|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - BORDETELLA PERTUSSIS PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779802
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - CAMPYLOBACTOR BY PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779816
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - CAMPYLOBACTOR BY PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779816
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - CRYPTOSPORIDIUM PCR
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779819
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$150.48 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$235.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$230.40
|
| Rate for Payer: Altius Commercial |
$230.40
|
| Rate for Payer: Beech Street Commercial |
$235.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$197.04
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$232.80
|
| Rate for Payer: Cigna of WY Commercial |
$235.20
|
| Rate for Payer: Entrust Commercial |
$228.00
|
| Rate for Payer: First Choice Health Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$158.40
|
| Rate for Payer: HealthUtah PPO |
$240.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$232.80
|
| Rate for Payer: Multiplan Medicare/VA |
$150.48
|
| Rate for Payer: One Health Plan of WY PPO |
$235.20
|
| Rate for Payer: PacificSource Commercial |
$216.00
|
| Rate for Payer: PHCS PPO |
$235.20
|
| Rate for Payer: Three Rivers PPO |
$180.00
|
| Rate for Payer: TriWest Veterans Administration |
$158.40
|
| Rate for Payer: United Healthcare Commercial |
$208.80
|
| Rate for Payer: United Healthcare Medicare |
$158.40
|
| Rate for Payer: WINHealth Partners Commercial |
$228.00
|
| Rate for Payer: Wise Provider Network Commercial |
$228.00
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - CRYPTOSPORIDIUM PCR
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779819
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$132.24 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$235.20
|
| Rate for Payer: Aetna of WY Medicare |
$158.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$230.40
|
| Rate for Payer: Altius Commercial |
$230.40
|
| Rate for Payer: Beech Street Commercial |
$235.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$197.04
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$232.80
|
| Rate for Payer: Cigna of WY Commercial |
$235.20
|
| Rate for Payer: Entrust Commercial |
$228.00
|
| Rate for Payer: First Choice Health Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$139.20
|
| Rate for Payer: HealthUtah PPO |
$240.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$232.80
|
| Rate for Payer: Multiplan Medicare/VA |
$132.24
|
| Rate for Payer: One Health Plan of WY PPO |
$235.20
|
| Rate for Payer: PacificSource Commercial |
$216.00
|
| Rate for Payer: PHCS PPO |
$235.20
|
| Rate for Payer: Three Rivers PPO |
$180.00
|
| Rate for Payer: TriWest Veterans Administration |
$139.20
|
| Rate for Payer: United Healthcare Commercial |
$208.80
|
| Rate for Payer: United Healthcare Medicare |
$139.20
|
| Rate for Payer: WINHealth Partners Commercial |
$235.20
|
| Rate for Payer: Wise Provider Network Commercial |
$228.00
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - EPSTEIN-BARR VIRUS DNA, QUANTITATIVE
|
Facility
|
IP
|
$440.00
|
|
|
Service Code
|
HCPCS 87799
|
| Hospital Charge Code |
3068779902
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$275.88 |
| Max. Negotiated Rate |
$440.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$431.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$422.40
|
| Rate for Payer: Altius Commercial |
$422.40
|
| Rate for Payer: Beech Street Commercial |
$431.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$361.24
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$426.80
|
| Rate for Payer: Cigna of WY Commercial |
$431.20
|
| Rate for Payer: Entrust Commercial |
$418.00
|
| Rate for Payer: First Choice Health Commercial |
$418.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$418.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$290.40
|
| Rate for Payer: HealthUtah PPO |
$440.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$426.80
|
| Rate for Payer: Multiplan Medicare/VA |
$275.88
|
| Rate for Payer: One Health Plan of WY PPO |
$431.20
|
| Rate for Payer: PacificSource Commercial |
$396.00
|
| Rate for Payer: PHCS PPO |
$431.20
|
| Rate for Payer: Three Rivers PPO |
$330.00
|
| Rate for Payer: TriWest Veterans Administration |
$290.40
|
| Rate for Payer: United Healthcare Commercial |
$382.80
|
| Rate for Payer: United Healthcare Medicare |
$290.40
|
| Rate for Payer: WINHealth Partners Commercial |
$418.00
|
| Rate for Payer: Wise Provider Network Commercial |
$418.00
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - EPSTEIN-BARR VIRUS DNA, QUANTITATIVE
|
Facility
|
OP
|
$440.00
|
|
|
Service Code
|
HCPCS 87799
|
| Hospital Charge Code |
3068779902
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$242.44 |
| Max. Negotiated Rate |
$440.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$431.20
|
| Rate for Payer: Aetna of WY Medicare |
$290.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$422.40
|
| Rate for Payer: Altius Commercial |
$422.40
|
| Rate for Payer: Beech Street Commercial |
$431.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$361.24
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$426.80
|
| Rate for Payer: Cigna of WY Commercial |
$431.20
|
| Rate for Payer: Entrust Commercial |
$418.00
|
| Rate for Payer: First Choice Health Commercial |
$418.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$418.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$255.20
|
| Rate for Payer: HealthUtah PPO |
$440.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$426.80
|
| Rate for Payer: Multiplan Medicare/VA |
$242.44
|
| Rate for Payer: One Health Plan of WY PPO |
$431.20
|
| Rate for Payer: PacificSource Commercial |
$396.00
|
| Rate for Payer: PHCS PPO |
$431.20
|
| Rate for Payer: Three Rivers PPO |
$330.00
|
| Rate for Payer: TriWest Veterans Administration |
$255.20
|
| Rate for Payer: United Healthcare Commercial |
$382.80
|
| Rate for Payer: United Healthcare Medicare |
$255.20
|
| Rate for Payer: WINHealth Partners Commercial |
$431.20
|
| Rate for Payer: Wise Provider Network Commercial |
$418.00
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - EPSTEIN BAR VIMS BY PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779813
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - EPSTEIN BAR VIMS BY PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779813
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - HISTOPLASMA PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779811
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - HISTOPLASMA PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779811
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - JC POLYOMA VIRUS PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779818
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - JC POLYOMA VIRUS PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779818
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - NEGATIVE GI PCR PANEL
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779821
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$150.48 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$235.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$230.40
|
| Rate for Payer: Altius Commercial |
$230.40
|
| Rate for Payer: Beech Street Commercial |
$235.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$197.04
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$232.80
|
| Rate for Payer: Cigna of WY Commercial |
$235.20
|
| Rate for Payer: Entrust Commercial |
$228.00
|
| Rate for Payer: First Choice Health Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$158.40
|
| Rate for Payer: HealthUtah PPO |
$240.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$232.80
|
| Rate for Payer: Multiplan Medicare/VA |
$150.48
|
| Rate for Payer: One Health Plan of WY PPO |
$235.20
|
| Rate for Payer: PacificSource Commercial |
$216.00
|
| Rate for Payer: PHCS PPO |
$235.20
|
| Rate for Payer: Three Rivers PPO |
$180.00
|
| Rate for Payer: TriWest Veterans Administration |
$158.40
|
| Rate for Payer: United Healthcare Commercial |
$208.80
|
| Rate for Payer: United Healthcare Medicare |
$158.40
|
| Rate for Payer: WINHealth Partners Commercial |
$228.00
|
| Rate for Payer: Wise Provider Network Commercial |
$228.00
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - NEGATIVE GI PCR PANEL
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779821
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$132.24 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$235.20
|
| Rate for Payer: Aetna of WY Medicare |
$158.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$230.40
|
| Rate for Payer: Altius Commercial |
$230.40
|
| Rate for Payer: Beech Street Commercial |
$235.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$197.04
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$232.80
|
| Rate for Payer: Cigna of WY Commercial |
$235.20
|
| Rate for Payer: Entrust Commercial |
$228.00
|
| Rate for Payer: First Choice Health Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$228.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$139.20
|
| Rate for Payer: HealthUtah PPO |
$240.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$232.80
|
| Rate for Payer: Multiplan Medicare/VA |
$132.24
|
| Rate for Payer: One Health Plan of WY PPO |
$235.20
|
| Rate for Payer: PacificSource Commercial |
$216.00
|
| Rate for Payer: PHCS PPO |
$235.20
|
| Rate for Payer: Three Rivers PPO |
$180.00
|
| Rate for Payer: TriWest Veterans Administration |
$139.20
|
| Rate for Payer: United Healthcare Commercial |
$208.80
|
| Rate for Payer: United Healthcare Medicare |
$139.20
|
| Rate for Payer: WINHealth Partners Commercial |
$235.20
|
| Rate for Payer: Wise Provider Network Commercial |
$228.00
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - NOROVIRUS PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779820
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - NOROVIRUS PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779820
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - PARECHOVIRUS PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779815
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - PARECHOVIRUS PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779815
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - RSV BY PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779808
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - RSV BY PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779808
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - TOXOPLASMA GONDII BY PCR
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779817
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$165.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$156.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$165.00
|
| Rate for Payer: WINHealth Partners Commercial |
$237.50
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - TOXOPLASMA GONDII BY PCR
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779817
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$245.00
|
| Rate for Payer: Aetna of WY Medicare |
$165.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$240.00
|
| Rate for Payer: Altius Commercial |
$240.00
|
| Rate for Payer: Beech Street Commercial |
$245.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$205.25
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$242.50
|
| Rate for Payer: Cigna of WY Commercial |
$245.00
|
| Rate for Payer: Entrust Commercial |
$237.50
|
| Rate for Payer: First Choice Health Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$237.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.00
|
| Rate for Payer: HealthUtah PPO |
$250.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$242.50
|
| Rate for Payer: Multiplan Medicare/VA |
$137.75
|
| Rate for Payer: One Health Plan of WY PPO |
$245.00
|
| Rate for Payer: PacificSource Commercial |
$225.00
|
| Rate for Payer: PHCS PPO |
$245.00
|
| Rate for Payer: Three Rivers PPO |
$187.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.00
|
| Rate for Payer: United Healthcare Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicare |
$145.00
|
| Rate for Payer: WINHealth Partners Commercial |
$245.00
|
| Rate for Payer: Wise Provider Network Commercial |
$237.50
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - VARICELLA ZOSTER BY PCR
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779814
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$240.10
|
| Rate for Payer: Aetna of WY Medicare |
$161.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$235.20
|
| Rate for Payer: Altius Commercial |
$235.20
|
| Rate for Payer: Beech Street Commercial |
$240.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$201.14
|
| Rate for Payer: Cash Price |
$171.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$237.65
|
| Rate for Payer: Cigna of WY Commercial |
$240.10
|
| Rate for Payer: Entrust Commercial |
$232.75
|
| Rate for Payer: First Choice Health Commercial |
$232.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$232.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$142.10
|
| Rate for Payer: HealthUtah PPO |
$245.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$237.65
|
| Rate for Payer: Multiplan Medicare/VA |
$135.00
|
| Rate for Payer: One Health Plan of WY PPO |
$240.10
|
| Rate for Payer: PacificSource Commercial |
$220.50
|
| Rate for Payer: PHCS PPO |
$240.10
|
| Rate for Payer: Three Rivers PPO |
$183.75
|
| Rate for Payer: TriWest Veterans Administration |
$142.10
|
| Rate for Payer: United Healthcare Commercial |
$213.15
|
| Rate for Payer: United Healthcare Medicare |
$142.10
|
| Rate for Payer: WINHealth Partners Commercial |
$240.10
|
| Rate for Payer: Wise Provider Network Commercial |
$232.75
|
|
|
HC INFECTIOUS DETECT AGENT NOS, DNA, AMP - VARICELLA ZOSTER BY PCR
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3068779814
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$153.62 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$240.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$235.20
|
| Rate for Payer: Altius Commercial |
$235.20
|
| Rate for Payer: Beech Street Commercial |
$240.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$201.14
|
| Rate for Payer: Cash Price |
$171.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$237.65
|
| Rate for Payer: Cigna of WY Commercial |
$240.10
|
| Rate for Payer: Entrust Commercial |
$232.75
|
| Rate for Payer: First Choice Health Commercial |
$232.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$232.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$161.70
|
| Rate for Payer: HealthUtah PPO |
$245.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$237.65
|
| Rate for Payer: Multiplan Medicare/VA |
$153.62
|
| Rate for Payer: One Health Plan of WY PPO |
$240.10
|
| Rate for Payer: PacificSource Commercial |
$220.50
|
| Rate for Payer: PHCS PPO |
$240.10
|
| Rate for Payer: Three Rivers PPO |
$183.75
|
| Rate for Payer: TriWest Veterans Administration |
$161.70
|
| Rate for Payer: United Healthcare Commercial |
$213.15
|
| Rate for Payer: United Healthcare Medicare |
$161.70
|
| Rate for Payer: WINHealth Partners Commercial |
$232.75
|
| Rate for Payer: Wise Provider Network Commercial |
$232.75
|
|
