Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS 19281
Hospital Charge Code 3201928101
Hospital Revenue Code 320
Min. Negotiated Rate $738.34
Max. Negotiated Rate $1,340.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,313.20
Rate for Payer: Aetna of WY Medicare $884.40
Rate for Payer: Altius Auto/Workers Compensation $1,286.40
Rate for Payer: Altius Commercial $1,286.40
Rate for Payer: Beech Street Commercial $1,313.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,100.14
Rate for Payer: Cash Price $938.00
Rate for Payer: ChoiceCare Network Commercial $1,299.80
Rate for Payer: Cigna of WY Commercial $1,313.20
Rate for Payer: Entrust Commercial $1,273.00
Rate for Payer: First Choice Health Commercial $1,273.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,273.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $777.20
Rate for Payer: HealthUtah PPO $1,340.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,299.80
Rate for Payer: Multiplan Medicare/VA $738.34
Rate for Payer: One Health Plan of WY PPO $1,313.20
Rate for Payer: PacificSource Commercial $1,206.00
Rate for Payer: PHCS PPO $1,313.20
Rate for Payer: Three Rivers PPO $1,005.00
Rate for Payer: TriWest Veterans Administration $777.20
Rate for Payer: United Healthcare Commercial $1,165.80
Rate for Payer: United Healthcare Medicare $777.20
Rate for Payer: WINHealth Partners Commercial $1,313.20
Rate for Payer: Wise Provider Network Commercial $1,273.00
Service Code HCPCS 19281
Hospital Charge Code 3201928101
Hospital Revenue Code 320
Min. Negotiated Rate $840.18
Max. Negotiated Rate $1,340.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,313.20
Rate for Payer: Altius Auto/Workers Compensation $1,286.40
Rate for Payer: Altius Commercial $1,286.40
Rate for Payer: Beech Street Commercial $1,313.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,100.14
Rate for Payer: Cash Price $938.00
Rate for Payer: ChoiceCare Network Commercial $1,299.80
Rate for Payer: Cigna of WY Commercial $1,313.20
Rate for Payer: Entrust Commercial $1,273.00
Rate for Payer: First Choice Health Commercial $1,273.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,273.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $884.40
Rate for Payer: HealthUtah PPO $1,340.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,299.80
Rate for Payer: Multiplan Medicare/VA $840.18
Rate for Payer: One Health Plan of WY PPO $1,313.20
Rate for Payer: PacificSource Commercial $1,206.00
Rate for Payer: PHCS PPO $1,313.20
Rate for Payer: Three Rivers PPO $1,005.00
Rate for Payer: TriWest Veterans Administration $884.40
Rate for Payer: United Healthcare Commercial $1,165.80
Rate for Payer: United Healthcare Medicare $884.40
Rate for Payer: WINHealth Partners Commercial $1,273.00
Rate for Payer: Wise Provider Network Commercial $1,273.00
Service Code HCPCS 19282
Hospital Charge Code 6101928201
Hospital Revenue Code 610
Min. Negotiated Rate $608.86
Max. Negotiated Rate $1,105.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,082.90
Rate for Payer: Aetna of WY Medicare $729.30
Rate for Payer: Altius Auto/Workers Compensation $1,060.80
Rate for Payer: Altius Commercial $1,060.80
Rate for Payer: Beech Street Commercial $1,082.90
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $907.20
Rate for Payer: Cash Price $773.50
Rate for Payer: ChoiceCare Network Commercial $1,071.85
Rate for Payer: Cigna of WY Commercial $1,082.90
Rate for Payer: Entrust Commercial $1,049.75
Rate for Payer: First Choice Health Commercial $1,049.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,049.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $640.90
Rate for Payer: HealthUtah PPO $1,105.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,071.85
Rate for Payer: Multiplan Medicare/VA $608.86
Rate for Payer: One Health Plan of WY PPO $1,082.90
Rate for Payer: PacificSource Commercial $994.50
Rate for Payer: PHCS PPO $1,082.90
Rate for Payer: Three Rivers PPO $828.75
Rate for Payer: TriWest Veterans Administration $640.90
Rate for Payer: United Healthcare Commercial $961.35
Rate for Payer: United Healthcare Medicare $640.90
Rate for Payer: WINHealth Partners Commercial $1,082.90
Rate for Payer: Wise Provider Network Commercial $1,049.75
Service Code HCPCS 19282
Hospital Charge Code 6101928201
Hospital Revenue Code 610
Min. Negotiated Rate $692.84
Max. Negotiated Rate $1,105.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,082.90
Rate for Payer: Altius Auto/Workers Compensation $1,060.80
Rate for Payer: Altius Commercial $1,060.80
Rate for Payer: Beech Street Commercial $1,082.90
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $907.20
Rate for Payer: Cash Price $773.50
Rate for Payer: ChoiceCare Network Commercial $1,071.85
Rate for Payer: Cigna of WY Commercial $1,082.90
Rate for Payer: Entrust Commercial $1,049.75
Rate for Payer: First Choice Health Commercial $1,049.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,049.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $729.30
Rate for Payer: HealthUtah PPO $1,105.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,071.85
Rate for Payer: Multiplan Medicare/VA $692.84
Rate for Payer: One Health Plan of WY PPO $1,082.90
Rate for Payer: PacificSource Commercial $994.50
Rate for Payer: PHCS PPO $1,082.90
Rate for Payer: Three Rivers PPO $828.75
Rate for Payer: TriWest Veterans Administration $729.30
Rate for Payer: United Healthcare Commercial $961.35
Rate for Payer: United Healthcare Medicare $729.30
Rate for Payer: WINHealth Partners Commercial $1,049.75
Rate for Payer: Wise Provider Network Commercial $1,049.75
Service Code HCPCS 32556
Hospital Charge Code 5103255601
Hospital Revenue Code 510
Min. Negotiated Rate $190.61
Max. Negotiated Rate $304.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $297.92
Rate for Payer: Altius Auto/Workers Compensation $291.84
Rate for Payer: Altius Commercial $291.84
Rate for Payer: Beech Street Commercial $297.92
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $249.58
Rate for Payer: Cash Price $212.80
Rate for Payer: ChoiceCare Network Commercial $294.88
Rate for Payer: Cigna of WY Commercial $297.92
Rate for Payer: Entrust Commercial $288.80
Rate for Payer: First Choice Health Commercial $288.80
Rate for Payer: Government Employees Health Association (GEHA) Commercial $288.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $200.64
Rate for Payer: HealthUtah PPO $304.00
Rate for Payer: Idaho Integrated Healthcare Commercial $294.88
Rate for Payer: Multiplan Medicare/VA $190.61
Rate for Payer: One Health Plan of WY PPO $297.92
Rate for Payer: PacificSource Commercial $273.60
Rate for Payer: PHCS PPO $297.92
Rate for Payer: Three Rivers PPO $228.00
Rate for Payer: TriWest Veterans Administration $200.64
Rate for Payer: United Healthcare Commercial $264.48
Rate for Payer: United Healthcare Medicare $200.64
Rate for Payer: WINHealth Partners Commercial $288.80
Rate for Payer: Wise Provider Network Commercial $288.80
Service Code HCPCS 32556
Hospital Charge Code 5103255601
Hospital Revenue Code 510
Min. Negotiated Rate $167.50
Max. Negotiated Rate $304.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $297.92
Rate for Payer: Aetna of WY Medicare $200.64
Rate for Payer: Altius Auto/Workers Compensation $291.84
Rate for Payer: Altius Commercial $291.84
Rate for Payer: Beech Street Commercial $297.92
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $249.58
Rate for Payer: Cash Price $212.80
Rate for Payer: ChoiceCare Network Commercial $294.88
Rate for Payer: Cigna of WY Commercial $297.92
Rate for Payer: Entrust Commercial $288.80
Rate for Payer: First Choice Health Commercial $288.80
Rate for Payer: Government Employees Health Association (GEHA) Commercial $288.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $176.32
Rate for Payer: HealthUtah PPO $304.00
Rate for Payer: Idaho Integrated Healthcare Commercial $294.88
Rate for Payer: Multiplan Medicare/VA $167.50
Rate for Payer: One Health Plan of WY PPO $297.92
Rate for Payer: PacificSource Commercial $273.60
Rate for Payer: PHCS PPO $297.92
Rate for Payer: Three Rivers PPO $228.00
Rate for Payer: TriWest Veterans Administration $176.32
Rate for Payer: United Healthcare Commercial $264.48
Rate for Payer: United Healthcare Medicare $176.32
Rate for Payer: WINHealth Partners Commercial $297.92
Rate for Payer: Wise Provider Network Commercial $288.80
Service Code HCPCS 10035
Hospital Charge Code 3611003501
Hospital Revenue Code 361
Min. Negotiated Rate $1,398.21
Max. Negotiated Rate $2,230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,185.40
Rate for Payer: Altius Auto/Workers Compensation $2,140.80
Rate for Payer: Altius Commercial $2,140.80
Rate for Payer: Beech Street Commercial $2,185.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,830.83
Rate for Payer: Cash Price $1,561.00
Rate for Payer: ChoiceCare Network Commercial $2,163.10
Rate for Payer: Cigna of WY Commercial $2,185.40
Rate for Payer: Entrust Commercial $2,118.50
Rate for Payer: First Choice Health Commercial $2,118.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,118.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,471.80
Rate for Payer: HealthUtah PPO $2,230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,163.10
Rate for Payer: Multiplan Medicare/VA $1,398.21
Rate for Payer: One Health Plan of WY PPO $2,185.40
Rate for Payer: PacificSource Commercial $2,007.00
Rate for Payer: PHCS PPO $2,185.40
Rate for Payer: Three Rivers PPO $1,672.50
Rate for Payer: TriWest Veterans Administration $1,471.80
Rate for Payer: United Healthcare Commercial $1,940.10
Rate for Payer: United Healthcare Medicare $1,471.80
Rate for Payer: WINHealth Partners Commercial $2,118.50
Rate for Payer: Wise Provider Network Commercial $2,118.50
Service Code HCPCS 10035
Hospital Charge Code 3611003501
Hospital Revenue Code 361
Min. Negotiated Rate $1,228.73
Max. Negotiated Rate $2,230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,185.40
Rate for Payer: Aetna of WY Medicare $1,471.80
Rate for Payer: Altius Auto/Workers Compensation $2,140.80
Rate for Payer: Altius Commercial $2,140.80
Rate for Payer: Beech Street Commercial $2,185.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1,830.83
Rate for Payer: Cash Price $1,561.00
Rate for Payer: ChoiceCare Network Commercial $2,163.10
Rate for Payer: Cigna of WY Commercial $2,185.40
Rate for Payer: Entrust Commercial $2,118.50
Rate for Payer: First Choice Health Commercial $2,118.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,118.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1,293.40
Rate for Payer: HealthUtah PPO $2,230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,163.10
Rate for Payer: Multiplan Medicare/VA $1,228.73
Rate for Payer: One Health Plan of WY PPO $2,185.40
Rate for Payer: PacificSource Commercial $2,007.00
Rate for Payer: PHCS PPO $2,185.40
Rate for Payer: Three Rivers PPO $1,672.50
Rate for Payer: TriWest Veterans Administration $1,293.40
Rate for Payer: United Healthcare Commercial $1,940.10
Rate for Payer: United Healthcare Medicare $1,293.40
Rate for Payer: WINHealth Partners Commercial $2,185.40
Rate for Payer: Wise Provider Network Commercial $2,118.50
Service Code HCPCS 28150
Hospital Charge Code 7612815001
Hospital Revenue Code 761
Min. Negotiated Rate $421.34
Max. Negotiated Rate $672.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $658.56
Rate for Payer: Altius Auto/Workers Compensation $645.12
Rate for Payer: Altius Commercial $645.12
Rate for Payer: Beech Street Commercial $658.56
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $551.71
Rate for Payer: Cash Price $470.40
Rate for Payer: ChoiceCare Network Commercial $651.84
Rate for Payer: Cigna of WY Commercial $658.56
Rate for Payer: Entrust Commercial $638.40
Rate for Payer: First Choice Health Commercial $638.40
Rate for Payer: Government Employees Health Association (GEHA) Commercial $638.40
Rate for Payer: Government Employees Health Association (GEHA) Medicare $443.52
Rate for Payer: HealthUtah PPO $672.00
Rate for Payer: Idaho Integrated Healthcare Commercial $651.84
Rate for Payer: Multiplan Medicare/VA $421.34
Rate for Payer: One Health Plan of WY PPO $658.56
Rate for Payer: PacificSource Commercial $604.80
Rate for Payer: PHCS PPO $658.56
Rate for Payer: Three Rivers PPO $504.00
Rate for Payer: TriWest Veterans Administration $443.52
Rate for Payer: United Healthcare Commercial $584.64
Rate for Payer: United Healthcare Medicare $443.52
Rate for Payer: WINHealth Partners Commercial $638.40
Rate for Payer: Wise Provider Network Commercial $638.40
Service Code HCPCS 28150
Hospital Charge Code 7612815001
Hospital Revenue Code 761
Min. Negotiated Rate $370.27
Max. Negotiated Rate $672.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $658.56
Rate for Payer: Aetna of WY Medicare $443.52
Rate for Payer: Altius Auto/Workers Compensation $645.12
Rate for Payer: Altius Commercial $645.12
Rate for Payer: Beech Street Commercial $658.56
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $551.71
Rate for Payer: Cash Price $470.40
Rate for Payer: ChoiceCare Network Commercial $651.84
Rate for Payer: Cigna of WY Commercial $658.56
Rate for Payer: Entrust Commercial $638.40
Rate for Payer: First Choice Health Commercial $638.40
Rate for Payer: Government Employees Health Association (GEHA) Commercial $638.40
Rate for Payer: Government Employees Health Association (GEHA) Medicare $389.76
Rate for Payer: HealthUtah PPO $672.00
Rate for Payer: Idaho Integrated Healthcare Commercial $651.84
Rate for Payer: Multiplan Medicare/VA $370.27
Rate for Payer: One Health Plan of WY PPO $658.56
Rate for Payer: PacificSource Commercial $604.80
Rate for Payer: PHCS PPO $658.56
Rate for Payer: Three Rivers PPO $504.00
Rate for Payer: TriWest Veterans Administration $389.76
Rate for Payer: United Healthcare Commercial $584.64
Rate for Payer: United Healthcare Medicare $389.76
Rate for Payer: WINHealth Partners Commercial $658.56
Rate for Payer: Wise Provider Network Commercial $638.40
Hospital Charge Code 7100000009
Hospital Revenue Code 710
Min. Negotiated Rate $9.40
Max. Negotiated Rate $15.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $14.70
Rate for Payer: Altius Auto/Workers Compensation $14.40
Rate for Payer: Altius Commercial $14.40
Rate for Payer: Beech Street Commercial $14.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $12.32
Rate for Payer: Cash Price $10.50
Rate for Payer: ChoiceCare Network Commercial $14.55
Rate for Payer: Cigna of WY Commercial $14.70
Rate for Payer: Entrust Commercial $14.25
Rate for Payer: First Choice Health Commercial $14.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $14.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $9.90
Rate for Payer: HealthUtah PPO $15.00
Rate for Payer: Idaho Integrated Healthcare Commercial $14.55
Rate for Payer: Multiplan Medicare/VA $9.40
Rate for Payer: One Health Plan of WY PPO $14.70
Rate for Payer: PacificSource Commercial $13.50
Rate for Payer: PHCS PPO $14.70
Rate for Payer: Three Rivers PPO $11.25
Rate for Payer: TriWest Veterans Administration $9.90
Rate for Payer: United Healthcare Commercial $13.05
Rate for Payer: United Healthcare Medicare $9.90
Rate for Payer: WINHealth Partners Commercial $14.25
Rate for Payer: Wise Provider Network Commercial $14.25
Hospital Charge Code 7100000009
Hospital Revenue Code 710
Min. Negotiated Rate $8.26
Max. Negotiated Rate $15.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $14.70
Rate for Payer: Aetna of WY Medicare $9.90
Rate for Payer: Altius Auto/Workers Compensation $14.40
Rate for Payer: Altius Commercial $14.40
Rate for Payer: Beech Street Commercial $14.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $12.32
Rate for Payer: Cash Price $10.50
Rate for Payer: ChoiceCare Network Commercial $14.55
Rate for Payer: Cigna of WY Commercial $14.70
Rate for Payer: Entrust Commercial $14.25
Rate for Payer: First Choice Health Commercial $14.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $14.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $8.70
Rate for Payer: HealthUtah PPO $15.00
Rate for Payer: Idaho Integrated Healthcare Commercial $14.55
Rate for Payer: Multiplan Medicare/VA $8.26
Rate for Payer: One Health Plan of WY PPO $14.70
Rate for Payer: PacificSource Commercial $13.50
Rate for Payer: PHCS PPO $14.70
Rate for Payer: Three Rivers PPO $11.25
Rate for Payer: TriWest Veterans Administration $8.70
Rate for Payer: United Healthcare Commercial $13.05
Rate for Payer: United Healthcare Medicare $8.70
Rate for Payer: WINHealth Partners Commercial $14.70
Rate for Payer: Wise Provider Network Commercial $14.25
Service Code HCPCS 83986
Hospital Charge Code 3018398601
Hospital Revenue Code 301
Min. Negotiated Rate $35.82
Max. Negotiated Rate $65.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $63.70
Rate for Payer: Aetna of WY Medicare $42.90
Rate for Payer: Altius Auto/Workers Compensation $62.40
Rate for Payer: Altius Commercial $62.40
Rate for Payer: Beech Street Commercial $63.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $53.36
Rate for Payer: Cash Price $45.50
Rate for Payer: ChoiceCare Network Commercial $63.05
Rate for Payer: Cigna of WY Commercial $63.70
Rate for Payer: Entrust Commercial $61.75
Rate for Payer: First Choice Health Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $37.70
Rate for Payer: HealthUtah PPO $65.00
Rate for Payer: Idaho Integrated Healthcare Commercial $63.05
Rate for Payer: Multiplan Medicare/VA $35.82
Rate for Payer: One Health Plan of WY PPO $63.70
Rate for Payer: PacificSource Commercial $58.50
Rate for Payer: PHCS PPO $63.70
Rate for Payer: Three Rivers PPO $48.75
Rate for Payer: TriWest Veterans Administration $37.70
Rate for Payer: United Healthcare Commercial $56.55
Rate for Payer: United Healthcare Medicare $37.70
Rate for Payer: WINHealth Partners Commercial $63.70
Rate for Payer: Wise Provider Network Commercial $61.75
Service Code HCPCS 83986
Hospital Charge Code 3018398601
Hospital Revenue Code 301
Min. Negotiated Rate $40.76
Max. Negotiated Rate $65.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $63.70
Rate for Payer: Altius Auto/Workers Compensation $62.40
Rate for Payer: Altius Commercial $62.40
Rate for Payer: Beech Street Commercial $63.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $53.36
Rate for Payer: Cash Price $45.50
Rate for Payer: ChoiceCare Network Commercial $63.05
Rate for Payer: Cigna of WY Commercial $63.70
Rate for Payer: Entrust Commercial $61.75
Rate for Payer: First Choice Health Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $42.90
Rate for Payer: HealthUtah PPO $65.00
Rate for Payer: Idaho Integrated Healthcare Commercial $63.05
Rate for Payer: Multiplan Medicare/VA $40.76
Rate for Payer: One Health Plan of WY PPO $63.70
Rate for Payer: PacificSource Commercial $58.50
Rate for Payer: PHCS PPO $63.70
Rate for Payer: Three Rivers PPO $48.75
Rate for Payer: TriWest Veterans Administration $42.90
Rate for Payer: United Healthcare Commercial $56.55
Rate for Payer: United Healthcare Medicare $42.90
Rate for Payer: WINHealth Partners Commercial $61.75
Rate for Payer: Wise Provider Network Commercial $61.75
Service Code HCPCS 83986
Hospital Charge Code 3018398603
Hospital Revenue Code 301
Min. Negotiated Rate $35.82
Max. Negotiated Rate $65.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $63.70
Rate for Payer: Aetna of WY Medicare $42.90
Rate for Payer: Altius Auto/Workers Compensation $62.40
Rate for Payer: Altius Commercial $62.40
Rate for Payer: Beech Street Commercial $63.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $53.36
Rate for Payer: Cash Price $45.50
Rate for Payer: ChoiceCare Network Commercial $63.05
Rate for Payer: Cigna of WY Commercial $63.70
Rate for Payer: Entrust Commercial $61.75
Rate for Payer: First Choice Health Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $37.70
Rate for Payer: HealthUtah PPO $65.00
Rate for Payer: Idaho Integrated Healthcare Commercial $63.05
Rate for Payer: Multiplan Medicare/VA $35.82
Rate for Payer: One Health Plan of WY PPO $63.70
Rate for Payer: PacificSource Commercial $58.50
Rate for Payer: PHCS PPO $63.70
Rate for Payer: Three Rivers PPO $48.75
Rate for Payer: TriWest Veterans Administration $37.70
Rate for Payer: United Healthcare Commercial $56.55
Rate for Payer: United Healthcare Medicare $37.70
Rate for Payer: WINHealth Partners Commercial $63.70
Rate for Payer: Wise Provider Network Commercial $61.75
Service Code HCPCS 83986
Hospital Charge Code 3018398603
Hospital Revenue Code 301
Min. Negotiated Rate $40.76
Max. Negotiated Rate $65.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $63.70
Rate for Payer: Altius Auto/Workers Compensation $62.40
Rate for Payer: Altius Commercial $62.40
Rate for Payer: Beech Street Commercial $63.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $53.36
Rate for Payer: Cash Price $45.50
Rate for Payer: ChoiceCare Network Commercial $63.05
Rate for Payer: Cigna of WY Commercial $63.70
Rate for Payer: Entrust Commercial $61.75
Rate for Payer: First Choice Health Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Commercial $61.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $42.90
Rate for Payer: HealthUtah PPO $65.00
Rate for Payer: Idaho Integrated Healthcare Commercial $63.05
Rate for Payer: Multiplan Medicare/VA $40.76
Rate for Payer: One Health Plan of WY PPO $63.70
Rate for Payer: PacificSource Commercial $58.50
Rate for Payer: PHCS PPO $63.70
Rate for Payer: Three Rivers PPO $48.75
Rate for Payer: TriWest Veterans Administration $42.90
Rate for Payer: United Healthcare Commercial $56.55
Rate for Payer: United Healthcare Medicare $42.90
Rate for Payer: WINHealth Partners Commercial $61.75
Rate for Payer: Wise Provider Network Commercial $61.75
Service Code HCPCS 99195
Hospital Charge Code 9409919501
Hospital Revenue Code 940
Min. Negotiated Rate $148.77
Max. Negotiated Rate $270.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $264.60
Rate for Payer: Aetna of WY Medicare $178.20
Rate for Payer: Altius Auto/Workers Compensation $259.20
Rate for Payer: Altius Commercial $259.20
Rate for Payer: Beech Street Commercial $264.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $221.67
Rate for Payer: Cash Price $189.00
Rate for Payer: ChoiceCare Network Commercial $261.90
Rate for Payer: Cigna of WY Commercial $264.60
Rate for Payer: Entrust Commercial $256.50
Rate for Payer: First Choice Health Commercial $256.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $256.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $156.60
Rate for Payer: HealthUtah PPO $270.00
Rate for Payer: Idaho Integrated Healthcare Commercial $261.90
Rate for Payer: Multiplan Medicare/VA $148.77
Rate for Payer: One Health Plan of WY PPO $264.60
Rate for Payer: PacificSource Commercial $243.00
Rate for Payer: PHCS PPO $264.60
Rate for Payer: Three Rivers PPO $202.50
Rate for Payer: TriWest Veterans Administration $156.60
Rate for Payer: United Healthcare Commercial $234.90
Rate for Payer: United Healthcare Medicare $156.60
Rate for Payer: WINHealth Partners Commercial $264.60
Rate for Payer: Wise Provider Network Commercial $256.50
Service Code HCPCS 99195
Hospital Charge Code 7619919501
Hospital Revenue Code 761
Min. Negotiated Rate $169.71
Max. Negotiated Rate $308.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $301.84
Rate for Payer: Aetna of WY Medicare $203.28
Rate for Payer: Altius Auto/Workers Compensation $295.68
Rate for Payer: Altius Commercial $295.68
Rate for Payer: Beech Street Commercial $301.84
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $252.87
Rate for Payer: Cash Price $215.60
Rate for Payer: ChoiceCare Network Commercial $298.76
Rate for Payer: Cigna of WY Commercial $301.84
Rate for Payer: Entrust Commercial $292.60
Rate for Payer: First Choice Health Commercial $292.60
Rate for Payer: Government Employees Health Association (GEHA) Commercial $292.60
Rate for Payer: Government Employees Health Association (GEHA) Medicare $178.64
Rate for Payer: HealthUtah PPO $308.00
Rate for Payer: Idaho Integrated Healthcare Commercial $298.76
Rate for Payer: Multiplan Medicare/VA $169.71
Rate for Payer: One Health Plan of WY PPO $301.84
Rate for Payer: PacificSource Commercial $277.20
Rate for Payer: PHCS PPO $301.84
Rate for Payer: Three Rivers PPO $231.00
Rate for Payer: TriWest Veterans Administration $178.64
Rate for Payer: United Healthcare Commercial $267.96
Rate for Payer: United Healthcare Medicare $178.64
Rate for Payer: WINHealth Partners Commercial $301.84
Rate for Payer: Wise Provider Network Commercial $292.60
Service Code HCPCS 99195
Hospital Charge Code 7619919501
Hospital Revenue Code 761
Min. Negotiated Rate $193.12
Max. Negotiated Rate $308.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $301.84
Rate for Payer: Altius Auto/Workers Compensation $295.68
Rate for Payer: Altius Commercial $295.68
Rate for Payer: Beech Street Commercial $301.84
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $252.87
Rate for Payer: Cash Price $215.60
Rate for Payer: ChoiceCare Network Commercial $298.76
Rate for Payer: Cigna of WY Commercial $301.84
Rate for Payer: Entrust Commercial $292.60
Rate for Payer: First Choice Health Commercial $292.60
Rate for Payer: Government Employees Health Association (GEHA) Commercial $292.60
Rate for Payer: Government Employees Health Association (GEHA) Medicare $203.28
Rate for Payer: HealthUtah PPO $308.00
Rate for Payer: Idaho Integrated Healthcare Commercial $298.76
Rate for Payer: Multiplan Medicare/VA $193.12
Rate for Payer: One Health Plan of WY PPO $301.84
Rate for Payer: PacificSource Commercial $277.20
Rate for Payer: PHCS PPO $301.84
Rate for Payer: Three Rivers PPO $231.00
Rate for Payer: TriWest Veterans Administration $203.28
Rate for Payer: United Healthcare Commercial $267.96
Rate for Payer: United Healthcare Medicare $203.28
Rate for Payer: WINHealth Partners Commercial $292.60
Rate for Payer: Wise Provider Network Commercial $292.60
Service Code HCPCS 99195
Hospital Charge Code 9409919501
Hospital Revenue Code 940
Min. Negotiated Rate $169.29
Max. Negotiated Rate $270.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $264.60
Rate for Payer: Altius Auto/Workers Compensation $259.20
Rate for Payer: Altius Commercial $259.20
Rate for Payer: Beech Street Commercial $264.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $221.67
Rate for Payer: Cash Price $189.00
Rate for Payer: ChoiceCare Network Commercial $261.90
Rate for Payer: Cigna of WY Commercial $264.60
Rate for Payer: Entrust Commercial $256.50
Rate for Payer: First Choice Health Commercial $256.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $256.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $178.20
Rate for Payer: HealthUtah PPO $270.00
Rate for Payer: Idaho Integrated Healthcare Commercial $261.90
Rate for Payer: Multiplan Medicare/VA $169.29
Rate for Payer: One Health Plan of WY PPO $264.60
Rate for Payer: PacificSource Commercial $243.00
Rate for Payer: PHCS PPO $264.60
Rate for Payer: Three Rivers PPO $202.50
Rate for Payer: TriWest Veterans Administration $178.20
Rate for Payer: United Healthcare Commercial $234.90
Rate for Payer: United Healthcare Medicare $178.20
Rate for Payer: WINHealth Partners Commercial $256.50
Rate for Payer: Wise Provider Network Commercial $256.50
Service Code HCPCS 86148
Hospital Charge Code 3028614802
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 86148
Hospital Charge Code 3028614802
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 86148
Hospital Charge Code 3028614804
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 86148
Hospital Charge Code 3028614804
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 86148
Hospital Charge Code 3028614803
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