|
HC PRO ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$5,980.00
|
|
|
Service Code
|
HCPCS 27446
|
| Hospital Charge Code |
9832744601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$937.23 |
| Max. Negotiated Rate |
$5,980.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,860.40
|
| Rate for Payer: Aetna of WY Medicare |
$1,102.62
|
| Rate for Payer: Beech Street Commercial |
$5,681.00
|
| Rate for Payer: Cash Price |
$4,186.00
|
| Rate for Payer: Cash Price |
$4,186.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,800.60
|
| Rate for Payer: Cigna of WY Commercial |
$5,860.40
|
| Rate for Payer: First Choice Health Commercial |
$5,382.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,681.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,102.62
|
| Rate for Payer: HealthUtah PPO |
$5,980.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,800.60
|
| Rate for Payer: Multiplan Medicare/VA |
$937.23
|
| Rate for Payer: One Health Plan of WY PPO |
$5,860.40
|
| Rate for Payer: PacificSource Commercial |
$5,382.00
|
| Rate for Payer: PHCS PPO |
$5,681.00
|
| Rate for Payer: Three Rivers PPO |
$4,485.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,102.62
|
| Rate for Payer: United Healthcare Commercial |
$5,202.60
|
| Rate for Payer: United Healthcare Medicare |
$1,102.62
|
| Rate for Payer: WINHealth Partners Commercial |
$5,083.00
|
|
|
HC PRO ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS
|
Professional
|
Both
|
$3,732.00
|
|
|
Service Code
|
HCPCS 25446
|
| Hospital Charge Code |
9832544601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$961.17 |
| Max. Negotiated Rate |
$3,732.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,657.36
|
| Rate for Payer: Aetna of WY Medicare |
$1,130.79
|
| Rate for Payer: Beech Street Commercial |
$3,545.40
|
| Rate for Payer: Cash Price |
$2,612.40
|
| Rate for Payer: Cash Price |
$2,612.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,620.04
|
| Rate for Payer: Cigna of WY Commercial |
$3,657.36
|
| Rate for Payer: First Choice Health Commercial |
$3,358.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,545.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,130.79
|
| Rate for Payer: HealthUtah PPO |
$3,732.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,620.04
|
| Rate for Payer: Multiplan Medicare/VA |
$961.17
|
| Rate for Payer: One Health Plan of WY PPO |
$3,657.36
|
| Rate for Payer: PacificSource Commercial |
$3,358.80
|
| Rate for Payer: PHCS PPO |
$3,545.40
|
| Rate for Payer: Three Rivers PPO |
$2,799.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,130.79
|
| Rate for Payer: United Healthcare Commercial |
$3,246.84
|
| Rate for Payer: United Healthcare Medicare |
$1,130.79
|
| Rate for Payer: WINHealth Partners Commercial |
$3,172.20
|
|
|
HC PRO ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$5,061.00
|
|
|
Service Code
|
HCPCS 29888
|
| Hospital Charge Code |
9832988801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$798.71 |
| Max. Negotiated Rate |
$5,061.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,959.78
|
| Rate for Payer: Aetna of WY Medicare |
$939.66
|
| Rate for Payer: Beech Street Commercial |
$4,807.95
|
| Rate for Payer: Cash Price |
$3,542.70
|
| Rate for Payer: Cash Price |
$3,542.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,909.17
|
| Rate for Payer: Cigna of WY Commercial |
$4,959.78
|
| Rate for Payer: First Choice Health Commercial |
$4,554.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,807.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$939.66
|
| Rate for Payer: HealthUtah PPO |
$5,061.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,909.17
|
| Rate for Payer: Multiplan Medicare/VA |
$798.71
|
| Rate for Payer: One Health Plan of WY PPO |
$4,959.78
|
| Rate for Payer: PacificSource Commercial |
$4,554.90
|
| Rate for Payer: PHCS PPO |
$4,807.95
|
| Rate for Payer: Three Rivers PPO |
$3,795.75
|
| Rate for Payer: TriWest Veterans Administration |
$939.66
|
| Rate for Payer: United Healthcare Commercial |
$4,403.07
|
| Rate for Payer: United Healthcare Medicare |
$939.66
|
| Rate for Payer: WINHealth Partners Commercial |
$4,301.85
|
|
|
HC PRO ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,933.00
|
|
|
Service Code
|
HCPCS 23044
|
| Hospital Charge Code |
9822304401
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$467.93 |
| Max. Negotiated Rate |
$1,933.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,894.34
|
| Rate for Payer: Aetna of WY Medicare |
$550.51
|
| Rate for Payer: Beech Street Commercial |
$1,836.35
|
| Rate for Payer: Cash Price |
$1,353.10
|
| Rate for Payer: Cash Price |
$1,353.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,875.01
|
| Rate for Payer: Cigna of WY Commercial |
$1,894.34
|
| Rate for Payer: First Choice Health Commercial |
$1,739.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,836.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$550.51
|
| Rate for Payer: HealthUtah PPO |
$1,933.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,875.01
|
| Rate for Payer: Multiplan Medicare/VA |
$467.93
|
| Rate for Payer: One Health Plan of WY PPO |
$1,894.34
|
| Rate for Payer: PacificSource Commercial |
$1,739.70
|
| Rate for Payer: PHCS PPO |
$1,836.35
|
| Rate for Payer: Three Rivers PPO |
$1,449.75
|
| Rate for Payer: TriWest Veterans Administration |
$550.51
|
| Rate for Payer: United Healthcare Commercial |
$1,681.71
|
| Rate for Payer: United Healthcare Medicare |
$550.51
|
| Rate for Payer: WINHealth Partners Commercial |
$1,643.05
|
|
|
HC PRO ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$2,483.00
|
|
|
Service Code
|
HCPCS 24006
|
| Hospital Charge Code |
9832400601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$591.28 |
| Max. Negotiated Rate |
$2,483.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,433.34
|
| Rate for Payer: Aetna of WY Medicare |
$695.62
|
| Rate for Payer: Beech Street Commercial |
$2,358.85
|
| Rate for Payer: Cash Price |
$1,738.10
|
| Rate for Payer: Cash Price |
$1,738.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,408.51
|
| Rate for Payer: Cigna of WY Commercial |
$2,433.34
|
| Rate for Payer: First Choice Health Commercial |
$2,234.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,358.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$695.62
|
| Rate for Payer: HealthUtah PPO |
$2,483.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,408.51
|
| Rate for Payer: Multiplan Medicare/VA |
$591.28
|
| Rate for Payer: One Health Plan of WY PPO |
$2,433.34
|
| Rate for Payer: PacificSource Commercial |
$2,234.70
|
| Rate for Payer: PHCS PPO |
$2,358.85
|
| Rate for Payer: Three Rivers PPO |
$1,862.25
|
| Rate for Payer: TriWest Veterans Administration |
$695.62
|
| Rate for Payer: United Healthcare Commercial |
$2,160.21
|
| Rate for Payer: United Healthcare Medicare |
$695.62
|
| Rate for Payer: WINHealth Partners Commercial |
$2,110.55
|
|
|
HC PRO ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,394.00
|
|
|
Service Code
|
HCPCS 24000
|
| Hospital Charge Code |
9832400001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$399.44 |
| Max. Negotiated Rate |
$2,394.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,346.12
|
| Rate for Payer: Aetna of WY Medicare |
$469.93
|
| Rate for Payer: Beech Street Commercial |
$2,274.30
|
| Rate for Payer: Cash Price |
$1,675.80
|
| Rate for Payer: Cash Price |
$1,675.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,322.18
|
| Rate for Payer: Cigna of WY Commercial |
$2,346.12
|
| Rate for Payer: First Choice Health Commercial |
$2,154.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,274.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$469.93
|
| Rate for Payer: HealthUtah PPO |
$2,394.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,322.18
|
| Rate for Payer: Multiplan Medicare/VA |
$399.44
|
| Rate for Payer: One Health Plan of WY PPO |
$2,346.12
|
| Rate for Payer: PacificSource Commercial |
$2,154.60
|
| Rate for Payer: PHCS PPO |
$2,274.30
|
| Rate for Payer: Three Rivers PPO |
$1,795.50
|
| Rate for Payer: TriWest Veterans Administration |
$469.93
|
| Rate for Payer: United Healthcare Commercial |
$2,082.78
|
| Rate for Payer: United Healthcare Medicare |
$469.93
|
| Rate for Payer: WINHealth Partners Commercial |
$2,034.90
|
|
|
HC PRO ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB
|
Professional
|
Both
|
$1,764.00
|
|
|
Service Code
|
HCPCS 24101
|
| Hospital Charge Code |
9822410101
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$420.24 |
| Max. Negotiated Rate |
$1,764.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,728.72
|
| Rate for Payer: Aetna of WY Medicare |
$494.40
|
| Rate for Payer: Beech Street Commercial |
$1,675.80
|
| Rate for Payer: Cash Price |
$1,234.80
|
| Rate for Payer: Cash Price |
$1,234.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,711.08
|
| Rate for Payer: Cigna of WY Commercial |
$1,728.72
|
| Rate for Payer: First Choice Health Commercial |
$1,587.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,675.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$494.40
|
| Rate for Payer: HealthUtah PPO |
$1,764.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,711.08
|
| Rate for Payer: Multiplan Medicare/VA |
$420.24
|
| Rate for Payer: One Health Plan of WY PPO |
$1,728.72
|
| Rate for Payer: PacificSource Commercial |
$1,587.60
|
| Rate for Payer: PHCS PPO |
$1,675.80
|
| Rate for Payer: Three Rivers PPO |
$1,323.00
|
| Rate for Payer: TriWest Veterans Administration |
$494.40
|
| Rate for Payer: United Healthcare Commercial |
$1,534.68
|
| Rate for Payer: United Healthcare Medicare |
$494.40
|
| Rate for Payer: WINHealth Partners Commercial |
$1,499.40
|
|
|
HC PRO ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$1,764.00
|
|
|
Service Code
|
HCPCS 24101
|
| Hospital Charge Code |
9832410101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$420.24 |
| Max. Negotiated Rate |
$1,764.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,728.72
|
| Rate for Payer: Aetna of WY Medicare |
$494.40
|
| Rate for Payer: Beech Street Commercial |
$1,675.80
|
| Rate for Payer: Cash Price |
$1,234.80
|
| Rate for Payer: Cash Price |
$1,234.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,711.08
|
| Rate for Payer: Cigna of WY Commercial |
$1,728.72
|
| Rate for Payer: First Choice Health Commercial |
$1,587.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,675.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$494.40
|
| Rate for Payer: HealthUtah PPO |
$1,764.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,711.08
|
| Rate for Payer: Multiplan Medicare/VA |
$420.24
|
| Rate for Payer: One Health Plan of WY PPO |
$1,728.72
|
| Rate for Payer: PacificSource Commercial |
$1,587.60
|
| Rate for Payer: PHCS PPO |
$1,675.80
|
| Rate for Payer: Three Rivers PPO |
$1,323.00
|
| Rate for Payer: TriWest Veterans Administration |
$494.40
|
| Rate for Payer: United Healthcare Commercial |
$1,534.68
|
| Rate for Payer: United Healthcare Medicare |
$494.40
|
| Rate for Payer: WINHealth Partners Commercial |
$1,499.40
|
|
|
HC PRO ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 26080
|
| Hospital Charge Code |
9832608001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$335.89 |
| Max. Negotiated Rate |
$1,411.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,382.78
|
| Rate for Payer: Aetna of WY Medicare |
$395.16
|
| Rate for Payer: Beech Street Commercial |
$1,340.45
|
| Rate for Payer: Cash Price |
$987.70
|
| Rate for Payer: Cash Price |
$987.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,368.67
|
| Rate for Payer: Cigna of WY Commercial |
$1,382.78
|
| Rate for Payer: First Choice Health Commercial |
$1,269.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,340.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$395.16
|
| Rate for Payer: HealthUtah PPO |
$1,411.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,368.67
|
| Rate for Payer: Multiplan Medicare/VA |
$335.89
|
| Rate for Payer: One Health Plan of WY PPO |
$1,382.78
|
| Rate for Payer: PacificSource Commercial |
$1,269.90
|
| Rate for Payer: PHCS PPO |
$1,340.45
|
| Rate for Payer: Three Rivers PPO |
$1,058.25
|
| Rate for Payer: TriWest Veterans Administration |
$395.16
|
| Rate for Payer: United Healthcare Commercial |
$1,227.57
|
| Rate for Payer: United Healthcare Medicare |
$395.16
|
| Rate for Payer: WINHealth Partners Commercial |
$1,199.35
|
|
|
HC PRO ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$1,197.00
|
|
|
Service Code
|
HCPCS 26075 NONPBBPAYER
|
| Hospital Charge Code |
9832607501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$284.92 |
| Max. Negotiated Rate |
$1,197.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,173.06
|
| Rate for Payer: Aetna of WY Medicare |
$335.20
|
| Rate for Payer: Beech Street Commercial |
$1,137.15
|
| Rate for Payer: Cash Price |
$837.90
|
| Rate for Payer: Cash Price |
$837.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,161.09
|
| Rate for Payer: Cigna of WY Commercial |
$1,173.06
|
| Rate for Payer: First Choice Health Commercial |
$1,077.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,137.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$335.20
|
| Rate for Payer: HealthUtah PPO |
$1,197.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,161.09
|
| Rate for Payer: Multiplan Medicare/VA |
$284.92
|
| Rate for Payer: One Health Plan of WY PPO |
$1,173.06
|
| Rate for Payer: PacificSource Commercial |
$1,077.30
|
| Rate for Payer: PHCS PPO |
$1,137.15
|
| Rate for Payer: Three Rivers PPO |
$897.75
|
| Rate for Payer: TriWest Veterans Administration |
$335.20
|
| Rate for Payer: United Healthcare Commercial |
$1,041.39
|
| Rate for Payer: United Healthcare Medicare |
$335.20
|
| Rate for Payer: WINHealth Partners Commercial |
$1,017.45
|
|
|
HC PRO ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 26075
|
| Hospital Charge Code |
9832607501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$284.92 |
| Max. Negotiated Rate |
$958.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$938.84
|
| Rate for Payer: Aetna of WY Medicare |
$335.20
|
| Rate for Payer: Beech Street Commercial |
$910.10
|
| Rate for Payer: Cash Price |
$670.60
|
| Rate for Payer: Cash Price |
$670.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$929.26
|
| Rate for Payer: Cigna of WY Commercial |
$938.84
|
| Rate for Payer: First Choice Health Commercial |
$862.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$910.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$335.20
|
| Rate for Payer: HealthUtah PPO |
$958.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$929.26
|
| Rate for Payer: Multiplan Medicare/VA |
$284.92
|
| Rate for Payer: One Health Plan of WY PPO |
$938.84
|
| Rate for Payer: PacificSource Commercial |
$862.20
|
| Rate for Payer: PHCS PPO |
$910.10
|
| Rate for Payer: Three Rivers PPO |
$718.50
|
| Rate for Payer: TriWest Veterans Administration |
$335.20
|
| Rate for Payer: United Healthcare Commercial |
$833.46
|
| Rate for Payer: United Healthcare Medicare |
$335.20
|
| Rate for Payer: WINHealth Partners Commercial |
$814.30
|
|
|
HC PRO ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 28052
|
| Hospital Charge Code |
9822805201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$213.38 |
| Max. Negotiated Rate |
$1,355.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,327.90
|
| Rate for Payer: Aetna of WY Medicare |
$251.03
|
| Rate for Payer: Beech Street Commercial |
$1,287.25
|
| Rate for Payer: Cash Price |
$948.50
|
| Rate for Payer: Cash Price |
$948.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,314.35
|
| Rate for Payer: Cigna of WY Commercial |
$1,327.90
|
| Rate for Payer: First Choice Health Commercial |
$1,219.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,287.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$251.03
|
| Rate for Payer: HealthUtah PPO |
$1,355.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,314.35
|
| Rate for Payer: Multiplan Medicare/VA |
$213.38
|
| Rate for Payer: One Health Plan of WY PPO |
$1,327.90
|
| Rate for Payer: PacificSource Commercial |
$1,219.50
|
| Rate for Payer: PHCS PPO |
$1,287.25
|
| Rate for Payer: Three Rivers PPO |
$1,016.25
|
| Rate for Payer: TriWest Veterans Administration |
$251.03
|
| Rate for Payer: United Healthcare Commercial |
$1,178.85
|
| Rate for Payer: United Healthcare Medicare |
$251.03
|
| Rate for Payer: WINHealth Partners Commercial |
$1,151.75
|
|
|
HC PRO ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
|
Professional
|
Both
|
$1,692.00
|
|
|
Service Code
|
HCPCS 28022
|
| Hospital Charge Code |
9822802201
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$272.45 |
| Max. Negotiated Rate |
$1,692.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,658.16
|
| Rate for Payer: Aetna of WY Medicare |
$320.53
|
| Rate for Payer: Beech Street Commercial |
$1,607.40
|
| Rate for Payer: Cash Price |
$1,184.40
|
| Rate for Payer: Cash Price |
$1,184.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,641.24
|
| Rate for Payer: Cigna of WY Commercial |
$1,658.16
|
| Rate for Payer: First Choice Health Commercial |
$1,522.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,607.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$320.53
|
| Rate for Payer: HealthUtah PPO |
$1,692.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,641.24
|
| Rate for Payer: Multiplan Medicare/VA |
$272.45
|
| Rate for Payer: One Health Plan of WY PPO |
$1,658.16
|
| Rate for Payer: PacificSource Commercial |
$1,522.80
|
| Rate for Payer: PHCS PPO |
$1,607.40
|
| Rate for Payer: Three Rivers PPO |
$1,269.00
|
| Rate for Payer: TriWest Veterans Administration |
$320.53
|
| Rate for Payer: United Healthcare Commercial |
$1,472.04
|
| Rate for Payer: United Healthcare Medicare |
$320.53
|
| Rate for Payer: WINHealth Partners Commercial |
$1,438.20
|
|
|
HC PRO ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$2,083.00
|
|
|
Service Code
|
HCPCS 25101
|
| Hospital Charge Code |
9832510101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$341.00 |
| Max. Negotiated Rate |
$2,083.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,041.34
|
| Rate for Payer: Aetna of WY Medicare |
$401.18
|
| Rate for Payer: Beech Street Commercial |
$1,978.85
|
| Rate for Payer: Cash Price |
$1,458.10
|
| Rate for Payer: Cash Price |
$1,458.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,020.51
|
| Rate for Payer: Cigna of WY Commercial |
$2,041.34
|
| Rate for Payer: First Choice Health Commercial |
$1,874.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,978.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$401.18
|
| Rate for Payer: HealthUtah PPO |
$2,083.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,020.51
|
| Rate for Payer: Multiplan Medicare/VA |
$341.00
|
| Rate for Payer: One Health Plan of WY PPO |
$2,041.34
|
| Rate for Payer: PacificSource Commercial |
$1,874.70
|
| Rate for Payer: PHCS PPO |
$1,978.85
|
| Rate for Payer: Three Rivers PPO |
$1,562.25
|
| Rate for Payer: TriWest Veterans Administration |
$401.18
|
| Rate for Payer: United Healthcare Commercial |
$1,812.21
|
| Rate for Payer: United Healthcare Medicare |
$401.18
|
| Rate for Payer: WINHealth Partners Commercial |
$1,770.55
|
|
|
HC PRO ARTIF INSEMINATION,INTRA-UTERINE
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 58322
|
| Hospital Charge Code |
9835832201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$46.50 |
| Max. Negotiated Rate |
$386.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$378.28
|
| Rate for Payer: Aetna of WY Medicare |
$54.70
|
| Rate for Payer: Beech Street Commercial |
$366.70
|
| Rate for Payer: Cash Price |
$270.20
|
| Rate for Payer: Cash Price |
$270.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$374.42
|
| Rate for Payer: Cigna of WY Commercial |
$378.28
|
| Rate for Payer: First Choice Health Commercial |
$347.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$366.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.70
|
| Rate for Payer: HealthUtah PPO |
$386.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$374.42
|
| Rate for Payer: Multiplan Medicare/VA |
$46.50
|
| Rate for Payer: One Health Plan of WY PPO |
$378.28
|
| Rate for Payer: PacificSource Commercial |
$347.40
|
| Rate for Payer: PHCS PPO |
$366.70
|
| Rate for Payer: Three Rivers PPO |
$289.50
|
| Rate for Payer: TriWest Veterans Administration |
$54.70
|
| Rate for Payer: United Healthcare Commercial |
$335.82
|
| Rate for Payer: United Healthcare Medicare |
$54.70
|
| Rate for Payer: WINHealth Partners Commercial |
$328.10
|
|
|
HC PRO ARTIF INSEMINATION,INTRA-UTERINE
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 58322 NONPBBPAYER
|
| Hospital Charge Code |
9835832201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$46.50 |
| Max. Negotiated Rate |
$482.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$472.36
|
| Rate for Payer: Aetna of WY Medicare |
$54.70
|
| Rate for Payer: Beech Street Commercial |
$457.90
|
| Rate for Payer: Cash Price |
$337.40
|
| Rate for Payer: Cash Price |
$337.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$467.54
|
| Rate for Payer: Cigna of WY Commercial |
$472.36
|
| Rate for Payer: First Choice Health Commercial |
$433.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$457.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.70
|
| Rate for Payer: HealthUtah PPO |
$482.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$467.54
|
| Rate for Payer: Multiplan Medicare/VA |
$46.50
|
| Rate for Payer: One Health Plan of WY PPO |
$472.36
|
| Rate for Payer: PacificSource Commercial |
$433.80
|
| Rate for Payer: PHCS PPO |
$457.90
|
| Rate for Payer: Three Rivers PPO |
$361.50
|
| Rate for Payer: TriWest Veterans Administration |
$54.70
|
| Rate for Payer: United Healthcare Commercial |
$419.34
|
| Rate for Payer: United Healthcare Medicare |
$54.70
|
| Rate for Payer: WINHealth Partners Commercial |
$409.70
|
|
|
HC PRO ASPIRAT/INJECTION GANGLION CYST(S)
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 20612
|
| Hospital Charge Code |
9832061201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$33.51 |
| Max. Negotiated Rate |
$346.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$339.08
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$161.70
|
| Rate for Payer: Aetna of WY Medicare |
$39.42
|
| Rate for Payer: Aetna of WY Medicare |
$39.42
|
| Rate for Payer: Beech Street Commercial |
$156.75
|
| Rate for Payer: Beech Street Commercial |
$328.70
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Cash Price |
$242.20
|
| Rate for Payer: Cash Price |
$242.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$335.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$160.05
|
| Rate for Payer: Cigna of WY Commercial |
$161.70
|
| Rate for Payer: Cigna of WY Commercial |
$339.08
|
| Rate for Payer: First Choice Health Commercial |
$148.50
|
| Rate for Payer: First Choice Health Commercial |
$311.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$328.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$156.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.42
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.42
|
| Rate for Payer: HealthUtah PPO |
$346.00
|
| Rate for Payer: HealthUtah PPO |
$165.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$335.62
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$160.05
|
| Rate for Payer: Multiplan Medicare/VA |
$33.51
|
| Rate for Payer: Multiplan Medicare/VA |
$33.51
|
| Rate for Payer: One Health Plan of WY PPO |
$339.08
|
| Rate for Payer: One Health Plan of WY PPO |
$161.70
|
| Rate for Payer: PacificSource Commercial |
$148.50
|
| Rate for Payer: PacificSource Commercial |
$311.40
|
| Rate for Payer: PHCS PPO |
$328.70
|
| Rate for Payer: PHCS PPO |
$156.75
|
| Rate for Payer: Three Rivers PPO |
$259.50
|
| Rate for Payer: Three Rivers PPO |
$123.75
|
| Rate for Payer: TriWest Veterans Administration |
$39.42
|
| Rate for Payer: TriWest Veterans Administration |
$39.42
|
| Rate for Payer: United Healthcare Commercial |
$143.55
|
| Rate for Payer: United Healthcare Commercial |
$301.02
|
| Rate for Payer: United Healthcare Medicare |
$39.42
|
| Rate for Payer: United Healthcare Medicare |
$39.42
|
| Rate for Payer: WINHealth Partners Commercial |
$294.10
|
| Rate for Payer: WINHealth Partners Commercial |
$140.25
|
|
|
HC PRO ASPIRAT/INJECTION GANGLION CYST(S)
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 20612 NONPBBPAYER
|
| Hospital Charge Code |
9832061201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$33.51 |
| Max. Negotiated Rate |
$206.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$201.88
|
| Rate for Payer: Aetna of WY Medicare |
$39.42
|
| Rate for Payer: Beech Street Commercial |
$195.70
|
| Rate for Payer: Cash Price |
$144.20
|
| Rate for Payer: Cash Price |
$144.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$199.82
|
| Rate for Payer: Cigna of WY Commercial |
$201.88
|
| Rate for Payer: First Choice Health Commercial |
$185.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$195.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.42
|
| Rate for Payer: HealthUtah PPO |
$206.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$199.82
|
| Rate for Payer: Multiplan Medicare/VA |
$33.51
|
| Rate for Payer: One Health Plan of WY PPO |
$201.88
|
| Rate for Payer: PacificSource Commercial |
$185.40
|
| Rate for Payer: PHCS PPO |
$195.70
|
| Rate for Payer: Three Rivers PPO |
$154.50
|
| Rate for Payer: TriWest Veterans Administration |
$39.42
|
| Rate for Payer: United Healthcare Commercial |
$179.22
|
| Rate for Payer: United Healthcare Medicare |
$39.42
|
| Rate for Payer: WINHealth Partners Commercial |
$175.10
|
|
|
HC PRO ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 51102
|
| Hospital Charge Code |
9835110201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$115.20 |
| Max. Negotiated Rate |
$602.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$589.96
|
| Rate for Payer: Aetna of WY Medicare |
$135.53
|
| Rate for Payer: Beech Street Commercial |
$571.90
|
| Rate for Payer: Cash Price |
$421.40
|
| Rate for Payer: Cash Price |
$421.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$583.94
|
| Rate for Payer: Cigna of WY Commercial |
$589.96
|
| Rate for Payer: First Choice Health Commercial |
$541.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$571.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$135.53
|
| Rate for Payer: HealthUtah PPO |
$602.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$583.94
|
| Rate for Payer: Multiplan Medicare/VA |
$115.20
|
| Rate for Payer: One Health Plan of WY PPO |
$589.96
|
| Rate for Payer: PacificSource Commercial |
$541.80
|
| Rate for Payer: PHCS PPO |
$571.90
|
| Rate for Payer: Three Rivers PPO |
$451.50
|
| Rate for Payer: TriWest Veterans Administration |
$135.53
|
| Rate for Payer: United Healthcare Commercial |
$523.74
|
| Rate for Payer: United Healthcare Medicare |
$135.53
|
| Rate for Payer: WINHealth Partners Commercial |
$511.70
|
|
|
HC PRO ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 51102 NONPBBPAYER
|
| Hospital Charge Code |
9835110201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$115.20 |
| Max. Negotiated Rate |
$753.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$737.94
|
| Rate for Payer: Aetna of WY Medicare |
$135.53
|
| Rate for Payer: Beech Street Commercial |
$715.35
|
| Rate for Payer: Cash Price |
$527.10
|
| Rate for Payer: Cash Price |
$527.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$730.41
|
| Rate for Payer: Cigna of WY Commercial |
$737.94
|
| Rate for Payer: First Choice Health Commercial |
$677.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$715.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$135.53
|
| Rate for Payer: HealthUtah PPO |
$753.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$730.41
|
| Rate for Payer: Multiplan Medicare/VA |
$115.20
|
| Rate for Payer: One Health Plan of WY PPO |
$737.94
|
| Rate for Payer: PacificSource Commercial |
$677.70
|
| Rate for Payer: PHCS PPO |
$715.35
|
| Rate for Payer: Three Rivers PPO |
$564.75
|
| Rate for Payer: TriWest Veterans Administration |
$135.53
|
| Rate for Payer: United Healthcare Commercial |
$655.11
|
| Rate for Payer: United Healthcare Medicare |
$135.53
|
| Rate for Payer: WINHealth Partners Commercial |
$640.05
|
|
|
HC PRO ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 51100
|
| Hospital Charge Code |
9835110001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$31.56 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$202.86
|
| Rate for Payer: Aetna of WY Medicare |
$37.13
|
| Rate for Payer: Beech Street Commercial |
$196.65
|
| Rate for Payer: Cash Price |
$144.90
|
| Rate for Payer: Cash Price |
$144.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$200.79
|
| Rate for Payer: Cigna of WY Commercial |
$202.86
|
| Rate for Payer: First Choice Health Commercial |
$186.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$196.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$37.13
|
| Rate for Payer: HealthUtah PPO |
$207.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$200.79
|
| Rate for Payer: Multiplan Medicare/VA |
$31.56
|
| Rate for Payer: One Health Plan of WY PPO |
$202.86
|
| Rate for Payer: PacificSource Commercial |
$186.30
|
| Rate for Payer: PHCS PPO |
$196.65
|
| Rate for Payer: Three Rivers PPO |
$155.25
|
| Rate for Payer: TriWest Veterans Administration |
$37.13
|
| Rate for Payer: United Healthcare Commercial |
$180.09
|
| Rate for Payer: United Healthcare Medicare |
$37.13
|
| Rate for Payer: WINHealth Partners Commercial |
$175.95
|
|
|
HC PRO ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 51100 NONPBBPAYER
|
| Hospital Charge Code |
9835110001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$31.56 |
| Max. Negotiated Rate |
$259.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$253.82
|
| Rate for Payer: Aetna of WY Medicare |
$37.13
|
| Rate for Payer: Beech Street Commercial |
$246.05
|
| Rate for Payer: Cash Price |
$181.30
|
| Rate for Payer: Cash Price |
$181.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$251.23
|
| Rate for Payer: Cigna of WY Commercial |
$253.82
|
| Rate for Payer: First Choice Health Commercial |
$233.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$246.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$37.13
|
| Rate for Payer: HealthUtah PPO |
$259.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$251.23
|
| Rate for Payer: Multiplan Medicare/VA |
$31.56
|
| Rate for Payer: One Health Plan of WY PPO |
$253.82
|
| Rate for Payer: PacificSource Commercial |
$233.10
|
| Rate for Payer: PHCS PPO |
$246.05
|
| Rate for Payer: Three Rivers PPO |
$194.25
|
| Rate for Payer: TriWest Veterans Administration |
$37.13
|
| Rate for Payer: United Healthcare Commercial |
$225.33
|
| Rate for Payer: United Healthcare Medicare |
$37.13
|
| Rate for Payer: WINHealth Partners Commercial |
$220.15
|
|
|
HC PRO ASST DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,BONE,=<20 SQ CM
|
Professional
|
Both
|
$2,675.00
|
|
|
Service Code
|
HCPCS 11044
|
| Hospital Charge Code |
9831104402
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$182.24 |
| Max. Negotiated Rate |
$2,675.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,621.50
|
| Rate for Payer: Aetna of WY Medicare |
$214.40
|
| Rate for Payer: Beech Street Commercial |
$2,541.25
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,594.75
|
| Rate for Payer: Cigna of WY Commercial |
$2,621.50
|
| Rate for Payer: First Choice Health Commercial |
$2,407.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,541.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$214.40
|
| Rate for Payer: HealthUtah PPO |
$2,675.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,594.75
|
| Rate for Payer: Multiplan Medicare/VA |
$182.24
|
| Rate for Payer: One Health Plan of WY PPO |
$2,621.50
|
| Rate for Payer: PacificSource Commercial |
$2,407.50
|
| Rate for Payer: PHCS PPO |
$2,541.25
|
| Rate for Payer: Three Rivers PPO |
$2,006.25
|
| Rate for Payer: TriWest Veterans Administration |
$214.40
|
| Rate for Payer: United Healthcare Commercial |
$2,327.25
|
| Rate for Payer: United Healthcare Medicare |
$214.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2,273.75
|
|
|
HC PRO AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 11730 NONPBBPAYER
|
| Hospital Charge Code |
9831173001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$269.50
|
| Rate for Payer: Aetna of WY Medicare |
$51.62
|
| Rate for Payer: Beech Street Commercial |
$261.25
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$266.75
|
| Rate for Payer: Cigna of WY Commercial |
$269.50
|
| Rate for Payer: First Choice Health Commercial |
$247.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$261.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.62
|
| Rate for Payer: HealthUtah PPO |
$275.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$266.75
|
| Rate for Payer: Multiplan Medicare/VA |
$43.88
|
| Rate for Payer: One Health Plan of WY PPO |
$269.50
|
| Rate for Payer: PacificSource Commercial |
$247.50
|
| Rate for Payer: PHCS PPO |
$261.25
|
| Rate for Payer: Three Rivers PPO |
$206.25
|
| Rate for Payer: TriWest Veterans Administration |
$51.62
|
| Rate for Payer: United Healthcare Commercial |
$239.25
|
| Rate for Payer: United Healthcare Medicare |
$51.62
|
| Rate for Payer: WINHealth Partners Commercial |
$233.75
|
|
|
HC PRO AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
9831173001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$406.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$397.88
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$215.60
|
| Rate for Payer: Aetna of WY Medicare |
$51.62
|
| Rate for Payer: Aetna of WY Medicare |
$51.62
|
| Rate for Payer: Beech Street Commercial |
$209.00
|
| Rate for Payer: Beech Street Commercial |
$385.70
|
| Rate for Payer: Cash Price |
$154.00
|
| Rate for Payer: Cash Price |
$154.00
|
| Rate for Payer: Cash Price |
$284.20
|
| Rate for Payer: Cash Price |
$284.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$393.82
|
| Rate for Payer: ChoiceCare Network Commercial |
$213.40
|
| Rate for Payer: Cigna of WY Commercial |
$215.60
|
| Rate for Payer: Cigna of WY Commercial |
$397.88
|
| Rate for Payer: First Choice Health Commercial |
$198.00
|
| Rate for Payer: First Choice Health Commercial |
$365.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$385.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$209.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.62
|
| Rate for Payer: HealthUtah PPO |
$406.00
|
| Rate for Payer: HealthUtah PPO |
$220.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$393.82
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$213.40
|
| Rate for Payer: Multiplan Medicare/VA |
$43.88
|
| Rate for Payer: Multiplan Medicare/VA |
$43.88
|
| Rate for Payer: One Health Plan of WY PPO |
$397.88
|
| Rate for Payer: One Health Plan of WY PPO |
$215.60
|
| Rate for Payer: PacificSource Commercial |
$198.00
|
| Rate for Payer: PacificSource Commercial |
$365.40
|
| Rate for Payer: PHCS PPO |
$385.70
|
| Rate for Payer: PHCS PPO |
$209.00
|
| Rate for Payer: Three Rivers PPO |
$304.50
|
| Rate for Payer: Three Rivers PPO |
$165.00
|
| Rate for Payer: TriWest Veterans Administration |
$51.62
|
| Rate for Payer: TriWest Veterans Administration |
$51.62
|
| Rate for Payer: United Healthcare Commercial |
$191.40
|
| Rate for Payer: United Healthcare Commercial |
$353.22
|
| Rate for Payer: United Healthcare Medicare |
$51.62
|
| Rate for Payer: United Healthcare Medicare |
$51.62
|
| Rate for Payer: WINHealth Partners Commercial |
$345.10
|
| Rate for Payer: WINHealth Partners Commercial |
$187.00
|
|
