Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS 83789
Hospital Charge Code 3018378905
Hospital Revenue Code 301
Min. Negotiated Rate $175.56
Max. Negotiated Rate $280.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $274.40
Rate for Payer: Altius Auto/Workers Compensation $268.80
Rate for Payer: Altius Commercial $268.80
Rate for Payer: Beech Street Commercial $274.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $229.88
Rate for Payer: Cash Price $196.00
Rate for Payer: ChoiceCare Network Commercial $271.60
Rate for Payer: Cigna of WY Commercial $274.40
Rate for Payer: Entrust Commercial $266.00
Rate for Payer: First Choice Health Commercial $266.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $266.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $184.80
Rate for Payer: HealthUtah PPO $280.00
Rate for Payer: Idaho Integrated Healthcare Commercial $271.60
Rate for Payer: Multiplan Medicare/VA $175.56
Rate for Payer: One Health Plan of WY PPO $274.40
Rate for Payer: PacificSource Commercial $252.00
Rate for Payer: PHCS PPO $274.40
Rate for Payer: Three Rivers PPO $210.00
Rate for Payer: TriWest Veterans Administration $184.80
Rate for Payer: United Healthcare Commercial $243.60
Rate for Payer: United Healthcare Medicare $184.80
Rate for Payer: WINHealth Partners Commercial $266.00
Rate for Payer: Wise Provider Network Commercial $266.00
Service Code HCPCS 51798
Hospital Charge Code 7615179801
Hospital Revenue Code 761
Min. Negotiated Rate $191.75
Max. Negotiated Rate $348.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $341.04
Rate for Payer: Aetna of WY Commercial/Medical Rental $221.48
Rate for Payer: Aetna of WY Medicare $229.68
Rate for Payer: Aetna of WY Medicare $149.16
Rate for Payer: Altius Auto/Workers Compensation $216.96
Rate for Payer: Altius Auto/Workers Compensation $334.08
Rate for Payer: Altius Commercial $334.08
Rate for Payer: Altius Commercial $216.96
Rate for Payer: Beech Street Commercial $221.48
Rate for Payer: Beech Street Commercial $341.04
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $285.71
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $185.55
Rate for Payer: Cash Price $158.20
Rate for Payer: Cash Price $243.60
Rate for Payer: ChoiceCare Network Commercial $337.56
Rate for Payer: ChoiceCare Network Commercial $219.22
Rate for Payer: Cigna of WY Commercial $221.48
Rate for Payer: Cigna of WY Commercial $341.04
Rate for Payer: Entrust Commercial $330.60
Rate for Payer: Entrust Commercial $214.70
Rate for Payer: First Choice Health Commercial $214.70
Rate for Payer: First Choice Health Commercial $330.60
Rate for Payer: Government Employees Health Association (GEHA) Commercial $214.70
Rate for Payer: Government Employees Health Association (GEHA) Commercial $330.60
Rate for Payer: Government Employees Health Association (GEHA) Medicare $201.84
Rate for Payer: Government Employees Health Association (GEHA) Medicare $131.08
Rate for Payer: HealthUtah PPO $226.00
Rate for Payer: HealthUtah PPO $348.00
Rate for Payer: Idaho Integrated Healthcare Commercial $219.22
Rate for Payer: Idaho Integrated Healthcare Commercial $337.56
Rate for Payer: Multiplan Medicare/VA $191.75
Rate for Payer: Multiplan Medicare/VA $124.53
Rate for Payer: One Health Plan of WY PPO $221.48
Rate for Payer: One Health Plan of WY PPO $341.04
Rate for Payer: PacificSource Commercial $313.20
Rate for Payer: PacificSource Commercial $203.40
Rate for Payer: PHCS PPO $221.48
Rate for Payer: PHCS PPO $341.04
Rate for Payer: Three Rivers PPO $169.50
Rate for Payer: Three Rivers PPO $261.00
Rate for Payer: TriWest Veterans Administration $201.84
Rate for Payer: TriWest Veterans Administration $131.08
Rate for Payer: United Healthcare Commercial $196.62
Rate for Payer: United Healthcare Commercial $302.76
Rate for Payer: United Healthcare Medicare $201.84
Rate for Payer: United Healthcare Medicare $131.08
Rate for Payer: WINHealth Partners Commercial $221.48
Rate for Payer: WINHealth Partners Commercial $341.04
Rate for Payer: Wise Provider Network Commercial $214.70
Rate for Payer: Wise Provider Network Commercial $330.60
Service Code HCPCS 51798
Hospital Charge Code 7615179801
Hospital Revenue Code 761
Min. Negotiated Rate $218.20
Max. Negotiated Rate $348.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $341.04
Rate for Payer: Aetna of WY Commercial/Medical Rental $221.48
Rate for Payer: Altius Auto/Workers Compensation $334.08
Rate for Payer: Altius Auto/Workers Compensation $216.96
Rate for Payer: Altius Commercial $216.96
Rate for Payer: Altius Commercial $334.08
Rate for Payer: Beech Street Commercial $341.04
Rate for Payer: Beech Street Commercial $221.48
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $185.55
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $285.71
Rate for Payer: Cash Price $243.60
Rate for Payer: Cash Price $158.20
Rate for Payer: ChoiceCare Network Commercial $219.22
Rate for Payer: ChoiceCare Network Commercial $337.56
Rate for Payer: Cigna of WY Commercial $341.04
Rate for Payer: Cigna of WY Commercial $221.48
Rate for Payer: Entrust Commercial $214.70
Rate for Payer: Entrust Commercial $330.60
Rate for Payer: First Choice Health Commercial $214.70
Rate for Payer: First Choice Health Commercial $330.60
Rate for Payer: Government Employees Health Association (GEHA) Commercial $214.70
Rate for Payer: Government Employees Health Association (GEHA) Commercial $330.60
Rate for Payer: Government Employees Health Association (GEHA) Medicare $229.68
Rate for Payer: Government Employees Health Association (GEHA) Medicare $149.16
Rate for Payer: HealthUtah PPO $348.00
Rate for Payer: HealthUtah PPO $226.00
Rate for Payer: Idaho Integrated Healthcare Commercial $219.22
Rate for Payer: Idaho Integrated Healthcare Commercial $337.56
Rate for Payer: Multiplan Medicare/VA $218.20
Rate for Payer: Multiplan Medicare/VA $141.70
Rate for Payer: One Health Plan of WY PPO $341.04
Rate for Payer: One Health Plan of WY PPO $221.48
Rate for Payer: PacificSource Commercial $313.20
Rate for Payer: PacificSource Commercial $203.40
Rate for Payer: PHCS PPO $221.48
Rate for Payer: PHCS PPO $341.04
Rate for Payer: Three Rivers PPO $169.50
Rate for Payer: Three Rivers PPO $261.00
Rate for Payer: TriWest Veterans Administration $229.68
Rate for Payer: TriWest Veterans Administration $149.16
Rate for Payer: United Healthcare Commercial $196.62
Rate for Payer: United Healthcare Commercial $302.76
Rate for Payer: United Healthcare Medicare $229.68
Rate for Payer: United Healthcare Medicare $149.16
Rate for Payer: WINHealth Partners Commercial $214.70
Rate for Payer: WINHealth Partners Commercial $330.60
Rate for Payer: Wise Provider Network Commercial $214.70
Rate for Payer: Wise Provider Network Commercial $330.60
Service Code HCPCS 51798
Hospital Charge Code 5105179801
Hospital Revenue Code 510
Min. Negotiated Rate $24.80
Max. Negotiated Rate $45.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $44.10
Rate for Payer: Aetna of WY Medicare $29.70
Rate for Payer: Altius Auto/Workers Compensation $43.20
Rate for Payer: Altius Commercial $43.20
Rate for Payer: Beech Street Commercial $44.10
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $36.94
Rate for Payer: Cash Price $31.50
Rate for Payer: ChoiceCare Network Commercial $43.65
Rate for Payer: Cigna of WY Commercial $44.10
Rate for Payer: Entrust Commercial $42.75
Rate for Payer: First Choice Health Commercial $42.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $42.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $26.10
Rate for Payer: HealthUtah PPO $45.00
Rate for Payer: Idaho Integrated Healthcare Commercial $43.65
Rate for Payer: Multiplan Medicare/VA $24.80
Rate for Payer: One Health Plan of WY PPO $44.10
Rate for Payer: PacificSource Commercial $40.50
Rate for Payer: PHCS PPO $44.10
Rate for Payer: Three Rivers PPO $33.75
Rate for Payer: TriWest Veterans Administration $26.10
Rate for Payer: United Healthcare Commercial $39.15
Rate for Payer: United Healthcare Medicare $26.10
Rate for Payer: WINHealth Partners Commercial $44.10
Rate for Payer: Wise Provider Network Commercial $42.75
Service Code HCPCS 51798
Hospital Charge Code 5105179801
Hospital Revenue Code 510
Min. Negotiated Rate $28.22
Max. Negotiated Rate $45.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $44.10
Rate for Payer: Altius Auto/Workers Compensation $43.20
Rate for Payer: Altius Commercial $43.20
Rate for Payer: Beech Street Commercial $44.10
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $36.94
Rate for Payer: Cash Price $31.50
Rate for Payer: ChoiceCare Network Commercial $43.65
Rate for Payer: Cigna of WY Commercial $44.10
Rate for Payer: Entrust Commercial $42.75
Rate for Payer: First Choice Health Commercial $42.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $42.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $29.70
Rate for Payer: HealthUtah PPO $45.00
Rate for Payer: Idaho Integrated Healthcare Commercial $43.65
Rate for Payer: Multiplan Medicare/VA $28.22
Rate for Payer: One Health Plan of WY PPO $44.10
Rate for Payer: PacificSource Commercial $40.50
Rate for Payer: PHCS PPO $44.10
Rate for Payer: Three Rivers PPO $33.75
Rate for Payer: TriWest Veterans Administration $29.70
Rate for Payer: United Healthcare Commercial $39.15
Rate for Payer: United Healthcare Medicare $29.70
Rate for Payer: WINHealth Partners Commercial $42.75
Rate for Payer: Wise Provider Network Commercial $42.75
Service Code HCPCS G0270
Hospital Charge Code 942G027001
Hospital Revenue Code 942
Min. Negotiated Rate $94.05
Max. Negotiated Rate $150.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $147.00
Rate for Payer: Altius Auto/Workers Compensation $144.00
Rate for Payer: Altius Commercial $144.00
Rate for Payer: Beech Street Commercial $147.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $123.15
Rate for Payer: Cash Price $105.00
Rate for Payer: ChoiceCare Network Commercial $145.50
Rate for Payer: Cigna of WY Commercial $147.00
Rate for Payer: Entrust Commercial $142.50
Rate for Payer: First Choice Health Commercial $142.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $142.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $99.00
Rate for Payer: HealthUtah PPO $150.00
Rate for Payer: Idaho Integrated Healthcare Commercial $145.50
Rate for Payer: Multiplan Medicare/VA $94.05
Rate for Payer: One Health Plan of WY PPO $147.00
Rate for Payer: PacificSource Commercial $135.00
Rate for Payer: PHCS PPO $147.00
Rate for Payer: Three Rivers PPO $112.50
Rate for Payer: TriWest Veterans Administration $99.00
Rate for Payer: United Healthcare Commercial $130.50
Rate for Payer: United Healthcare Medicare $99.00
Rate for Payer: WINHealth Partners Commercial $142.50
Rate for Payer: Wise Provider Network Commercial $142.50
Service Code HCPCS G0270
Hospital Charge Code 942G027001
Hospital Revenue Code 942
Min. Negotiated Rate $82.65
Max. Negotiated Rate $150.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $147.00
Rate for Payer: Aetna of WY Medicare $99.00
Rate for Payer: Altius Auto/Workers Compensation $144.00
Rate for Payer: Altius Commercial $144.00
Rate for Payer: Beech Street Commercial $147.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $123.15
Rate for Payer: Cash Price $105.00
Rate for Payer: ChoiceCare Network Commercial $145.50
Rate for Payer: Cigna of WY Commercial $147.00
Rate for Payer: Entrust Commercial $142.50
Rate for Payer: First Choice Health Commercial $142.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $142.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $87.00
Rate for Payer: HealthUtah PPO $150.00
Rate for Payer: Idaho Integrated Healthcare Commercial $145.50
Rate for Payer: Multiplan Medicare/VA $82.65
Rate for Payer: One Health Plan of WY PPO $147.00
Rate for Payer: PacificSource Commercial $135.00
Rate for Payer: PHCS PPO $147.00
Rate for Payer: Three Rivers PPO $112.50
Rate for Payer: TriWest Veterans Administration $87.00
Rate for Payer: United Healthcare Commercial $130.50
Rate for Payer: United Healthcare Medicare $87.00
Rate for Payer: WINHealth Partners Commercial $147.00
Rate for Payer: Wise Provider Network Commercial $142.50
Service Code HCPCS G0271
Hospital Charge Code 942G027101
Hospital Revenue Code 942
Min. Negotiated Rate $31.35
Max. Negotiated Rate $50.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $49.00
Rate for Payer: Altius Auto/Workers Compensation $48.00
Rate for Payer: Altius Commercial $48.00
Rate for Payer: Beech Street Commercial $49.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $41.05
Rate for Payer: Cash Price $35.00
Rate for Payer: ChoiceCare Network Commercial $48.50
Rate for Payer: Cigna of WY Commercial $49.00
Rate for Payer: Entrust Commercial $47.50
Rate for Payer: First Choice Health Commercial $47.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $47.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $33.00
Rate for Payer: HealthUtah PPO $50.00
Rate for Payer: Idaho Integrated Healthcare Commercial $48.50
Rate for Payer: Multiplan Medicare/VA $31.35
Rate for Payer: One Health Plan of WY PPO $49.00
Rate for Payer: PacificSource Commercial $45.00
Rate for Payer: PHCS PPO $49.00
Rate for Payer: Three Rivers PPO $37.50
Rate for Payer: TriWest Veterans Administration $33.00
Rate for Payer: United Healthcare Commercial $43.50
Rate for Payer: United Healthcare Medicare $33.00
Rate for Payer: WINHealth Partners Commercial $47.50
Rate for Payer: Wise Provider Network Commercial $47.50
Service Code HCPCS G0271
Hospital Charge Code 942G027101
Hospital Revenue Code 942
Min. Negotiated Rate $27.55
Max. Negotiated Rate $50.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $49.00
Rate for Payer: Aetna of WY Medicare $33.00
Rate for Payer: Altius Auto/Workers Compensation $48.00
Rate for Payer: Altius Commercial $48.00
Rate for Payer: Beech Street Commercial $49.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $41.05
Rate for Payer: Cash Price $35.00
Rate for Payer: ChoiceCare Network Commercial $48.50
Rate for Payer: Cigna of WY Commercial $49.00
Rate for Payer: Entrust Commercial $47.50
Rate for Payer: First Choice Health Commercial $47.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $47.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $29.00
Rate for Payer: HealthUtah PPO $50.00
Rate for Payer: Idaho Integrated Healthcare Commercial $48.50
Rate for Payer: Multiplan Medicare/VA $27.55
Rate for Payer: One Health Plan of WY PPO $49.00
Rate for Payer: PacificSource Commercial $45.00
Rate for Payer: PHCS PPO $49.00
Rate for Payer: Three Rivers PPO $37.50
Rate for Payer: TriWest Veterans Administration $29.00
Rate for Payer: United Healthcare Commercial $43.50
Rate for Payer: United Healthcare Medicare $29.00
Rate for Payer: WINHealth Partners Commercial $49.00
Rate for Payer: Wise Provider Network Commercial $47.50
Service Code HCPCS 97802
Hospital Charge Code 9429780201
Hospital Revenue Code 942
Min. Negotiated Rate $125.40
Max. Negotiated Rate $200.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $196.00
Rate for Payer: Altius Auto/Workers Compensation $192.00
Rate for Payer: Altius Commercial $192.00
Rate for Payer: Beech Street Commercial $196.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $164.20
Rate for Payer: Cash Price $140.00
Rate for Payer: ChoiceCare Network Commercial $194.00
Rate for Payer: Cigna of WY Commercial $196.00
Rate for Payer: Entrust Commercial $190.00
Rate for Payer: First Choice Health Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $132.00
Rate for Payer: HealthUtah PPO $200.00
Rate for Payer: Idaho Integrated Healthcare Commercial $194.00
Rate for Payer: Multiplan Medicare/VA $125.40
Rate for Payer: One Health Plan of WY PPO $196.00
Rate for Payer: PacificSource Commercial $180.00
Rate for Payer: PHCS PPO $196.00
Rate for Payer: Three Rivers PPO $150.00
Rate for Payer: TriWest Veterans Administration $132.00
Rate for Payer: United Healthcare Commercial $174.00
Rate for Payer: United Healthcare Medicare $132.00
Rate for Payer: WINHealth Partners Commercial $190.00
Rate for Payer: Wise Provider Network Commercial $190.00
Service Code HCPCS 97802
Hospital Charge Code 9429780201
Hospital Revenue Code 942
Min. Negotiated Rate $110.20
Max. Negotiated Rate $200.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $196.00
Rate for Payer: Aetna of WY Medicare $132.00
Rate for Payer: Altius Auto/Workers Compensation $192.00
Rate for Payer: Altius Commercial $192.00
Rate for Payer: Beech Street Commercial $196.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $164.20
Rate for Payer: Cash Price $140.00
Rate for Payer: ChoiceCare Network Commercial $194.00
Rate for Payer: Cigna of WY Commercial $196.00
Rate for Payer: Entrust Commercial $190.00
Rate for Payer: First Choice Health Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $116.00
Rate for Payer: HealthUtah PPO $200.00
Rate for Payer: Idaho Integrated Healthcare Commercial $194.00
Rate for Payer: Multiplan Medicare/VA $110.20
Rate for Payer: One Health Plan of WY PPO $196.00
Rate for Payer: PacificSource Commercial $180.00
Rate for Payer: PHCS PPO $196.00
Rate for Payer: Three Rivers PPO $150.00
Rate for Payer: TriWest Veterans Administration $116.00
Rate for Payer: United Healthcare Commercial $174.00
Rate for Payer: United Healthcare Medicare $116.00
Rate for Payer: WINHealth Partners Commercial $196.00
Rate for Payer: Wise Provider Network Commercial $190.00
Service Code HCPCS 97804
Hospital Charge Code 9429780401
Hospital Revenue Code 942
Min. Negotiated Rate $22.04
Max. Negotiated Rate $40.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $39.20
Rate for Payer: Aetna of WY Medicare $26.40
Rate for Payer: Altius Auto/Workers Compensation $38.40
Rate for Payer: Altius Commercial $38.40
Rate for Payer: Beech Street Commercial $39.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $32.84
Rate for Payer: Cash Price $28.00
Rate for Payer: ChoiceCare Network Commercial $38.80
Rate for Payer: Cigna of WY Commercial $39.20
Rate for Payer: Entrust Commercial $38.00
Rate for Payer: First Choice Health Commercial $38.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $38.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $23.20
Rate for Payer: HealthUtah PPO $40.00
Rate for Payer: Idaho Integrated Healthcare Commercial $38.80
Rate for Payer: Multiplan Medicare/VA $22.04
Rate for Payer: One Health Plan of WY PPO $39.20
Rate for Payer: PacificSource Commercial $36.00
Rate for Payer: PHCS PPO $39.20
Rate for Payer: Three Rivers PPO $30.00
Rate for Payer: TriWest Veterans Administration $23.20
Rate for Payer: United Healthcare Commercial $34.80
Rate for Payer: United Healthcare Medicare $23.20
Rate for Payer: WINHealth Partners Commercial $39.20
Rate for Payer: Wise Provider Network Commercial $38.00
Service Code HCPCS 97804
Hospital Charge Code 9429780401
Hospital Revenue Code 942
Min. Negotiated Rate $25.08
Max. Negotiated Rate $40.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $39.20
Rate for Payer: Altius Auto/Workers Compensation $38.40
Rate for Payer: Altius Commercial $38.40
Rate for Payer: Beech Street Commercial $39.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $32.84
Rate for Payer: Cash Price $28.00
Rate for Payer: ChoiceCare Network Commercial $38.80
Rate for Payer: Cigna of WY Commercial $39.20
Rate for Payer: Entrust Commercial $38.00
Rate for Payer: First Choice Health Commercial $38.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $38.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $26.40
Rate for Payer: HealthUtah PPO $40.00
Rate for Payer: Idaho Integrated Healthcare Commercial $38.80
Rate for Payer: Multiplan Medicare/VA $25.08
Rate for Payer: One Health Plan of WY PPO $39.20
Rate for Payer: PacificSource Commercial $36.00
Rate for Payer: PHCS PPO $39.20
Rate for Payer: Three Rivers PPO $30.00
Rate for Payer: TriWest Veterans Administration $26.40
Rate for Payer: United Healthcare Commercial $34.80
Rate for Payer: United Healthcare Medicare $26.40
Rate for Payer: WINHealth Partners Commercial $38.00
Rate for Payer: Wise Provider Network Commercial $38.00
Service Code HCPCS 97803
Hospital Charge Code 9429780301
Hospital Revenue Code 942
Min. Negotiated Rate $87.78
Max. Negotiated Rate $140.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $137.20
Rate for Payer: Altius Auto/Workers Compensation $134.40
Rate for Payer: Altius Commercial $134.40
Rate for Payer: Beech Street Commercial $137.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $114.94
Rate for Payer: Cash Price $98.00
Rate for Payer: ChoiceCare Network Commercial $135.80
Rate for Payer: Cigna of WY Commercial $137.20
Rate for Payer: Entrust Commercial $133.00
Rate for Payer: First Choice Health Commercial $133.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $133.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $92.40
Rate for Payer: HealthUtah PPO $140.00
Rate for Payer: Idaho Integrated Healthcare Commercial $135.80
Rate for Payer: Multiplan Medicare/VA $87.78
Rate for Payer: One Health Plan of WY PPO $137.20
Rate for Payer: PacificSource Commercial $126.00
Rate for Payer: PHCS PPO $137.20
Rate for Payer: Three Rivers PPO $105.00
Rate for Payer: TriWest Veterans Administration $92.40
Rate for Payer: United Healthcare Commercial $121.80
Rate for Payer: United Healthcare Medicare $92.40
Rate for Payer: WINHealth Partners Commercial $133.00
Rate for Payer: Wise Provider Network Commercial $133.00
Service Code HCPCS 97803
Hospital Charge Code 9429780301
Hospital Revenue Code 942
Min. Negotiated Rate $77.14
Max. Negotiated Rate $140.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $137.20
Rate for Payer: Aetna of WY Medicare $92.40
Rate for Payer: Altius Auto/Workers Compensation $134.40
Rate for Payer: Altius Commercial $134.40
Rate for Payer: Beech Street Commercial $137.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $114.94
Rate for Payer: Cash Price $98.00
Rate for Payer: ChoiceCare Network Commercial $135.80
Rate for Payer: Cigna of WY Commercial $137.20
Rate for Payer: Entrust Commercial $133.00
Rate for Payer: First Choice Health Commercial $133.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $133.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $81.20
Rate for Payer: HealthUtah PPO $140.00
Rate for Payer: Idaho Integrated Healthcare Commercial $135.80
Rate for Payer: Multiplan Medicare/VA $77.14
Rate for Payer: One Health Plan of WY PPO $137.20
Rate for Payer: PacificSource Commercial $126.00
Rate for Payer: PHCS PPO $137.20
Rate for Payer: Three Rivers PPO $105.00
Rate for Payer: TriWest Veterans Administration $81.20
Rate for Payer: United Healthcare Commercial $121.80
Rate for Payer: United Healthcare Medicare $81.20
Rate for Payer: WINHealth Partners Commercial $137.20
Rate for Payer: Wise Provider Network Commercial $133.00
Service Code HCPCS 80053
Hospital Charge Code 3018005301
Hospital Revenue Code 301
Min. Negotiated Rate $121.22
Max. Negotiated Rate $220.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $215.60
Rate for Payer: Aetna of WY Medicare $145.20
Rate for Payer: Altius Auto/Workers Compensation $211.20
Rate for Payer: Altius Commercial $211.20
Rate for Payer: Beech Street Commercial $215.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $180.62
Rate for Payer: Cash Price $154.00
Rate for Payer: ChoiceCare Network Commercial $213.40
Rate for Payer: Cigna of WY Commercial $215.60
Rate for Payer: Entrust Commercial $209.00
Rate for Payer: First Choice Health Commercial $209.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $209.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $127.60
Rate for Payer: HealthUtah PPO $220.00
Rate for Payer: Idaho Integrated Healthcare Commercial $213.40
Rate for Payer: Multiplan Medicare/VA $121.22
Rate for Payer: One Health Plan of WY PPO $215.60
Rate for Payer: PacificSource Commercial $198.00
Rate for Payer: PHCS PPO $215.60
Rate for Payer: Three Rivers PPO $165.00
Rate for Payer: TriWest Veterans Administration $127.60
Rate for Payer: United Healthcare Commercial $191.40
Rate for Payer: United Healthcare Medicare $127.60
Rate for Payer: WINHealth Partners Commercial $215.60
Rate for Payer: Wise Provider Network Commercial $209.00
Service Code HCPCS 80053
Hospital Charge Code 3018005301
Hospital Revenue Code 301
Min. Negotiated Rate $137.94
Max. Negotiated Rate $220.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $215.60
Rate for Payer: Altius Auto/Workers Compensation $211.20
Rate for Payer: Altius Commercial $211.20
Rate for Payer: Beech Street Commercial $215.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $180.62
Rate for Payer: Cash Price $154.00
Rate for Payer: ChoiceCare Network Commercial $213.40
Rate for Payer: Cigna of WY Commercial $215.60
Rate for Payer: Entrust Commercial $209.00
Rate for Payer: First Choice Health Commercial $209.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $209.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $145.20
Rate for Payer: HealthUtah PPO $220.00
Rate for Payer: Idaho Integrated Healthcare Commercial $213.40
Rate for Payer: Multiplan Medicare/VA $137.94
Rate for Payer: One Health Plan of WY PPO $215.60
Rate for Payer: PacificSource Commercial $198.00
Rate for Payer: PHCS PPO $215.60
Rate for Payer: Three Rivers PPO $165.00
Rate for Payer: TriWest Veterans Administration $145.20
Rate for Payer: United Healthcare Commercial $191.40
Rate for Payer: United Healthcare Medicare $145.20
Rate for Payer: WINHealth Partners Commercial $209.00
Rate for Payer: Wise Provider Network Commercial $209.00
Service Code HCPCS 87116
Hospital Charge Code 3068711601
Hospital Revenue Code 306
Min. Negotiated Rate $311.32
Max. Negotiated Rate $565.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $553.70
Rate for Payer: Aetna of WY Medicare $372.90
Rate for Payer: Altius Auto/Workers Compensation $542.40
Rate for Payer: Altius Commercial $542.40
Rate for Payer: Beech Street Commercial $553.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $463.86
Rate for Payer: Cash Price $395.50
Rate for Payer: ChoiceCare Network Commercial $548.05
Rate for Payer: Cigna of WY Commercial $553.70
Rate for Payer: Entrust Commercial $536.75
Rate for Payer: First Choice Health Commercial $536.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $536.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $327.70
Rate for Payer: HealthUtah PPO $565.00
Rate for Payer: Idaho Integrated Healthcare Commercial $548.05
Rate for Payer: Multiplan Medicare/VA $311.32
Rate for Payer: One Health Plan of WY PPO $553.70
Rate for Payer: PacificSource Commercial $508.50
Rate for Payer: PHCS PPO $553.70
Rate for Payer: Three Rivers PPO $423.75
Rate for Payer: TriWest Veterans Administration $327.70
Rate for Payer: United Healthcare Commercial $491.55
Rate for Payer: United Healthcare Medicare $327.70
Rate for Payer: WINHealth Partners Commercial $553.70
Rate for Payer: Wise Provider Network Commercial $536.75
Service Code HCPCS 87116
Hospital Charge Code 3068711601
Hospital Revenue Code 306
Min. Negotiated Rate $354.26
Max. Negotiated Rate $565.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $553.70
Rate for Payer: Altius Auto/Workers Compensation $542.40
Rate for Payer: Altius Commercial $542.40
Rate for Payer: Beech Street Commercial $553.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $463.86
Rate for Payer: Cash Price $395.50
Rate for Payer: ChoiceCare Network Commercial $548.05
Rate for Payer: Cigna of WY Commercial $553.70
Rate for Payer: Entrust Commercial $536.75
Rate for Payer: First Choice Health Commercial $536.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $536.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $372.90
Rate for Payer: HealthUtah PPO $565.00
Rate for Payer: Idaho Integrated Healthcare Commercial $548.05
Rate for Payer: Multiplan Medicare/VA $354.26
Rate for Payer: One Health Plan of WY PPO $553.70
Rate for Payer: PacificSource Commercial $508.50
Rate for Payer: PHCS PPO $553.70
Rate for Payer: Three Rivers PPO $423.75
Rate for Payer: TriWest Veterans Administration $372.90
Rate for Payer: United Healthcare Commercial $491.55
Rate for Payer: United Healthcare Medicare $372.90
Rate for Payer: WINHealth Partners Commercial $536.75
Rate for Payer: Wise Provider Network Commercial $536.75
Service Code HCPCS 82043
Hospital Charge Code 3018204301
Hospital Revenue Code 301
Min. Negotiated Rate $115.71
Max. Negotiated Rate $210.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $205.80
Rate for Payer: Aetna of WY Medicare $138.60
Rate for Payer: Altius Auto/Workers Compensation $201.60
Rate for Payer: Altius Commercial $201.60
Rate for Payer: Beech Street Commercial $205.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $172.41
Rate for Payer: Cash Price $147.00
Rate for Payer: ChoiceCare Network Commercial $203.70
Rate for Payer: Cigna of WY Commercial $205.80
Rate for Payer: Entrust Commercial $199.50
Rate for Payer: First Choice Health Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $121.80
Rate for Payer: HealthUtah PPO $210.00
Rate for Payer: Idaho Integrated Healthcare Commercial $203.70
Rate for Payer: Multiplan Medicare/VA $115.71
Rate for Payer: One Health Plan of WY PPO $205.80
Rate for Payer: PacificSource Commercial $189.00
Rate for Payer: PHCS PPO $205.80
Rate for Payer: Three Rivers PPO $157.50
Rate for Payer: TriWest Veterans Administration $121.80
Rate for Payer: United Healthcare Commercial $182.70
Rate for Payer: United Healthcare Medicare $121.80
Rate for Payer: WINHealth Partners Commercial $205.80
Rate for Payer: Wise Provider Network Commercial $199.50
Service Code HCPCS 82043
Hospital Charge Code 3018204301
Hospital Revenue Code 301
Min. Negotiated Rate $131.67
Max. Negotiated Rate $210.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $205.80
Rate for Payer: Altius Auto/Workers Compensation $201.60
Rate for Payer: Altius Commercial $201.60
Rate for Payer: Beech Street Commercial $205.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $172.41
Rate for Payer: Cash Price $147.00
Rate for Payer: ChoiceCare Network Commercial $203.70
Rate for Payer: Cigna of WY Commercial $205.80
Rate for Payer: Entrust Commercial $199.50
Rate for Payer: First Choice Health Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $138.60
Rate for Payer: HealthUtah PPO $210.00
Rate for Payer: Idaho Integrated Healthcare Commercial $203.70
Rate for Payer: Multiplan Medicare/VA $131.67
Rate for Payer: One Health Plan of WY PPO $205.80
Rate for Payer: PacificSource Commercial $189.00
Rate for Payer: PHCS PPO $205.80
Rate for Payer: Three Rivers PPO $157.50
Rate for Payer: TriWest Veterans Administration $138.60
Rate for Payer: United Healthcare Commercial $182.70
Rate for Payer: United Healthcare Medicare $138.60
Rate for Payer: WINHealth Partners Commercial $199.50
Rate for Payer: Wise Provider Network Commercial $199.50
Service Code HCPCS 82043
Hospital Charge Code 3018204303
Hospital Revenue Code 301
Min. Negotiated Rate $115.71
Max. Negotiated Rate $210.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $205.80
Rate for Payer: Aetna of WY Medicare $138.60
Rate for Payer: Altius Auto/Workers Compensation $201.60
Rate for Payer: Altius Commercial $201.60
Rate for Payer: Beech Street Commercial $205.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $172.41
Rate for Payer: Cash Price $147.00
Rate for Payer: ChoiceCare Network Commercial $203.70
Rate for Payer: Cigna of WY Commercial $205.80
Rate for Payer: Entrust Commercial $199.50
Rate for Payer: First Choice Health Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $121.80
Rate for Payer: HealthUtah PPO $210.00
Rate for Payer: Idaho Integrated Healthcare Commercial $203.70
Rate for Payer: Multiplan Medicare/VA $115.71
Rate for Payer: One Health Plan of WY PPO $205.80
Rate for Payer: PacificSource Commercial $189.00
Rate for Payer: PHCS PPO $205.80
Rate for Payer: Three Rivers PPO $157.50
Rate for Payer: TriWest Veterans Administration $121.80
Rate for Payer: United Healthcare Commercial $182.70
Rate for Payer: United Healthcare Medicare $121.80
Rate for Payer: WINHealth Partners Commercial $205.80
Rate for Payer: Wise Provider Network Commercial $199.50
Service Code HCPCS 82043
Hospital Charge Code 3018204303
Hospital Revenue Code 301
Min. Negotiated Rate $131.67
Max. Negotiated Rate $210.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $205.80
Rate for Payer: Altius Auto/Workers Compensation $201.60
Rate for Payer: Altius Commercial $201.60
Rate for Payer: Beech Street Commercial $205.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $172.41
Rate for Payer: Cash Price $147.00
Rate for Payer: ChoiceCare Network Commercial $203.70
Rate for Payer: Cigna of WY Commercial $205.80
Rate for Payer: Entrust Commercial $199.50
Rate for Payer: First Choice Health Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $138.60
Rate for Payer: HealthUtah PPO $210.00
Rate for Payer: Idaho Integrated Healthcare Commercial $203.70
Rate for Payer: Multiplan Medicare/VA $131.67
Rate for Payer: One Health Plan of WY PPO $205.80
Rate for Payer: PacificSource Commercial $189.00
Rate for Payer: PHCS PPO $205.80
Rate for Payer: Three Rivers PPO $157.50
Rate for Payer: TriWest Veterans Administration $138.60
Rate for Payer: United Healthcare Commercial $182.70
Rate for Payer: United Healthcare Medicare $138.60
Rate for Payer: WINHealth Partners Commercial $199.50
Rate for Payer: Wise Provider Network Commercial $199.50
Service Code HCPCS 82043
Hospital Charge Code 3018204302
Hospital Revenue Code 301
Min. Negotiated Rate $110.20
Max. Negotiated Rate $200.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $196.00
Rate for Payer: Aetna of WY Medicare $132.00
Rate for Payer: Altius Auto/Workers Compensation $192.00
Rate for Payer: Altius Commercial $192.00
Rate for Payer: Beech Street Commercial $196.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $164.20
Rate for Payer: Cash Price $140.00
Rate for Payer: ChoiceCare Network Commercial $194.00
Rate for Payer: Cigna of WY Commercial $196.00
Rate for Payer: Entrust Commercial $190.00
Rate for Payer: First Choice Health Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $116.00
Rate for Payer: HealthUtah PPO $200.00
Rate for Payer: Idaho Integrated Healthcare Commercial $194.00
Rate for Payer: Multiplan Medicare/VA $110.20
Rate for Payer: One Health Plan of WY PPO $196.00
Rate for Payer: PacificSource Commercial $180.00
Rate for Payer: PHCS PPO $196.00
Rate for Payer: Three Rivers PPO $150.00
Rate for Payer: TriWest Veterans Administration $116.00
Rate for Payer: United Healthcare Commercial $174.00
Rate for Payer: United Healthcare Medicare $116.00
Rate for Payer: WINHealth Partners Commercial $196.00
Rate for Payer: Wise Provider Network Commercial $190.00
Service Code HCPCS 82043
Hospital Charge Code 3018204302
Hospital Revenue Code 301
Min. Negotiated Rate $125.40
Max. Negotiated Rate $200.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $196.00
Rate for Payer: Altius Auto/Workers Compensation $192.00
Rate for Payer: Altius Commercial $192.00
Rate for Payer: Beech Street Commercial $196.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $164.20
Rate for Payer: Cash Price $140.00
Rate for Payer: ChoiceCare Network Commercial $194.00
Rate for Payer: Cigna of WY Commercial $196.00
Rate for Payer: Entrust Commercial $190.00
Rate for Payer: First Choice Health Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $190.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $132.00
Rate for Payer: HealthUtah PPO $200.00
Rate for Payer: Idaho Integrated Healthcare Commercial $194.00
Rate for Payer: Multiplan Medicare/VA $125.40
Rate for Payer: One Health Plan of WY PPO $196.00
Rate for Payer: PacificSource Commercial $180.00
Rate for Payer: PHCS PPO $196.00
Rate for Payer: Three Rivers PPO $150.00
Rate for Payer: TriWest Veterans Administration $132.00
Rate for Payer: United Healthcare Commercial $174.00
Rate for Payer: United Healthcare Medicare $132.00
Rate for Payer: WINHealth Partners Commercial $190.00
Rate for Payer: Wise Provider Network Commercial $190.00