|
HC BACTERIA CULTURE SCREEN - STREP CULTURE GRP A
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
3068708103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.74 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$88.20
|
| Rate for Payer: Aetna of WY Medicare |
$59.40
|
| Rate for Payer: Altius Commercial |
$86.40
|
| Rate for Payer: Beech Street Commercial |
$88.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$87.30
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$87.30
|
| Rate for Payer: Cigna of WY Commercial |
$88.20
|
| Rate for Payer: Entrust Commercial |
$85.50
|
| Rate for Payer: First Choice Health Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$85.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.30
|
| Rate for Payer: HealthUtah PPO |
$90.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$87.30
|
| Rate for Payer: Multiplan Medicare/VA |
$48.74
|
| Rate for Payer: One Health Plan of WY PPO |
$88.20
|
| Rate for Payer: PacificSource Commercial |
$81.00
|
| Rate for Payer: PHCS PPO |
$88.20
|
| Rate for Payer: Three Rivers PPO |
$67.50
|
| Rate for Payer: TriWest Veterans Administration |
$51.30
|
| Rate for Payer: United Healthcare Commercial |
$85.95
|
| Rate for Payer: United Healthcare Medicare |
$51.30
|
| Rate for Payer: WINHealth Partners Commercial |
$88.20
|
| Rate for Payer: Wise Provider Network Commercial |
$85.50
|
|
|
HC BACTERIUM, ANTIBODY
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660903
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$91.56 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$154.84
|
| Rate for Payer: Aetna of WY Medicare |
$101.12
|
| Rate for Payer: Altius Commercial |
$151.68
|
| Rate for Payer: Beech Street Commercial |
$154.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$153.26
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$153.26
|
| Rate for Payer: Cigna of WY Commercial |
$154.84
|
| Rate for Payer: Entrust Commercial |
$150.10
|
| Rate for Payer: First Choice Health Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$96.38
|
| Rate for Payer: HealthUtah PPO |
$158.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$153.26
|
| Rate for Payer: Multiplan Medicare/VA |
$91.56
|
| Rate for Payer: One Health Plan of WY PPO |
$154.84
|
| Rate for Payer: PacificSource Commercial |
$142.20
|
| Rate for Payer: PHCS PPO |
$154.84
|
| Rate for Payer: Three Rivers PPO |
$118.50
|
| Rate for Payer: TriWest Veterans Administration |
$96.38
|
| Rate for Payer: United Healthcare Commercial |
$150.89
|
| Rate for Payer: United Healthcare Medicare |
$96.38
|
| Rate for Payer: WINHealth Partners Commercial |
$150.10
|
| Rate for Payer: Wise Provider Network Commercial |
$150.10
|
|
|
HC BACTERIUM, ANTIBODY
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660903
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$85.56 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$154.84
|
| Rate for Payer: Aetna of WY Medicare |
$104.28
|
| Rate for Payer: Altius Commercial |
$151.68
|
| Rate for Payer: Beech Street Commercial |
$154.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$153.26
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$153.26
|
| Rate for Payer: Cigna of WY Commercial |
$154.84
|
| Rate for Payer: Entrust Commercial |
$150.10
|
| Rate for Payer: First Choice Health Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$90.06
|
| Rate for Payer: HealthUtah PPO |
$158.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$153.26
|
| Rate for Payer: Multiplan Medicare/VA |
$85.56
|
| Rate for Payer: One Health Plan of WY PPO |
$154.84
|
| Rate for Payer: PacificSource Commercial |
$142.20
|
| Rate for Payer: PHCS PPO |
$154.84
|
| Rate for Payer: Three Rivers PPO |
$118.50
|
| Rate for Payer: TriWest Veterans Administration |
$90.06
|
| Rate for Payer: United Healthcare Commercial |
$150.89
|
| Rate for Payer: United Healthcare Medicare |
$90.06
|
| Rate for Payer: WINHealth Partners Commercial |
$154.84
|
| Rate for Payer: Wise Provider Network Commercial |
$150.10
|
|
|
HC BACTERIUM, ANTIBODY - LISTERIA ANTIBODY TOTAL
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660909
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$85.56 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$154.84
|
| Rate for Payer: Aetna of WY Medicare |
$104.28
|
| Rate for Payer: Altius Commercial |
$151.68
|
| Rate for Payer: Beech Street Commercial |
$154.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$153.26
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$153.26
|
| Rate for Payer: Cigna of WY Commercial |
$154.84
|
| Rate for Payer: Entrust Commercial |
$150.10
|
| Rate for Payer: First Choice Health Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$90.06
|
| Rate for Payer: HealthUtah PPO |
$158.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$153.26
|
| Rate for Payer: Multiplan Medicare/VA |
$85.56
|
| Rate for Payer: One Health Plan of WY PPO |
$154.84
|
| Rate for Payer: PacificSource Commercial |
$142.20
|
| Rate for Payer: PHCS PPO |
$154.84
|
| Rate for Payer: Three Rivers PPO |
$118.50
|
| Rate for Payer: TriWest Veterans Administration |
$90.06
|
| Rate for Payer: United Healthcare Commercial |
$150.89
|
| Rate for Payer: United Healthcare Medicare |
$90.06
|
| Rate for Payer: WINHealth Partners Commercial |
$154.84
|
| Rate for Payer: Wise Provider Network Commercial |
$150.10
|
|
|
HC BACTERIUM, ANTIBODY - LISTERIA ANTIBODY TOTAL
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660909
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$91.56 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$154.84
|
| Rate for Payer: Aetna of WY Medicare |
$101.12
|
| Rate for Payer: Altius Commercial |
$151.68
|
| Rate for Payer: Beech Street Commercial |
$154.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$153.26
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$153.26
|
| Rate for Payer: Cigna of WY Commercial |
$154.84
|
| Rate for Payer: Entrust Commercial |
$150.10
|
| Rate for Payer: First Choice Health Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$96.38
|
| Rate for Payer: HealthUtah PPO |
$158.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$153.26
|
| Rate for Payer: Multiplan Medicare/VA |
$91.56
|
| Rate for Payer: One Health Plan of WY PPO |
$154.84
|
| Rate for Payer: PacificSource Commercial |
$142.20
|
| Rate for Payer: PHCS PPO |
$154.84
|
| Rate for Payer: Three Rivers PPO |
$118.50
|
| Rate for Payer: TriWest Veterans Administration |
$96.38
|
| Rate for Payer: United Healthcare Commercial |
$150.89
|
| Rate for Payer: United Healthcare Medicare |
$96.38
|
| Rate for Payer: WINHealth Partners Commercial |
$150.10
|
| Rate for Payer: Wise Provider Network Commercial |
$150.10
|
|
|
HC BACTERIUM, ANTIBODY - SACCHAROPOLYSPORA RECTIVIRGULA
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660904
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$155.41 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$189.42
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.59
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$155.41
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$163.59
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$163.59
|
| Rate for Payer: WINHealth Partners Commercial |
$281.26
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - SACCHAROPOLYSPORA RECTIVIRGULA
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660904
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$183.68
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$175.07
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$166.32
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$175.07
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$175.07
|
| Rate for Payer: WINHealth Partners Commercial |
$272.65
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - THERMOACTINOMYCES CANDIDUS
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660907
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$155.41 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$189.42
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.59
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$155.41
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$163.59
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$163.59
|
| Rate for Payer: WINHealth Partners Commercial |
$281.26
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - THERMOACTINOMYCES CANDIDUS
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660907
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$183.68
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$175.07
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$166.32
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$175.07
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$175.07
|
| Rate for Payer: WINHealth Partners Commercial |
$272.65
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - THERMOACTINOMYCES SACCHARI
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660906
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$155.41 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$189.42
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.59
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$155.41
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$163.59
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$163.59
|
| Rate for Payer: WINHealth Partners Commercial |
$281.26
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - THERMOACTINOMYCES SACCHARI
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660906
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$183.68
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$175.07
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$166.32
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$175.07
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$175.07
|
| Rate for Payer: WINHealth Partners Commercial |
$272.65
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - THERMOACTINOMYCES VULGARIS
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660905
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$183.68
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$175.07
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$166.32
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$175.07
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$175.07
|
| Rate for Payer: WINHealth Partners Commercial |
$272.65
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - THERMOACTINOMYCES VULGARIS
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660905
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$155.41 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$281.26
|
| Rate for Payer: Aetna of WY Medicare |
$189.42
|
| Rate for Payer: Altius Commercial |
$275.52
|
| Rate for Payer: Beech Street Commercial |
$281.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$278.39
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$278.39
|
| Rate for Payer: Cigna of WY Commercial |
$281.26
|
| Rate for Payer: Entrust Commercial |
$272.65
|
| Rate for Payer: First Choice Health Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$272.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.59
|
| Rate for Payer: HealthUtah PPO |
$287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$278.39
|
| Rate for Payer: Multiplan Medicare/VA |
$155.41
|
| Rate for Payer: One Health Plan of WY PPO |
$281.26
|
| Rate for Payer: PacificSource Commercial |
$258.30
|
| Rate for Payer: PHCS PPO |
$281.26
|
| Rate for Payer: Three Rivers PPO |
$215.25
|
| Rate for Payer: TriWest Veterans Administration |
$163.59
|
| Rate for Payer: United Healthcare Commercial |
$274.08
|
| Rate for Payer: United Healthcare Medicare |
$163.59
|
| Rate for Payer: WINHealth Partners Commercial |
$281.26
|
| Rate for Payer: Wise Provider Network Commercial |
$272.65
|
|
|
HC BACTERIUM, ANTIBODY - TOXIC SHOCK SYNDROME ANTIBODY
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660902
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$91.56 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$154.84
|
| Rate for Payer: Aetna of WY Medicare |
$101.12
|
| Rate for Payer: Altius Commercial |
$151.68
|
| Rate for Payer: Beech Street Commercial |
$154.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$153.26
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$153.26
|
| Rate for Payer: Cigna of WY Commercial |
$154.84
|
| Rate for Payer: Entrust Commercial |
$150.10
|
| Rate for Payer: First Choice Health Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$96.38
|
| Rate for Payer: HealthUtah PPO |
$158.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$153.26
|
| Rate for Payer: Multiplan Medicare/VA |
$91.56
|
| Rate for Payer: One Health Plan of WY PPO |
$154.84
|
| Rate for Payer: PacificSource Commercial |
$142.20
|
| Rate for Payer: PHCS PPO |
$154.84
|
| Rate for Payer: Three Rivers PPO |
$118.50
|
| Rate for Payer: TriWest Veterans Administration |
$96.38
|
| Rate for Payer: United Healthcare Commercial |
$150.89
|
| Rate for Payer: United Healthcare Medicare |
$96.38
|
| Rate for Payer: WINHealth Partners Commercial |
$150.10
|
| Rate for Payer: Wise Provider Network Commercial |
$150.10
|
|
|
HC BACTERIUM, ANTIBODY - TOXIC SHOCK SYNDROME ANTIBODY
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660902
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$85.56 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$154.84
|
| Rate for Payer: Aetna of WY Medicare |
$104.28
|
| Rate for Payer: Altius Commercial |
$151.68
|
| Rate for Payer: Beech Street Commercial |
$154.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$153.26
|
| Rate for Payer: Cash Price |
$110.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$153.26
|
| Rate for Payer: Cigna of WY Commercial |
$154.84
|
| Rate for Payer: Entrust Commercial |
$150.10
|
| Rate for Payer: First Choice Health Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$150.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$90.06
|
| Rate for Payer: HealthUtah PPO |
$158.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$153.26
|
| Rate for Payer: Multiplan Medicare/VA |
$85.56
|
| Rate for Payer: One Health Plan of WY PPO |
$154.84
|
| Rate for Payer: PacificSource Commercial |
$142.20
|
| Rate for Payer: PHCS PPO |
$154.84
|
| Rate for Payer: Three Rivers PPO |
$118.50
|
| Rate for Payer: TriWest Veterans Administration |
$90.06
|
| Rate for Payer: United Healthcare Commercial |
$150.89
|
| Rate for Payer: United Healthcare Medicare |
$90.06
|
| Rate for Payer: WINHealth Partners Commercial |
$154.84
|
| Rate for Payer: Wise Provider Network Commercial |
$150.10
|
|
|
HC BACTERIUM, ANTIBODY - TRICHODERM VIRIDE IGG
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660908
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$152.70 |
| Max. Negotiated Rate |
$282.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$276.36
|
| Rate for Payer: Aetna of WY Medicare |
$186.12
|
| Rate for Payer: Altius Commercial |
$270.72
|
| Rate for Payer: Beech Street Commercial |
$276.36
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$273.54
|
| Rate for Payer: Cash Price |
$197.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$273.54
|
| Rate for Payer: Cigna of WY Commercial |
$276.36
|
| Rate for Payer: Entrust Commercial |
$267.90
|
| Rate for Payer: First Choice Health Commercial |
$267.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$267.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$160.74
|
| Rate for Payer: HealthUtah PPO |
$282.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$273.54
|
| Rate for Payer: Multiplan Medicare/VA |
$152.70
|
| Rate for Payer: One Health Plan of WY PPO |
$276.36
|
| Rate for Payer: PacificSource Commercial |
$253.80
|
| Rate for Payer: PHCS PPO |
$276.36
|
| Rate for Payer: Three Rivers PPO |
$211.50
|
| Rate for Payer: TriWest Veterans Administration |
$160.74
|
| Rate for Payer: United Healthcare Commercial |
$269.31
|
| Rate for Payer: United Healthcare Medicare |
$160.74
|
| Rate for Payer: WINHealth Partners Commercial |
$276.36
|
| Rate for Payer: Wise Provider Network Commercial |
$267.90
|
|
|
HC BACTERIUM, ANTIBODY - TRICHODERM VIRIDE IGG
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
3028660908
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$163.42 |
| Max. Negotiated Rate |
$282.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$276.36
|
| Rate for Payer: Aetna of WY Medicare |
$180.48
|
| Rate for Payer: Altius Commercial |
$270.72
|
| Rate for Payer: Beech Street Commercial |
$276.36
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$273.54
|
| Rate for Payer: Cash Price |
$197.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$273.54
|
| Rate for Payer: Cigna of WY Commercial |
$276.36
|
| Rate for Payer: Entrust Commercial |
$267.90
|
| Rate for Payer: First Choice Health Commercial |
$267.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$267.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$172.02
|
| Rate for Payer: HealthUtah PPO |
$282.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$273.54
|
| Rate for Payer: Multiplan Medicare/VA |
$163.42
|
| Rate for Payer: One Health Plan of WY PPO |
$276.36
|
| Rate for Payer: PacificSource Commercial |
$253.80
|
| Rate for Payer: PHCS PPO |
$276.36
|
| Rate for Payer: Three Rivers PPO |
$211.50
|
| Rate for Payer: TriWest Veterans Administration |
$172.02
|
| Rate for Payer: United Healthcare Commercial |
$269.31
|
| Rate for Payer: United Healthcare Medicare |
$172.02
|
| Rate for Payer: WINHealth Partners Commercial |
$267.90
|
| Rate for Payer: Wise Provider Network Commercial |
$267.90
|
|
|
HC BARTONELLA, ANTIBODY - BARTONELLA AB IGG
|
Facility
|
OP
|
$164.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3028661102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$88.81 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.72
|
| Rate for Payer: Aetna of WY Medicare |
$108.24
|
| Rate for Payer: Altius Commercial |
$157.44
|
| Rate for Payer: Beech Street Commercial |
$160.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$159.08
|
| Rate for Payer: Cash Price |
$114.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$159.08
|
| Rate for Payer: Cigna of WY Commercial |
$160.72
|
| Rate for Payer: Entrust Commercial |
$155.80
|
| Rate for Payer: First Choice Health Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$93.48
|
| Rate for Payer: HealthUtah PPO |
$164.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$159.08
|
| Rate for Payer: Multiplan Medicare/VA |
$88.81
|
| Rate for Payer: One Health Plan of WY PPO |
$160.72
|
| Rate for Payer: PacificSource Commercial |
$147.60
|
| Rate for Payer: PHCS PPO |
$160.72
|
| Rate for Payer: Three Rivers PPO |
$123.00
|
| Rate for Payer: TriWest Veterans Administration |
$93.48
|
| Rate for Payer: United Healthcare Commercial |
$156.62
|
| Rate for Payer: United Healthcare Medicare |
$93.48
|
| Rate for Payer: WINHealth Partners Commercial |
$160.72
|
| Rate for Payer: Wise Provider Network Commercial |
$155.80
|
|
|
HC BARTONELLA, ANTIBODY - BARTONELLA AB IGG
|
Facility
|
IP
|
$164.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3028661102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$95.04 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.72
|
| Rate for Payer: Aetna of WY Medicare |
$104.96
|
| Rate for Payer: Altius Commercial |
$157.44
|
| Rate for Payer: Beech Street Commercial |
$160.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$159.08
|
| Rate for Payer: Cash Price |
$114.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$159.08
|
| Rate for Payer: Cigna of WY Commercial |
$160.72
|
| Rate for Payer: Entrust Commercial |
$155.80
|
| Rate for Payer: First Choice Health Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.04
|
| Rate for Payer: HealthUtah PPO |
$164.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$159.08
|
| Rate for Payer: Multiplan Medicare/VA |
$95.04
|
| Rate for Payer: One Health Plan of WY PPO |
$160.72
|
| Rate for Payer: PacificSource Commercial |
$147.60
|
| Rate for Payer: PHCS PPO |
$160.72
|
| Rate for Payer: Three Rivers PPO |
$123.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.04
|
| Rate for Payer: United Healthcare Commercial |
$156.62
|
| Rate for Payer: United Healthcare Medicare |
$100.04
|
| Rate for Payer: WINHealth Partners Commercial |
$155.80
|
| Rate for Payer: Wise Provider Network Commercial |
$155.80
|
|
|
HC BARTONELLA, ANTIBODY - BARTONELLA AB IGM
|
Facility
|
OP
|
$164.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3028661103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$88.81 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.72
|
| Rate for Payer: Aetna of WY Medicare |
$108.24
|
| Rate for Payer: Altius Commercial |
$157.44
|
| Rate for Payer: Beech Street Commercial |
$160.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$159.08
|
| Rate for Payer: Cash Price |
$114.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$159.08
|
| Rate for Payer: Cigna of WY Commercial |
$160.72
|
| Rate for Payer: Entrust Commercial |
$155.80
|
| Rate for Payer: First Choice Health Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$93.48
|
| Rate for Payer: HealthUtah PPO |
$164.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$159.08
|
| Rate for Payer: Multiplan Medicare/VA |
$88.81
|
| Rate for Payer: One Health Plan of WY PPO |
$160.72
|
| Rate for Payer: PacificSource Commercial |
$147.60
|
| Rate for Payer: PHCS PPO |
$160.72
|
| Rate for Payer: Three Rivers PPO |
$123.00
|
| Rate for Payer: TriWest Veterans Administration |
$93.48
|
| Rate for Payer: United Healthcare Commercial |
$156.62
|
| Rate for Payer: United Healthcare Medicare |
$93.48
|
| Rate for Payer: WINHealth Partners Commercial |
$160.72
|
| Rate for Payer: Wise Provider Network Commercial |
$155.80
|
|
|
HC BARTONELLA, ANTIBODY - BARTONELLA AB IGM
|
Facility
|
IP
|
$164.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3028661103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$95.04 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.72
|
| Rate for Payer: Aetna of WY Medicare |
$104.96
|
| Rate for Payer: Altius Commercial |
$157.44
|
| Rate for Payer: Beech Street Commercial |
$160.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$159.08
|
| Rate for Payer: Cash Price |
$114.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$159.08
|
| Rate for Payer: Cigna of WY Commercial |
$160.72
|
| Rate for Payer: Entrust Commercial |
$155.80
|
| Rate for Payer: First Choice Health Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.04
|
| Rate for Payer: HealthUtah PPO |
$164.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$159.08
|
| Rate for Payer: Multiplan Medicare/VA |
$95.04
|
| Rate for Payer: One Health Plan of WY PPO |
$160.72
|
| Rate for Payer: PacificSource Commercial |
$147.60
|
| Rate for Payer: PHCS PPO |
$160.72
|
| Rate for Payer: Three Rivers PPO |
$123.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.04
|
| Rate for Payer: United Healthcare Commercial |
$156.62
|
| Rate for Payer: United Healthcare Medicare |
$100.04
|
| Rate for Payer: WINHealth Partners Commercial |
$155.80
|
| Rate for Payer: Wise Provider Network Commercial |
$155.80
|
|
|
HC BARTONELLA, ANTIBODY - BARTONELLA AB PANEL
|
Facility
|
OP
|
$164.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3028661101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$88.81 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.72
|
| Rate for Payer: Aetna of WY Medicare |
$108.24
|
| Rate for Payer: Altius Commercial |
$157.44
|
| Rate for Payer: Beech Street Commercial |
$160.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$159.08
|
| Rate for Payer: Cash Price |
$114.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$159.08
|
| Rate for Payer: Cigna of WY Commercial |
$160.72
|
| Rate for Payer: Entrust Commercial |
$155.80
|
| Rate for Payer: First Choice Health Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$93.48
|
| Rate for Payer: HealthUtah PPO |
$164.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$159.08
|
| Rate for Payer: Multiplan Medicare/VA |
$88.81
|
| Rate for Payer: One Health Plan of WY PPO |
$160.72
|
| Rate for Payer: PacificSource Commercial |
$147.60
|
| Rate for Payer: PHCS PPO |
$160.72
|
| Rate for Payer: Three Rivers PPO |
$123.00
|
| Rate for Payer: TriWest Veterans Administration |
$93.48
|
| Rate for Payer: United Healthcare Commercial |
$156.62
|
| Rate for Payer: United Healthcare Medicare |
$93.48
|
| Rate for Payer: WINHealth Partners Commercial |
$160.72
|
| Rate for Payer: Wise Provider Network Commercial |
$155.80
|
|
|
HC BARTONELLA, ANTIBODY - BARTONELLA AB PANEL
|
Facility
|
IP
|
$164.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3028661101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$95.04 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.72
|
| Rate for Payer: Aetna of WY Medicare |
$104.96
|
| Rate for Payer: Altius Commercial |
$157.44
|
| Rate for Payer: Beech Street Commercial |
$160.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$159.08
|
| Rate for Payer: Cash Price |
$114.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$159.08
|
| Rate for Payer: Cigna of WY Commercial |
$160.72
|
| Rate for Payer: Entrust Commercial |
$155.80
|
| Rate for Payer: First Choice Health Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.04
|
| Rate for Payer: HealthUtah PPO |
$164.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$159.08
|
| Rate for Payer: Multiplan Medicare/VA |
$95.04
|
| Rate for Payer: One Health Plan of WY PPO |
$160.72
|
| Rate for Payer: PacificSource Commercial |
$147.60
|
| Rate for Payer: PHCS PPO |
$160.72
|
| Rate for Payer: Three Rivers PPO |
$123.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.04
|
| Rate for Payer: United Healthcare Commercial |
$156.62
|
| Rate for Payer: United Healthcare Medicare |
$100.04
|
| Rate for Payer: WINHealth Partners Commercial |
$155.80
|
| Rate for Payer: Wise Provider Network Commercial |
$155.80
|
|
|
HC BASIC METABOLIC PANEL CALCIUM TOTAL
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
HCPCS 80048
|
| Hospital Charge Code |
3018004801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$116.48 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$196.98
|
| Rate for Payer: Aetna of WY Medicare |
$128.64
|
| Rate for Payer: Altius Commercial |
$192.96
|
| Rate for Payer: Beech Street Commercial |
$196.98
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$194.97
|
| Rate for Payer: Cash Price |
$140.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$194.97
|
| Rate for Payer: Cigna of WY Commercial |
$196.98
|
| Rate for Payer: Entrust Commercial |
$190.95
|
| Rate for Payer: First Choice Health Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$122.61
|
| Rate for Payer: HealthUtah PPO |
$201.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$194.97
|
| Rate for Payer: Multiplan Medicare/VA |
$116.48
|
| Rate for Payer: One Health Plan of WY PPO |
$196.98
|
| Rate for Payer: PacificSource Commercial |
$180.90
|
| Rate for Payer: PHCS PPO |
$196.98
|
| Rate for Payer: Three Rivers PPO |
$150.75
|
| Rate for Payer: TriWest Veterans Administration |
$122.61
|
| Rate for Payer: United Healthcare Commercial |
$191.96
|
| Rate for Payer: United Healthcare Medicare |
$122.61
|
| Rate for Payer: WINHealth Partners Commercial |
$190.95
|
| Rate for Payer: Wise Provider Network Commercial |
$190.95
|
|
|
HC BASIC METABOLIC PANEL CALCIUM TOTAL
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
HCPCS 80048
|
| Hospital Charge Code |
3018004801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.84 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$196.98
|
| Rate for Payer: Aetna of WY Medicare |
$132.66
|
| Rate for Payer: Altius Commercial |
$192.96
|
| Rate for Payer: Beech Street Commercial |
$196.98
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$194.97
|
| Rate for Payer: Cash Price |
$140.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$194.97
|
| Rate for Payer: Cigna of WY Commercial |
$196.98
|
| Rate for Payer: Entrust Commercial |
$190.95
|
| Rate for Payer: First Choice Health Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$190.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$114.57
|
| Rate for Payer: HealthUtah PPO |
$201.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$194.97
|
| Rate for Payer: Multiplan Medicare/VA |
$108.84
|
| Rate for Payer: One Health Plan of WY PPO |
$196.98
|
| Rate for Payer: PacificSource Commercial |
$180.90
|
| Rate for Payer: PHCS PPO |
$196.98
|
| Rate for Payer: Three Rivers PPO |
$150.75
|
| Rate for Payer: TriWest Veterans Administration |
$114.57
|
| Rate for Payer: United Healthcare Commercial |
$191.96
|
| Rate for Payer: United Healthcare Medicare |
$114.57
|
| Rate for Payer: WINHealth Partners Commercial |
$196.98
|
| Rate for Payer: Wise Provider Network Commercial |
$190.95
|
|
