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Service Code HCPCS 73725
Hospital Charge Code 6167372505
Hospital Revenue Code 616
Min. Negotiated Rate $1,479.72
Max. Negotiated Rate $2,360.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,312.80
Rate for Payer: Altius Auto/Workers Compensation $2,265.60
Rate for Payer: Altius Commercial $2,265.60
Rate for Payer: Beech Street Commercial $2,312.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,937.56
Rate for Payer: Cash Price $1,652.00
Rate for Payer: ChoiceCare Network Commercial $2,289.20
Rate for Payer: Cigna of WY Commercial $2,312.80
Rate for Payer: Entrust Commercial $2,242.00
Rate for Payer: First Choice Health Commercial $2,242.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,242.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,557.60
Rate for Payer: HealthUtah PPO $2,360.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,289.20
Rate for Payer: Multiplan Medicare/VA $1,479.72
Rate for Payer: One Health Plan of WY PPO $2,312.80
Rate for Payer: PacificSource Commercial $2,124.00
Rate for Payer: PHCS PPO $2,312.80
Rate for Payer: Three Rivers PPO $1,770.00
Rate for Payer: TriWest Veterans Administration $1,557.60
Rate for Payer: United Healthcare Commercial $2,053.20
Rate for Payer: United Healthcare Medicare $1,557.60
Rate for Payer: WINHealth Partners Commercial $2,242.00
Rate for Payer: Wise Provider Network Commercial $2,242.00
Service Code HCPCS 70549
Hospital Charge Code 6157054901
Hospital Revenue Code 615
Min. Negotiated Rate $2,920.30
Max. Negotiated Rate $5,300.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $5,194.00
Rate for Payer: Aetna of WY Medicare $3,498.00
Rate for Payer: Altius Auto/Workers Compensation $5,088.00
Rate for Payer: Altius Commercial $5,088.00
Rate for Payer: Beech Street Commercial $5,194.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $4,351.30
Rate for Payer: Cash Price $3,710.00
Rate for Payer: ChoiceCare Network Commercial $5,141.00
Rate for Payer: Cigna of WY Commercial $5,194.00
Rate for Payer: Entrust Commercial $5,035.00
Rate for Payer: First Choice Health Commercial $5,035.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $5,035.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $3,074.00
Rate for Payer: HealthUtah PPO $5,300.00
Rate for Payer: Idaho Integrated Healthcare Commercial $5,141.00
Rate for Payer: Multiplan Medicare/VA $2,920.30
Rate for Payer: One Health Plan of WY PPO $5,194.00
Rate for Payer: PacificSource Commercial $4,770.00
Rate for Payer: PHCS PPO $5,194.00
Rate for Payer: Three Rivers PPO $3,975.00
Rate for Payer: TriWest Veterans Administration $3,074.00
Rate for Payer: United Healthcare Commercial $4,611.00
Rate for Payer: United Healthcare Medicare $3,074.00
Rate for Payer: WINHealth Partners Commercial $5,194.00
Rate for Payer: Wise Provider Network Commercial $5,035.00
Service Code HCPCS 70549
Hospital Charge Code 6157054901
Hospital Revenue Code 615
Min. Negotiated Rate $3,323.10
Max. Negotiated Rate $5,300.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $5,194.00
Rate for Payer: Altius Auto/Workers Compensation $5,088.00
Rate for Payer: Altius Commercial $5,088.00
Rate for Payer: Beech Street Commercial $5,194.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $4,351.30
Rate for Payer: Cash Price $3,710.00
Rate for Payer: ChoiceCare Network Commercial $5,141.00
Rate for Payer: Cigna of WY Commercial $5,194.00
Rate for Payer: Entrust Commercial $5,035.00
Rate for Payer: First Choice Health Commercial $5,035.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $5,035.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $3,498.00
Rate for Payer: HealthUtah PPO $5,300.00
Rate for Payer: Idaho Integrated Healthcare Commercial $5,141.00
Rate for Payer: Multiplan Medicare/VA $3,323.10
Rate for Payer: One Health Plan of WY PPO $5,194.00
Rate for Payer: PacificSource Commercial $4,770.00
Rate for Payer: PHCS PPO $5,194.00
Rate for Payer: Three Rivers PPO $3,975.00
Rate for Payer: TriWest Veterans Administration $3,498.00
Rate for Payer: United Healthcare Commercial $4,611.00
Rate for Payer: United Healthcare Medicare $3,498.00
Rate for Payer: WINHealth Partners Commercial $5,035.00
Rate for Payer: Wise Provider Network Commercial $5,035.00
Service Code HCPCS 70547
Hospital Charge Code 6157054701
Hospital Revenue Code 615
Min. Negotiated Rate $887.20
Max. Negotiated Rate $1,415.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,386.70
Rate for Payer: Altius Auto/Workers Compensation $1,358.40
Rate for Payer: Altius Commercial $1,358.40
Rate for Payer: Beech Street Commercial $1,386.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,161.72
Rate for Payer: Cash Price $990.50
Rate for Payer: ChoiceCare Network Commercial $1,372.55
Rate for Payer: Cigna of WY Commercial $1,386.70
Rate for Payer: Entrust Commercial $1,344.25
Rate for Payer: First Choice Health Commercial $1,344.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,344.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $933.90
Rate for Payer: HealthUtah PPO $1,415.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,372.55
Rate for Payer: Multiplan Medicare/VA $887.20
Rate for Payer: One Health Plan of WY PPO $1,386.70
Rate for Payer: PacificSource Commercial $1,273.50
Rate for Payer: PHCS PPO $1,386.70
Rate for Payer: Three Rivers PPO $1,061.25
Rate for Payer: TriWest Veterans Administration $933.90
Rate for Payer: United Healthcare Commercial $1,231.05
Rate for Payer: United Healthcare Medicare $933.90
Rate for Payer: WINHealth Partners Commercial $1,344.25
Rate for Payer: Wise Provider Network Commercial $1,344.25
Service Code HCPCS 70547
Hospital Charge Code 6157054701
Hospital Revenue Code 615
Min. Negotiated Rate $779.66
Max. Negotiated Rate $1,415.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,386.70
Rate for Payer: Aetna of WY Medicare $933.90
Rate for Payer: Altius Auto/Workers Compensation $1,358.40
Rate for Payer: Altius Commercial $1,358.40
Rate for Payer: Beech Street Commercial $1,386.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,161.72
Rate for Payer: Cash Price $990.50
Rate for Payer: ChoiceCare Network Commercial $1,372.55
Rate for Payer: Cigna of WY Commercial $1,386.70
Rate for Payer: Entrust Commercial $1,344.25
Rate for Payer: First Choice Health Commercial $1,344.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,344.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $820.70
Rate for Payer: HealthUtah PPO $1,415.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,372.55
Rate for Payer: Multiplan Medicare/VA $779.66
Rate for Payer: One Health Plan of WY PPO $1,386.70
Rate for Payer: PacificSource Commercial $1,273.50
Rate for Payer: PHCS PPO $1,386.70
Rate for Payer: Three Rivers PPO $1,061.25
Rate for Payer: TriWest Veterans Administration $820.70
Rate for Payer: United Healthcare Commercial $1,231.05
Rate for Payer: United Healthcare Medicare $820.70
Rate for Payer: WINHealth Partners Commercial $1,386.70
Rate for Payer: Wise Provider Network Commercial $1,344.25
Service Code HCPCS 70548
Hospital Charge Code 6157054801
Hospital Revenue Code 615
Min. Negotiated Rate $1,881.00
Max. Negotiated Rate $3,000.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,940.00
Rate for Payer: Altius Auto/Workers Compensation $2,880.00
Rate for Payer: Altius Commercial $2,880.00
Rate for Payer: Beech Street Commercial $2,940.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,463.00
Rate for Payer: Cash Price $2,100.00
Rate for Payer: ChoiceCare Network Commercial $2,910.00
Rate for Payer: Cigna of WY Commercial $2,940.00
Rate for Payer: Entrust Commercial $2,850.00
Rate for Payer: First Choice Health Commercial $2,850.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,850.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,980.00
Rate for Payer: HealthUtah PPO $3,000.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,910.00
Rate for Payer: Multiplan Medicare/VA $1,881.00
Rate for Payer: One Health Plan of WY PPO $2,940.00
Rate for Payer: PacificSource Commercial $2,700.00
Rate for Payer: PHCS PPO $2,940.00
Rate for Payer: Three Rivers PPO $2,250.00
Rate for Payer: TriWest Veterans Administration $1,980.00
Rate for Payer: United Healthcare Commercial $2,610.00
Rate for Payer: United Healthcare Medicare $1,980.00
Rate for Payer: WINHealth Partners Commercial $2,850.00
Rate for Payer: Wise Provider Network Commercial $2,850.00
Service Code HCPCS 70548
Hospital Charge Code 6157054801
Hospital Revenue Code 615
Min. Negotiated Rate $1,653.00
Max. Negotiated Rate $3,000.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,940.00
Rate for Payer: Aetna of WY Medicare $1,980.00
Rate for Payer: Altius Auto/Workers Compensation $2,880.00
Rate for Payer: Altius Commercial $2,880.00
Rate for Payer: Beech Street Commercial $2,940.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,463.00
Rate for Payer: Cash Price $2,100.00
Rate for Payer: ChoiceCare Network Commercial $2,910.00
Rate for Payer: Cigna of WY Commercial $2,940.00
Rate for Payer: Entrust Commercial $2,850.00
Rate for Payer: First Choice Health Commercial $2,850.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,850.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,740.00
Rate for Payer: HealthUtah PPO $3,000.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,910.00
Rate for Payer: Multiplan Medicare/VA $1,653.00
Rate for Payer: One Health Plan of WY PPO $2,940.00
Rate for Payer: PacificSource Commercial $2,700.00
Rate for Payer: PHCS PPO $2,940.00
Rate for Payer: Three Rivers PPO $2,250.00
Rate for Payer: TriWest Veterans Administration $1,740.00
Rate for Payer: United Healthcare Commercial $2,610.00
Rate for Payer: United Healthcare Medicare $1,740.00
Rate for Payer: WINHealth Partners Commercial $2,940.00
Rate for Payer: Wise Provider Network Commercial $2,850.00
Service Code HCPCS 72198
Hospital Charge Code 6147219802
Hospital Revenue Code 614
Min. Negotiated Rate $1,303.12
Max. Negotiated Rate $2,365.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,317.70
Rate for Payer: Aetna of WY Medicare $1,560.90
Rate for Payer: Altius Auto/Workers Compensation $2,270.40
Rate for Payer: Altius Commercial $2,270.40
Rate for Payer: Beech Street Commercial $2,317.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,941.66
Rate for Payer: Cash Price $1,655.50
Rate for Payer: ChoiceCare Network Commercial $2,294.05
Rate for Payer: Cigna of WY Commercial $2,317.70
Rate for Payer: Entrust Commercial $2,246.75
Rate for Payer: First Choice Health Commercial $2,246.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,246.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,371.70
Rate for Payer: HealthUtah PPO $2,365.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,294.05
Rate for Payer: Multiplan Medicare/VA $1,303.12
Rate for Payer: One Health Plan of WY PPO $2,317.70
Rate for Payer: PacificSource Commercial $2,128.50
Rate for Payer: PHCS PPO $2,317.70
Rate for Payer: Three Rivers PPO $1,773.75
Rate for Payer: TriWest Veterans Administration $1,371.70
Rate for Payer: United Healthcare Commercial $2,057.55
Rate for Payer: United Healthcare Medicare $1,371.70
Rate for Payer: WINHealth Partners Commercial $2,317.70
Rate for Payer: Wise Provider Network Commercial $2,246.75
Service Code HCPCS 72198
Hospital Charge Code 6147219802
Hospital Revenue Code 614
Min. Negotiated Rate $1,482.86
Max. Negotiated Rate $2,365.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,317.70
Rate for Payer: Altius Auto/Workers Compensation $2,270.40
Rate for Payer: Altius Commercial $2,270.40
Rate for Payer: Beech Street Commercial $2,317.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,941.66
Rate for Payer: Cash Price $1,655.50
Rate for Payer: ChoiceCare Network Commercial $2,294.05
Rate for Payer: Cigna of WY Commercial $2,317.70
Rate for Payer: Entrust Commercial $2,246.75
Rate for Payer: First Choice Health Commercial $2,246.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,246.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,560.90
Rate for Payer: HealthUtah PPO $2,365.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,294.05
Rate for Payer: Multiplan Medicare/VA $1,482.86
Rate for Payer: One Health Plan of WY PPO $2,317.70
Rate for Payer: PacificSource Commercial $2,128.50
Rate for Payer: PHCS PPO $2,317.70
Rate for Payer: Three Rivers PPO $1,773.75
Rate for Payer: TriWest Veterans Administration $1,560.90
Rate for Payer: United Healthcare Commercial $2,057.55
Rate for Payer: United Healthcare Medicare $1,560.90
Rate for Payer: WINHealth Partners Commercial $2,246.75
Rate for Payer: Wise Provider Network Commercial $2,246.75
Service Code HCPCS 73225
Hospital Charge Code 6107322504
Hospital Revenue Code 610
Min. Negotiated Rate $1,327.91
Max. Negotiated Rate $2,410.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,361.80
Rate for Payer: Aetna of WY Medicare $1,590.60
Rate for Payer: Altius Auto/Workers Compensation $2,313.60
Rate for Payer: Altius Commercial $2,313.60
Rate for Payer: Beech Street Commercial $2,361.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,978.61
Rate for Payer: Cash Price $1,687.00
Rate for Payer: ChoiceCare Network Commercial $2,337.70
Rate for Payer: Cigna of WY Commercial $2,361.80
Rate for Payer: Entrust Commercial $2,289.50
Rate for Payer: First Choice Health Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,397.80
Rate for Payer: HealthUtah PPO $2,410.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,337.70
Rate for Payer: Multiplan Medicare/VA $1,327.91
Rate for Payer: One Health Plan of WY PPO $2,361.80
Rate for Payer: PacificSource Commercial $2,169.00
Rate for Payer: PHCS PPO $2,361.80
Rate for Payer: Three Rivers PPO $1,807.50
Rate for Payer: TriWest Veterans Administration $1,397.80
Rate for Payer: United Healthcare Commercial $2,096.70
Rate for Payer: United Healthcare Medicare $1,397.80
Rate for Payer: WINHealth Partners Commercial $2,361.80
Rate for Payer: Wise Provider Network Commercial $2,289.50
Service Code HCPCS 73225
Hospital Charge Code 6107322504
Hospital Revenue Code 610
Min. Negotiated Rate $1,511.07
Max. Negotiated Rate $2,410.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,361.80
Rate for Payer: Altius Auto/Workers Compensation $2,313.60
Rate for Payer: Altius Commercial $2,313.60
Rate for Payer: Beech Street Commercial $2,361.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,978.61
Rate for Payer: Cash Price $1,687.00
Rate for Payer: ChoiceCare Network Commercial $2,337.70
Rate for Payer: Cigna of WY Commercial $2,361.80
Rate for Payer: Entrust Commercial $2,289.50
Rate for Payer: First Choice Health Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,590.60
Rate for Payer: HealthUtah PPO $2,410.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,337.70
Rate for Payer: Multiplan Medicare/VA $1,511.07
Rate for Payer: One Health Plan of WY PPO $2,361.80
Rate for Payer: PacificSource Commercial $2,169.00
Rate for Payer: PHCS PPO $2,361.80
Rate for Payer: Three Rivers PPO $1,807.50
Rate for Payer: TriWest Veterans Administration $1,590.60
Rate for Payer: United Healthcare Commercial $2,096.70
Rate for Payer: United Healthcare Medicare $1,590.60
Rate for Payer: WINHealth Partners Commercial $2,289.50
Rate for Payer: Wise Provider Network Commercial $2,289.50
Service Code HCPCS 73225
Hospital Charge Code 6107322506
Hospital Revenue Code 610
Min. Negotiated Rate $1,327.91
Max. Negotiated Rate $2,410.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,361.80
Rate for Payer: Aetna of WY Medicare $1,590.60
Rate for Payer: Altius Auto/Workers Compensation $2,313.60
Rate for Payer: Altius Commercial $2,313.60
Rate for Payer: Beech Street Commercial $2,361.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,978.61
Rate for Payer: Cash Price $1,687.00
Rate for Payer: ChoiceCare Network Commercial $2,337.70
Rate for Payer: Cigna of WY Commercial $2,361.80
Rate for Payer: Entrust Commercial $2,289.50
Rate for Payer: First Choice Health Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,397.80
Rate for Payer: HealthUtah PPO $2,410.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,337.70
Rate for Payer: Multiplan Medicare/VA $1,327.91
Rate for Payer: One Health Plan of WY PPO $2,361.80
Rate for Payer: PacificSource Commercial $2,169.00
Rate for Payer: PHCS PPO $2,361.80
Rate for Payer: Three Rivers PPO $1,807.50
Rate for Payer: TriWest Veterans Administration $1,397.80
Rate for Payer: United Healthcare Commercial $2,096.70
Rate for Payer: United Healthcare Medicare $1,397.80
Rate for Payer: WINHealth Partners Commercial $2,361.80
Rate for Payer: Wise Provider Network Commercial $2,289.50
Service Code HCPCS 73225
Hospital Charge Code 6107322506
Hospital Revenue Code 610
Min. Negotiated Rate $1,511.07
Max. Negotiated Rate $2,410.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,361.80
Rate for Payer: Altius Auto/Workers Compensation $2,313.60
Rate for Payer: Altius Commercial $2,313.60
Rate for Payer: Beech Street Commercial $2,361.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,978.61
Rate for Payer: Cash Price $1,687.00
Rate for Payer: ChoiceCare Network Commercial $2,337.70
Rate for Payer: Cigna of WY Commercial $2,361.80
Rate for Payer: Entrust Commercial $2,289.50
Rate for Payer: First Choice Health Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,289.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,590.60
Rate for Payer: HealthUtah PPO $2,410.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,337.70
Rate for Payer: Multiplan Medicare/VA $1,511.07
Rate for Payer: One Health Plan of WY PPO $2,361.80
Rate for Payer: PacificSource Commercial $2,169.00
Rate for Payer: PHCS PPO $2,361.80
Rate for Payer: Three Rivers PPO $1,807.50
Rate for Payer: TriWest Veterans Administration $1,590.60
Rate for Payer: United Healthcare Commercial $2,096.70
Rate for Payer: United Healthcare Medicare $1,590.60
Rate for Payer: WINHealth Partners Commercial $2,289.50
Rate for Payer: Wise Provider Network Commercial $2,289.50
Service Code HCPCS 74185
Hospital Charge Code 6107418503
Hospital Revenue Code 610
Min. Negotiated Rate $1,467.18
Max. Negotiated Rate $2,340.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,293.20
Rate for Payer: Altius Auto/Workers Compensation $2,246.40
Rate for Payer: Altius Commercial $2,246.40
Rate for Payer: Beech Street Commercial $2,293.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,921.14
Rate for Payer: Cash Price $1,638.00
Rate for Payer: ChoiceCare Network Commercial $2,269.80
Rate for Payer: Cigna of WY Commercial $2,293.20
Rate for Payer: Entrust Commercial $2,223.00
Rate for Payer: First Choice Health Commercial $2,223.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,223.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,544.40
Rate for Payer: HealthUtah PPO $2,340.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,269.80
Rate for Payer: Multiplan Medicare/VA $1,467.18
Rate for Payer: One Health Plan of WY PPO $2,293.20
Rate for Payer: PacificSource Commercial $2,106.00
Rate for Payer: PHCS PPO $2,293.20
Rate for Payer: Three Rivers PPO $1,755.00
Rate for Payer: TriWest Veterans Administration $1,544.40
Rate for Payer: United Healthcare Commercial $2,035.80
Rate for Payer: United Healthcare Medicare $1,544.40
Rate for Payer: WINHealth Partners Commercial $2,223.00
Rate for Payer: Wise Provider Network Commercial $2,223.00
Service Code HCPCS 74185
Hospital Charge Code 6107418503
Hospital Revenue Code 610
Min. Negotiated Rate $1,289.34
Max. Negotiated Rate $2,340.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,293.20
Rate for Payer: Aetna of WY Medicare $1,544.40
Rate for Payer: Altius Auto/Workers Compensation $2,246.40
Rate for Payer: Altius Commercial $2,246.40
Rate for Payer: Beech Street Commercial $2,293.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,921.14
Rate for Payer: Cash Price $1,638.00
Rate for Payer: ChoiceCare Network Commercial $2,269.80
Rate for Payer: Cigna of WY Commercial $2,293.20
Rate for Payer: Entrust Commercial $2,223.00
Rate for Payer: First Choice Health Commercial $2,223.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,223.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,357.20
Rate for Payer: HealthUtah PPO $2,340.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,269.80
Rate for Payer: Multiplan Medicare/VA $1,289.34
Rate for Payer: One Health Plan of WY PPO $2,293.20
Rate for Payer: PacificSource Commercial $2,106.00
Rate for Payer: PHCS PPO $2,293.20
Rate for Payer: Three Rivers PPO $1,755.00
Rate for Payer: TriWest Veterans Administration $1,357.20
Rate for Payer: United Healthcare Commercial $2,035.80
Rate for Payer: United Healthcare Medicare $1,357.20
Rate for Payer: WINHealth Partners Commercial $2,293.20
Rate for Payer: Wise Provider Network Commercial $2,223.00
Service Code HCPCS 74183
Hospital Charge Code 6147418302
Hospital Revenue Code 614
Min. Negotiated Rate $2,066.25
Max. Negotiated Rate $3,750.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,675.00
Rate for Payer: Aetna of WY Medicare $2,475.00
Rate for Payer: Altius Auto/Workers Compensation $3,600.00
Rate for Payer: Altius Commercial $3,600.00
Rate for Payer: Beech Street Commercial $3,675.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $3,078.75
Rate for Payer: Cash Price $2,625.00
Rate for Payer: ChoiceCare Network Commercial $3,637.50
Rate for Payer: Cigna of WY Commercial $3,675.00
Rate for Payer: Entrust Commercial $3,562.50
Rate for Payer: First Choice Health Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,175.00
Rate for Payer: HealthUtah PPO $3,750.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,637.50
Rate for Payer: Multiplan Medicare/VA $2,066.25
Rate for Payer: One Health Plan of WY PPO $3,675.00
Rate for Payer: PacificSource Commercial $3,375.00
Rate for Payer: PHCS PPO $3,675.00
Rate for Payer: Three Rivers PPO $2,812.50
Rate for Payer: TriWest Veterans Administration $2,175.00
Rate for Payer: United Healthcare Commercial $3,262.50
Rate for Payer: United Healthcare Medicare $2,175.00
Rate for Payer: WINHealth Partners Commercial $3,675.00
Rate for Payer: Wise Provider Network Commercial $3,562.50
Service Code HCPCS 74183
Hospital Charge Code 6147418302
Hospital Revenue Code 614
Min. Negotiated Rate $2,351.25
Max. Negotiated Rate $3,750.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,675.00
Rate for Payer: Altius Auto/Workers Compensation $3,600.00
Rate for Payer: Altius Commercial $3,600.00
Rate for Payer: Beech Street Commercial $3,675.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $3,078.75
Rate for Payer: Cash Price $2,625.00
Rate for Payer: ChoiceCare Network Commercial $3,637.50
Rate for Payer: Cigna of WY Commercial $3,675.00
Rate for Payer: Entrust Commercial $3,562.50
Rate for Payer: First Choice Health Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,475.00
Rate for Payer: HealthUtah PPO $3,750.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,637.50
Rate for Payer: Multiplan Medicare/VA $2,351.25
Rate for Payer: One Health Plan of WY PPO $3,675.00
Rate for Payer: PacificSource Commercial $3,375.00
Rate for Payer: PHCS PPO $3,675.00
Rate for Payer: Three Rivers PPO $2,812.50
Rate for Payer: TriWest Veterans Administration $2,475.00
Rate for Payer: United Healthcare Commercial $3,262.50
Rate for Payer: United Healthcare Medicare $2,475.00
Rate for Payer: WINHealth Partners Commercial $3,562.50
Rate for Payer: Wise Provider Network Commercial $3,562.50
Service Code HCPCS 74183
Hospital Charge Code 6147418303
Hospital Revenue Code 614
Min. Negotiated Rate $2,351.25
Max. Negotiated Rate $3,750.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,675.00
Rate for Payer: Altius Auto/Workers Compensation $3,600.00
Rate for Payer: Altius Commercial $3,600.00
Rate for Payer: Beech Street Commercial $3,675.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $3,078.75
Rate for Payer: Cash Price $2,625.00
Rate for Payer: ChoiceCare Network Commercial $3,637.50
Rate for Payer: Cigna of WY Commercial $3,675.00
Rate for Payer: Entrust Commercial $3,562.50
Rate for Payer: First Choice Health Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,475.00
Rate for Payer: HealthUtah PPO $3,750.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,637.50
Rate for Payer: Multiplan Medicare/VA $2,351.25
Rate for Payer: One Health Plan of WY PPO $3,675.00
Rate for Payer: PacificSource Commercial $3,375.00
Rate for Payer: PHCS PPO $3,675.00
Rate for Payer: Three Rivers PPO $2,812.50
Rate for Payer: TriWest Veterans Administration $2,475.00
Rate for Payer: United Healthcare Commercial $3,262.50
Rate for Payer: United Healthcare Medicare $2,475.00
Rate for Payer: WINHealth Partners Commercial $3,562.50
Rate for Payer: Wise Provider Network Commercial $3,562.50
Service Code HCPCS 74183
Hospital Charge Code 6147418303
Hospital Revenue Code 614
Min. Negotiated Rate $2,066.25
Max. Negotiated Rate $3,750.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,675.00
Rate for Payer: Aetna of WY Medicare $2,475.00
Rate for Payer: Altius Auto/Workers Compensation $3,600.00
Rate for Payer: Altius Commercial $3,600.00
Rate for Payer: Beech Street Commercial $3,675.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $3,078.75
Rate for Payer: Cash Price $2,625.00
Rate for Payer: ChoiceCare Network Commercial $3,637.50
Rate for Payer: Cigna of WY Commercial $3,675.00
Rate for Payer: Entrust Commercial $3,562.50
Rate for Payer: First Choice Health Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,175.00
Rate for Payer: HealthUtah PPO $3,750.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,637.50
Rate for Payer: Multiplan Medicare/VA $2,066.25
Rate for Payer: One Health Plan of WY PPO $3,675.00
Rate for Payer: PacificSource Commercial $3,375.00
Rate for Payer: PHCS PPO $3,675.00
Rate for Payer: Three Rivers PPO $2,812.50
Rate for Payer: TriWest Veterans Administration $2,175.00
Rate for Payer: United Healthcare Commercial $3,262.50
Rate for Payer: United Healthcare Medicare $2,175.00
Rate for Payer: WINHealth Partners Commercial $3,675.00
Rate for Payer: Wise Provider Network Commercial $3,562.50
Service Code HCPCS 74183
Hospital Charge Code 6147418301
Hospital Revenue Code 614
Min. Negotiated Rate $2,066.25
Max. Negotiated Rate $3,750.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,675.00
Rate for Payer: Aetna of WY Medicare $2,475.00
Rate for Payer: Altius Auto/Workers Compensation $3,600.00
Rate for Payer: Altius Commercial $3,600.00
Rate for Payer: Beech Street Commercial $3,675.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $3,078.75
Rate for Payer: Cash Price $2,625.00
Rate for Payer: ChoiceCare Network Commercial $3,637.50
Rate for Payer: Cigna of WY Commercial $3,675.00
Rate for Payer: Entrust Commercial $3,562.50
Rate for Payer: First Choice Health Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,175.00
Rate for Payer: HealthUtah PPO $3,750.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,637.50
Rate for Payer: Multiplan Medicare/VA $2,066.25
Rate for Payer: One Health Plan of WY PPO $3,675.00
Rate for Payer: PacificSource Commercial $3,375.00
Rate for Payer: PHCS PPO $3,675.00
Rate for Payer: Three Rivers PPO $2,812.50
Rate for Payer: TriWest Veterans Administration $2,175.00
Rate for Payer: United Healthcare Commercial $3,262.50
Rate for Payer: United Healthcare Medicare $2,175.00
Rate for Payer: WINHealth Partners Commercial $3,675.00
Rate for Payer: Wise Provider Network Commercial $3,562.50
Service Code HCPCS 74183
Hospital Charge Code 6147418301
Hospital Revenue Code 614
Min. Negotiated Rate $2,351.25
Max. Negotiated Rate $3,750.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,675.00
Rate for Payer: Altius Auto/Workers Compensation $3,600.00
Rate for Payer: Altius Commercial $3,600.00
Rate for Payer: Beech Street Commercial $3,675.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $3,078.75
Rate for Payer: Cash Price $2,625.00
Rate for Payer: ChoiceCare Network Commercial $3,637.50
Rate for Payer: Cigna of WY Commercial $3,675.00
Rate for Payer: Entrust Commercial $3,562.50
Rate for Payer: First Choice Health Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,562.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,475.00
Rate for Payer: HealthUtah PPO $3,750.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,637.50
Rate for Payer: Multiplan Medicare/VA $2,351.25
Rate for Payer: One Health Plan of WY PPO $3,675.00
Rate for Payer: PacificSource Commercial $3,375.00
Rate for Payer: PHCS PPO $3,675.00
Rate for Payer: Three Rivers PPO $2,812.50
Rate for Payer: TriWest Veterans Administration $2,475.00
Rate for Payer: United Healthcare Commercial $3,262.50
Rate for Payer: United Healthcare Medicare $2,475.00
Rate for Payer: WINHealth Partners Commercial $3,562.50
Rate for Payer: Wise Provider Network Commercial $3,562.50
Service Code HCPCS 74181
Hospital Charge Code 6147418102
Hospital Revenue Code 614
Min. Negotiated Rate $1,972.58
Max. Negotiated Rate $3,580.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,508.40
Rate for Payer: Aetna of WY Medicare $2,362.80
Rate for Payer: Altius Auto/Workers Compensation $3,436.80
Rate for Payer: Altius Commercial $3,436.80
Rate for Payer: Beech Street Commercial $3,508.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,939.18
Rate for Payer: Cash Price $2,506.00
Rate for Payer: ChoiceCare Network Commercial $3,472.60
Rate for Payer: Cigna of WY Commercial $3,508.40
Rate for Payer: Entrust Commercial $3,401.00
Rate for Payer: First Choice Health Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,076.40
Rate for Payer: HealthUtah PPO $3,580.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,472.60
Rate for Payer: Multiplan Medicare/VA $1,972.58
Rate for Payer: One Health Plan of WY PPO $3,508.40
Rate for Payer: PacificSource Commercial $3,222.00
Rate for Payer: PHCS PPO $3,508.40
Rate for Payer: Three Rivers PPO $2,685.00
Rate for Payer: TriWest Veterans Administration $2,076.40
Rate for Payer: United Healthcare Commercial $3,114.60
Rate for Payer: United Healthcare Medicare $2,076.40
Rate for Payer: WINHealth Partners Commercial $3,508.40
Rate for Payer: Wise Provider Network Commercial $3,401.00
Service Code HCPCS 74181
Hospital Charge Code 6147418102
Hospital Revenue Code 614
Min. Negotiated Rate $2,244.66
Max. Negotiated Rate $3,580.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,508.40
Rate for Payer: Altius Auto/Workers Compensation $3,436.80
Rate for Payer: Altius Commercial $3,436.80
Rate for Payer: Beech Street Commercial $3,508.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,939.18
Rate for Payer: Cash Price $2,506.00
Rate for Payer: ChoiceCare Network Commercial $3,472.60
Rate for Payer: Cigna of WY Commercial $3,508.40
Rate for Payer: Entrust Commercial $3,401.00
Rate for Payer: First Choice Health Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,362.80
Rate for Payer: HealthUtah PPO $3,580.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,472.60
Rate for Payer: Multiplan Medicare/VA $2,244.66
Rate for Payer: One Health Plan of WY PPO $3,508.40
Rate for Payer: PacificSource Commercial $3,222.00
Rate for Payer: PHCS PPO $3,508.40
Rate for Payer: Three Rivers PPO $2,685.00
Rate for Payer: TriWest Veterans Administration $2,362.80
Rate for Payer: United Healthcare Commercial $3,114.60
Rate for Payer: United Healthcare Medicare $2,362.80
Rate for Payer: WINHealth Partners Commercial $3,401.00
Rate for Payer: Wise Provider Network Commercial $3,401.00
Service Code HCPCS 74181
Hospital Charge Code 6147418101
Hospital Revenue Code 614
Min. Negotiated Rate $2,244.66
Max. Negotiated Rate $3,580.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,508.40
Rate for Payer: Altius Auto/Workers Compensation $3,436.80
Rate for Payer: Altius Commercial $3,436.80
Rate for Payer: Beech Street Commercial $3,508.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,939.18
Rate for Payer: Cash Price $2,506.00
Rate for Payer: ChoiceCare Network Commercial $3,472.60
Rate for Payer: Cigna of WY Commercial $3,508.40
Rate for Payer: Entrust Commercial $3,401.00
Rate for Payer: First Choice Health Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,362.80
Rate for Payer: HealthUtah PPO $3,580.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,472.60
Rate for Payer: Multiplan Medicare/VA $2,244.66
Rate for Payer: One Health Plan of WY PPO $3,508.40
Rate for Payer: PacificSource Commercial $3,222.00
Rate for Payer: PHCS PPO $3,508.40
Rate for Payer: Three Rivers PPO $2,685.00
Rate for Payer: TriWest Veterans Administration $2,362.80
Rate for Payer: United Healthcare Commercial $3,114.60
Rate for Payer: United Healthcare Medicare $2,362.80
Rate for Payer: WINHealth Partners Commercial $3,401.00
Rate for Payer: Wise Provider Network Commercial $3,401.00
Service Code HCPCS 74181
Hospital Charge Code 6147418101
Hospital Revenue Code 614
Min. Negotiated Rate $1,972.58
Max. Negotiated Rate $3,580.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $3,508.40
Rate for Payer: Aetna of WY Medicare $2,362.80
Rate for Payer: Altius Auto/Workers Compensation $3,436.80
Rate for Payer: Altius Commercial $3,436.80
Rate for Payer: Beech Street Commercial $3,508.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,939.18
Rate for Payer: Cash Price $2,506.00
Rate for Payer: ChoiceCare Network Commercial $3,472.60
Rate for Payer: Cigna of WY Commercial $3,508.40
Rate for Payer: Entrust Commercial $3,401.00
Rate for Payer: First Choice Health Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $3,401.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $2,076.40
Rate for Payer: HealthUtah PPO $3,580.00
Rate for Payer: Idaho Integrated Healthcare Commercial $3,472.60
Rate for Payer: Multiplan Medicare/VA $1,972.58
Rate for Payer: One Health Plan of WY PPO $3,508.40
Rate for Payer: PacificSource Commercial $3,222.00
Rate for Payer: PHCS PPO $3,508.40
Rate for Payer: Three Rivers PPO $2,685.00
Rate for Payer: TriWest Veterans Administration $2,076.40
Rate for Payer: United Healthcare Commercial $3,114.60
Rate for Payer: United Healthcare Medicare $2,076.40
Rate for Payer: WINHealth Partners Commercial $3,508.40
Rate for Payer: Wise Provider Network Commercial $3,401.00