|
ARTIFICIAL INSEMINATION INTRA-CERVICAL
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 58321
|
| Hospital Charge Code |
58321
|
| Min. Negotiated Rate |
$38.91 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$326.34
|
| Rate for Payer: Aetna of WY Medicare |
$45.78
|
| Rate for Payer: Beech Street Commercial |
$316.35
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$323.01
|
| Rate for Payer: Cigna of WY Commercial |
$326.34
|
| Rate for Payer: First Choice Health Commercial |
$299.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$316.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$45.78
|
| Rate for Payer: HealthUtah PPO |
$333.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$323.01
|
| Rate for Payer: Multiplan Medicare/VA |
$38.91
|
| Rate for Payer: One Health Plan of WY PPO |
$326.34
|
| Rate for Payer: PacificSource Commercial |
$299.70
|
| Rate for Payer: PHCS PPO |
$316.35
|
| Rate for Payer: Three Rivers PPO |
$249.75
|
| Rate for Payer: TriWest Veterans Administration |
$45.78
|
| Rate for Payer: United Healthcare Commercial |
$289.71
|
| Rate for Payer: United Healthcare Medicare |
$45.78
|
| Rate for Payer: WINHealth Partners Commercial |
$283.05
|
|
|
ARTIFICIAL INSEMINATION INTRA-UTERINE
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 58322
|
| Hospital Charge Code |
58322
|
| Min. Negotiated Rate |
$46.50 |
| Max. Negotiated Rate |
$482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$472.36
|
| Rate for Payer: Aetna of WY Medicare |
$54.70
|
| Rate for Payer: Beech Street Commercial |
$457.90
|
| Rate for Payer: Cash Price |
$337.40
|
| Rate for Payer: Cash Price |
$337.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$467.54
|
| Rate for Payer: Cigna of WY Commercial |
$472.36
|
| Rate for Payer: First Choice Health Commercial |
$433.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$457.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.70
|
| Rate for Payer: HealthUtah PPO |
$482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$467.54
|
| Rate for Payer: Multiplan Medicare/VA |
$46.50
|
| Rate for Payer: One Health Plan of WY PPO |
$472.36
|
| Rate for Payer: PacificSource Commercial |
$433.80
|
| Rate for Payer: PHCS PPO |
$457.90
|
| Rate for Payer: Three Rivers PPO |
$361.50
|
| Rate for Payer: TriWest Veterans Administration |
$54.70
|
| Rate for Payer: United Healthcare Commercial |
$419.34
|
| Rate for Payer: United Healthcare Medicare |
$54.70
|
| Rate for Payer: WINHealth Partners Commercial |
$409.70
|
|
|
ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
HCPCS 36620
|
| Hospital Charge Code |
36620
|
| Min. Negotiated Rate |
$35.53 |
| Max. Negotiated Rate |
$229.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$224.42
|
| Rate for Payer: Aetna of WY Medicare |
$41.80
|
| Rate for Payer: Beech Street Commercial |
$217.55
|
| Rate for Payer: Cash Price |
$160.30
|
| Rate for Payer: Cash Price |
$160.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$222.13
|
| Rate for Payer: Cigna of WY Commercial |
$224.42
|
| Rate for Payer: First Choice Health Commercial |
$206.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$217.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.80
|
| Rate for Payer: HealthUtah PPO |
$229.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$222.13
|
| Rate for Payer: Multiplan Medicare/VA |
$35.53
|
| Rate for Payer: One Health Plan of WY PPO |
$224.42
|
| Rate for Payer: PacificSource Commercial |
$206.10
|
| Rate for Payer: PHCS PPO |
$217.55
|
| Rate for Payer: Three Rivers PPO |
$171.75
|
| Rate for Payer: TriWest Veterans Administration |
$41.80
|
| Rate for Payer: United Healthcare Commercial |
$199.23
|
| Rate for Payer: United Healthcare Medicare |
$41.80
|
| Rate for Payer: WINHealth Partners Commercial |
$194.65
|
|
|
ARTLINE PRESSURE TUBING TRANSDUCER
|
Facility
|
IP
|
$42.49
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.64 |
| Max. Negotiated Rate |
$42.49 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$41.64
|
| Rate for Payer: Altius Auto/Workers Compensation |
$40.79
|
| Rate for Payer: Altius Commercial |
$40.79
|
| Rate for Payer: Beech Street Commercial |
$41.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$34.88
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: ChoiceCare Network Commercial |
$41.22
|
| Rate for Payer: Cigna of WY Commercial |
$41.64
|
| Rate for Payer: Entrust Commercial |
$40.37
|
| Rate for Payer: First Choice Health Commercial |
$40.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$40.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$28.04
|
| Rate for Payer: HealthUtah PPO |
$42.49
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$41.22
|
| Rate for Payer: Multiplan Medicare/VA |
$26.64
|
| Rate for Payer: One Health Plan of WY PPO |
$41.64
|
| Rate for Payer: PacificSource Commercial |
$38.24
|
| Rate for Payer: PHCS PPO |
$41.64
|
| Rate for Payer: Three Rivers PPO |
$31.87
|
| Rate for Payer: TriWest Veterans Administration |
$28.04
|
| Rate for Payer: United Healthcare Commercial |
$36.97
|
| Rate for Payer: United Healthcare Medicare |
$28.04
|
| Rate for Payer: WINHealth Partners Commercial |
$40.37
|
| Rate for Payer: Wise Provider Network Commercial |
$40.37
|
|
|
ARTLINE PRESSURE TUBING TRANSDUCER
|
Facility
|
OP
|
$42.49
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$42.49 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$41.64
|
| Rate for Payer: Aetna of WY Medicare |
$28.04
|
| Rate for Payer: Altius Auto/Workers Compensation |
$40.79
|
| Rate for Payer: Altius Commercial |
$40.79
|
| Rate for Payer: Beech Street Commercial |
$41.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$34.88
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: ChoiceCare Network Commercial |
$41.22
|
| Rate for Payer: Cigna of WY Commercial |
$41.64
|
| Rate for Payer: Entrust Commercial |
$40.37
|
| Rate for Payer: First Choice Health Commercial |
$40.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$40.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.64
|
| Rate for Payer: HealthUtah PPO |
$42.49
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$41.22
|
| Rate for Payer: Multiplan Medicare/VA |
$23.41
|
| Rate for Payer: One Health Plan of WY PPO |
$41.64
|
| Rate for Payer: PacificSource Commercial |
$38.24
|
| Rate for Payer: PHCS PPO |
$41.64
|
| Rate for Payer: Three Rivers PPO |
$31.87
|
| Rate for Payer: TriWest Veterans Administration |
$24.64
|
| Rate for Payer: United Healthcare Commercial |
$36.97
|
| Rate for Payer: United Healthcare Medicare |
$24.64
|
| Rate for Payer: WINHealth Partners Commercial |
$41.64
|
| Rate for Payer: Wise Provider Network Commercial |
$40.37
|
|
|
ASAHI SCION BLUE J-TIP 190
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$208.48 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$325.85
|
| Rate for Payer: Altius Auto/Workers Compensation |
$319.20
|
| Rate for Payer: Altius Commercial |
$319.20
|
| Rate for Payer: Beech Street Commercial |
$325.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$272.98
|
| Rate for Payer: Cash Price |
$232.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$322.52
|
| Rate for Payer: Cigna of WY Commercial |
$325.85
|
| Rate for Payer: Entrust Commercial |
$315.88
|
| Rate for Payer: First Choice Health Commercial |
$315.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$315.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$219.45
|
| Rate for Payer: HealthUtah PPO |
$332.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$322.52
|
| Rate for Payer: Multiplan Medicare/VA |
$208.48
|
| Rate for Payer: One Health Plan of WY PPO |
$325.85
|
| Rate for Payer: PacificSource Commercial |
$299.25
|
| Rate for Payer: PHCS PPO |
$325.85
|
| Rate for Payer: Three Rivers PPO |
$249.38
|
| Rate for Payer: TriWest Veterans Administration |
$219.45
|
| Rate for Payer: United Healthcare Commercial |
$289.28
|
| Rate for Payer: United Healthcare Medicare |
$219.45
|
| Rate for Payer: WINHealth Partners Commercial |
$315.88
|
| Rate for Payer: Wise Provider Network Commercial |
$315.88
|
|
|
ASAHI SCION BLUE J-TIP 190
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$183.21 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$325.85
|
| Rate for Payer: Aetna of WY Medicare |
$219.45
|
| Rate for Payer: Altius Auto/Workers Compensation |
$319.20
|
| Rate for Payer: Altius Commercial |
$319.20
|
| Rate for Payer: Beech Street Commercial |
$325.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$272.98
|
| Rate for Payer: Cash Price |
$232.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$322.52
|
| Rate for Payer: Cigna of WY Commercial |
$325.85
|
| Rate for Payer: Entrust Commercial |
$315.88
|
| Rate for Payer: First Choice Health Commercial |
$315.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$315.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$192.85
|
| Rate for Payer: HealthUtah PPO |
$332.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$322.52
|
| Rate for Payer: Multiplan Medicare/VA |
$183.21
|
| Rate for Payer: One Health Plan of WY PPO |
$325.85
|
| Rate for Payer: PacificSource Commercial |
$299.25
|
| Rate for Payer: PHCS PPO |
$325.85
|
| Rate for Payer: Three Rivers PPO |
$249.38
|
| Rate for Payer: TriWest Veterans Administration |
$192.85
|
| Rate for Payer: United Healthcare Commercial |
$289.28
|
| Rate for Payer: United Healthcare Medicare |
$192.85
|
| Rate for Payer: WINHealth Partners Commercial |
$325.85
|
| Rate for Payer: Wise Provider Network Commercial |
$315.88
|
|
|
ASAHI SCION WIRE BLACK J-TIP 190CM
|
Facility
|
OP
|
$455.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Aetna of WY Medicare |
$300.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$436.80
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$373.56
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$263.90
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$250.70
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$263.90
|
| Rate for Payer: United Healthcare Commercial |
$395.85
|
| Rate for Payer: United Healthcare Medicare |
$263.90
|
| Rate for Payer: WINHealth Partners Commercial |
$445.90
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
ASAHI SCION WIRE BLACK J-TIP 190CM
|
Facility
|
IP
|
$455.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$285.28 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$436.80
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$373.56
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$300.30
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$285.28
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$300.30
|
| Rate for Payer: United Healthcare Commercial |
$395.85
|
| Rate for Payer: United Healthcare Medicare |
$300.30
|
| Rate for Payer: WINHealth Partners Commercial |
$432.25
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
ASCORBIC ACID (VITAMIN C) 500 MG TABLET [10584]
|
Facility
|
IP
|
$0.13
|
|
|
Service Code
|
NDC 0904052361
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.13
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.12
|
| Rate for Payer: Altius Commercial |
$0.12
|
| Rate for Payer: Beech Street Commercial |
$0.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.11
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.13
|
| Rate for Payer: Cigna of WY Commercial |
$0.13
|
| Rate for Payer: Entrust Commercial |
$0.12
|
| Rate for Payer: First Choice Health Commercial |
$0.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.09
|
| Rate for Payer: HealthUtah PPO |
$0.13
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.13
|
| Rate for Payer: Multiplan Medicare/VA |
$0.08
|
| Rate for Payer: One Health Plan of WY PPO |
$0.13
|
| Rate for Payer: PacificSource Commercial |
$0.12
|
| Rate for Payer: PHCS PPO |
$0.13
|
| Rate for Payer: Three Rivers PPO |
$0.10
|
| Rate for Payer: TriWest Veterans Administration |
$0.09
|
| Rate for Payer: United Healthcare Commercial |
$0.11
|
| Rate for Payer: United Healthcare Medicare |
$0.09
|
| Rate for Payer: WINHealth Partners Commercial |
$0.12
|
| Rate for Payer: Wise Provider Network Commercial |
$0.12
|
|
|
ASCORBIC ACID (VITAMIN C) 500 MG TABLET [10584]
|
Facility
|
OP
|
$0.13
|
|
|
Service Code
|
NDC 0904052361
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.13
|
| Rate for Payer: Aetna of WY Medicare |
$0.09
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.12
|
| Rate for Payer: Altius Commercial |
$0.12
|
| Rate for Payer: Beech Street Commercial |
$0.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.11
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.13
|
| Rate for Payer: Cigna of WY Commercial |
$0.13
|
| Rate for Payer: Entrust Commercial |
$0.12
|
| Rate for Payer: First Choice Health Commercial |
$0.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.08
|
| Rate for Payer: HealthUtah PPO |
$0.13
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.13
|
| Rate for Payer: Multiplan Medicare/VA |
$0.07
|
| Rate for Payer: One Health Plan of WY PPO |
$0.13
|
| Rate for Payer: PacificSource Commercial |
$0.12
|
| Rate for Payer: PHCS PPO |
$0.13
|
| Rate for Payer: Three Rivers PPO |
$0.10
|
| Rate for Payer: TriWest Veterans Administration |
$0.08
|
| Rate for Payer: United Healthcare Commercial |
$0.11
|
| Rate for Payer: United Healthcare Medicare |
$0.08
|
| Rate for Payer: WINHealth Partners Commercial |
$0.13
|
| Rate for Payer: Wise Provider Network Commercial |
$0.12
|
|
|
ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 51102
|
| Hospital Charge Code |
51102
|
| Min. Negotiated Rate |
$115.20 |
| Max. Negotiated Rate |
$753.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$737.94
|
| Rate for Payer: Aetna of WY Medicare |
$135.53
|
| Rate for Payer: Beech Street Commercial |
$715.35
|
| Rate for Payer: Cash Price |
$527.10
|
| Rate for Payer: Cash Price |
$527.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$730.41
|
| Rate for Payer: Cigna of WY Commercial |
$737.94
|
| Rate for Payer: First Choice Health Commercial |
$677.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$715.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$135.53
|
| Rate for Payer: HealthUtah PPO |
$753.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$730.41
|
| Rate for Payer: Multiplan Medicare/VA |
$115.20
|
| Rate for Payer: One Health Plan of WY PPO |
$737.94
|
| Rate for Payer: PacificSource Commercial |
$677.70
|
| Rate for Payer: PHCS PPO |
$715.35
|
| Rate for Payer: Three Rivers PPO |
$564.75
|
| Rate for Payer: TriWest Veterans Administration |
$135.53
|
| Rate for Payer: United Healthcare Commercial |
$655.11
|
| Rate for Payer: United Healthcare Medicare |
$135.53
|
| Rate for Payer: WINHealth Partners Commercial |
$640.05
|
|
|
ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 51100
|
| Hospital Charge Code |
51100
|
| Min. Negotiated Rate |
$31.56 |
| Max. Negotiated Rate |
$259.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$253.82
|
| Rate for Payer: Aetna of WY Medicare |
$37.13
|
| Rate for Payer: Beech Street Commercial |
$246.05
|
| Rate for Payer: Cash Price |
$181.30
|
| Rate for Payer: Cash Price |
$181.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$251.23
|
| Rate for Payer: Cigna of WY Commercial |
$253.82
|
| Rate for Payer: First Choice Health Commercial |
$233.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$246.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$37.13
|
| Rate for Payer: HealthUtah PPO |
$259.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$251.23
|
| Rate for Payer: Multiplan Medicare/VA |
$31.56
|
| Rate for Payer: One Health Plan of WY PPO |
$253.82
|
| Rate for Payer: PacificSource Commercial |
$233.10
|
| Rate for Payer: PHCS PPO |
$246.05
|
| Rate for Payer: Three Rivers PPO |
$194.25
|
| Rate for Payer: TriWest Veterans Administration |
$37.13
|
| Rate for Payer: United Healthcare Commercial |
$225.33
|
| Rate for Payer: United Healthcare Medicare |
$37.13
|
| Rate for Payer: WINHealth Partners Commercial |
$220.15
|
|
|
ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 20612
|
| Hospital Charge Code |
20612
|
| Min. Negotiated Rate |
$33.51 |
| Max. Negotiated Rate |
$206.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$201.88
|
| Rate for Payer: Aetna of WY Medicare |
$39.42
|
| Rate for Payer: Beech Street Commercial |
$195.70
|
| Rate for Payer: Cash Price |
$144.20
|
| Rate for Payer: Cash Price |
$144.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$199.82
|
| Rate for Payer: Cigna of WY Commercial |
$201.88
|
| Rate for Payer: First Choice Health Commercial |
$185.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$195.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.42
|
| Rate for Payer: HealthUtah PPO |
$206.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$199.82
|
| Rate for Payer: Multiplan Medicare/VA |
$33.51
|
| Rate for Payer: One Health Plan of WY PPO |
$201.88
|
| Rate for Payer: PacificSource Commercial |
$185.40
|
| Rate for Payer: PHCS PPO |
$195.70
|
| Rate for Payer: Three Rivers PPO |
$154.50
|
| Rate for Payer: TriWest Veterans Administration |
$39.42
|
| Rate for Payer: United Healthcare Commercial |
$179.22
|
| Rate for Payer: United Healthcare Medicare |
$39.42
|
| Rate for Payer: WINHealth Partners Commercial |
$175.10
|
|
|
ASPIRIN 300 MG RECTAL SUPPOSITORY [857]
|
Facility
|
IP
|
$4.67
|
|
|
Service Code
|
NDC 0574703412
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$4.67 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.58
|
| Rate for Payer: Altius Auto/Workers Compensation |
$4.48
|
| Rate for Payer: Altius Commercial |
$4.48
|
| Rate for Payer: Beech Street Commercial |
$4.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.53
|
| Rate for Payer: Cigna of WY Commercial |
$4.58
|
| Rate for Payer: Entrust Commercial |
$4.44
|
| Rate for Payer: First Choice Health Commercial |
$4.44
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.44
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.08
|
| Rate for Payer: HealthUtah PPO |
$4.67
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.53
|
| Rate for Payer: Multiplan Medicare/VA |
$2.93
|
| Rate for Payer: One Health Plan of WY PPO |
$4.58
|
| Rate for Payer: PacificSource Commercial |
$4.20
|
| Rate for Payer: PHCS PPO |
$4.58
|
| Rate for Payer: Three Rivers PPO |
$3.50
|
| Rate for Payer: TriWest Veterans Administration |
$3.08
|
| Rate for Payer: United Healthcare Commercial |
$4.06
|
| Rate for Payer: United Healthcare Medicare |
$3.08
|
| Rate for Payer: WINHealth Partners Commercial |
$4.44
|
| Rate for Payer: Wise Provider Network Commercial |
$4.44
|
|
|
ASPIRIN 300 MG RECTAL SUPPOSITORY [857]
|
Facility
|
OP
|
$4.67
|
|
|
Service Code
|
NDC 0574703412
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$4.67 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.58
|
| Rate for Payer: Aetna of WY Medicare |
$3.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$4.48
|
| Rate for Payer: Altius Commercial |
$4.48
|
| Rate for Payer: Beech Street Commercial |
$4.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.53
|
| Rate for Payer: Cigna of WY Commercial |
$4.58
|
| Rate for Payer: Entrust Commercial |
$4.44
|
| Rate for Payer: First Choice Health Commercial |
$4.44
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.44
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.71
|
| Rate for Payer: HealthUtah PPO |
$4.67
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.53
|
| Rate for Payer: Multiplan Medicare/VA |
$2.57
|
| Rate for Payer: One Health Plan of WY PPO |
$4.58
|
| Rate for Payer: PacificSource Commercial |
$4.20
|
| Rate for Payer: PHCS PPO |
$4.58
|
| Rate for Payer: Three Rivers PPO |
$3.50
|
| Rate for Payer: TriWest Veterans Administration |
$2.71
|
| Rate for Payer: United Healthcare Commercial |
$4.06
|
| Rate for Payer: United Healthcare Medicare |
$2.71
|
| Rate for Payer: WINHealth Partners Commercial |
$4.58
|
| Rate for Payer: Wise Provider Network Commercial |
$4.44
|
|
|
ASPIRIN 325 MG TABLET [3179]
|
Facility
|
IP
|
$0.06
|
|
|
Service Code
|
NDC 0536105429
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.06
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.06
|
| Rate for Payer: Altius Commercial |
$0.06
|
| Rate for Payer: Beech Street Commercial |
$0.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.06
|
| Rate for Payer: Cigna of WY Commercial |
$0.06
|
| Rate for Payer: Entrust Commercial |
$0.06
|
| Rate for Payer: First Choice Health Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.04
|
| Rate for Payer: HealthUtah PPO |
$0.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.06
|
| Rate for Payer: Multiplan Medicare/VA |
$0.04
|
| Rate for Payer: One Health Plan of WY PPO |
$0.06
|
| Rate for Payer: PacificSource Commercial |
$0.05
|
| Rate for Payer: PHCS PPO |
$0.06
|
| Rate for Payer: Three Rivers PPO |
$0.05
|
| Rate for Payer: TriWest Veterans Administration |
$0.04
|
| Rate for Payer: United Healthcare Commercial |
$0.05
|
| Rate for Payer: United Healthcare Medicare |
$0.04
|
| Rate for Payer: WINHealth Partners Commercial |
$0.06
|
| Rate for Payer: Wise Provider Network Commercial |
$0.06
|
|
|
ASPIRIN 325 MG TABLET [3179]
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
NDC 0536105429
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.06
|
| Rate for Payer: Aetna of WY Medicare |
$0.04
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.06
|
| Rate for Payer: Altius Commercial |
$0.06
|
| Rate for Payer: Beech Street Commercial |
$0.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.06
|
| Rate for Payer: Cigna of WY Commercial |
$0.06
|
| Rate for Payer: Entrust Commercial |
$0.06
|
| Rate for Payer: First Choice Health Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.03
|
| Rate for Payer: HealthUtah PPO |
$0.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.06
|
| Rate for Payer: Multiplan Medicare/VA |
$0.03
|
| Rate for Payer: One Health Plan of WY PPO |
$0.06
|
| Rate for Payer: PacificSource Commercial |
$0.05
|
| Rate for Payer: PHCS PPO |
$0.06
|
| Rate for Payer: Three Rivers PPO |
$0.05
|
| Rate for Payer: TriWest Veterans Administration |
$0.03
|
| Rate for Payer: United Healthcare Commercial |
$0.05
|
| Rate for Payer: United Healthcare Medicare |
$0.03
|
| Rate for Payer: WINHealth Partners Commercial |
$0.06
|
| Rate for Payer: Wise Provider Network Commercial |
$0.06
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET [15387]
|
Facility
|
OP
|
$0.09
|
|
|
Service Code
|
NDC 0904404073
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.09 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.09
|
| Rate for Payer: Aetna of WY Medicare |
$0.06
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.09
|
| Rate for Payer: Altius Commercial |
$0.09
|
| Rate for Payer: Beech Street Commercial |
$0.09
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.09
|
| Rate for Payer: Cigna of WY Commercial |
$0.09
|
| Rate for Payer: Entrust Commercial |
$0.09
|
| Rate for Payer: First Choice Health Commercial |
$0.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.05
|
| Rate for Payer: HealthUtah PPO |
$0.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.09
|
| Rate for Payer: Multiplan Medicare/VA |
$0.05
|
| Rate for Payer: One Health Plan of WY PPO |
$0.09
|
| Rate for Payer: PacificSource Commercial |
$0.08
|
| Rate for Payer: PHCS PPO |
$0.09
|
| Rate for Payer: Three Rivers PPO |
$0.07
|
| Rate for Payer: TriWest Veterans Administration |
$0.05
|
| Rate for Payer: United Healthcare Commercial |
$0.08
|
| Rate for Payer: United Healthcare Medicare |
$0.05
|
| Rate for Payer: WINHealth Partners Commercial |
$0.09
|
| Rate for Payer: Wise Provider Network Commercial |
$0.09
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET [15387]
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
NDC 6373943402
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.26
|
| Rate for Payer: Aetna of WY Medicare |
$0.18
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.26
|
| Rate for Payer: Altius Commercial |
$0.26
|
| Rate for Payer: Beech Street Commercial |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$0.19
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.26
|
| Rate for Payer: Cigna of WY Commercial |
$0.26
|
| Rate for Payer: Entrust Commercial |
$0.26
|
| Rate for Payer: First Choice Health Commercial |
$0.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.16
|
| Rate for Payer: HealthUtah PPO |
$0.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.26
|
| Rate for Payer: Multiplan Medicare/VA |
$0.15
|
| Rate for Payer: One Health Plan of WY PPO |
$0.26
|
| Rate for Payer: PacificSource Commercial |
$0.24
|
| Rate for Payer: PHCS PPO |
$0.26
|
| Rate for Payer: Three Rivers PPO |
$0.20
|
| Rate for Payer: TriWest Veterans Administration |
$0.16
|
| Rate for Payer: United Healthcare Commercial |
$0.23
|
| Rate for Payer: United Healthcare Medicare |
$0.16
|
| Rate for Payer: WINHealth Partners Commercial |
$0.26
|
| Rate for Payer: Wise Provider Network Commercial |
$0.26
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET [15387]
|
Facility
|
OP
|
$0.20
|
|
|
Service Code
|
NDC 6655300201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.20
|
| Rate for Payer: Aetna of WY Medicare |
$0.13
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.19
|
| Rate for Payer: Altius Commercial |
$0.19
|
| Rate for Payer: Beech Street Commercial |
$0.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.19
|
| Rate for Payer: Cigna of WY Commercial |
$0.20
|
| Rate for Payer: Entrust Commercial |
$0.19
|
| Rate for Payer: First Choice Health Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.12
|
| Rate for Payer: HealthUtah PPO |
$0.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.19
|
| Rate for Payer: Multiplan Medicare/VA |
$0.11
|
| Rate for Payer: One Health Plan of WY PPO |
$0.20
|
| Rate for Payer: PacificSource Commercial |
$0.18
|
| Rate for Payer: PHCS PPO |
$0.20
|
| Rate for Payer: Three Rivers PPO |
$0.15
|
| Rate for Payer: TriWest Veterans Administration |
$0.12
|
| Rate for Payer: United Healthcare Commercial |
$0.17
|
| Rate for Payer: United Healthcare Medicare |
$0.12
|
| Rate for Payer: WINHealth Partners Commercial |
$0.20
|
| Rate for Payer: Wise Provider Network Commercial |
$0.19
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET [15387]
|
Facility
|
IP
|
$0.06
|
|
|
Service Code
|
NDC 0904679489
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.06
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.06
|
| Rate for Payer: Altius Commercial |
$0.06
|
| Rate for Payer: Beech Street Commercial |
$0.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.06
|
| Rate for Payer: Cigna of WY Commercial |
$0.06
|
| Rate for Payer: Entrust Commercial |
$0.06
|
| Rate for Payer: First Choice Health Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.04
|
| Rate for Payer: HealthUtah PPO |
$0.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.06
|
| Rate for Payer: Multiplan Medicare/VA |
$0.04
|
| Rate for Payer: One Health Plan of WY PPO |
$0.06
|
| Rate for Payer: PacificSource Commercial |
$0.05
|
| Rate for Payer: PHCS PPO |
$0.06
|
| Rate for Payer: Three Rivers PPO |
$0.05
|
| Rate for Payer: TriWest Veterans Administration |
$0.04
|
| Rate for Payer: United Healthcare Commercial |
$0.05
|
| Rate for Payer: United Healthcare Medicare |
$0.04
|
| Rate for Payer: WINHealth Partners Commercial |
$0.06
|
| Rate for Payer: Wise Provider Network Commercial |
$0.06
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET [15387]
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
NDC 0904679489
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.06
|
| Rate for Payer: Aetna of WY Medicare |
$0.04
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.06
|
| Rate for Payer: Altius Commercial |
$0.06
|
| Rate for Payer: Beech Street Commercial |
$0.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.06
|
| Rate for Payer: Cigna of WY Commercial |
$0.06
|
| Rate for Payer: Entrust Commercial |
$0.06
|
| Rate for Payer: First Choice Health Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.03
|
| Rate for Payer: HealthUtah PPO |
$0.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.06
|
| Rate for Payer: Multiplan Medicare/VA |
$0.03
|
| Rate for Payer: One Health Plan of WY PPO |
$0.06
|
| Rate for Payer: PacificSource Commercial |
$0.05
|
| Rate for Payer: PHCS PPO |
$0.06
|
| Rate for Payer: Three Rivers PPO |
$0.05
|
| Rate for Payer: TriWest Veterans Administration |
$0.03
|
| Rate for Payer: United Healthcare Commercial |
$0.05
|
| Rate for Payer: United Healthcare Medicare |
$0.03
|
| Rate for Payer: WINHealth Partners Commercial |
$0.06
|
| Rate for Payer: Wise Provider Network Commercial |
$0.06
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET [15387]
|
Facility
|
IP
|
$0.09
|
|
|
Service Code
|
NDC 0904404073
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.09 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.09
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.09
|
| Rate for Payer: Altius Commercial |
$0.09
|
| Rate for Payer: Beech Street Commercial |
$0.09
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.09
|
| Rate for Payer: Cigna of WY Commercial |
$0.09
|
| Rate for Payer: Entrust Commercial |
$0.09
|
| Rate for Payer: First Choice Health Commercial |
$0.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.06
|
| Rate for Payer: HealthUtah PPO |
$0.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.09
|
| Rate for Payer: Multiplan Medicare/VA |
$0.06
|
| Rate for Payer: One Health Plan of WY PPO |
$0.09
|
| Rate for Payer: PacificSource Commercial |
$0.08
|
| Rate for Payer: PHCS PPO |
$0.09
|
| Rate for Payer: Three Rivers PPO |
$0.07
|
| Rate for Payer: TriWest Veterans Administration |
$0.06
|
| Rate for Payer: United Healthcare Commercial |
$0.08
|
| Rate for Payer: United Healthcare Medicare |
$0.06
|
| Rate for Payer: WINHealth Partners Commercial |
$0.09
|
| Rate for Payer: Wise Provider Network Commercial |
$0.09
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET [15387]
|
Facility
|
IP
|
$0.20
|
|
|
Service Code
|
NDC 6655300201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.19
|
| Rate for Payer: Altius Commercial |
$0.19
|
| Rate for Payer: Beech Street Commercial |
$0.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.19
|
| Rate for Payer: Cigna of WY Commercial |
$0.20
|
| Rate for Payer: Entrust Commercial |
$0.19
|
| Rate for Payer: First Choice Health Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.13
|
| Rate for Payer: HealthUtah PPO |
$0.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.19
|
| Rate for Payer: Multiplan Medicare/VA |
$0.13
|
| Rate for Payer: One Health Plan of WY PPO |
$0.20
|
| Rate for Payer: PacificSource Commercial |
$0.18
|
| Rate for Payer: PHCS PPO |
$0.20
|
| Rate for Payer: Three Rivers PPO |
$0.15
|
| Rate for Payer: TriWest Veterans Administration |
$0.13
|
| Rate for Payer: United Healthcare Commercial |
$0.17
|
| Rate for Payer: United Healthcare Medicare |
$0.13
|
| Rate for Payer: WINHealth Partners Commercial |
$0.19
|
| Rate for Payer: Wise Provider Network Commercial |
$0.19
|
|
