$135.24
|
| Rate for Payer: Three Rivers PPO |
$103.50
|
| Rate for Payer: TriWest Veterans Administration |
$78.66
|
| Rate for Payer: United Healthcare Commercial |
$131.79
|
| Rate for Payer: United Healthcare Medicare |
$78.66
|
| Rate for Payer: WINHealth Partners Commercial |
$135.24
|
| Rate for Payer: Wise Provider Network Commercial |
$131.10
|
|
|
HC ASSAY OF URINE POTASSIUM - POTASSIUM 24 HOUR URINE
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 84133
|
| Hospital Charge Code |
3018413305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: United Healthcare Commercial |
$51.57
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.92
|
| Rate for Payer: Aetna of WY Medicare |
$34.56
|
| Rate for Payer: Altius Commercial |
$51.84
|
| Rate for Payer: Beech Street Commercial |
$52.92
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.38
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$52.38
|
| Rate for Payer: Cigna of WY Commercial |
$52.92
|
| Rate for Payer: Entrust Commercial |
$51.30
|
| Rate for Payer: First Choice Health Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.94
|
| Rate for Payer: HealthUtah PPO |
$54.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$52.38
|
| Rate for Payer: Multiplan Medicare/VA |
$31.29
|
| Rate for Payer: One Health Plan of WY PPO |
$52.92
|
| Rate for Payer: PacificSource Commercial |
$48.60
|
| Rate for Payer: PHCS PPO |
$52.92
|
| Rate for Payer: Three Rivers PPO |
$40.50
|
| Rate for Payer: TriWest Veterans Administration |
$32.94
|
| Rate for Payer: United Healthcare Medicare |
$32.94
|
| Rate for Payer: WINHealth Partners Commercial |
$51.30
|
| Rate for Payer: Wise Provider Network Commercial |
$51.30
|
|
|
HC ASSAY OF URINE POTASSIUM - POTASSIUM 24 HOUR URINE
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 84133
|
| Hospital Charge Code |
3018413305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.92
|
| Rate for Payer: Aetna of WY Medicare |
$35.64
|
| Rate for Payer: Altius Commercial |
$51.84
|
| Rate for Payer: Beech Street Commercial |
$52.92
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.38
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$52.38
|
| Rate for Payer: Cigna of WY Commercial |
$52.92
|
| Rate for Payer: Entrust Commercial |
$51.30
|
| Rate for Payer: First Choice Health Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$30.78
|
| Rate for Payer: HealthUtah PPO |
$54.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$52.38
|
| Rate for Payer: Multiplan Medicare/VA |
$29.24
|
| Rate for Payer: One Health Plan of WY PPO |
$52.92
|
| Rate for Payer: PacificSource Commercial |
$48.60
|
| Rate for Payer: PHCS PPO |
$52.92
|
| Rate for Payer: Three Rivers PPO |
$40.50
|
| Rate for Payer: TriWest Veterans Administration |
$30.78
|
| Rate for Payer: United Healthcare Commercial |
$51.57
|
| Rate for Payer: United Healthcare Medicare |
$30.78
|
| Rate for Payer: WINHealth Partners Commercial |
$52.92
|
| Rate for Payer: Wise Provider Network Commercial |
$51.30
|
|
|
HC ASSAY OF URINE POTASSIUM - POTASSIUM BODY FLUID
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 84133
|
| Hospital Charge Code |
3018413301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.92
|
| Rate for Payer: Aetna of WY Medicare |
$34.56
|
| Rate for Payer: Altius Commercial |
$51.84
|
| Rate for Payer: Beech Street Commercial |
$52.92
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.38
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$52.38
|
| Rate for Payer: Cigna of WY Commercial |
$52.92
|
| Rate for Payer: Entrust Commercial |
$51.30
|
| Rate for Payer: First Choice Health Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.94
|
| Rate for Payer: HealthUtah PPO |
$54.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$52.38
|
| Rate for Payer: Multiplan Medicare/VA |
$31.29
|
| Rate for Payer: One Health Plan of WY PPO |
$52.92
|
| Rate for Payer: PacificSource Commercial |
$48.60
|
| Rate for Payer: PHCS PPO |
$52.92
|
| Rate for Payer: Three Rivers PPO |
$40.50
|
| Rate for Payer: TriWest Veterans Administration |
$32.94
|
| Rate for Payer: United Healthcare Commercial |
$51.57
|
| Rate for Payer: United Healthcare Medicare |
$32.94
|
| Rate for Payer: WINHealth Partners Commercial |
$51.30
|
| Rate for Payer: Wise Provider Network Commercial |
$51.30
|
|
|
HC ASSAY OF URINE POTASSIUM - POTASSIUM BODY FLUID
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 84133
|
| Hospital Charge Code |
3018413301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.92
|
| Rate for Payer: Aetna of WY Medicare |
$35.64
|
| Rate for Payer: Altius Commercial |
$51.84
|
| Rate for Payer: Beech Street Commercial |
$52.92
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.38
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$52.38
|
| Rate for Payer: Cigna of WY Commercial |
$52.92
|
| Rate for Payer: Entrust Commercial |
$51.30
|
| Rate for Payer: First Choice Health Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$30.78
|
| Rate for Payer: HealthUtah PPO |
$54.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$52.38
|
| Rate for Payer: Multiplan Medicare/VA |
$29.24
|
| Rate for Payer: One Health Plan of WY PPO |
$52.92
|
| Rate for Payer: PacificSource Commercial |
$48.60
|
| Rate for Payer: PHCS PPO |
$52.92
|
| Rate for Payer: Three Rivers PPO |
$40.50
|
| Rate for Payer: TriWest Veterans Administration |
$30.78
|
| Rate for Payer: United Healthcare Commercial |
$51.57
|
| Rate for Payer: United Healthcare Medicare |
$30.78
|
| Rate for Payer: WINHealth Partners Commercial |
$52.92
|
| Rate for Payer: Wise Provider Network Commercial |
$51.30
|
|
|
HC ASSAY OF URINE POTASSIUM - POTASSIUM RANDOM URINE
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 84133
|
| Hospital Charge Code |
3018413303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.92
|
| Rate for Payer: Aetna of WY Medicare |
$34.56
|
| Rate for Payer: Altius Commercial |
$51.84
|
| Rate for Payer: Beech Street Commercial |
$52.92
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.38
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$52.38
|
| Rate for Payer: Cigna of WY Commercial |
$52.92
|
| Rate for Payer: Entrust Commercial |
$51.30
|
| Rate for Payer: First Choice Health Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.94
|
| Rate for Payer: HealthUtah PPO |
$54.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$52.38
|
| Rate for Payer: Multiplan Medicare/VA |
$31.29
|
| Rate for Payer: One Health Plan of WY PPO |
$52.92
|
| Rate for Payer: PacificSource Commercial |
$48.60
|
| Rate for Payer: PHCS PPO |
$52.92
|
| Rate for Payer: Three Rivers PPO |
$40.50
|
| Rate for Payer: TriWest Veterans Administration |
$32.94
|
| Rate for Payer: United Healthcare Commercial |
$51.57
|
| Rate for Payer: United Healthcare Medicare |
$32.94
|
| Rate for Payer: WINHealth Partners Commercial |
$51.30
|
| Rate for Payer: Wise Provider Network Commercial |
$51.30
|
|
|
HC ASSAY OF URINE POTASSIUM - POTASSIUM RANDOM URINE
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 84133
|
| Hospital Charge Code |
3018413303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$52.92
|
| Rate for Payer: Aetna of WY Medicare |
$35.64
|
| Rate for Payer: Altius Commercial |
$51.84
|
| Rate for Payer: Beech Street Commercial |
$52.92
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.38
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$52.38
|
| Rate for Payer: Cigna of WY Commercial |
$52.92
|
| Rate for Payer: Entrust Commercial |
$51.30
|
| Rate for Payer: First Choice Health Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$51.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$30.78
|
| Rate for Payer: HealthUtah PPO |
$54.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$52.38
|
| Rate for Payer: Multiplan Medicare/VA |
$29.24
|
| Rate for Payer: One Health Plan of WY PPO |
$52.92
|
| Rate for Payer: PacificSource Commercial |
$48.60
|
| Rate for Payer: PHCS PPO |
$52.92
|
| Rate for Payer: Three Rivers PPO |
$40.50
|
| Rate for Payer: TriWest Veterans Administration |
$30.78
|
| Rate for Payer: United Healthcare Commercial |
$51.57
|
| Rate for Payer: United Healthcare Medicare |
$30.78
|
| Rate for Payer: WINHealth Partners Commercial |
$52.92
|
| Rate for Payer: Wise Provider Network Commercial |
$51.30
|
|
|
HC ASSAY OF URINE SODIUM - SODIUM 24 HOUR URINE
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
HCPCS 84300
|
| Hospital Charge Code |
3018430003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$73.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$71.54
|
| Rate for Payer: Aetna of WY Medicare |
$46.72
|
| Rate for Payer: Altius Commercial |
$70.08
|
| Rate for Payer: Beech Street Commercial |
$71.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$70.81
|
| Rate for Payer: Cash Price |
$51.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$70.81
|
| Rate for Payer: Cigna of WY Commercial |
$71.54
|
| Rate for Payer: Entrust Commercial |
$69.35
|
| Rate for Payer: First Choice Health Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.53
|
| Rate for Payer: HealthUtah PPO |
$73.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$70.81
|
| Rate for Payer: Multiplan Medicare/VA |
$42.30
|
| Rate for Payer: One Health Plan of WY PPO |
$71.54
|
| Rate for Payer: PacificSource Commercial |
$65.70
|
| Rate for Payer: PHCS PPO |
$71.54
|
| Rate for Payer: Three Rivers PPO |
$54.75
|
| Rate for Payer: TriWest Veterans Administration |
$44.53
|
| Rate for Payer: United Healthcare Commercial |
$69.72
|
| Rate for Payer: United Healthcare Medicare |
$44.53
|
| Rate for Payer: WINHealth Partners Commercial |
$69.35
|
| Rate for Payer: Wise Provider Network Commercial |
$69.35
|
|
|
HC ASSAY OF URINE SODIUM - SODIUM 24 HOUR URINE
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
HCPCS 84300
|
| Hospital Charge Code |
3018430003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$73.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$71.54
|
| Rate for Payer: Aetna of WY Medicare |
$48.18
|
| Rate for Payer: Altius Commercial |
$70.08
|
| Rate for Payer: Beech Street Commercial |
$71.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$70.81
|
| Rate for Payer: Cash Price |
$51.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$70.81
|
| Rate for Payer: Cigna of WY Commercial |
$71.54
|
| Rate for Payer: Entrust Commercial |
$69.35
|
| Rate for Payer: First Choice Health Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.61
|
| Rate for Payer: HealthUtah PPO |
$73.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$70.81
|
| Rate for Payer: Multiplan Medicare/VA |
$39.53
|
| Rate for Payer: One Health Plan of WY PPO |
$71.54
|
| Rate for Payer: PacificSource Commercial |
$65.70
|
| Rate for Payer: PHCS PPO |
$71.54
|
| Rate for Payer: Three Rivers PPO |
$54.75
|
| Rate for Payer: TriWest Veterans Administration |
$41.61
|
| Rate for Payer: United Healthcare Commercial |
$69.72
|
| Rate for Payer: United Healthcare Medicare |
$41.61
|
| Rate for Payer: WINHealth Partners Commercial |
$71.54
|
| Rate for Payer: Wise Provider Network Commercial |
$69.35
|
|
|
HC ASSAY OF URINE SODIUM - SODIUM RANDOM URINE
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
HCPCS 84300
|
| Hospital Charge Code |
3018430001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$73.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$71.54
|
| Rate for Payer: Aetna of WY Medicare |
$48.18
|
| Rate for Payer: Altius Commercial |
$70.08
|
| Rate for Payer: Beech Street Commercial |
$71.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$70.81
|
| Rate for Payer: Cash Price |
$51.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$70.81
|
| Rate for Payer: Cigna of WY Commercial |
$71.54
|
| Rate for Payer: Entrust Commercial |
$69.35
|
| Rate for Payer: First Choice Health Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.61
|
| Rate for Payer: HealthUtah PPO |
$73.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$70.81
|
| Rate for Payer: Multiplan Medicare/VA |
$39.53
|
| Rate for Payer: One Health Plan of WY PPO |
$71.54
|
| Rate for Payer: PacificSource Commercial |
$65.70
|
| Rate for Payer: PHCS PPO |
$71.54
|
| Rate for Payer: Three Rivers PPO |
$54.75
|
| Rate for Payer: TriWest Veterans Administration |
$41.61
|
| Rate for Payer: United Healthcare Commercial |
$69.72
|
| Rate for Payer: United Healthcare Medicare |
$41.61
|
| Rate for Payer: WINHealth Partners Commercial |
$71.54
|
| Rate for Payer: Wise Provider Network Commercial |
$69.35
|
|
|
HC ASSAY OF URINE SODIUM - SODIUM RANDOM URINE
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
HCPCS 84300
|
| Hospital Charge Code |
3018430001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$73.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$71.54
|
| Rate for Payer: Aetna of WY Medicare |
$46.72
|
| Rate for Payer: Altius Commercial |
$70.08
|
| Rate for Payer: Beech Street Commercial |
$71.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$70.81
|
| Rate for Payer: Cash Price |
$51.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$70.81
|
| Rate for Payer: Cigna of WY Commercial |
$71.54
|
| Rate for Payer: Entrust Commercial |
$69.35
|
| Rate for Payer: First Choice Health Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.53
|
| Rate for Payer: HealthUtah PPO |
$73.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$70.81
|
| Rate for Payer: Multiplan Medicare/VA |
$42.30
|
| Rate for Payer: One Health Plan of WY PPO |
$71.54
|
| Rate for Payer: PacificSource Commercial |
$65.70
|
| Rate for Payer: PHCS PPO |
$71.54
|
| Rate for Payer: Three Rivers PPO |
$54.75
|
| Rate for Payer: TriWest Veterans Administration |
$44.53
|
| Rate for Payer: United Healthcare Commercial |
$69.72
|
| Rate for Payer: United Healthcare Medicare |
$44.53
|
| Rate for Payer: WINHealth Partners Commercial |
$69.35
|
| Rate for Payer: Wise Provider Network Commercial |
$69.35
|
|
|
HC ASSAY OF URINE SULFATE - SULFATE, URINE
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
HCPCS 84392
|
| Hospital Charge Code |
3018439201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.78 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$53.90
|
| Rate for Payer: Aetna of WY Medicare |
$36.30
|
| Rate for Payer: Altius Commercial |
$52.80
|
| Rate for Payer: Beech Street Commercial |
$53.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$53.35
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$53.35
|
| Rate for Payer: Cigna of WY Commercial |
$53.90
|
| Rate for Payer: Entrust Commercial |
$52.25
|
| Rate for Payer: First Choice Health Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.35
|
| Rate for Payer: HealthUtah PPO |
$55.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$53.35
|
| Rate for Payer: Multiplan Medicare/VA |
$29.78
|
| Rate for Payer: One Health Plan of WY PPO |
$53.90
|
| Rate for Payer: PacificSource Commercial |
$49.50
|
| Rate for Payer: PHCS PPO |
$53.90
|
| Rate for Payer: Three Rivers PPO |
$41.25
|
| Rate for Payer: TriWest Veterans Administration |
$31.35
|
| Rate for Payer: United Healthcare Commercial |
$52.52
|
| Rate for Payer: United Healthcare Medicare |
$31.35
|
| Rate for Payer: WINHealth Partners Commercial |
$53.90
|
| Rate for Payer: Wise Provider Network Commercial |
$52.25
|
|
|
HC ASSAY OF URINE SULFATE - SULFATE, URINE
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
HCPCS 84392
|
| Hospital Charge Code |
3018439201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.87 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$53.90
|
| Rate for Payer: Aetna of WY Medicare |
$35.20
|
| Rate for Payer: Altius Commercial |
$52.80
|
| Rate for Payer: Beech Street Commercial |
$53.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$53.35
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$53.35
|
| Rate for Payer: Cigna of WY Commercial |
$53.90
|
| Rate for Payer: Entrust Commercial |
$52.25
|
| Rate for Payer: First Choice Health Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$52.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$33.55
|
| Rate for Payer: HealthUtah PPO |
$55.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$53.35
|
| Rate for Payer: Multiplan Medicare/VA |
$31.87
|
| Rate for Payer: One Health Plan of WY PPO |
$53.90
|
| Rate for Payer: PacificSource Commercial |
$49.50
|
| Rate for Payer: PHCS PPO |
$53.90
|
| Rate for Payer: Three Rivers PPO |
$41.25
|
| Rate for Payer: TriWest Veterans Administration |
$33.55
|
| Rate for Payer: United Healthcare Commercial |
$52.52
|
| Rate for Payer: United Healthcare Medicare |
$33.55
|
| Rate for Payer: WINHealth Partners Commercial |
$52.25
|
| Rate for Payer: Wise Provider Network Commercial |
$52.25
|
|
|
HC ASSAY OF URINE VMA - VMA, URINE
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
HCPCS 84585
|
| Hospital Charge Code |
3018458502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.56 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$131.32
|
| Rate for Payer: Aetna of WY Medicare |
$88.44
|
| Rate for Payer: Altius Commercial |
$128.64
|
| Rate for Payer: Beech Street Commercial |
$131.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$129.98
|
| Rate for Payer: Cash Price |
$93.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$129.98
|
| Rate for Payer: Cigna of WY Commercial |
$131.32
|
| Rate for Payer: Entrust Commercial |
$127.30
|
| Rate for Payer: First Choice Health Commercial |
$127.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$127.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$76.38
|
| Rate for Payer: HealthUtah PPO |
$134.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$129.98
|
| Rate for Payer: Multiplan Medicare/VA |
$72.56
|
| Rate for Payer: One Health Plan of WY PPO |
$131.32
|
| Rate for Payer: PacificSource Commercial |
$120.60
|
| Rate for Payer: PHCS PPO |
$131.32
|
| Rate for Payer: Three Rivers PPO |
$100.50
|
| Rate for Payer: TriWest Veterans Administration |
$76.38
|
| Rate for Payer: United Healthcare Commercial |
$127.97
|
| Rate for Payer: United Healthcare Medicare |
$76.38
|
| Rate for Payer: WINHealth Partners Commercial |
$131.32
|
| Rate for Payer: Wise Provider Network Commercial |
$127.30
|
|
|
HC ASSAY OF URINE VMA - VMA, URINE
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
HCPCS 84585
|
| Hospital Charge Code |
3018458502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.65 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$131.32
|
| Rate for Payer: Aetna of WY Medicare |
$85.76
|
| Rate for Payer: Altius Commercial |
$128.64
|
| Rate for Payer: Beech Street Commercial |
$131.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$129.98
|
| Rate for Payer: Cash Price |
$93.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$129.98
|
| Rate for Payer: Cigna of WY Commercial |
$131.32
|
| Rate for Payer: Entrust Commercial |
$127.30
|
| Rate for Payer: First Choice Health Commercial |
$127.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$127.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$81.74
|
| Rate for Payer: HealthUtah PPO |
$134.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$129.98
|
| Rate for Payer: Multiplan Medicare/VA |
$77.65
|
| Rate for Payer: One Health Plan of WY PPO |
$131.32
|
| Rate for Payer: PacificSource Commercial |
$120.60
|
| Rate for Payer: PHCS PPO |
$131.32
|
| Rate for Payer: Three Rivers PPO |
$100.50
|
| Rate for Payer: TriWest Veterans Administration |
$81.74
|
| Rate for Payer: United Healthcare Commercial |
$127.97
|
| Rate for Payer: United Healthcare Medicare |
$81.74
|
| Rate for Payer: WINHealth Partners Commercial |
$127.30
|
| Rate for Payer: Wise Provider Network Commercial |
$127.30
|
|
