|
HC PRO CARDIAC STRESS TST XERS&/OR RX CONT ECG I&R ONLY
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 93018
|
| Hospital Charge Code |
9829301801
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$11.34 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$161.70
|
| Rate for Payer: Aetna of WY Medicare |
$13.34
|
| Rate for Payer: Beech Street Commercial |
$156.75
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$160.05
|
| Rate for Payer: Cigna of WY Commercial |
$161.70
|
| Rate for Payer: First Choice Health Commercial |
$148.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$156.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.34
|
| Rate for Payer: HealthUtah PPO |
$165.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$160.05
|
| Rate for Payer: Multiplan Medicare/VA |
$11.34
|
| Rate for Payer: One Health Plan of WY PPO |
$161.70
|
| Rate for Payer: PacificSource Commercial |
$148.50
|
| Rate for Payer: PHCS PPO |
$156.75
|
| Rate for Payer: Three Rivers PPO |
$123.75
|
| Rate for Payer: TriWest Veterans Administration |
$13.34
|
| Rate for Payer: United Healthcare Commercial |
$143.55
|
| Rate for Payer: United Healthcare Medicare |
$13.34
|
| Rate for Payer: WINHealth Partners Commercial |
$156.75
|
|
|
HC PRO CARDIAC STRESS TST XERS&/OR RX CONT ECG W/O I&R
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 93016
|
| Hospital Charge Code |
9829301601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$218.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$213.64
|
| Rate for Payer: Aetna of WY Medicare |
$20.22
|
| Rate for Payer: Beech Street Commercial |
$207.10
|
| Rate for Payer: Cash Price |
$152.60
|
| Rate for Payer: Cash Price |
$152.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$211.46
|
| Rate for Payer: Cigna of WY Commercial |
$213.64
|
| Rate for Payer: First Choice Health Commercial |
$196.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$207.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$20.22
|
| Rate for Payer: HealthUtah PPO |
$218.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$211.46
|
| Rate for Payer: Multiplan Medicare/VA |
$17.19
|
| Rate for Payer: One Health Plan of WY PPO |
$213.64
|
| Rate for Payer: PacificSource Commercial |
$196.20
|
| Rate for Payer: PHCS PPO |
$207.10
|
| Rate for Payer: Three Rivers PPO |
$163.50
|
| Rate for Payer: TriWest Veterans Administration |
$20.22
|
| Rate for Payer: United Healthcare Commercial |
$189.66
|
| Rate for Payer: United Healthcare Medicare |
$20.22
|
| Rate for Payer: WINHealth Partners Commercial |
$207.10
|
|
|
HC PRO CARDIAC STRESS TST XERS&/OR RX CONT ECG W/O I&R
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 93016
|
| Hospital Charge Code |
9839301601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$121.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$118.58
|
| Rate for Payer: Aetna of WY Medicare |
$20.22
|
| Rate for Payer: Beech Street Commercial |
$114.95
|
| Rate for Payer: Cash Price |
$84.70
|
| Rate for Payer: Cash Price |
$84.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$117.37
|
| Rate for Payer: Cigna of WY Commercial |
$118.58
|
| Rate for Payer: First Choice Health Commercial |
$108.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$114.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$20.22
|
| Rate for Payer: HealthUtah PPO |
$121.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$117.37
|
| Rate for Payer: Multiplan Medicare/VA |
$17.19
|
| Rate for Payer: One Health Plan of WY PPO |
$118.58
|
| Rate for Payer: PacificSource Commercial |
$108.90
|
| Rate for Payer: PHCS PPO |
$114.95
|
| Rate for Payer: Three Rivers PPO |
$90.75
|
| Rate for Payer: TriWest Veterans Administration |
$20.22
|
| Rate for Payer: United Healthcare Commercial |
$105.27
|
| Rate for Payer: United Healthcare Medicare |
$20.22
|
| Rate for Payer: WINHealth Partners Commercial |
$114.95
|
|
|
HC PRO CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL
|
Professional
|
Both
|
$1,025.00
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
9839296001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$87.41 |
| Max. Negotiated Rate |
$1,025.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,004.50
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$800.66
|
| Rate for Payer: Aetna of WY Medicare |
$102.84
|
| Rate for Payer: Aetna of WY Medicare |
$102.84
|
| Rate for Payer: Beech Street Commercial |
$973.75
|
| Rate for Payer: Beech Street Commercial |
$776.15
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cash Price |
$571.90
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cash Price |
$571.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$994.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$792.49
|
| Rate for Payer: Cigna of WY Commercial |
$800.66
|
| Rate for Payer: Cigna of WY Commercial |
$1,004.50
|
| Rate for Payer: First Choice Health Commercial |
$735.30
|
| Rate for Payer: First Choice Health Commercial |
$922.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$776.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$973.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$102.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$102.84
|
| Rate for Payer: HealthUtah PPO |
$1,025.00
|
| Rate for Payer: HealthUtah PPO |
$817.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$792.49
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$994.25
|
| Rate for Payer: Multiplan Medicare/VA |
$87.41
|
| Rate for Payer: Multiplan Medicare/VA |
$87.41
|
| Rate for Payer: One Health Plan of WY PPO |
$1,004.50
|
| Rate for Payer: One Health Plan of WY PPO |
$800.66
|
| Rate for Payer: PacificSource Commercial |
$735.30
|
| Rate for Payer: PacificSource Commercial |
$922.50
|
| Rate for Payer: PHCS PPO |
$776.15
|
| Rate for Payer: PHCS PPO |
$973.75
|
| Rate for Payer: Three Rivers PPO |
$612.75
|
| Rate for Payer: Three Rivers PPO |
$768.75
|
| Rate for Payer: TriWest Veterans Administration |
$102.84
|
| Rate for Payer: TriWest Veterans Administration |
$102.84
|
| Rate for Payer: United Healthcare Commercial |
$710.79
|
| Rate for Payer: United Healthcare Commercial |
$891.75
|
| Rate for Payer: United Healthcare Medicare |
$102.84
|
| Rate for Payer: United Healthcare Medicare |
$102.84
|
| Rate for Payer: WINHealth Partners Commercial |
$973.75
|
| Rate for Payer: WINHealth Partners Commercial |
$776.15
|
|
|
HC PRO CARPECTOMY 1 BONE
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 25210
|
| Hospital Charge Code |
9832521001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$412.89 |
| Max. Negotiated Rate |
$1,734.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,699.32
|
| Rate for Payer: Aetna of WY Medicare |
$485.75
|
| Rate for Payer: Beech Street Commercial |
$1,647.30
|
| Rate for Payer: Cash Price |
$1,213.80
|
| Rate for Payer: Cash Price |
$1,213.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,681.98
|
| Rate for Payer: Cigna of WY Commercial |
$1,699.32
|
| Rate for Payer: First Choice Health Commercial |
$1,560.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,647.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$485.75
|
| Rate for Payer: HealthUtah PPO |
$1,734.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,681.98
|
| Rate for Payer: Multiplan Medicare/VA |
$412.89
|
| Rate for Payer: One Health Plan of WY PPO |
$1,699.32
|
| Rate for Payer: PacificSource Commercial |
$1,560.60
|
| Rate for Payer: PHCS PPO |
$1,647.30
|
| Rate for Payer: Three Rivers PPO |
$1,300.50
|
| Rate for Payer: TriWest Veterans Administration |
$485.75
|
| Rate for Payer: United Healthcare Commercial |
$1,508.58
|
| Rate for Payer: United Healthcare Medicare |
$485.75
|
| Rate for Payer: WINHealth Partners Commercial |
$1,473.90
|
|
|
HC PRO CARPECTOMY ALL BONES PROXIMAL ROW
|
Professional
|
Both
|
$2,166.00
|
|
|
Service Code
|
HCPCS 25215
|
| Hospital Charge Code |
9832521501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$515.69 |
| Max. Negotiated Rate |
$2,166.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,122.68
|
| Rate for Payer: Aetna of WY Medicare |
$606.69
|
| Rate for Payer: Beech Street Commercial |
$2,057.70
|
| Rate for Payer: Cash Price |
$1,516.20
|
| Rate for Payer: Cash Price |
$1,516.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,101.02
|
| Rate for Payer: Cigna of WY Commercial |
$2,122.68
|
| Rate for Payer: First Choice Health Commercial |
$1,949.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,057.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$606.69
|
| Rate for Payer: HealthUtah PPO |
$2,166.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,101.02
|
| Rate for Payer: Multiplan Medicare/VA |
$515.69
|
| Rate for Payer: One Health Plan of WY PPO |
$2,122.68
|
| Rate for Payer: PacificSource Commercial |
$1,949.40
|
| Rate for Payer: PHCS PPO |
$2,057.70
|
| Rate for Payer: Three Rivers PPO |
$1,624.50
|
| Rate for Payer: TriWest Veterans Administration |
$606.69
|
| Rate for Payer: United Healthcare Commercial |
$1,884.42
|
| Rate for Payer: United Healthcare Medicare |
$606.69
|
| Rate for Payer: WINHealth Partners Commercial |
$1,841.10
|
|
|
HC PRO CA SCREEN;FLEXI SIGMOIDSCOPE
|
Professional
|
Both
|
$1,928.00
|
|
|
Service Code
|
HCPCS G0104
|
| Hospital Charge Code |
983G010401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$46.16 |
| Max. Negotiated Rate |
$1,928.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,889.44
|
| Rate for Payer: Aetna of WY Medicare |
$54.31
|
| Rate for Payer: Beech Street Commercial |
$1,831.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,870.16
|
| Rate for Payer: Cigna of WY Commercial |
$1,889.44
|
| Rate for Payer: First Choice Health Commercial |
$1,735.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,831.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.31
|
| Rate for Payer: HealthUtah PPO |
$1,928.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,870.16
|
| Rate for Payer: Multiplan Medicare/VA |
$46.16
|
| Rate for Payer: One Health Plan of WY PPO |
$1,889.44
|
| Rate for Payer: PacificSource Commercial |
$1,735.20
|
| Rate for Payer: PHCS PPO |
$1,831.60
|
| Rate for Payer: Three Rivers PPO |
$1,446.00
|
| Rate for Payer: TriWest Veterans Administration |
$54.31
|
| Rate for Payer: United Healthcare Commercial |
$1,677.36
|
| Rate for Payer: United Healthcare Medicare |
$54.31
|
| Rate for Payer: WINHealth Partners Commercial |
$1,831.60
|
|
|
HC PRO CATHJ UMBILICAL VEIN DX/THER NB
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 36510 NONPBBPAYER
|
| Hospital Charge Code |
9833651001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$43.11 |
| Max. Negotiated Rate |
$278.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$272.44
|
| Rate for Payer: Aetna of WY Medicare |
$50.72
|
| Rate for Payer: Beech Street Commercial |
$264.10
|
| Rate for Payer: Cash Price |
$194.60
|
| Rate for Payer: Cash Price |
$194.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$269.66
|
| Rate for Payer: Cigna of WY Commercial |
$272.44
|
| Rate for Payer: First Choice Health Commercial |
$250.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$264.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.72
|
| Rate for Payer: HealthUtah PPO |
$278.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$269.66
|
| Rate for Payer: Multiplan Medicare/VA |
$43.11
|
| Rate for Payer: One Health Plan of WY PPO |
$272.44
|
| Rate for Payer: PacificSource Commercial |
$250.20
|
| Rate for Payer: PHCS PPO |
$264.10
|
| Rate for Payer: Three Rivers PPO |
$208.50
|
| Rate for Payer: TriWest Veterans Administration |
$50.72
|
| Rate for Payer: United Healthcare Commercial |
$241.86
|
| Rate for Payer: United Healthcare Medicare |
$50.72
|
| Rate for Payer: WINHealth Partners Commercial |
$236.30
|
|
|
HC PRO CATHJ UMBILICAL VEIN DX/THER NB
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 36510
|
| Hospital Charge Code |
9833651001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$43.11 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$217.56
|
| Rate for Payer: Aetna of WY Medicare |
$50.72
|
| Rate for Payer: Beech Street Commercial |
$210.90
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$215.34
|
| Rate for Payer: Cigna of WY Commercial |
$217.56
|
| Rate for Payer: First Choice Health Commercial |
$199.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$210.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.72
|
| Rate for Payer: HealthUtah PPO |
$222.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$215.34
|
| Rate for Payer: Multiplan Medicare/VA |
$43.11
|
| Rate for Payer: One Health Plan of WY PPO |
$217.56
|
| Rate for Payer: PacificSource Commercial |
$199.80
|
| Rate for Payer: PHCS PPO |
$210.90
|
| Rate for Payer: Three Rivers PPO |
$166.50
|
| Rate for Payer: TriWest Veterans Administration |
$50.72
|
| Rate for Payer: United Healthcare Commercial |
$193.14
|
| Rate for Payer: United Healthcare Medicare |
$50.72
|
| Rate for Payer: WINHealth Partners Commercial |
$188.70
|
|
|
HC PRO CATH PLACE CATH IN VEIN,SELECT
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 36011
|
| Hospital Charge Code |
9833601101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$122.86 |
| Max. Negotiated Rate |
$593.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$581.14
|
| Rate for Payer: Aetna of WY Medicare |
$144.54
|
| Rate for Payer: Beech Street Commercial |
$563.35
|
| Rate for Payer: Cash Price |
$415.10
|
| Rate for Payer: Cash Price |
$415.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$575.21
|
| Rate for Payer: Cigna of WY Commercial |
$581.14
|
| Rate for Payer: First Choice Health Commercial |
$533.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$563.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$144.54
|
| Rate for Payer: HealthUtah PPO |
$593.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$575.21
|
| Rate for Payer: Multiplan Medicare/VA |
$122.86
|
| Rate for Payer: One Health Plan of WY PPO |
$581.14
|
| Rate for Payer: PacificSource Commercial |
$533.70
|
| Rate for Payer: PHCS PPO |
$563.35
|
| Rate for Payer: Three Rivers PPO |
$444.75
|
| Rate for Payer: TriWest Veterans Administration |
$144.54
|
| Rate for Payer: United Healthcare Commercial |
$515.91
|
| Rate for Payer: United Healthcare Medicare |
$144.54
|
| Rate for Payer: WINHealth Partners Commercial |
$504.05
|
|
|
HC PRO CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI
|
Professional
|
Both
|
$436.00
|
|
|
Service Code
|
HCPCS 58340
|
| Hospital Charge Code |
9835834001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$47.13 |
| Max. Negotiated Rate |
$436.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$427.28
|
| Rate for Payer: Aetna of WY Medicare |
$55.45
|
| Rate for Payer: Beech Street Commercial |
$414.20
|
| Rate for Payer: Cash Price |
$305.20
|
| Rate for Payer: Cash Price |
$305.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$422.92
|
| Rate for Payer: Cigna of WY Commercial |
$427.28
|
| Rate for Payer: First Choice Health Commercial |
$392.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$414.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$55.45
|
| Rate for Payer: HealthUtah PPO |
$436.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$422.92
|
| Rate for Payer: Multiplan Medicare/VA |
$47.13
|
| Rate for Payer: One Health Plan of WY PPO |
$427.28
|
| Rate for Payer: PacificSource Commercial |
$392.40
|
| Rate for Payer: PHCS PPO |
$414.20
|
| Rate for Payer: Three Rivers PPO |
$327.00
|
| Rate for Payer: TriWest Veterans Administration |
$55.45
|
| Rate for Payer: United Healthcare Commercial |
$379.32
|
| Rate for Payer: United Healthcare Medicare |
$55.45
|
| Rate for Payer: WINHealth Partners Commercial |
$370.60
|
|
|
HC PRO CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
HCPCS 58340 NONPBBPAYER
|
| Hospital Charge Code |
9835834001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$47.13 |
| Max. Negotiated Rate |
$545.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$534.10
|
| Rate for Payer: Aetna of WY Medicare |
$55.45
|
| Rate for Payer: Beech Street Commercial |
$517.75
|
| Rate for Payer: Cash Price |
$381.50
|
| Rate for Payer: Cash Price |
$381.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$528.65
|
| Rate for Payer: Cigna of WY Commercial |
$534.10
|
| Rate for Payer: First Choice Health Commercial |
$490.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$517.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$55.45
|
| Rate for Payer: HealthUtah PPO |
$545.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$528.65
|
| Rate for Payer: Multiplan Medicare/VA |
$47.13
|
| Rate for Payer: One Health Plan of WY PPO |
$534.10
|
| Rate for Payer: PacificSource Commercial |
$490.50
|
| Rate for Payer: PHCS PPO |
$517.75
|
| Rate for Payer: Three Rivers PPO |
$408.75
|
| Rate for Payer: TriWest Veterans Administration |
$55.45
|
| Rate for Payer: United Healthcare Commercial |
$474.15
|
| Rate for Payer: United Healthcare Medicare |
$55.45
|
| Rate for Payer: WINHealth Partners Commercial |
$463.25
|
|
|
HC PRO CAUTERIZATION OF CERVIX
|
Professional
|
Both
|
$2,008.00
|
|
|
Service Code
|
HCPCS 57510 NONPBBPAYER
|
| Hospital Charge Code |
9835751001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$92.58 |
| Max. Negotiated Rate |
$2,008.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,967.84
|
| Rate for Payer: Aetna of WY Medicare |
$108.92
|
| Rate for Payer: Beech Street Commercial |
$1,907.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,947.76
|
| Rate for Payer: Cigna of WY Commercial |
$1,967.84
|
| Rate for Payer: First Choice Health Commercial |
$1,807.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,907.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$108.92
|
| Rate for Payer: HealthUtah PPO |
$2,008.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,947.76
|
| Rate for Payer: Multiplan Medicare/VA |
$92.58
|
| Rate for Payer: One Health Plan of WY PPO |
$1,967.84
|
| Rate for Payer: PacificSource Commercial |
$1,807.20
|
| Rate for Payer: PHCS PPO |
$1,907.60
|
| Rate for Payer: Three Rivers PPO |
$1,506.00
|
| Rate for Payer: TriWest Veterans Administration |
$108.92
|
| Rate for Payer: United Healthcare Commercial |
$1,746.96
|
| Rate for Payer: United Healthcare Medicare |
$108.92
|
| Rate for Payer: WINHealth Partners Commercial |
$1,706.80
|
|
|
HC PRO CAUTERIZATION OF CERVIX
|
Professional
|
Both
|
$1,606.00
|
|
|
Service Code
|
HCPCS 57510
|
| Hospital Charge Code |
9835751001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$92.58 |
| Max. Negotiated Rate |
$1,606.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,573.88
|
| Rate for Payer: Aetna of WY Medicare |
$108.92
|
| Rate for Payer: Beech Street Commercial |
$1,525.70
|
| Rate for Payer: Cash Price |
$1,124.20
|
| Rate for Payer: Cash Price |
$1,124.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,557.82
|
| Rate for Payer: Cigna of WY Commercial |
$1,573.88
|
| Rate for Payer: First Choice Health Commercial |
$1,445.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,525.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$108.92
|
| Rate for Payer: HealthUtah PPO |
$1,606.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,557.82
|
| Rate for Payer: Multiplan Medicare/VA |
$92.58
|
| Rate for Payer: One Health Plan of WY PPO |
$1,573.88
|
| Rate for Payer: PacificSource Commercial |
$1,445.40
|
| Rate for Payer: PHCS PPO |
$1,525.70
|
| Rate for Payer: Three Rivers PPO |
$1,204.50
|
| Rate for Payer: TriWest Veterans Administration |
$108.92
|
| Rate for Payer: United Healthcare Commercial |
$1,397.22
|
| Rate for Payer: United Healthcare Medicare |
$108.92
|
| Rate for Payer: WINHealth Partners Commercial |
$1,365.10
|
|
|
HC PRO CEPHALIC VERSION EXTERNAL
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 59412
|
| Hospital Charge Code |
9835941201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$82.23 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$303.80
|
| Rate for Payer: Aetna of WY Medicare |
$96.74
|
| Rate for Payer: Beech Street Commercial |
$294.50
|
| Rate for Payer: Cash Price |
$217.00
|
| Rate for Payer: Cash Price |
$217.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$300.70
|
| Rate for Payer: Cigna of WY Commercial |
$303.80
|
| Rate for Payer: First Choice Health Commercial |
$279.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$294.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$96.74
|
| Rate for Payer: HealthUtah PPO |
$310.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$300.70
|
| Rate for Payer: Multiplan Medicare/VA |
$82.23
|
| Rate for Payer: One Health Plan of WY PPO |
$303.80
|
| Rate for Payer: PacificSource Commercial |
$279.00
|
| Rate for Payer: PHCS PPO |
$294.50
|
| Rate for Payer: Three Rivers PPO |
$232.50
|
| Rate for Payer: TriWest Veterans Administration |
$96.74
|
| Rate for Payer: United Healthcare Commercial |
$269.70
|
| Rate for Payer: United Healthcare Medicare |
$96.74
|
| Rate for Payer: WINHealth Partners Commercial |
$263.50
|
|
|
HC PRO CERCLAGE CERVIX PREGNANCY VAGINAL
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 59320
|
| Hospital Charge Code |
9825932001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$121.46 |
| Max. Negotiated Rate |
$365.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$357.70
|
| Rate for Payer: Aetna of WY Medicare |
$142.90
|
| Rate for Payer: Beech Street Commercial |
$346.75
|
| Rate for Payer: Cash Price |
$255.50
|
| Rate for Payer: Cash Price |
$255.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$354.05
|
| Rate for Payer: Cigna of WY Commercial |
$357.70
|
| Rate for Payer: First Choice Health Commercial |
$328.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$346.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$142.90
|
| Rate for Payer: HealthUtah PPO |
$365.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$354.05
|
| Rate for Payer: Multiplan Medicare/VA |
$121.46
|
| Rate for Payer: One Health Plan of WY PPO |
$357.70
|
| Rate for Payer: PacificSource Commercial |
$328.50
|
| Rate for Payer: PHCS PPO |
$346.75
|
| Rate for Payer: Three Rivers PPO |
$273.75
|
| Rate for Payer: TriWest Veterans Administration |
$142.90
|
| Rate for Payer: United Healthcare Commercial |
$317.55
|
| Rate for Payer: United Healthcare Medicare |
$142.90
|
| Rate for Payer: WINHealth Partners Commercial |
$310.25
|
|
|
HC PRO CERVICAL ARTIFICIAL DISKECTOMY
|
Professional
|
Both
|
$6,594.00
|
|
|
Service Code
|
HCPCS 22856
|
| Hospital Charge Code |
9832285601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$4,945.50 |
| Max. Negotiated Rate |
$6,594.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,462.12
|
| Rate for Payer: Beech Street Commercial |
$6,264.30
|
| Rate for Payer: Cash Price |
$4,615.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,396.18
|
| Rate for Payer: Cigna of WY Commercial |
$6,462.12
|
| Rate for Payer: First Choice Health Commercial |
$5,934.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,264.30
|
| Rate for Payer: HealthUtah PPO |
$6,594.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,396.18
|
| Rate for Payer: One Health Plan of WY PPO |
$6,462.12
|
| Rate for Payer: PacificSource Commercial |
$5,934.60
|
| Rate for Payer: PHCS PPO |
$6,264.30
|
| Rate for Payer: Three Rivers PPO |
$4,945.50
|
| Rate for Payer: United Healthcare Commercial |
$5,736.78
|
| Rate for Payer: WINHealth Partners Commercial |
$5,604.90
|
|
|
HC PRO CESAREAN DELIVERY ONLY
|
Professional
|
Both
|
$2,745.00
|
|
|
Service Code
|
HCPCS 59514
|
| Hospital Charge Code |
9835951401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$723.15 |
| Max. Negotiated Rate |
$2,690.10 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,690.10
|
| Rate for Payer: Aetna of WY Medicare |
$850.77
|
| Rate for Payer: Beech Street Commercial |
$2,607.75
|
| Rate for Payer: Cash Price |
$1,921.50
|
| Rate for Payer: Cash Price |
$1,921.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,662.65
|
| Rate for Payer: Cigna of WY Commercial |
$2,690.10
|
| Rate for Payer: First Choice Health Commercial |
$2,470.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,607.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$850.77
|
| Rate for Payer: HealthUtah PPO |
$1,762.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,662.65
|
| Rate for Payer: Multiplan Medicare/VA |
$723.15
|
| Rate for Payer: One Health Plan of WY PPO |
$2,690.10
|
| Rate for Payer: PacificSource Commercial |
$2,470.50
|
| Rate for Payer: PHCS PPO |
$2,607.75
|
| Rate for Payer: Three Rivers PPO |
$2,058.75
|
| Rate for Payer: TriWest Veterans Administration |
$850.77
|
| Rate for Payer: United Healthcare Commercial |
$2,388.15
|
| Rate for Payer: United Healthcare Medicare |
$850.77
|
| Rate for Payer: WINHealth Partners Commercial |
$2,333.25
|
|
|
HC PRO CESAREAN DELIVERY ONLY W/POSTPARTUM CARE
|
Professional
|
Both
|
$3,811.00
|
|
|
Service Code
|
HCPCS 59515
|
| Hospital Charge Code |
9835951501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,073.55 |
| Max. Negotiated Rate |
$3,811.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,734.78
|
| Rate for Payer: Aetna of WY Medicare |
$1,263.00
|
| Rate for Payer: Beech Street Commercial |
$3,620.45
|
| Rate for Payer: Cash Price |
$2,667.70
|
| Rate for Payer: Cash Price |
$2,667.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,696.67
|
| Rate for Payer: Cigna of WY Commercial |
$3,734.78
|
| Rate for Payer: First Choice Health Commercial |
$3,429.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,620.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,263.00
|
| Rate for Payer: HealthUtah PPO |
$3,811.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,696.67
|
| Rate for Payer: Multiplan Medicare/VA |
$1,073.55
|
| Rate for Payer: One Health Plan of WY PPO |
$3,734.78
|
| Rate for Payer: PacificSource Commercial |
$3,429.90
|
| Rate for Payer: PHCS PPO |
$3,620.45
|
| Rate for Payer: Three Rivers PPO |
$2,858.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,263.00
|
| Rate for Payer: United Healthcare Commercial |
$3,315.57
|
| Rate for Payer: United Healthcare Medicare |
$1,263.00
|
| Rate for Payer: WINHealth Partners Commercial |
$3,239.35
|
|
|
HC PRO CESAREAN DELIVERY/PRE & POST PARTUM
|
Professional
|
Both
|
$7,066.00
|
|
|
Service Code
|
HCPCS 59510
|
| Hospital Charge Code |
9835951001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$2,168.44 |
| Max. Negotiated Rate |
$6,924.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,924.68
|
| Rate for Payer: Aetna of WY Medicare |
$2,551.10
|
| Rate for Payer: Beech Street Commercial |
$6,712.70
|
| Rate for Payer: Cash Price |
$4,946.20
|
| Rate for Payer: Cash Price |
$4,946.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,854.02
|
| Rate for Payer: Cigna of WY Commercial |
$6,924.68
|
| Rate for Payer: First Choice Health Commercial |
$6,359.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,712.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,551.10
|
| Rate for Payer: HealthUtah PPO |
$2,765.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,854.02
|
| Rate for Payer: Multiplan Medicare/VA |
$2,168.44
|
| Rate for Payer: One Health Plan of WY PPO |
$6,924.68
|
| Rate for Payer: PacificSource Commercial |
$6,359.40
|
| Rate for Payer: PHCS PPO |
$6,712.70
|
| Rate for Payer: Three Rivers PPO |
$5,299.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,551.10
|
| Rate for Payer: United Healthcare Commercial |
$6,147.42
|
| Rate for Payer: United Healthcare Medicare |
$2,551.10
|
| Rate for Payer: WINHealth Partners Commercial |
$6,006.10
|
|
|
HC PRO CHANGE OF BLADDER TUBE,SIMPLE
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
9835170501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$42.07 |
| Max. Negotiated Rate |
$407.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$398.86
|
| Rate for Payer: Aetna of WY Medicare |
$49.49
|
| Rate for Payer: Beech Street Commercial |
$386.65
|
| Rate for Payer: Cash Price |
$284.90
|
| Rate for Payer: Cash Price |
$284.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$394.79
|
| Rate for Payer: Cigna of WY Commercial |
$398.86
|
| Rate for Payer: First Choice Health Commercial |
$366.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$386.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$49.49
|
| Rate for Payer: HealthUtah PPO |
$407.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$394.79
|
| Rate for Payer: Multiplan Medicare/VA |
$42.07
|
| Rate for Payer: One Health Plan of WY PPO |
$398.86
|
| Rate for Payer: PacificSource Commercial |
$366.30
|
| Rate for Payer: PHCS PPO |
$386.65
|
| Rate for Payer: Three Rivers PPO |
$305.25
|
| Rate for Payer: TriWest Veterans Administration |
$49.49
|
| Rate for Payer: United Healthcare Commercial |
$354.09
|
| Rate for Payer: United Healthcare Medicare |
$49.49
|
| Rate for Payer: WINHealth Partners Commercial |
$345.95
|
|
|
HC PRO CHEMICAL CAUTERIZATION OF GRANULATION TISSUE
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 17250
|
| Hospital Charge Code |
9831725001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$30.87 |
| Max. Negotiated Rate |
$148.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$145.04
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$297.92
|
| Rate for Payer: Aetna of WY Medicare |
$36.32
|
| Rate for Payer: Aetna of WY Medicare |
$36.32
|
| Rate for Payer: Beech Street Commercial |
$288.80
|
| Rate for Payer: Beech Street Commercial |
$140.60
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$103.60
|
| Rate for Payer: Cash Price |
$103.60
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$294.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$143.56
|
| Rate for Payer: Cigna of WY Commercial |
$145.04
|
| Rate for Payer: Cigna of WY Commercial |
$297.92
|
| Rate for Payer: First Choice Health Commercial |
$273.60
|
| Rate for Payer: First Choice Health Commercial |
$133.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$140.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$288.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$36.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$36.32
|
| Rate for Payer: HealthUtah PPO |
$148.00
|
| Rate for Payer: HealthUtah PPO |
$304.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$294.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$143.56
|
| Rate for Payer: Multiplan Medicare/VA |
$30.87
|
| Rate for Payer: Multiplan Medicare/VA |
$30.87
|
| Rate for Payer: One Health Plan of WY PPO |
$297.92
|
| Rate for Payer: One Health Plan of WY PPO |
$145.04
|
| Rate for Payer: PacificSource Commercial |
$133.20
|
| Rate for Payer: PacificSource Commercial |
$273.60
|
| Rate for Payer: PHCS PPO |
$140.60
|
| Rate for Payer: PHCS PPO |
$288.80
|
| Rate for Payer: Three Rivers PPO |
$111.00
|
| Rate for Payer: Three Rivers PPO |
$228.00
|
| Rate for Payer: TriWest Veterans Administration |
$36.32
|
| Rate for Payer: TriWest Veterans Administration |
$36.32
|
| Rate for Payer: United Healthcare Commercial |
$264.48
|
| Rate for Payer: United Healthcare Commercial |
$128.76
|
| Rate for Payer: United Healthcare Medicare |
$36.32
|
| Rate for Payer: United Healthcare Medicare |
$36.32
|
| Rate for Payer: WINHealth Partners Commercial |
$125.80
|
| Rate for Payer: WINHealth Partners Commercial |
$258.40
|
|
|
HC PRO CHEMICAL CAUTERIZATION OF GRANULATION TISSUE
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 17250 NONPBBPAYER
|
| Hospital Charge Code |
9831725001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$30.87 |
| Max. Negotiated Rate |
$185.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$181.30
|
| Rate for Payer: Aetna of WY Medicare |
$36.32
|
| Rate for Payer: Beech Street Commercial |
$175.75
|
| Rate for Payer: Cash Price |
$129.50
|
| Rate for Payer: Cash Price |
$129.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$179.45
|
| Rate for Payer: Cigna of WY Commercial |
$181.30
|
| Rate for Payer: First Choice Health Commercial |
$166.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$175.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$36.32
|
| Rate for Payer: HealthUtah PPO |
$185.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$179.45
|
| Rate for Payer: Multiplan Medicare/VA |
$30.87
|
| Rate for Payer: One Health Plan of WY PPO |
$181.30
|
| Rate for Payer: PacificSource Commercial |
$166.50
|
| Rate for Payer: PHCS PPO |
$175.75
|
| Rate for Payer: Three Rivers PPO |
$138.75
|
| Rate for Payer: TriWest Veterans Administration |
$36.32
|
| Rate for Payer: United Healthcare Commercial |
$160.95
|
| Rate for Payer: United Healthcare Medicare |
$36.32
|
| Rate for Payer: WINHealth Partners Commercial |
$157.25
|
|
|
HC PRO CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 64643
|
| Hospital Charge Code |
9836464301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$56.42 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$359.66
|
| Rate for Payer: Aetna of WY Medicare |
$66.38
|
| Rate for Payer: Beech Street Commercial |
$348.65
|
| Rate for Payer: Cash Price |
$256.90
|
| Rate for Payer: Cash Price |
$256.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$355.99
|
| Rate for Payer: Cigna of WY Commercial |
$359.66
|
| Rate for Payer: First Choice Health Commercial |
$330.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$348.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$66.38
|
| Rate for Payer: HealthUtah PPO |
$367.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$355.99
|
| Rate for Payer: Multiplan Medicare/VA |
$56.42
|
| Rate for Payer: One Health Plan of WY PPO |
$359.66
|
| Rate for Payer: PacificSource Commercial |
$330.30
|
| Rate for Payer: PHCS PPO |
$348.65
|
| Rate for Payer: Three Rivers PPO |
$275.25
|
| Rate for Payer: TriWest Veterans Administration |
$66.38
|
| Rate for Payer: United Healthcare Commercial |
$319.29
|
| Rate for Payer: United Healthcare Medicare |
$66.38
|
| Rate for Payer: WINHealth Partners Commercial |
$311.95
|
|
|
HC PRO CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 64646
|
| Hospital Charge Code |
9826464601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$93.58 |
| Max. Negotiated Rate |
$736.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$721.28
|
| Rate for Payer: Aetna of WY Medicare |
$110.09
|
| Rate for Payer: Beech Street Commercial |
$699.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$713.92
|
| Rate for Payer: Cigna of WY Commercial |
$721.28
|
| Rate for Payer: First Choice Health Commercial |
$662.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$699.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$110.09
|
| Rate for Payer: HealthUtah PPO |
$736.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$713.92
|
| Rate for Payer: Multiplan Medicare/VA |
$93.58
|
| Rate for Payer: One Health Plan of WY PPO |
$721.28
|
| Rate for Payer: PacificSource Commercial |
$662.40
|
| Rate for Payer: PHCS PPO |
$699.20
|
| Rate for Payer: Three Rivers PPO |
$552.00
|
| Rate for Payer: TriWest Veterans Administration |
$110.09
|
| Rate for Payer: United Healthcare Commercial |
$640.32
|
| Rate for Payer: United Healthcare Medicare |
$110.09
|
| Rate for Payer: WINHealth Partners Commercial |
$625.60
|
|
