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Service Code HCPCS 86403
Hospital Charge Code 3028640306
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 86403
Hospital Charge Code 3028640306
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 86747
Hospital Charge Code 3028674701
Hospital Revenue Code 302
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 86747
Hospital Charge Code 3028674701
Hospital Revenue Code 302
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 88331
Hospital Charge Code 3108833101
Hospital Revenue Code 310
Min. Negotiated Rate $534.47
Max. Negotiated Rate $970.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $950.60
Rate for Payer: Aetna of WY Medicare $640.20
Rate for Payer: Altius Auto/Workers Compensation $931.20
Rate for Payer: Altius Commercial $931.20
Rate for Payer: Beech Street Commercial $950.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $796.37
Rate for Payer: Cash Price $679.00
Rate for Payer: ChoiceCare Network Commercial $940.90
Rate for Payer: Cigna of WY Commercial $950.60
Rate for Payer: Entrust Commercial $921.50
Rate for Payer: First Choice Health Commercial $921.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $921.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $562.60
Rate for Payer: HealthUtah PPO $970.00
Rate for Payer: Idaho Integrated Healthcare Commercial $940.90
Rate for Payer: Multiplan Medicare/VA $534.47
Rate for Payer: One Health Plan of WY PPO $950.60
Rate for Payer: PacificSource Commercial $873.00
Rate for Payer: PHCS PPO $950.60
Rate for Payer: Three Rivers PPO $727.50
Rate for Payer: TriWest Veterans Administration $562.60
Rate for Payer: United Healthcare Commercial $843.90
Rate for Payer: United Healthcare Medicare $562.60
Rate for Payer: WINHealth Partners Commercial $950.60
Rate for Payer: Wise Provider Network Commercial $921.50
Service Code HCPCS 88331
Hospital Charge Code 3108833101
Hospital Revenue Code 310
Min. Negotiated Rate $608.19
Max. Negotiated Rate $970.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $950.60
Rate for Payer: Altius Auto/Workers Compensation $931.20
Rate for Payer: Altius Commercial $931.20
Rate for Payer: Beech Street Commercial $950.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $796.37
Rate for Payer: Cash Price $679.00
Rate for Payer: ChoiceCare Network Commercial $940.90
Rate for Payer: Cigna of WY Commercial $950.60
Rate for Payer: Entrust Commercial $921.50
Rate for Payer: First Choice Health Commercial $921.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $921.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $640.20
Rate for Payer: HealthUtah PPO $970.00
Rate for Payer: Idaho Integrated Healthcare Commercial $940.90
Rate for Payer: Multiplan Medicare/VA $608.19
Rate for Payer: One Health Plan of WY PPO $950.60
Rate for Payer: PacificSource Commercial $873.00
Rate for Payer: PHCS PPO $950.60
Rate for Payer: Three Rivers PPO $727.50
Rate for Payer: TriWest Veterans Administration $640.20
Rate for Payer: United Healthcare Commercial $843.90
Rate for Payer: United Healthcare Medicare $640.20
Rate for Payer: WINHealth Partners Commercial $921.50
Rate for Payer: Wise Provider Network Commercial $921.50
Service Code HCPCS 88332
Hospital Charge Code 3128833203
Hospital Revenue Code 312
Min. Negotiated Rate $198.36
Max. Negotiated Rate $360.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $352.80
Rate for Payer: Aetna of WY Medicare $237.60
Rate for Payer: Altius Auto/Workers Compensation $345.60
Rate for Payer: Altius Commercial $345.60
Rate for Payer: Beech Street Commercial $352.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $295.56
Rate for Payer: Cash Price $252.00
Rate for Payer: ChoiceCare Network Commercial $349.20
Rate for Payer: Cigna of WY Commercial $352.80
Rate for Payer: Entrust Commercial $342.00
Rate for Payer: First Choice Health Commercial $342.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $342.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $208.80
Rate for Payer: HealthUtah PPO $360.00
Rate for Payer: Idaho Integrated Healthcare Commercial $349.20
Rate for Payer: Multiplan Medicare/VA $198.36
Rate for Payer: One Health Plan of WY PPO $352.80
Rate for Payer: PacificSource Commercial $324.00
Rate for Payer: PHCS PPO $352.80
Rate for Payer: Three Rivers PPO $270.00
Rate for Payer: TriWest Veterans Administration $208.80
Rate for Payer: United Healthcare Commercial $313.20
Rate for Payer: United Healthcare Medicare $208.80
Rate for Payer: WINHealth Partners Commercial $352.80
Rate for Payer: Wise Provider Network Commercial $342.00
Service Code HCPCS 88332
Hospital Charge Code 3128833203
Hospital Revenue Code 312
Min. Negotiated Rate $225.72
Max. Negotiated Rate $360.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $352.80
Rate for Payer: Altius Auto/Workers Compensation $345.60
Rate for Payer: Altius Commercial $345.60
Rate for Payer: Beech Street Commercial $352.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $295.56
Rate for Payer: Cash Price $252.00
Rate for Payer: ChoiceCare Network Commercial $349.20
Rate for Payer: Cigna of WY Commercial $352.80
Rate for Payer: Entrust Commercial $342.00
Rate for Payer: First Choice Health Commercial $342.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $342.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $237.60
Rate for Payer: HealthUtah PPO $360.00
Rate for Payer: Idaho Integrated Healthcare Commercial $349.20
Rate for Payer: Multiplan Medicare/VA $225.72
Rate for Payer: One Health Plan of WY PPO $352.80
Rate for Payer: PacificSource Commercial $324.00
Rate for Payer: PHCS PPO $352.80
Rate for Payer: Three Rivers PPO $270.00
Rate for Payer: TriWest Veterans Administration $237.60
Rate for Payer: United Healthcare Commercial $313.20
Rate for Payer: United Healthcare Medicare $237.60
Rate for Payer: WINHealth Partners Commercial $342.00
Rate for Payer: Wise Provider Network Commercial $342.00
Service Code HCPCS P9070
Hospital Charge Code 390P907001
Hospital Revenue Code 390
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 P9070
Hospital Charge Code 390P907001
Hospital Revenue Code 390
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 80503
Hospital Charge Code 3018050301
Hospital Revenue Code 301
Min. Negotiated Rate $60.61
Max. Negotiated Rate $110.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $107.80
Rate for Payer: Aetna of WY Medicare $72.60
Rate for Payer: Altius Auto/Workers Compensation $105.60
Rate for Payer: Altius Commercial $105.60
Rate for Payer: Beech Street Commercial $107.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $90.31
Rate for Payer: Cash Price $77.00
Rate for Payer: ChoiceCare Network Commercial $106.70
Rate for Payer: Cigna of WY Commercial $107.80
Rate for Payer: Entrust Commercial $104.50
Rate for Payer: First Choice Health Commercial $104.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $104.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $63.80
Rate for Payer: HealthUtah PPO $110.00
Rate for Payer: Idaho Integrated Healthcare Commercial $106.70
Rate for Payer: Multiplan Medicare/VA $60.61
Rate for Payer: One Health Plan of WY PPO $107.80
Rate for Payer: PacificSource Commercial $99.00
Rate for Payer: PHCS PPO $107.80
Rate for Payer: Three Rivers PPO $82.50
Rate for Payer: TriWest Veterans Administration $63.80
Rate for Payer: United Healthcare Commercial $95.70
Rate for Payer: United Healthcare Medicare $63.80
Rate for Payer: WINHealth Partners Commercial $107.80
Rate for Payer: Wise Provider Network Commercial $104.50
Service Code HCPCS 80503
Hospital Charge Code 3018050301
Hospital Revenue Code 301
Min. Negotiated Rate $68.97
Max. Negotiated Rate $110.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $107.80
Rate for Payer: Altius Auto/Workers Compensation $105.60
Rate for Payer: Altius Commercial $105.60
Rate for Payer: Beech Street Commercial $107.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $90.31
Rate for Payer: Cash Price $77.00
Rate for Payer: ChoiceCare Network Commercial $106.70
Rate for Payer: Cigna of WY Commercial $107.80
Rate for Payer: Entrust Commercial $104.50
Rate for Payer: First Choice Health Commercial $104.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $104.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $72.60
Rate for Payer: HealthUtah PPO $110.00
Rate for Payer: Idaho Integrated Healthcare Commercial $106.70
Rate for Payer: Multiplan Medicare/VA $68.97
Rate for Payer: One Health Plan of WY PPO $107.80
Rate for Payer: PacificSource Commercial $99.00
Rate for Payer: PHCS PPO $107.80
Rate for Payer: Three Rivers PPO $82.50
Rate for Payer: TriWest Veterans Administration $72.60
Rate for Payer: United Healthcare Commercial $95.70
Rate for Payer: United Healthcare Medicare $72.60
Rate for Payer: WINHealth Partners Commercial $104.50
Rate for Payer: Wise Provider Network Commercial $104.50
Service Code HCPCS J7326
Hospital Charge Code 636J732601
Hospital Revenue Code 636
Min. Negotiated Rate $1,430.95
Max. Negotiated Rate $2,597.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,545.06
Rate for Payer: Aetna of WY Medicare $1,714.02
Rate for Payer: Altius Auto/Workers Compensation $2,493.12
Rate for Payer: Altius Commercial $2,493.12
Rate for Payer: Beech Street Commercial $2,545.06
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,132.14
Rate for Payer: Cash Price $1,817.90
Rate for Payer: ChoiceCare Network Commercial $2,519.09
Rate for Payer: Cigna of WY Commercial $2,545.06
Rate for Payer: Entrust Commercial $2,467.15
Rate for Payer: First Choice Health Commercial $2,467.15
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,467.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,506.26
Rate for Payer: HealthUtah PPO $2,597.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,519.09
Rate for Payer: Multiplan Medicare/VA $1,430.95
Rate for Payer: One Health Plan of WY PPO $2,545.06
Rate for Payer: PacificSource Commercial $2,337.30
Rate for Payer: PHCS PPO $2,545.06
Rate for Payer: Three Rivers PPO $1,947.75
Rate for Payer: TriWest Veterans Administration $1,506.26
Rate for Payer: United Healthcare Commercial $2,259.39
Rate for Payer: United Healthcare Medicare $1,506.26
Rate for Payer: WINHealth Partners Commercial $2,545.06
Rate for Payer: Wise Provider Network Commercial $2,467.15
Service Code HCPCS J7326
Hospital Charge Code 636J732601
Hospital Revenue Code 636
Min. Negotiated Rate $1,628.32
Max. Negotiated Rate $2,597.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,545.06
Rate for Payer: Altius Auto/Workers Compensation $2,493.12
Rate for Payer: Altius Commercial $2,493.12
Rate for Payer: Beech Street Commercial $2,545.06
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $2,132.14
Rate for Payer: Cash Price $1,817.90
Rate for Payer: ChoiceCare Network Commercial $2,519.09
Rate for Payer: Cigna of WY Commercial $2,545.06
Rate for Payer: Entrust Commercial $2,467.15
Rate for Payer: First Choice Health Commercial $2,467.15
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,467.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,714.02
Rate for Payer: HealthUtah PPO $2,597.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,519.09
Rate for Payer: Multiplan Medicare/VA $1,628.32
Rate for Payer: One Health Plan of WY PPO $2,545.06
Rate for Payer: PacificSource Commercial $2,337.30
Rate for Payer: PHCS PPO $2,545.06
Rate for Payer: Three Rivers PPO $1,947.75
Rate for Payer: TriWest Veterans Administration $1,714.02
Rate for Payer: United Healthcare Commercial $2,259.39
Rate for Payer: United Healthcare Medicare $1,714.02
Rate for Payer: WINHealth Partners Commercial $2,467.15
Rate for Payer: Wise Provider Network Commercial $2,467.15
Service Code HCPCS 99211
Hospital Charge Code 5109921101
Hospital Revenue Code 510
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
Service Code HCPCS 99211
Hospital Charge Code 5109921101
Hospital Revenue Code 510
Min. Negotiated Rate $8.82
Max. Negotiated Rate $25.44
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: 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 $25.44
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
Service Code HCPCS 99202
Hospital Charge Code 5109920201
Hospital Revenue Code 510
Min. Negotiated Rate $22.04
Max. Negotiated Rate $77.55
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: 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 $77.55
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 99202
Hospital Charge Code 5109920201
Hospital Revenue Code 510
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 99203
Hospital Charge Code 5109920301
Hospital Revenue Code 510
Min. Negotiated Rate $36.99
Max. Negotiated Rate $59.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $57.82
Rate for Payer: Altius Auto/Workers Compensation $56.64
Rate for Payer: Altius Commercial $56.64
Rate for Payer: Beech Street Commercial $57.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $48.44
Rate for Payer: Cash Price $41.30
Rate for Payer: ChoiceCare Network Commercial $57.23
Rate for Payer: Cigna of WY Commercial $57.82
Rate for Payer: Entrust Commercial $56.05
Rate for Payer: First Choice Health Commercial $56.05
Rate for Payer: Government Employees Health Association (GEHA) Commercial $56.05
Rate for Payer: Government Employees Health Association (GEHA) Medicare $38.94
Rate for Payer: HealthUtah PPO $59.00
Rate for Payer: Idaho Integrated Healthcare Commercial $57.23
Rate for Payer: Multiplan Medicare/VA $36.99
Rate for Payer: One Health Plan of WY PPO $57.82
Rate for Payer: PacificSource Commercial $53.10
Rate for Payer: PHCS PPO $57.82
Rate for Payer: Three Rivers PPO $44.25
Rate for Payer: TriWest Veterans Administration $38.94
Rate for Payer: United Healthcare Commercial $51.33
Rate for Payer: United Healthcare Medicare $38.94
Rate for Payer: WINHealth Partners Commercial $56.05
Rate for Payer: Wise Provider Network Commercial $56.05
Service Code HCPCS 99203
Hospital Charge Code 5109920301
Hospital Revenue Code 510
Min. Negotiated Rate $32.51
Max. Negotiated Rate $115.84
Rate for Payer: Aetna of WY Commercial/Medical Rental $57.82
Rate for Payer: Aetna of WY Medicare $38.94
Rate for Payer: Altius Auto/Workers Compensation $56.64
Rate for Payer: Altius Commercial $56.64
Rate for Payer: Beech Street Commercial $57.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $48.44
Rate for Payer: Cash Price $41.30
Rate for Payer: Cash Price $41.30
Rate for Payer: ChoiceCare Network Commercial $57.23
Rate for Payer: Cigna of WY Commercial $57.82
Rate for Payer: Entrust Commercial $56.05
Rate for Payer: First Choice Health Commercial $56.05
Rate for Payer: Government Employees Health Association (GEHA) Commercial $56.05
Rate for Payer: Government Employees Health Association (GEHA) Medicare $34.22
Rate for Payer: HealthUtah PPO $115.84
Rate for Payer: Idaho Integrated Healthcare Commercial $57.23
Rate for Payer: Multiplan Medicare/VA $32.51
Rate for Payer: One Health Plan of WY PPO $57.82
Rate for Payer: PacificSource Commercial $53.10
Rate for Payer: PHCS PPO $57.82
Rate for Payer: Three Rivers PPO $44.25
Rate for Payer: TriWest Veterans Administration $34.22
Rate for Payer: United Healthcare Commercial $51.33
Rate for Payer: United Healthcare Medicare $34.22
Rate for Payer: WINHealth Partners Commercial $57.82
Rate for Payer: Wise Provider Network Commercial $56.05
Service Code HCPCS 99204
Hospital Charge Code 5109920401
Hospital Revenue Code 510
Min. Negotiated Rate $50.79
Max. Negotiated Rate $81.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $79.38
Rate for Payer: Altius Auto/Workers Compensation $77.76
Rate for Payer: Altius Commercial $77.76
Rate for Payer: Beech Street Commercial $79.38
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $66.50
Rate for Payer: Cash Price $56.70
Rate for Payer: ChoiceCare Network Commercial $78.57
Rate for Payer: Cigna of WY Commercial $79.38
Rate for Payer: Entrust Commercial $76.95
Rate for Payer: First Choice Health Commercial $76.95
Rate for Payer: Government Employees Health Association (GEHA) Commercial $76.95
Rate for Payer: Government Employees Health Association (GEHA) Medicare $53.46
Rate for Payer: HealthUtah PPO $81.00
Rate for Payer: Idaho Integrated Healthcare Commercial $78.57
Rate for Payer: Multiplan Medicare/VA $50.79
Rate for Payer: One Health Plan of WY PPO $79.38
Rate for Payer: PacificSource Commercial $72.90
Rate for Payer: PHCS PPO $79.38
Rate for Payer: Three Rivers PPO $60.75
Rate for Payer: TriWest Veterans Administration $53.46
Rate for Payer: United Healthcare Commercial $70.47
Rate for Payer: United Healthcare Medicare $53.46
Rate for Payer: WINHealth Partners Commercial $76.95
Rate for Payer: Wise Provider Network Commercial $76.95
Service Code HCPCS 99204
Hospital Charge Code 5109920401
Hospital Revenue Code 510
Min. Negotiated Rate $44.63
Max. Negotiated Rate $164.99
Rate for Payer: Aetna of WY Commercial/Medical Rental $79.38
Rate for Payer: Aetna of WY Medicare $53.46
Rate for Payer: Altius Auto/Workers Compensation $77.76
Rate for Payer: Altius Commercial $77.76
Rate for Payer: Beech Street Commercial $79.38
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $66.50
Rate for Payer: Cash Price $56.70
Rate for Payer: Cash Price $56.70
Rate for Payer: ChoiceCare Network Commercial $78.57
Rate for Payer: Cigna of WY Commercial $79.38
Rate for Payer: Entrust Commercial $76.95
Rate for Payer: First Choice Health Commercial $76.95
Rate for Payer: Government Employees Health Association (GEHA) Commercial $76.95
Rate for Payer: Government Employees Health Association (GEHA) Medicare $46.98
Rate for Payer: HealthUtah PPO $164.99
Rate for Payer: Idaho Integrated Healthcare Commercial $78.57
Rate for Payer: Multiplan Medicare/VA $44.63
Rate for Payer: One Health Plan of WY PPO $79.38
Rate for Payer: PacificSource Commercial $72.90
Rate for Payer: PHCS PPO $79.38
Rate for Payer: Three Rivers PPO $60.75
Rate for Payer: TriWest Veterans Administration $46.98
Rate for Payer: United Healthcare Commercial $70.47
Rate for Payer: United Healthcare Medicare $46.98
Rate for Payer: WINHealth Partners Commercial $79.38
Rate for Payer: Wise Provider Network Commercial $76.95
Service Code HCPCS 99205
Hospital Charge Code 5109920501
Hospital Revenue Code 510
Min. Negotiated Rate $60.06
Max. Negotiated Rate $210.10
Rate for Payer: Aetna of WY Commercial/Medical Rental $106.82
Rate for Payer: Aetna of WY Medicare $71.94
Rate for Payer: Altius Auto/Workers Compensation $104.64
Rate for Payer: Altius Commercial $104.64
Rate for Payer: Beech Street Commercial $106.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $89.49
Rate for Payer: Cash Price $76.30
Rate for Payer: Cash Price $76.30
Rate for Payer: ChoiceCare Network Commercial $105.73
Rate for Payer: Cigna of WY Commercial $106.82
Rate for Payer: Entrust Commercial $103.55
Rate for Payer: First Choice Health Commercial $103.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $103.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $63.22
Rate for Payer: HealthUtah PPO $210.10
Rate for Payer: Idaho Integrated Healthcare Commercial $105.73
Rate for Payer: Multiplan Medicare/VA $60.06
Rate for Payer: One Health Plan of WY PPO $106.82
Rate for Payer: PacificSource Commercial $98.10
Rate for Payer: PHCS PPO $106.82
Rate for Payer: Three Rivers PPO $81.75
Rate for Payer: TriWest Veterans Administration $63.22
Rate for Payer: United Healthcare Commercial $94.83
Rate for Payer: United Healthcare Medicare $63.22
Rate for Payer: WINHealth Partners Commercial $106.82
Rate for Payer: Wise Provider Network Commercial $103.55
Service Code HCPCS 99205
Hospital Charge Code 5109920501
Hospital Revenue Code 510
Min. Negotiated Rate $68.34
Max. Negotiated Rate $109.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $106.82
Rate for Payer: Altius Auto/Workers Compensation $104.64
Rate for Payer: Altius Commercial $104.64
Rate for Payer: Beech Street Commercial $106.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $89.49
Rate for Payer: Cash Price $76.30
Rate for Payer: ChoiceCare Network Commercial $105.73
Rate for Payer: Cigna of WY Commercial $106.82
Rate for Payer: Entrust Commercial $103.55
Rate for Payer: First Choice Health Commercial $103.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $103.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $71.94
Rate for Payer: HealthUtah PPO $109.00
Rate for Payer: Idaho Integrated Healthcare Commercial $105.73
Rate for Payer: Multiplan Medicare/VA $68.34
Rate for Payer: One Health Plan of WY PPO $106.82
Rate for Payer: PacificSource Commercial $98.10
Rate for Payer: PHCS PPO $106.82
Rate for Payer: Three Rivers PPO $81.75
Rate for Payer: TriWest Veterans Administration $71.94
Rate for Payer: United Healthcare Commercial $94.83
Rate for Payer: United Healthcare Medicare $71.94
Rate for Payer: WINHealth Partners Commercial $103.55
Rate for Payer: Wise Provider Network Commercial $103.55
Service Code HCPCS 99212
Hospital Charge Code 5109921201
Hospital Revenue Code 510
Min. Negotiated Rate $14.33
Max. Negotiated Rate $45.64
Rate for Payer: Aetna of WY Commercial/Medical Rental $25.48
Rate for Payer: Aetna of WY Medicare $17.16
Rate for Payer: Altius Auto/Workers Compensation $24.96
Rate for Payer: Altius Commercial $24.96
Rate for Payer: Beech Street Commercial $25.48
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $21.35
Rate for Payer: Cash Price $18.20
Rate for Payer: Cash Price $18.20
Rate for Payer: ChoiceCare Network Commercial $25.22
Rate for Payer: Cigna of WY Commercial $25.48
Rate for Payer: Entrust Commercial $24.70
Rate for Payer: First Choice Health Commercial $24.70
Rate for Payer: Government Employees Health Association (GEHA) Commercial $24.70
Rate for Payer: Government Employees Health Association (GEHA) Medicare $15.08
Rate for Payer: HealthUtah PPO $45.64
Rate for Payer: Idaho Integrated Healthcare Commercial $25.22
Rate for Payer: Multiplan Medicare/VA $14.33
Rate for Payer: One Health Plan of WY PPO $25.48
Rate for Payer: PacificSource Commercial $23.40
Rate for Payer: PHCS PPO $25.48
Rate for Payer: Three Rivers PPO $19.50
Rate for Payer: TriWest Veterans Administration $15.08
Rate for Payer: United Healthcare Commercial $22.62
Rate for Payer: United Healthcare Medicare $15.08
Rate for Payer: WINHealth Partners Commercial $25.48
Rate for Payer: Wise Provider Network Commercial $24.70