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Service Code HCPCS 86160
Hospital Charge Code 3028616001
Hospital Revenue Code 302
Min. Negotiated Rate $94.76
Max. Negotiated Rate $175.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $171.50
Rate for Payer: Aetna of WY Medicare $115.50
Rate for Payer: Altius Commercial $168.00
Rate for Payer: Beech Street Commercial $171.50
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $169.75
Rate for Payer: Cash Price $122.50
Rate for Payer: ChoiceCare Network Commercial $169.75
Rate for Payer: Cigna of WY Commercial $171.50
Rate for Payer: Entrust Commercial $166.25
Rate for Payer: First Choice Health Commercial $166.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $166.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $99.75
Rate for Payer: HealthUtah PPO $175.00
Rate for Payer: Idaho Integrated Healthcare Commercial $169.75
Rate for Payer: Multiplan Medicare/VA $94.76
Rate for Payer: One Health Plan of WY PPO $171.50
Rate for Payer: PacificSource Commercial $157.50
Rate for Payer: PHCS PPO $171.50
Rate for Payer: Three Rivers PPO $131.25
Rate for Payer: TriWest Veterans Administration $99.75
Rate for Payer: United Healthcare Commercial $167.12
Rate for Payer: United Healthcare Medicare $99.75
Rate for Payer: WINHealth Partners Commercial $171.50
Rate for Payer: Wise Provider Network Commercial $166.25
Service Code HCPCS 86160
Hospital Charge Code 3028616001
Hospital Revenue Code 302
Min. Negotiated Rate $101.41
Max. Negotiated Rate $175.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $171.50
Rate for Payer: Aetna of WY Medicare $112.00
Rate for Payer: Altius Commercial $168.00
Rate for Payer: Beech Street Commercial $171.50
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $169.75
Rate for Payer: Cash Price $122.50
Rate for Payer: ChoiceCare Network Commercial $169.75
Rate for Payer: Cigna of WY Commercial $171.50
Rate for Payer: Entrust Commercial $166.25
Rate for Payer: First Choice Health Commercial $166.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $166.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $106.75
Rate for Payer: HealthUtah PPO $175.00
Rate for Payer: Idaho Integrated Healthcare Commercial $169.75
Rate for Payer: Multiplan Medicare/VA $101.41
Rate for Payer: One Health Plan of WY PPO $171.50
Rate for Payer: PacificSource Commercial $157.50
Rate for Payer: PHCS PPO $171.50
Rate for Payer: Three Rivers PPO $131.25
Rate for Payer: TriWest Veterans Administration $106.75
Rate for Payer: United Healthcare Commercial $167.12
Rate for Payer: United Healthcare Medicare $106.75
Rate for Payer: WINHealth Partners Commercial $166.25
Rate for Payer: Wise Provider Network Commercial $166.25
Service Code HCPCS 86160
Hospital Charge Code 3028616004
Hospital Revenue Code 302
Min. Negotiated Rate $56.86
Max. Negotiated Rate $105.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $102.90
Rate for Payer: Aetna of WY Medicare $69.30
Rate for Payer: Altius Commercial $100.80
Rate for Payer: Beech Street Commercial $102.90
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $101.85
Rate for Payer: Cash Price $73.50
Rate for Payer: ChoiceCare Network Commercial $101.85
Rate for Payer: Cigna of WY Commercial $102.90
Rate for Payer: Entrust Commercial $99.75
Rate for Payer: First Choice Health Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $59.85
Rate for Payer: HealthUtah PPO $105.00
Rate for Payer: Idaho Integrated Healthcare Commercial $101.85
Rate for Payer: Multiplan Medicare/VA $56.86
Rate for Payer: One Health Plan of WY PPO $102.90
Rate for Payer: PacificSource Commercial $94.50
Rate for Payer: PHCS PPO $102.90
Rate for Payer: Three Rivers PPO $78.75
Rate for Payer: TriWest Veterans Administration $59.85
Rate for Payer: United Healthcare Commercial $100.28
Rate for Payer: United Healthcare Medicare $59.85
Rate for Payer: WINHealth Partners Commercial $102.90
Rate for Payer: Wise Provider Network Commercial $99.75
Service Code HCPCS 86160
Hospital Charge Code 3028616004
Hospital Revenue Code 302
Min. Negotiated Rate $60.85
Max. Negotiated Rate $105.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $102.90
Rate for Payer: Aetna of WY Medicare $67.20
Rate for Payer: Altius Commercial $100.80
Rate for Payer: Beech Street Commercial $102.90
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $101.85
Rate for Payer: Cash Price $73.50
Rate for Payer: ChoiceCare Network Commercial $101.85
Rate for Payer: Cigna of WY Commercial $102.90
Rate for Payer: Entrust Commercial $99.75
Rate for Payer: First Choice Health Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $64.05
Rate for Payer: HealthUtah PPO $105.00
Rate for Payer: Idaho Integrated Healthcare Commercial $101.85
Rate for Payer: Multiplan Medicare/VA $60.85
Rate for Payer: One Health Plan of WY PPO $102.90
Rate for Payer: PacificSource Commercial $94.50
Rate for Payer: PHCS PPO $102.90
Rate for Payer: Three Rivers PPO $78.75
Rate for Payer: TriWest Veterans Administration $64.05
Rate for Payer: United Healthcare Commercial $100.28
Rate for Payer: United Healthcare Medicare $64.05
Rate for Payer: WINHealth Partners Commercial $99.75
Rate for Payer: Wise Provider Network Commercial $99.75
Service Code HCPCS 86160
Hospital Charge Code 3028616005
Hospital Revenue Code 302
Min. Negotiated Rate $60.85
Max. Negotiated Rate $105.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $102.90
Rate for Payer: Aetna of WY Medicare $67.20
Rate for Payer: Altius Commercial $100.80
Rate for Payer: Beech Street Commercial $102.90
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $101.85
Rate for Payer: Cash Price $73.50
Rate for Payer: ChoiceCare Network Commercial $101.85
Rate for Payer: Cigna of WY Commercial $102.90
Rate for Payer: Entrust Commercial $99.75
Rate for Payer: First Choice Health Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $64.05
Rate for Payer: HealthUtah PPO $105.00
Rate for Payer: Idaho Integrated Healthcare Commercial $101.85
Rate for Payer: Multiplan Medicare/VA $60.85
Rate for Payer: One Health Plan of WY PPO $102.90
Rate for Payer: PacificSource Commercial $94.50
Rate for Payer: PHCS PPO $102.90
Rate for Payer: Three Rivers PPO $78.75
Rate for Payer: TriWest Veterans Administration $64.05
Rate for Payer: United Healthcare Commercial $100.28
Rate for Payer: United Healthcare Medicare $64.05
Rate for Payer: WINHealth Partners Commercial $99.75
Rate for Payer: Wise Provider Network Commercial $99.75
Service Code HCPCS 86160
Hospital Charge Code 3028616005
Hospital Revenue Code 302
Min. Negotiated Rate $56.86
Max. Negotiated Rate $105.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $102.90
Rate for Payer: Aetna of WY Medicare $69.30
Rate for Payer: Altius Commercial $100.80
Rate for Payer: Beech Street Commercial $102.90
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $101.85
Rate for Payer: Cash Price $73.50
Rate for Payer: ChoiceCare Network Commercial $101.85
Rate for Payer: Cigna of WY Commercial $102.90
Rate for Payer: Entrust Commercial $99.75
Rate for Payer: First Choice Health Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $99.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $59.85
Rate for Payer: HealthUtah PPO $105.00
Rate for Payer: Idaho Integrated Healthcare Commercial $101.85
Rate for Payer: Multiplan Medicare/VA $56.86
Rate for Payer: One Health Plan of WY PPO $102.90
Rate for Payer: PacificSource Commercial $94.50
Rate for Payer: PHCS PPO $102.90
Rate for Payer: Three Rivers PPO $78.75
Rate for Payer: TriWest Veterans Administration $59.85
Rate for Payer: United Healthcare Commercial $100.28
Rate for Payer: United Healthcare Medicare $59.85
Rate for Payer: WINHealth Partners Commercial $102.90
Rate for Payer: Wise Provider Network Commercial $99.75
Service Code HCPCS 86160
Hospital Charge Code 3028616006
Hospital Revenue Code 302
Min. Negotiated Rate $106.05
Max. Negotiated Rate $183.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $179.34
Rate for Payer: Aetna of WY Medicare $117.12
Rate for Payer: Altius Commercial $175.68
Rate for Payer: Beech Street Commercial $179.34
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $177.51
Rate for Payer: Cash Price $128.10
Rate for Payer: ChoiceCare Network Commercial $177.51
Rate for Payer: Cigna of WY Commercial $179.34
Rate for Payer: Entrust Commercial $173.85
Rate for Payer: First Choice Health Commercial $173.85
Rate for Payer: Government Employees Health Association (GEHA) Commercial $173.85
Rate for Payer: Government Employees Health Association (GEHA) Medicare $111.63
Rate for Payer: HealthUtah PPO $183.00
Rate for Payer: Idaho Integrated Healthcare Commercial $177.51
Rate for Payer: Multiplan Medicare/VA $106.05
Rate for Payer: One Health Plan of WY PPO $179.34
Rate for Payer: PacificSource Commercial $164.70
Rate for Payer: PHCS PPO $179.34
Rate for Payer: Three Rivers PPO $137.25
Rate for Payer: TriWest Veterans Administration $111.63
Rate for Payer: United Healthcare Commercial $174.76
Rate for Payer: United Healthcare Medicare $111.63
Rate for Payer: WINHealth Partners Commercial $173.85
Rate for Payer: Wise Provider Network Commercial $173.85
Service Code HCPCS 86160
Hospital Charge Code 3028616006
Hospital Revenue Code 302
Min. Negotiated Rate $99.09
Max. Negotiated Rate $183.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $179.34
Rate for Payer: Aetna of WY Medicare $120.78
Rate for Payer: Altius Commercial $175.68
Rate for Payer: Beech Street Commercial $179.34
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $177.51
Rate for Payer: Cash Price $128.10
Rate for Payer: ChoiceCare Network Commercial $177.51
Rate for Payer: Cigna of WY Commercial $179.34
Rate for Payer: Entrust Commercial $173.85
Rate for Payer: First Choice Health Commercial $173.85
Rate for Payer: Government Employees Health Association (GEHA) Commercial $173.85
Rate for Payer: Government Employees Health Association (GEHA) Medicare $104.31
Rate for Payer: HealthUtah PPO $183.00
Rate for Payer: Idaho Integrated Healthcare Commercial $177.51
Rate for Payer: Multiplan Medicare/VA $99.09
Rate for Payer: One Health Plan of WY PPO $179.34
Rate for Payer: PacificSource Commercial $164.70
Rate for Payer: PHCS PPO $179.34
Rate for Payer: Three Rivers PPO $137.25
Rate for Payer: TriWest Veterans Administration $104.31
Rate for Payer: United Healthcare Commercial $174.76
Rate for Payer: United Healthcare Medicare $104.31
Rate for Payer: WINHealth Partners Commercial $179.34
Rate for Payer: Wise Provider Network Commercial $173.85
Service Code HCPCS 86161
Hospital Charge Code 3028616102
Hospital Revenue Code 302
Min. Negotiated Rate $46.36
Max. Negotiated Rate $80.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $78.40
Rate for Payer: Aetna of WY Medicare $51.20
Rate for Payer: Altius Commercial $76.80
Rate for Payer: Beech Street Commercial $78.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $77.60
Rate for Payer: Cash Price $56.00
Rate for Payer: ChoiceCare Network Commercial $77.60
Rate for Payer: Cigna of WY Commercial $78.40
Rate for Payer: Entrust Commercial $76.00
Rate for Payer: First Choice Health Commercial $76.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $76.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $48.80
Rate for Payer: HealthUtah PPO $80.00
Rate for Payer: Idaho Integrated Healthcare Commercial $77.60
Rate for Payer: Multiplan Medicare/VA $46.36
Rate for Payer: One Health Plan of WY PPO $78.40
Rate for Payer: PacificSource Commercial $72.00
Rate for Payer: PHCS PPO $78.40
Rate for Payer: Three Rivers PPO $60.00
Rate for Payer: TriWest Veterans Administration $48.80
Rate for Payer: United Healthcare Commercial $76.40
Rate for Payer: United Healthcare Medicare $48.80
Rate for Payer: WINHealth Partners Commercial $76.00
Rate for Payer: Wise Provider Network Commercial $76.00
Service Code HCPCS 86161
Hospital Charge Code 3028616102
Hospital Revenue Code 302
Min. Negotiated Rate $43.32
Max. Negotiated Rate $80.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $78.40
Rate for Payer: Aetna of WY Medicare $52.80
Rate for Payer: Altius Commercial $76.80
Rate for Payer: Beech Street Commercial $78.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $77.60
Rate for Payer: Cash Price $56.00
Rate for Payer: ChoiceCare Network Commercial $77.60
Rate for Payer: Cigna of WY Commercial $78.40
Rate for Payer: Entrust Commercial $76.00
Rate for Payer: First Choice Health Commercial $76.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $76.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $45.60
Rate for Payer: HealthUtah PPO $80.00
Rate for Payer: Idaho Integrated Healthcare Commercial $77.60
Rate for Payer: Multiplan Medicare/VA $43.32
Rate for Payer: One Health Plan of WY PPO $78.40
Rate for Payer: PacificSource Commercial $72.00
Rate for Payer: PHCS PPO $78.40
Rate for Payer: Three Rivers PPO $60.00
Rate for Payer: TriWest Veterans Administration $45.60
Rate for Payer: United Healthcare Commercial $76.40
Rate for Payer: United Healthcare Medicare $45.60
Rate for Payer: WINHealth Partners Commercial $78.40
Rate for Payer: Wise Provider Network Commercial $76.00
Service Code HCPCS 86161
Hospital Charge Code 3028616101
Hospital Revenue Code 302
Min. Negotiated Rate $66.06
Max. Negotiated Rate $122.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $119.56
Rate for Payer: Aetna of WY Medicare $80.52
Rate for Payer: Altius Commercial $117.12
Rate for Payer: Beech Street Commercial $119.56
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $118.34
Rate for Payer: Cash Price $85.40
Rate for Payer: ChoiceCare Network Commercial $118.34
Rate for Payer: Cigna of WY Commercial $119.56
Rate for Payer: Entrust Commercial $115.90
Rate for Payer: First Choice Health Commercial $115.90
Rate for Payer: Government Employees Health Association (GEHA) Commercial $115.90
Rate for Payer: Government Employees Health Association (GEHA) Medicare $69.54
Rate for Payer: HealthUtah PPO $122.00
Rate for Payer: Idaho Integrated Healthcare Commercial $118.34
Rate for Payer: Multiplan Medicare/VA $66.06
Rate for Payer: One Health Plan of WY PPO $119.56
Rate for Payer: PacificSource Commercial $109.80
Rate for Payer: PHCS PPO $119.56
Rate for Payer: Three Rivers PPO $91.50
Rate for Payer: TriWest Veterans Administration $69.54
Rate for Payer: United Healthcare Commercial $116.51
Rate for Payer: United Healthcare Medicare $69.54
Rate for Payer: WINHealth Partners Commercial $119.56
Rate for Payer: Wise Provider Network Commercial $115.90
Service Code HCPCS 86161
Hospital Charge Code 3028616101
Hospital Revenue Code 302
Min. Negotiated Rate $70.70
Max. Negotiated Rate $122.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $119.56
Rate for Payer: Aetna of WY Medicare $78.08
Rate for Payer: Altius Commercial $117.12
Rate for Payer: Beech Street Commercial $119.56
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $118.34
Rate for Payer: Cash Price $85.40
Rate for Payer: ChoiceCare Network Commercial $118.34
Rate for Payer: Cigna of WY Commercial $119.56
Rate for Payer: Entrust Commercial $115.90
Rate for Payer: First Choice Health Commercial $115.90
Rate for Payer: Government Employees Health Association (GEHA) Commercial $115.90
Rate for Payer: Government Employees Health Association (GEHA) Medicare $74.42
Rate for Payer: HealthUtah PPO $122.00
Rate for Payer: Idaho Integrated Healthcare Commercial $118.34
Rate for Payer: Multiplan Medicare/VA $70.70
Rate for Payer: One Health Plan of WY PPO $119.56
Rate for Payer: PacificSource Commercial $109.80
Rate for Payer: PHCS PPO $119.56
Rate for Payer: Three Rivers PPO $91.50
Rate for Payer: TriWest Veterans Administration $74.42
Rate for Payer: United Healthcare Commercial $116.51
Rate for Payer: United Healthcare Medicare $74.42
Rate for Payer: WINHealth Partners Commercial $115.90
Rate for Payer: Wise Provider Network Commercial $115.90
Service Code HCPCS 86162
Hospital Charge Code 3028616201
Hospital Revenue Code 302
Min. Negotiated Rate $169.21
Max. Negotiated Rate $292.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $286.16
Rate for Payer: Aetna of WY Medicare $186.88
Rate for Payer: Altius Commercial $280.32
Rate for Payer: Beech Street Commercial $286.16
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $283.24
Rate for Payer: Cash Price $204.40
Rate for Payer: ChoiceCare Network Commercial $283.24
Rate for Payer: Cigna of WY Commercial $286.16
Rate for Payer: Entrust Commercial $277.40
Rate for Payer: First Choice Health Commercial $277.40
Rate for Payer: Government Employees Health Association (GEHA) Commercial $277.40
Rate for Payer: Government Employees Health Association (GEHA) Medicare $178.12
Rate for Payer: HealthUtah PPO $292.00
Rate for Payer: Idaho Integrated Healthcare Commercial $283.24
Rate for Payer: Multiplan Medicare/VA $169.21
Rate for Payer: One Health Plan of WY PPO $286.16
Rate for Payer: PacificSource Commercial $262.80
Rate for Payer: PHCS PPO $286.16
Rate for Payer: Three Rivers PPO $219.00
Rate for Payer: TriWest Veterans Administration $178.12
Rate for Payer: United Healthcare Commercial $278.86
Rate for Payer: United Healthcare Medicare $178.12
Rate for Payer: WINHealth Partners Commercial $277.40
Rate for Payer: Wise Provider Network Commercial $277.40
Service Code HCPCS 86162
Hospital Charge Code 3028616201
Hospital Revenue Code 302
Min. Negotiated Rate $158.12
Max. Negotiated Rate $292.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $286.16
Rate for Payer: Aetna of WY Medicare $192.72
Rate for Payer: Altius Commercial $280.32
Rate for Payer: Beech Street Commercial $286.16
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $283.24
Rate for Payer: Cash Price $204.40
Rate for Payer: ChoiceCare Network Commercial $283.24
Rate for Payer: Cigna of WY Commercial $286.16
Rate for Payer: Entrust Commercial $277.40
Rate for Payer: First Choice Health Commercial $277.40
Rate for Payer: Government Employees Health Association (GEHA) Commercial $277.40
Rate for Payer: Government Employees Health Association (GEHA) Medicare $166.44
Rate for Payer: HealthUtah PPO $292.00
Rate for Payer: Idaho Integrated Healthcare Commercial $283.24
Rate for Payer: Multiplan Medicare/VA $158.12
Rate for Payer: One Health Plan of WY PPO $286.16
Rate for Payer: PacificSource Commercial $262.80
Rate for Payer: PHCS PPO $286.16
Rate for Payer: Three Rivers PPO $219.00
Rate for Payer: TriWest Veterans Administration $166.44
Rate for Payer: United Healthcare Commercial $278.86
Rate for Payer: United Healthcare Medicare $166.44
Rate for Payer: WINHealth Partners Commercial $286.16
Rate for Payer: Wise Provider Network Commercial $277.40
Service Code HCPCS 85025
Hospital Charge Code 3058502501
Hospital Revenue Code 305
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
Service Code HCPCS 85025
Hospital Charge Code 3058502501
Hospital Revenue Code 305
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
Service Code HCPCS 85027
Hospital Charge Code 3058502701
Hospital Revenue Code 305
Min. Negotiated Rate $14.49
Max. Negotiated Rate $25.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $24.50
Rate for Payer: Aetna of WY Medicare $16.00
Rate for Payer: Altius Commercial $24.00
Rate for Payer: Beech Street Commercial $24.50
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $24.25
Rate for Payer: Cash Price $17.50
Rate for Payer: ChoiceCare Network Commercial $24.25
Rate for Payer: Cigna of WY Commercial $24.50
Rate for Payer: Entrust Commercial $23.75
Rate for Payer: First Choice Health Commercial $23.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $23.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $15.25
Rate for Payer: HealthUtah PPO $25.00
Rate for Payer: Idaho Integrated Healthcare Commercial $24.25
Rate for Payer: Multiplan Medicare/VA $14.49
Rate for Payer: One Health Plan of WY PPO $24.50
Rate for Payer: PacificSource Commercial $22.50
Rate for Payer: PHCS PPO $24.50
Rate for Payer: Three Rivers PPO $18.75
Rate for Payer: TriWest Veterans Administration $15.25
Rate for Payer: United Healthcare Commercial $23.88
Rate for Payer: United Healthcare Medicare $15.25
Rate for Payer: WINHealth Partners Commercial $23.75
Rate for Payer: Wise Provider Network Commercial $23.75
Service Code HCPCS 85027
Hospital Charge Code 3058502701
Hospital Revenue Code 305
Min. Negotiated Rate $13.54
Max. Negotiated Rate $25.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $24.50
Rate for Payer: Aetna of WY Medicare $16.50
Rate for Payer: Altius Commercial $24.00
Rate for Payer: Beech Street Commercial $24.50
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $24.25
Rate for Payer: Cash Price $17.50
Rate for Payer: ChoiceCare Network Commercial $24.25
Rate for Payer: Cigna of WY Commercial $24.50
Rate for Payer: Entrust Commercial $23.75
Rate for Payer: First Choice Health Commercial $23.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $23.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $14.25
Rate for Payer: HealthUtah PPO $25.00
Rate for Payer: Idaho Integrated Healthcare Commercial $24.25
Rate for Payer: Multiplan Medicare/VA $13.54
Rate for Payer: One Health Plan of WY PPO $24.50
Rate for Payer: PacificSource Commercial $22.50
Rate for Payer: PHCS PPO $24.50
Rate for Payer: Three Rivers PPO $18.75
Rate for Payer: TriWest Veterans Administration $14.25
Rate for Payer: United Healthcare Commercial $23.88
Rate for Payer: United Healthcare Medicare $14.25
Rate for Payer: WINHealth Partners Commercial $24.50
Rate for Payer: Wise Provider Network Commercial $23.75
Service Code HCPCS 10180
Hospital Charge Code 7611018001
Hospital Revenue Code 761
Min. Negotiated Rate $439.84
Max. Negotiated Rate $759.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $743.82
Rate for Payer: Aetna of WY Medicare $485.76
Rate for Payer: Altius Commercial $728.64
Rate for Payer: Beech Street Commercial $743.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $736.23
Rate for Payer: Cash Price $531.30
Rate for Payer: ChoiceCare Network Commercial $736.23
Rate for Payer: Cigna of WY Commercial $743.82
Rate for Payer: Entrust Commercial $721.05
Rate for Payer: First Choice Health Commercial $721.05
Rate for Payer: Government Employees Health Association (GEHA) Commercial $721.05
Rate for Payer: Government Employees Health Association (GEHA) Medicare $462.99
Rate for Payer: HealthUtah PPO $759.00
Rate for Payer: Idaho Integrated Healthcare Commercial $736.23
Rate for Payer: Multiplan Medicare/VA $439.84
Rate for Payer: One Health Plan of WY PPO $743.82
Rate for Payer: PacificSource Commercial $683.10
Rate for Payer: PHCS PPO $743.82
Rate for Payer: Three Rivers PPO $569.25
Rate for Payer: TriWest Veterans Administration $462.99
Rate for Payer: United Healthcare Commercial $724.84
Rate for Payer: United Healthcare Medicare $462.99
Rate for Payer: WINHealth Partners Commercial $721.05
Rate for Payer: Wise Provider Network Commercial $721.05
Service Code HCPCS 10180
Hospital Charge Code 7611018001
Hospital Revenue Code 761
Min. Negotiated Rate $411.00
Max. Negotiated Rate $759.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $743.82
Rate for Payer: Aetna of WY Medicare $500.94
Rate for Payer: Altius Commercial $728.64
Rate for Payer: Beech Street Commercial $743.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $736.23
Rate for Payer: Cash Price $531.30
Rate for Payer: ChoiceCare Network Commercial $736.23
Rate for Payer: Cigna of WY Commercial $743.82
Rate for Payer: Entrust Commercial $721.05
Rate for Payer: First Choice Health Commercial $721.05
Rate for Payer: Government Employees Health Association (GEHA) Commercial $721.05
Rate for Payer: Government Employees Health Association (GEHA) Medicare $432.63
Rate for Payer: HealthUtah PPO $759.00
Rate for Payer: Idaho Integrated Healthcare Commercial $736.23
Rate for Payer: Multiplan Medicare/VA $411.00
Rate for Payer: One Health Plan of WY PPO $743.82
Rate for Payer: PacificSource Commercial $683.10
Rate for Payer: PHCS PPO $743.82
Rate for Payer: Three Rivers PPO $569.25
Rate for Payer: TriWest Veterans Administration $432.63
Rate for Payer: United Healthcare Commercial $724.84
Rate for Payer: United Healthcare Medicare $432.63
Rate for Payer: WINHealth Partners Commercial $743.82
Rate for Payer: Wise Provider Network Commercial $721.05
Service Code HCPCS 51729
Hospital Charge Code 5105172901
Hospital Revenue Code 510
Min. Negotiated Rate $145.66
Max. Negotiated Rate $269.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $263.62
Rate for Payer: Aetna of WY Medicare $177.54
Rate for Payer: Altius Commercial $258.24
Rate for Payer: Beech Street Commercial $263.62
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $260.93
Rate for Payer: Cash Price $188.30
Rate for Payer: ChoiceCare Network Commercial $260.93
Rate for Payer: Cigna of WY Commercial $263.62
Rate for Payer: Entrust Commercial $255.55
Rate for Payer: First Choice Health Commercial $255.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $255.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $153.33
Rate for Payer: HealthUtah PPO $269.00
Rate for Payer: Idaho Integrated Healthcare Commercial $260.93
Rate for Payer: Multiplan Medicare/VA $145.66
Rate for Payer: One Health Plan of WY PPO $263.62
Rate for Payer: PacificSource Commercial $242.10
Rate for Payer: PHCS PPO $263.62
Rate for Payer: Three Rivers PPO $201.75
Rate for Payer: TriWest Veterans Administration $153.33
Rate for Payer: United Healthcare Commercial $256.90
Rate for Payer: United Healthcare Medicare $153.33
Rate for Payer: WINHealth Partners Commercial $263.62
Rate for Payer: Wise Provider Network Commercial $255.55
Service Code HCPCS 51729
Hospital Charge Code 5105172901
Hospital Revenue Code 510
Min. Negotiated Rate $155.89
Max. Negotiated Rate $269.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $263.62
Rate for Payer: Aetna of WY Medicare $172.16
Rate for Payer: Altius Commercial $258.24
Rate for Payer: Beech Street Commercial $263.62
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $260.93
Rate for Payer: Cash Price $188.30
Rate for Payer: ChoiceCare Network Commercial $260.93
Rate for Payer: Cigna of WY Commercial $263.62
Rate for Payer: Entrust Commercial $255.55
Rate for Payer: First Choice Health Commercial $255.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $255.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $164.09
Rate for Payer: HealthUtah PPO $269.00
Rate for Payer: Idaho Integrated Healthcare Commercial $260.93
Rate for Payer: Multiplan Medicare/VA $155.89
Rate for Payer: One Health Plan of WY PPO $263.62
Rate for Payer: PacificSource Commercial $242.10
Rate for Payer: PHCS PPO $263.62
Rate for Payer: Three Rivers PPO $201.75
Rate for Payer: TriWest Veterans Administration $164.09
Rate for Payer: United Healthcare Commercial $256.90
Rate for Payer: United Healthcare Medicare $164.09
Rate for Payer: WINHealth Partners Commercial $255.55
Rate for Payer: Wise Provider Network Commercial $255.55
Service Code HCPCS A6538
Hospital Charge Code 420A653801
Hospital Revenue Code 420
Min. Negotiated Rate $390.58
Max. Negotiated Rate $674.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $660.52
Rate for Payer: Aetna of WY Medicare $431.36
Rate for Payer: Altius Commercial $647.04
Rate for Payer: Beech Street Commercial $660.52
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $653.78
Rate for Payer: Cash Price $471.80
Rate for Payer: ChoiceCare Network Commercial $653.78
Rate for Payer: Cigna of WY Commercial $660.52
Rate for Payer: Entrust Commercial $640.30
Rate for Payer: First Choice Health Commercial $640.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $640.30
Rate for Payer: Government Employees Health Association (GEHA) Medicare $411.14
Rate for Payer: HealthUtah PPO $674.00
Rate for Payer: Idaho Integrated Healthcare Commercial $653.78
Rate for Payer: Multiplan Medicare/VA $390.58
Rate for Payer: One Health Plan of WY PPO $660.52
Rate for Payer: PacificSource Commercial $606.60
Rate for Payer: PHCS PPO $660.52
Rate for Payer: Three Rivers PPO $505.50
Rate for Payer: TriWest Veterans Administration $411.14
Rate for Payer: United Healthcare Commercial $643.67
Rate for Payer: United Healthcare Medicare $411.14
Rate for Payer: WINHealth Partners Commercial $640.30
Rate for Payer: Wise Provider Network Commercial $640.30
Service Code HCPCS A6538
Hospital Charge Code 420A653801
Hospital Revenue Code 420
Min. Negotiated Rate $364.97
Max. Negotiated Rate $674.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $660.52
Rate for Payer: Aetna of WY Medicare $444.84
Rate for Payer: Altius Commercial $647.04
Rate for Payer: Beech Street Commercial $660.52
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $653.78
Rate for Payer: Cash Price $471.80
Rate for Payer: ChoiceCare Network Commercial $653.78
Rate for Payer: Cigna of WY Commercial $660.52
Rate for Payer: Entrust Commercial $640.30
Rate for Payer: First Choice Health Commercial $640.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $640.30
Rate for Payer: Government Employees Health Association (GEHA) Medicare $384.18
Rate for Payer: HealthUtah PPO $674.00
Rate for Payer: Idaho Integrated Healthcare Commercial $653.78
Rate for Payer: Multiplan Medicare/VA $364.97
Rate for Payer: One Health Plan of WY PPO $660.52
Rate for Payer: PacificSource Commercial $606.60
Rate for Payer: PHCS PPO $660.52
Rate for Payer: Three Rivers PPO $505.50
Rate for Payer: TriWest Veterans Administration $384.18
Rate for Payer: United Healthcare Commercial $643.67
Rate for Payer: United Healthcare Medicare $384.18
Rate for Payer: WINHealth Partners Commercial $660.52
Rate for Payer: Wise Provider Network Commercial $640.30
Service Code HCPCS 42960
Hospital Charge Code 7614296001
Hospital Revenue Code 761
Min. Negotiated Rate $246.92
Max. Negotiated Rate $456.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $446.88
Rate for Payer: Aetna of WY Medicare $300.96
Rate for Payer: Altius Commercial $437.76
Rate for Payer: Beech Street Commercial $446.88
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $442.32
Rate for Payer: Cash Price $319.20
Rate for Payer: ChoiceCare Network Commercial $442.32
Rate for Payer: Cigna of WY Commercial $446.88
Rate for Payer: Entrust Commercial $433.20
Rate for Payer: First Choice Health Commercial $433.20
Rate for Payer: Government Employees Health Association (GEHA) Commercial $433.20
Rate for Payer: Government Employees Health Association (GEHA) Medicare $259.92
Rate for Payer: HealthUtah PPO $456.00
Rate for Payer: Idaho Integrated Healthcare Commercial $442.32
Rate for Payer: Multiplan Medicare/VA $246.92
Rate for Payer: One Health Plan of WY PPO $446.88
Rate for Payer: PacificSource Commercial $410.40
Rate for Payer: PHCS PPO $446.88
Rate for Payer: Three Rivers PPO $342.00
Rate for Payer: TriWest Veterans Administration $259.92
Rate for Payer: United Healthcare Commercial $435.48
Rate for Payer: United Healthcare Medicare $259.92
Rate for Payer: WINHealth Partners Commercial $446.88
Rate for Payer: Wise Provider Network Commercial $433.20