Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS 86376
Hospital Charge Code 3028637601
Hospital Revenue Code 302
Min. Negotiated Rate $93.67
Max. Negotiated Rate $170.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $166.60
Rate for Payer: Aetna of WY Medicare $112.20
Rate for Payer: Altius Auto/Workers Compensation $163.20
Rate for Payer: Altius Commercial $163.20
Rate for Payer: Beech Street Commercial $166.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $139.57
Rate for Payer: Cash Price $119.00
Rate for Payer: ChoiceCare Network Commercial $164.90
Rate for Payer: Cigna of WY Commercial $166.60
Rate for Payer: Entrust Commercial $161.50
Rate for Payer: First Choice Health Commercial $161.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $161.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $98.60
Rate for Payer: HealthUtah PPO $170.00
Rate for Payer: Idaho Integrated Healthcare Commercial $164.90
Rate for Payer: Multiplan Medicare/VA $93.67
Rate for Payer: One Health Plan of WY PPO $166.60
Rate for Payer: PacificSource Commercial $153.00
Rate for Payer: PHCS PPO $166.60
Rate for Payer: Three Rivers PPO $127.50
Rate for Payer: TriWest Veterans Administration $98.60
Rate for Payer: United Healthcare Commercial $147.90
Rate for Payer: United Healthcare Medicare $98.60
Rate for Payer: WINHealth Partners Commercial $166.60
Rate for Payer: Wise Provider Network Commercial $161.50
Service Code HCPCS 86376
Hospital Charge Code 3028637601
Hospital Revenue Code 302
Min. Negotiated Rate $106.59
Max. Negotiated Rate $170.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $166.60
Rate for Payer: Altius Auto/Workers Compensation $163.20
Rate for Payer: Altius Commercial $163.20
Rate for Payer: Beech Street Commercial $166.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $139.57
Rate for Payer: Cash Price $119.00
Rate for Payer: ChoiceCare Network Commercial $164.90
Rate for Payer: Cigna of WY Commercial $166.60
Rate for Payer: Entrust Commercial $161.50
Rate for Payer: First Choice Health Commercial $161.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $161.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $112.20
Rate for Payer: HealthUtah PPO $170.00
Rate for Payer: Idaho Integrated Healthcare Commercial $164.90
Rate for Payer: Multiplan Medicare/VA $106.59
Rate for Payer: One Health Plan of WY PPO $166.60
Rate for Payer: PacificSource Commercial $153.00
Rate for Payer: PHCS PPO $166.60
Rate for Payer: Three Rivers PPO $127.50
Rate for Payer: TriWest Veterans Administration $112.20
Rate for Payer: United Healthcare Commercial $147.90
Rate for Payer: United Healthcare Medicare $112.20
Rate for Payer: WINHealth Partners Commercial $161.50
Rate for Payer: Wise Provider Network Commercial $161.50
Service Code HCPCS 86376
Hospital Charge Code 3028637603
Hospital Revenue Code 302
Min. Negotiated Rate $104.69
Max. Negotiated Rate $190.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $186.20
Rate for Payer: Aetna of WY Medicare $125.40
Rate for Payer: Altius Auto/Workers Compensation $182.40
Rate for Payer: Altius Commercial $182.40
Rate for Payer: Beech Street Commercial $186.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $155.99
Rate for Payer: Cash Price $133.00
Rate for Payer: ChoiceCare Network Commercial $184.30
Rate for Payer: Cigna of WY Commercial $186.20
Rate for Payer: Entrust Commercial $180.50
Rate for Payer: First Choice Health Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $110.20
Rate for Payer: HealthUtah PPO $190.00
Rate for Payer: Idaho Integrated Healthcare Commercial $184.30
Rate for Payer: Multiplan Medicare/VA $104.69
Rate for Payer: One Health Plan of WY PPO $186.20
Rate for Payer: PacificSource Commercial $171.00
Rate for Payer: PHCS PPO $186.20
Rate for Payer: Three Rivers PPO $142.50
Rate for Payer: TriWest Veterans Administration $110.20
Rate for Payer: United Healthcare Commercial $165.30
Rate for Payer: United Healthcare Medicare $110.20
Rate for Payer: WINHealth Partners Commercial $186.20
Rate for Payer: Wise Provider Network Commercial $180.50
Service Code HCPCS 86376
Hospital Charge Code 3028637603
Hospital Revenue Code 302
Min. Negotiated Rate $119.13
Max. Negotiated Rate $190.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $186.20
Rate for Payer: Altius Auto/Workers Compensation $182.40
Rate for Payer: Altius Commercial $182.40
Rate for Payer: Beech Street Commercial $186.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $155.99
Rate for Payer: Cash Price $133.00
Rate for Payer: ChoiceCare Network Commercial $184.30
Rate for Payer: Cigna of WY Commercial $186.20
Rate for Payer: Entrust Commercial $180.50
Rate for Payer: First Choice Health Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $125.40
Rate for Payer: HealthUtah PPO $190.00
Rate for Payer: Idaho Integrated Healthcare Commercial $184.30
Rate for Payer: Multiplan Medicare/VA $119.13
Rate for Payer: One Health Plan of WY PPO $186.20
Rate for Payer: PacificSource Commercial $171.00
Rate for Payer: PHCS PPO $186.20
Rate for Payer: Three Rivers PPO $142.50
Rate for Payer: TriWest Veterans Administration $125.40
Rate for Payer: United Healthcare Commercial $165.30
Rate for Payer: United Healthcare Medicare $125.40
Rate for Payer: WINHealth Partners Commercial $180.50
Rate for Payer: Wise Provider Network Commercial $180.50
Service Code HCPCS 86376
Hospital Charge Code 3028637602
Hospital Revenue Code 302
Min. Negotiated Rate $90.92
Max. Negotiated Rate $165.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $161.70
Rate for Payer: Aetna of WY Medicare $108.90
Rate for Payer: Altius Auto/Workers Compensation $158.40
Rate for Payer: Altius Commercial $158.40
Rate for Payer: Beech Street Commercial $161.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $135.46
Rate for Payer: Cash Price $115.50
Rate for Payer: ChoiceCare Network Commercial $160.05
Rate for Payer: Cigna of WY Commercial $161.70
Rate for Payer: Entrust Commercial $156.75
Rate for Payer: First Choice Health Commercial $156.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $156.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $95.70
Rate for Payer: HealthUtah PPO $165.00
Rate for Payer: Idaho Integrated Healthcare Commercial $160.05
Rate for Payer: Multiplan Medicare/VA $90.92
Rate for Payer: One Health Plan of WY PPO $161.70
Rate for Payer: PacificSource Commercial $148.50
Rate for Payer: PHCS PPO $161.70
Rate for Payer: Three Rivers PPO $123.75
Rate for Payer: TriWest Veterans Administration $95.70
Rate for Payer: United Healthcare Commercial $143.55
Rate for Payer: United Healthcare Medicare $95.70
Rate for Payer: WINHealth Partners Commercial $161.70
Rate for Payer: Wise Provider Network Commercial $156.75
Service Code HCPCS 86376
Hospital Charge Code 3028637602
Hospital Revenue Code 302
Min. Negotiated Rate $103.46
Max. Negotiated Rate $165.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $161.70
Rate for Payer: Altius Auto/Workers Compensation $158.40
Rate for Payer: Altius Commercial $158.40
Rate for Payer: Beech Street Commercial $161.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $135.46
Rate for Payer: Cash Price $115.50
Rate for Payer: ChoiceCare Network Commercial $160.05
Rate for Payer: Cigna of WY Commercial $161.70
Rate for Payer: Entrust Commercial $156.75
Rate for Payer: First Choice Health Commercial $156.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $156.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $108.90
Rate for Payer: HealthUtah PPO $165.00
Rate for Payer: Idaho Integrated Healthcare Commercial $160.05
Rate for Payer: Multiplan Medicare/VA $103.46
Rate for Payer: One Health Plan of WY PPO $161.70
Rate for Payer: PacificSource Commercial $148.50
Rate for Payer: PHCS PPO $161.70
Rate for Payer: Three Rivers PPO $123.75
Rate for Payer: TriWest Veterans Administration $108.90
Rate for Payer: United Healthcare Commercial $143.55
Rate for Payer: United Healthcare Medicare $108.90
Rate for Payer: WINHealth Partners Commercial $156.75
Rate for Payer: Wise Provider Network Commercial $156.75
Hospital Charge Code 3000000001
Hospital Revenue Code 300
Min. Negotiated Rate $8.82
Max. Negotiated Rate $16.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $15.68
Rate for Payer: Aetna of WY Medicare $10.56
Rate for Payer: Altius Auto/Workers Compensation $15.36
Rate for Payer: Altius Commercial $15.36
Rate for Payer: Beech Street Commercial $15.68
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $13.14
Rate for Payer: Cash Price $11.20
Rate for Payer: ChoiceCare Network Commercial $15.52
Rate for Payer: Cigna of WY Commercial $15.68
Rate for Payer: Entrust Commercial $15.20
Rate for Payer: First Choice Health Commercial $15.20
Rate for Payer: Government Employees Health Association (GEHA) Commercial $15.20
Rate for Payer: Government Employees Health Association (GEHA) Medicare $9.28
Rate for Payer: HealthUtah PPO $16.00
Rate for Payer: Idaho Integrated Healthcare Commercial $15.52
Rate for Payer: Multiplan Medicare/VA $8.82
Rate for Payer: One Health Plan of WY PPO $15.68
Rate for Payer: PacificSource Commercial $14.40
Rate for Payer: PHCS PPO $15.68
Rate for Payer: Three Rivers PPO $12.00
Rate for Payer: TriWest Veterans Administration $9.28
Rate for Payer: United Healthcare Commercial $13.92
Rate for Payer: United Healthcare Medicare $9.28
Rate for Payer: WINHealth Partners Commercial $15.68
Rate for Payer: Wise Provider Network Commercial $15.20
Hospital Charge Code 3000000001
Hospital Revenue Code 300
Min. Negotiated Rate $10.03
Max. Negotiated Rate $16.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $15.68
Rate for Payer: Altius Auto/Workers Compensation $15.36
Rate for Payer: Altius Commercial $15.36
Rate for Payer: Beech Street Commercial $15.68
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $13.14
Rate for Payer: Cash Price $11.20
Rate for Payer: ChoiceCare Network Commercial $15.52
Rate for Payer: Cigna of WY Commercial $15.68
Rate for Payer: Entrust Commercial $15.20
Rate for Payer: First Choice Health Commercial $15.20
Rate for Payer: Government Employees Health Association (GEHA) Commercial $15.20
Rate for Payer: Government Employees Health Association (GEHA) Medicare $10.56
Rate for Payer: HealthUtah PPO $16.00
Rate for Payer: Idaho Integrated Healthcare Commercial $15.52
Rate for Payer: Multiplan Medicare/VA $10.03
Rate for Payer: One Health Plan of WY PPO $15.68
Rate for Payer: PacificSource Commercial $14.40
Rate for Payer: PHCS PPO $15.68
Rate for Payer: Three Rivers PPO $12.00
Rate for Payer: TriWest Veterans Administration $10.56
Rate for Payer: United Healthcare Commercial $13.92
Rate for Payer: United Healthcare Medicare $10.56
Rate for Payer: WINHealth Partners Commercial $15.20
Rate for Payer: Wise Provider Network Commercial $15.20
Hospital Charge Code 3600000043
Hospital Revenue Code 360
Min. Negotiated Rate $351.12
Max. Negotiated Rate $560.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $548.80
Rate for Payer: Altius Auto/Workers Compensation $537.60
Rate for Payer: Altius Commercial $537.60
Rate for Payer: Beech Street Commercial $548.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $459.76
Rate for Payer: Cash Price $392.00
Rate for Payer: ChoiceCare Network Commercial $543.20
Rate for Payer: Cigna of WY Commercial $548.80
Rate for Payer: Entrust Commercial $532.00
Rate for Payer: First Choice Health Commercial $532.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $532.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $369.60
Rate for Payer: HealthUtah PPO $560.00
Rate for Payer: Idaho Integrated Healthcare Commercial $543.20
Rate for Payer: Multiplan Medicare/VA $351.12
Rate for Payer: One Health Plan of WY PPO $548.80
Rate for Payer: PacificSource Commercial $504.00
Rate for Payer: PHCS PPO $548.80
Rate for Payer: Three Rivers PPO $420.00
Rate for Payer: TriWest Veterans Administration $369.60
Rate for Payer: United Healthcare Commercial $487.20
Rate for Payer: United Healthcare Medicare $369.60
Rate for Payer: WINHealth Partners Commercial $532.00
Rate for Payer: Wise Provider Network Commercial $532.00
Hospital Charge Code 3600000043
Hospital Revenue Code 360
Min. Negotiated Rate $308.56
Max. Negotiated Rate $560.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $548.80
Rate for Payer: Aetna of WY Medicare $369.60
Rate for Payer: Altius Auto/Workers Compensation $537.60
Rate for Payer: Altius Commercial $537.60
Rate for Payer: Beech Street Commercial $548.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $459.76
Rate for Payer: Cash Price $392.00
Rate for Payer: ChoiceCare Network Commercial $543.20
Rate for Payer: Cigna of WY Commercial $548.80
Rate for Payer: Entrust Commercial $532.00
Rate for Payer: First Choice Health Commercial $532.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $532.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $324.80
Rate for Payer: HealthUtah PPO $560.00
Rate for Payer: Idaho Integrated Healthcare Commercial $543.20
Rate for Payer: Multiplan Medicare/VA $308.56
Rate for Payer: One Health Plan of WY PPO $548.80
Rate for Payer: PacificSource Commercial $504.00
Rate for Payer: PHCS PPO $548.80
Rate for Payer: Three Rivers PPO $420.00
Rate for Payer: TriWest Veterans Administration $324.80
Rate for Payer: United Healthcare Commercial $487.20
Rate for Payer: United Healthcare Medicare $324.80
Rate for Payer: WINHealth Partners Commercial $548.80
Rate for Payer: Wise Provider Network Commercial $532.00
Service Code HCPCS J7298
Hospital Charge Code 636J729801
Hospital Revenue Code 636
Min. Negotiated Rate $1,338.64
Max. Negotiated Rate $2,135.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,092.30
Rate for Payer: Altius Auto/Workers Compensation $2,049.60
Rate for Payer: Altius Commercial $2,049.60
Rate for Payer: Beech Street Commercial $2,092.30
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,752.84
Rate for Payer: Cash Price $1,494.50
Rate for Payer: ChoiceCare Network Commercial $2,070.95
Rate for Payer: Cigna of WY Commercial $2,092.30
Rate for Payer: Entrust Commercial $2,028.25
Rate for Payer: First Choice Health Commercial $2,028.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,028.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,409.10
Rate for Payer: HealthUtah PPO $2,135.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,070.95
Rate for Payer: Multiplan Medicare/VA $1,338.64
Rate for Payer: One Health Plan of WY PPO $2,092.30
Rate for Payer: PacificSource Commercial $1,921.50
Rate for Payer: PHCS PPO $2,092.30
Rate for Payer: Three Rivers PPO $1,601.25
Rate for Payer: TriWest Veterans Administration $1,409.10
Rate for Payer: United Healthcare Commercial $1,857.45
Rate for Payer: United Healthcare Medicare $1,409.10
Rate for Payer: WINHealth Partners Commercial $2,028.25
Rate for Payer: Wise Provider Network Commercial $2,028.25
Service Code HCPCS J7298
Hospital Charge Code 636J729801
Hospital Revenue Code 636
Min. Negotiated Rate $1,176.38
Max. Negotiated Rate $2,135.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,092.30
Rate for Payer: Aetna of WY Medicare $1,409.10
Rate for Payer: Altius Auto/Workers Compensation $2,049.60
Rate for Payer: Altius Commercial $2,049.60
Rate for Payer: Beech Street Commercial $2,092.30
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,752.84
Rate for Payer: Cash Price $1,494.50
Rate for Payer: ChoiceCare Network Commercial $2,070.95
Rate for Payer: Cigna of WY Commercial $2,092.30
Rate for Payer: Entrust Commercial $2,028.25
Rate for Payer: First Choice Health Commercial $2,028.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,028.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,238.30
Rate for Payer: HealthUtah PPO $2,135.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,070.95
Rate for Payer: Multiplan Medicare/VA $1,176.38
Rate for Payer: One Health Plan of WY PPO $2,092.30
Rate for Payer: PacificSource Commercial $1,921.50
Rate for Payer: PHCS PPO $2,092.30
Rate for Payer: Three Rivers PPO $1,601.25
Rate for Payer: TriWest Veterans Administration $1,238.30
Rate for Payer: United Healthcare Commercial $1,857.45
Rate for Payer: United Healthcare Medicare $1,238.30
Rate for Payer: WINHealth Partners Commercial $2,092.30
Rate for Payer: Wise Provider Network Commercial $2,028.25
Service Code HCPCS 86381
Hospital Charge Code 3028638101
Hospital Revenue Code 302
Min. Negotiated Rate $62.70
Max. Negotiated Rate $100.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $98.00
Rate for Payer: Altius Auto/Workers Compensation $96.00
Rate for Payer: Altius Commercial $96.00
Rate for Payer: Beech Street Commercial $98.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $82.10
Rate for Payer: Cash Price $70.00
Rate for Payer: ChoiceCare Network Commercial $97.00
Rate for Payer: Cigna of WY Commercial $98.00
Rate for Payer: Entrust Commercial $95.00
Rate for Payer: First Choice Health Commercial $95.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $95.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $66.00
Rate for Payer: HealthUtah PPO $100.00
Rate for Payer: Idaho Integrated Healthcare Commercial $97.00
Rate for Payer: Multiplan Medicare/VA $62.70
Rate for Payer: One Health Plan of WY PPO $98.00
Rate for Payer: PacificSource Commercial $90.00
Rate for Payer: PHCS PPO $98.00
Rate for Payer: Three Rivers PPO $75.00
Rate for Payer: TriWest Veterans Administration $66.00
Rate for Payer: United Healthcare Commercial $87.00
Rate for Payer: United Healthcare Medicare $66.00
Rate for Payer: WINHealth Partners Commercial $95.00
Rate for Payer: Wise Provider Network Commercial $95.00
Service Code HCPCS 86381
Hospital Charge Code 3028638101
Hospital Revenue Code 302
Min. Negotiated Rate $55.10
Max. Negotiated Rate $100.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $98.00
Rate for Payer: Aetna of WY Medicare $66.00
Rate for Payer: Altius Auto/Workers Compensation $96.00
Rate for Payer: Altius Commercial $96.00
Rate for Payer: Beech Street Commercial $98.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $82.10
Rate for Payer: Cash Price $70.00
Rate for Payer: ChoiceCare Network Commercial $97.00
Rate for Payer: Cigna of WY Commercial $98.00
Rate for Payer: Entrust Commercial $95.00
Rate for Payer: First Choice Health Commercial $95.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $95.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $58.00
Rate for Payer: HealthUtah PPO $100.00
Rate for Payer: Idaho Integrated Healthcare Commercial $97.00
Rate for Payer: Multiplan Medicare/VA $55.10
Rate for Payer: One Health Plan of WY PPO $98.00
Rate for Payer: PacificSource Commercial $90.00
Rate for Payer: PHCS PPO $98.00
Rate for Payer: Three Rivers PPO $75.00
Rate for Payer: TriWest Veterans Administration $58.00
Rate for Payer: United Healthcare Commercial $87.00
Rate for Payer: United Healthcare Medicare $58.00
Rate for Payer: WINHealth Partners Commercial $98.00
Rate for Payer: Wise Provider Network Commercial $95.00
Service Code HCPCS 81294
Hospital Charge Code 3108129401
Hospital Revenue Code 310
Min. Negotiated Rate $991.80
Max. Negotiated Rate $1,800.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,764.00
Rate for Payer: Aetna of WY Medicare $1,188.00
Rate for Payer: Altius Auto/Workers Compensation $1,728.00
Rate for Payer: Altius Commercial $1,728.00
Rate for Payer: Beech Street Commercial $1,764.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,477.80
Rate for Payer: Cash Price $1,260.00
Rate for Payer: ChoiceCare Network Commercial $1,746.00
Rate for Payer: Cigna of WY Commercial $1,764.00
Rate for Payer: Entrust Commercial $1,710.00
Rate for Payer: First Choice Health Commercial $1,710.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,710.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,044.00
Rate for Payer: HealthUtah PPO $1,800.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,746.00
Rate for Payer: Multiplan Medicare/VA $991.80
Rate for Payer: One Health Plan of WY PPO $1,764.00
Rate for Payer: PacificSource Commercial $1,620.00
Rate for Payer: PHCS PPO $1,764.00
Rate for Payer: Three Rivers PPO $1,350.00
Rate for Payer: TriWest Veterans Administration $1,044.00
Rate for Payer: United Healthcare Commercial $1,566.00
Rate for Payer: United Healthcare Medicare $1,044.00
Rate for Payer: WINHealth Partners Commercial $1,764.00
Rate for Payer: Wise Provider Network Commercial $1,710.00
Service Code HCPCS 81294
Hospital Charge Code 3108129401
Hospital Revenue Code 310
Min. Negotiated Rate $1,128.60
Max. Negotiated Rate $1,800.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,764.00
Rate for Payer: Altius Auto/Workers Compensation $1,728.00
Rate for Payer: Altius Commercial $1,728.00
Rate for Payer: Beech Street Commercial $1,764.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,477.80
Rate for Payer: Cash Price $1,260.00
Rate for Payer: ChoiceCare Network Commercial $1,746.00
Rate for Payer: Cigna of WY Commercial $1,764.00
Rate for Payer: Entrust Commercial $1,710.00
Rate for Payer: First Choice Health Commercial $1,710.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,710.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,188.00
Rate for Payer: HealthUtah PPO $1,800.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,746.00
Rate for Payer: Multiplan Medicare/VA $1,128.60
Rate for Payer: One Health Plan of WY PPO $1,764.00
Rate for Payer: PacificSource Commercial $1,620.00
Rate for Payer: PHCS PPO $1,764.00
Rate for Payer: Three Rivers PPO $1,350.00
Rate for Payer: TriWest Veterans Administration $1,188.00
Rate for Payer: United Healthcare Commercial $1,566.00
Rate for Payer: United Healthcare Medicare $1,188.00
Rate for Payer: WINHealth Partners Commercial $1,710.00
Rate for Payer: Wise Provider Network Commercial $1,710.00
Service Code HCPCS 81292
Hospital Charge Code 3108129201
Hospital Revenue Code 310
Min. Negotiated Rate $3,306.00
Max. Negotiated Rate $6,000.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $5,880.00
Rate for Payer: Aetna of WY Medicare $3,960.00
Rate for Payer: Altius Auto/Workers Compensation $5,760.00
Rate for Payer: Altius Commercial $5,760.00
Rate for Payer: Beech Street Commercial $5,880.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $4,926.00
Rate for Payer: Cash Price $4,200.00
Rate for Payer: ChoiceCare Network Commercial $5,820.00
Rate for Payer: Cigna of WY Commercial $5,880.00
Rate for Payer: Entrust Commercial $5,700.00
Rate for Payer: First Choice Health Commercial $5,700.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $5,700.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $3,480.00
Rate for Payer: HealthUtah PPO $6,000.00
Rate for Payer: Idaho Integrated Healthcare Commercial $5,820.00
Rate for Payer: Multiplan Medicare/VA $3,306.00
Rate for Payer: One Health Plan of WY PPO $5,880.00
Rate for Payer: PacificSource Commercial $5,400.00
Rate for Payer: PHCS PPO $5,880.00
Rate for Payer: Three Rivers PPO $4,500.00
Rate for Payer: TriWest Veterans Administration $3,480.00
Rate for Payer: United Healthcare Commercial $5,220.00
Rate for Payer: United Healthcare Medicare $3,480.00
Rate for Payer: WINHealth Partners Commercial $5,880.00
Rate for Payer: Wise Provider Network Commercial $5,700.00
Service Code HCPCS 81292
Hospital Charge Code 3108129201
Hospital Revenue Code 310
Min. Negotiated Rate $3,762.00
Max. Negotiated Rate $6,000.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $5,880.00
Rate for Payer: Altius Auto/Workers Compensation $5,760.00
Rate for Payer: Altius Commercial $5,760.00
Rate for Payer: Beech Street Commercial $5,880.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $4,926.00
Rate for Payer: Cash Price $4,200.00
Rate for Payer: ChoiceCare Network Commercial $5,820.00
Rate for Payer: Cigna of WY Commercial $5,880.00
Rate for Payer: Entrust Commercial $5,700.00
Rate for Payer: First Choice Health Commercial $5,700.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $5,700.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $3,960.00
Rate for Payer: HealthUtah PPO $6,000.00
Rate for Payer: Idaho Integrated Healthcare Commercial $5,820.00
Rate for Payer: Multiplan Medicare/VA $3,762.00
Rate for Payer: One Health Plan of WY PPO $5,880.00
Rate for Payer: PacificSource Commercial $5,400.00
Rate for Payer: PHCS PPO $5,880.00
Rate for Payer: Three Rivers PPO $4,500.00
Rate for Payer: TriWest Veterans Administration $3,960.00
Rate for Payer: United Healthcare Commercial $5,220.00
Rate for Payer: United Healthcare Medicare $3,960.00
Rate for Payer: WINHealth Partners Commercial $5,700.00
Rate for Payer: Wise Provider Network Commercial $5,700.00
Service Code HCPCS 23700
Hospital Charge Code 5102370001
Hospital Revenue Code 510
Min. Negotiated Rate $110.75
Max. Negotiated Rate $201.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $196.98
Rate for Payer: Aetna of WY Medicare $132.66
Rate for Payer: Altius Auto/Workers Compensation $192.96
Rate for Payer: Altius Commercial $192.96
Rate for Payer: Beech Street Commercial $196.98
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $165.02
Rate for Payer: Cash Price $140.70
Rate for Payer: ChoiceCare Network Commercial $194.97
Rate for Payer: Cigna of WY Commercial $196.98
Rate for Payer: Entrust Commercial $190.95
Rate for Payer: First Choice Health Commercial $190.95
Rate for Payer: Government Employees Health Association (GEHA) Commercial $190.95
Rate for Payer: Government Employees Health Association (GEHA) Medicare $116.58
Rate for Payer: HealthUtah PPO $201.00
Rate for Payer: Idaho Integrated Healthcare Commercial $194.97
Rate for Payer: Multiplan Medicare/VA $110.75
Rate for Payer: One Health Plan of WY PPO $196.98
Rate for Payer: PacificSource Commercial $180.90
Rate for Payer: PHCS PPO $196.98
Rate for Payer: Three Rivers PPO $150.75
Rate for Payer: TriWest Veterans Administration $116.58
Rate for Payer: United Healthcare Commercial $174.87
Rate for Payer: United Healthcare Medicare $116.58
Rate for Payer: WINHealth Partners Commercial $196.98
Rate for Payer: Wise Provider Network Commercial $190.95
Service Code HCPCS 23700
Hospital Charge Code 5102370001
Hospital Revenue Code 510
Min. Negotiated Rate $126.03
Max. Negotiated Rate $201.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $196.98
Rate for Payer: Altius Auto/Workers Compensation $192.96
Rate for Payer: Altius Commercial $192.96
Rate for Payer: Beech Street Commercial $196.98
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $165.02
Rate for Payer: Cash Price $140.70
Rate for Payer: ChoiceCare Network Commercial $194.97
Rate for Payer: Cigna of WY Commercial $196.98
Rate for Payer: Entrust Commercial $190.95
Rate for Payer: First Choice Health Commercial $190.95
Rate for Payer: Government Employees Health Association (GEHA) Commercial $190.95
Rate for Payer: Government Employees Health Association (GEHA) Medicare $132.66
Rate for Payer: HealthUtah PPO $201.00
Rate for Payer: Idaho Integrated Healthcare Commercial $194.97
Rate for Payer: Multiplan Medicare/VA $126.03
Rate for Payer: One Health Plan of WY PPO $196.98
Rate for Payer: PacificSource Commercial $180.90
Rate for Payer: PHCS PPO $196.98
Rate for Payer: Three Rivers PPO $150.75
Rate for Payer: TriWest Veterans Administration $132.66
Rate for Payer: United Healthcare Commercial $174.87
Rate for Payer: United Healthcare Medicare $132.66
Rate for Payer: WINHealth Partners Commercial $190.95
Rate for Payer: Wise Provider Network Commercial $190.95
Service Code HCPCS 99155
Hospital Charge Code 9839915501
Hospital Revenue Code 983
Min. Negotiated Rate $172.42
Max. Negotiated Rate $275.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $269.50
Rate for Payer: Altius Auto/Workers Compensation $264.00
Rate for Payer: Altius Commercial $264.00
Rate for Payer: Beech Street Commercial $269.50
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $225.78
Rate for Payer: Cash Price $192.50
Rate for Payer: ChoiceCare Network Commercial $266.75
Rate for Payer: Cigna of WY Commercial $269.50
Rate for Payer: Entrust Commercial $261.25
Rate for Payer: First Choice Health Commercial $261.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $261.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $181.50
Rate for Payer: HealthUtah PPO $275.00
Rate for Payer: Idaho Integrated Healthcare Commercial $266.75
Rate for Payer: Multiplan Medicare/VA $172.42
Rate for Payer: One Health Plan of WY PPO $269.50
Rate for Payer: PacificSource Commercial $247.50
Rate for Payer: PHCS PPO $269.50
Rate for Payer: Three Rivers PPO $206.25
Rate for Payer: TriWest Veterans Administration $181.50
Rate for Payer: United Healthcare Commercial $239.25
Rate for Payer: United Healthcare Medicare $181.50
Rate for Payer: WINHealth Partners Commercial $261.25
Rate for Payer: Wise Provider Network Commercial $261.25
Service Code HCPCS 99155
Hospital Charge Code 9839915501
Hospital Revenue Code 983
Min. Negotiated Rate $151.52
Max. Negotiated Rate $275.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $269.50
Rate for Payer: Aetna of WY Medicare $181.50
Rate for Payer: Altius Auto/Workers Compensation $264.00
Rate for Payer: Altius Commercial $264.00
Rate for Payer: Beech Street Commercial $269.50
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $225.78
Rate for Payer: Cash Price $192.50
Rate for Payer: ChoiceCare Network Commercial $266.75
Rate for Payer: Cigna of WY Commercial $269.50
Rate for Payer: Entrust Commercial $261.25
Rate for Payer: First Choice Health Commercial $261.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $261.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $159.50
Rate for Payer: HealthUtah PPO $275.00
Rate for Payer: Idaho Integrated Healthcare Commercial $266.75
Rate for Payer: Multiplan Medicare/VA $151.52
Rate for Payer: One Health Plan of WY PPO $269.50
Rate for Payer: PacificSource Commercial $247.50
Rate for Payer: PHCS PPO $269.50
Rate for Payer: Three Rivers PPO $206.25
Rate for Payer: TriWest Veterans Administration $159.50
Rate for Payer: United Healthcare Commercial $239.25
Rate for Payer: United Healthcare Medicare $159.50
Rate for Payer: WINHealth Partners Commercial $269.50
Rate for Payer: Wise Provider Network Commercial $261.25
Service Code HCPCS 99157
Hospital Charge Code 3709915701
Hospital Revenue Code 370
Min. Negotiated Rate $19.28
Max. Negotiated Rate $35.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $34.30
Rate for Payer: Aetna of WY Medicare $23.10
Rate for Payer: Altius Auto/Workers Compensation $33.60
Rate for Payer: Altius Commercial $33.60
Rate for Payer: Beech Street Commercial $34.30
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $28.74
Rate for Payer: Cash Price $24.50
Rate for Payer: ChoiceCare Network Commercial $33.95
Rate for Payer: Cigna of WY Commercial $34.30
Rate for Payer: Entrust Commercial $33.25
Rate for Payer: First Choice Health Commercial $33.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $33.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $20.30
Rate for Payer: HealthUtah PPO $35.00
Rate for Payer: Idaho Integrated Healthcare Commercial $33.95
Rate for Payer: Multiplan Medicare/VA $19.28
Rate for Payer: One Health Plan of WY PPO $34.30
Rate for Payer: PacificSource Commercial $31.50
Rate for Payer: PHCS PPO $34.30
Rate for Payer: Three Rivers PPO $26.25
Rate for Payer: TriWest Veterans Administration $20.30
Rate for Payer: United Healthcare Commercial $30.45
Rate for Payer: United Healthcare Medicare $20.30
Rate for Payer: WINHealth Partners Commercial $34.30
Rate for Payer: Wise Provider Network Commercial $33.25
Service Code HCPCS 99157
Hospital Charge Code 3709915701
Hospital Revenue Code 370
Min. Negotiated Rate $21.94
Max. Negotiated Rate $35.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $34.30
Rate for Payer: Altius Auto/Workers Compensation $33.60
Rate for Payer: Altius Commercial $33.60
Rate for Payer: Beech Street Commercial $34.30
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $28.74
Rate for Payer: Cash Price $24.50
Rate for Payer: ChoiceCare Network Commercial $33.95
Rate for Payer: Cigna of WY Commercial $34.30
Rate for Payer: Entrust Commercial $33.25
Rate for Payer: First Choice Health Commercial $33.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $33.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $23.10
Rate for Payer: HealthUtah PPO $35.00
Rate for Payer: Idaho Integrated Healthcare Commercial $33.95
Rate for Payer: Multiplan Medicare/VA $21.94
Rate for Payer: One Health Plan of WY PPO $34.30
Rate for Payer: PacificSource Commercial $31.50
Rate for Payer: PHCS PPO $34.30
Rate for Payer: Three Rivers PPO $26.25
Rate for Payer: TriWest Veterans Administration $23.10
Rate for Payer: United Healthcare Commercial $30.45
Rate for Payer: United Healthcare Medicare $23.10
Rate for Payer: WINHealth Partners Commercial $33.25
Rate for Payer: Wise Provider Network Commercial $33.25
Service Code HCPCS 99156
Hospital Charge Code 3709915601
Hospital Revenue Code 370
Min. Negotiated Rate $159.88
Max. Negotiated Rate $255.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $249.90
Rate for Payer: Aetna of WY Commercial/Medical Rental $220.50
Rate for Payer: Altius Auto/Workers Compensation $244.80
Rate for Payer: Altius Auto/Workers Compensation $216.00
Rate for Payer: Altius Commercial $216.00
Rate for Payer: Altius Commercial $244.80
Rate for Payer: Beech Street Commercial $249.90
Rate for Payer: Beech Street Commercial $220.50
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $184.72
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $209.36
Rate for Payer: Cash Price $178.50
Rate for Payer: Cash Price $157.50
Rate for Payer: ChoiceCare Network Commercial $218.25
Rate for Payer: ChoiceCare Network Commercial $247.35
Rate for Payer: Cigna of WY Commercial $249.90
Rate for Payer: Cigna of WY Commercial $220.50
Rate for Payer: Entrust Commercial $213.75
Rate for Payer: Entrust Commercial $242.25
Rate for Payer: First Choice Health Commercial $213.75
Rate for Payer: First Choice Health Commercial $242.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $213.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $242.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $168.30
Rate for Payer: Government Employees Health Association (GEHA) Medicare $148.50
Rate for Payer: HealthUtah PPO $255.00
Rate for Payer: HealthUtah PPO $225.00
Rate for Payer: Idaho Integrated Healthcare Commercial $218.25
Rate for Payer: Idaho Integrated Healthcare Commercial $247.35
Rate for Payer: Multiplan Medicare/VA $159.88
Rate for Payer: Multiplan Medicare/VA $141.08
Rate for Payer: One Health Plan of WY PPO $249.90
Rate for Payer: One Health Plan of WY PPO $220.50
Rate for Payer: PacificSource Commercial $229.50
Rate for Payer: PacificSource Commercial $202.50
Rate for Payer: PHCS PPO $220.50
Rate for Payer: PHCS PPO $249.90
Rate for Payer: Three Rivers PPO $168.75
Rate for Payer: Three Rivers PPO $191.25
Rate for Payer: TriWest Veterans Administration $168.30
Rate for Payer: TriWest Veterans Administration $148.50
Rate for Payer: United Healthcare Commercial $195.75
Rate for Payer: United Healthcare Commercial $221.85
Rate for Payer: United Healthcare Medicare $168.30
Rate for Payer: United Healthcare Medicare $148.50
Rate for Payer: WINHealth Partners Commercial $213.75
Rate for Payer: WINHealth Partners Commercial $242.25
Rate for Payer: Wise Provider Network Commercial $213.75
Rate for Payer: Wise Provider Network Commercial $242.25