|
HC PRO INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 20650 NONPBBPAYER
|
| Hospital Charge Code |
9832065001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$138.14 |
| Max. Negotiated Rate |
$808.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$791.84
|
| Rate for Payer: Aetna of WY Medicare |
$162.52
|
| Rate for Payer: Beech Street Commercial |
$767.60
|
| Rate for Payer: Cash Price |
$565.60
|
| Rate for Payer: Cash Price |
$565.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$783.76
|
| Rate for Payer: Cigna of WY Commercial |
$791.84
|
| Rate for Payer: First Choice Health Commercial |
$727.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$767.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$162.52
|
| Rate for Payer: HealthUtah PPO |
$808.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$783.76
|
| Rate for Payer: Multiplan Medicare/VA |
$138.14
|
| Rate for Payer: One Health Plan of WY PPO |
$791.84
|
| Rate for Payer: PacificSource Commercial |
$727.20
|
| Rate for Payer: PHCS PPO |
$767.60
|
| Rate for Payer: Three Rivers PPO |
$606.00
|
| Rate for Payer: TriWest Veterans Administration |
$162.52
|
| Rate for Payer: United Healthcare Commercial |
$702.96
|
| Rate for Payer: United Healthcare Medicare |
$162.52
|
| Rate for Payer: WINHealth Partners Commercial |
$686.80
|
|
|
HC PRO INSERT NASAL SEPTAL BUTTON
|
Professional
|
Both
|
$1,064.00
|
|
|
Service Code
|
HCPCS 30220
|
| Hospital Charge Code |
9833022001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$106.60 |
| Max. Negotiated Rate |
$1,064.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,042.72
|
| Rate for Payer: Aetna of WY Medicare |
$125.41
|
| Rate for Payer: Beech Street Commercial |
$1,010.80
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,032.08
|
| Rate for Payer: Cigna of WY Commercial |
$1,042.72
|
| Rate for Payer: First Choice Health Commercial |
$957.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,010.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$125.41
|
| Rate for Payer: HealthUtah PPO |
$1,064.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,032.08
|
| Rate for Payer: Multiplan Medicare/VA |
$106.60
|
| Rate for Payer: One Health Plan of WY PPO |
$1,042.72
|
| Rate for Payer: PacificSource Commercial |
$957.60
|
| Rate for Payer: PHCS PPO |
$1,010.80
|
| Rate for Payer: Three Rivers PPO |
$798.00
|
| Rate for Payer: TriWest Veterans Administration |
$125.41
|
| Rate for Payer: United Healthcare Commercial |
$925.68
|
| Rate for Payer: United Healthcare Medicare |
$125.41
|
| Rate for Payer: WINHealth Partners Commercial |
$904.40
|
|
|
HC PRO INSERT NEEDLE,INTRAOSSEOUS INFUSN
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 36680 NONPBBPAYER
|
| Hospital Charge Code |
9833668001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$47.67 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$303.80
|
| Rate for Payer: Aetna of WY Medicare |
$56.08
|
| 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 |
$56.08
|
| Rate for Payer: HealthUtah PPO |
$310.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$300.70
|
| Rate for Payer: Multiplan Medicare/VA |
$47.67
|
| 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 |
$56.08
|
| Rate for Payer: United Healthcare Commercial |
$269.70
|
| Rate for Payer: United Healthcare Medicare |
$56.08
|
| Rate for Payer: WINHealth Partners Commercial |
$263.50
|
|
|
HC PRO INSERT NEEDLE,INTRAOSSEOUS INFUSN
|
Professional
|
Both
|
$1,422.00
|
|
|
Service Code
|
HCPCS 36680
|
| Hospital Charge Code |
9833668001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$47.67 |
| Max. Negotiated Rate |
$1,422.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,393.56
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$243.04
|
| Rate for Payer: Aetna of WY Medicare |
$56.08
|
| Rate for Payer: Aetna of WY Medicare |
$56.08
|
| Rate for Payer: Beech Street Commercial |
$235.60
|
| Rate for Payer: Beech Street Commercial |
$1,350.90
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$995.40
|
| Rate for Payer: Cash Price |
$995.40
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$240.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,379.34
|
| Rate for Payer: Cigna of WY Commercial |
$1,393.56
|
| Rate for Payer: Cigna of WY Commercial |
$243.04
|
| Rate for Payer: First Choice Health Commercial |
$223.20
|
| Rate for Payer: First Choice Health Commercial |
$1,279.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,350.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$235.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$56.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$56.08
|
| Rate for Payer: HealthUtah PPO |
$1,422.00
|
| Rate for Payer: HealthUtah PPO |
$248.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$240.56
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,379.34
|
| Rate for Payer: Multiplan Medicare/VA |
$47.67
|
| Rate for Payer: Multiplan Medicare/VA |
$47.67
|
| Rate for Payer: One Health Plan of WY PPO |
$243.04
|
| Rate for Payer: One Health Plan of WY PPO |
$1,393.56
|
| Rate for Payer: PacificSource Commercial |
$1,279.80
|
| Rate for Payer: PacificSource Commercial |
$223.20
|
| Rate for Payer: PHCS PPO |
$1,350.90
|
| Rate for Payer: PHCS PPO |
$235.60
|
| Rate for Payer: Three Rivers PPO |
$1,066.50
|
| Rate for Payer: Three Rivers PPO |
$186.00
|
| Rate for Payer: TriWest Veterans Administration |
$56.08
|
| Rate for Payer: TriWest Veterans Administration |
$56.08
|
| Rate for Payer: United Healthcare Commercial |
$215.76
|
| Rate for Payer: United Healthcare Commercial |
$1,237.14
|
| Rate for Payer: United Healthcare Medicare |
$56.08
|
| Rate for Payer: United Healthcare Medicare |
$56.08
|
| Rate for Payer: WINHealth Partners Commercial |
$1,208.70
|
| Rate for Payer: WINHealth Partners Commercial |
$210.80
|
|
|
HC PRO INSERT,NON-INDWELLING BLADDER CATHETER
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 51701 NONPBBPAYER
|
| Hospital Charge Code |
9835170101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$20.65 |
| Max. Negotiated Rate |
$136.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$133.28
|
| Rate for Payer: Aetna of WY Medicare |
$24.29
|
| Rate for Payer: Beech Street Commercial |
$129.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$131.92
|
| Rate for Payer: Cigna of WY Commercial |
$133.28
|
| Rate for Payer: First Choice Health Commercial |
$122.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$129.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.29
|
| Rate for Payer: HealthUtah PPO |
$136.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$131.92
|
| Rate for Payer: Multiplan Medicare/VA |
$20.65
|
| Rate for Payer: One Health Plan of WY PPO |
$133.28
|
| Rate for Payer: PacificSource Commercial |
$122.40
|
| Rate for Payer: PHCS PPO |
$129.20
|
| Rate for Payer: Three Rivers PPO |
$102.00
|
| Rate for Payer: TriWest Veterans Administration |
$24.29
|
| Rate for Payer: United Healthcare Commercial |
$118.32
|
| Rate for Payer: United Healthcare Medicare |
$24.29
|
| Rate for Payer: WINHealth Partners Commercial |
$115.60
|
|
|
HC PRO INSERT,NON-INDWELLING BLADDER CATHETER
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
HCPCS 51701
|
| Hospital Charge Code |
9835170101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$20.65 |
| Max. Negotiated Rate |
$109.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$106.82
|
| Rate for Payer: Aetna of WY Medicare |
$24.29
|
| Rate for Payer: Beech Street Commercial |
$103.55
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$105.73
|
| Rate for Payer: Cigna of WY Commercial |
$106.82
|
| Rate for Payer: First Choice Health Commercial |
$98.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$103.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.29
|
| Rate for Payer: HealthUtah PPO |
$109.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$105.73
|
| Rate for Payer: Multiplan Medicare/VA |
$20.65
|
| Rate for Payer: One Health Plan of WY PPO |
$106.82
|
| Rate for Payer: PacificSource Commercial |
$98.10
|
| Rate for Payer: PHCS PPO |
$103.55
|
| Rate for Payer: Three Rivers PPO |
$81.75
|
| Rate for Payer: TriWest Veterans Administration |
$24.29
|
| Rate for Payer: United Healthcare Commercial |
$94.83
|
| Rate for Payer: United Healthcare Medicare |
$24.29
|
| Rate for Payer: WINHealth Partners Commercial |
$92.65
|
|
|
HC PRO INSERT NON-TUNNEL CV CATH >5 Y/O
|
Professional
|
Both
|
$703.00
|
|
|
Service Code
|
HCPCS 36556
|
| Hospital Charge Code |
9833655601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$703.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$688.94
|
| Rate for Payer: Aetna of WY Medicare |
$79.57
|
| Rate for Payer: Beech Street Commercial |
$667.85
|
| Rate for Payer: Cash Price |
$492.10
|
| Rate for Payer: Cash Price |
$492.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$681.91
|
| Rate for Payer: Cigna of WY Commercial |
$688.94
|
| Rate for Payer: First Choice Health Commercial |
$632.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$667.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$79.57
|
| Rate for Payer: HealthUtah PPO |
$703.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$681.91
|
| Rate for Payer: Multiplan Medicare/VA |
$67.63
|
| Rate for Payer: One Health Plan of WY PPO |
$688.94
|
| Rate for Payer: PacificSource Commercial |
$632.70
|
| Rate for Payer: PHCS PPO |
$667.85
|
| Rate for Payer: Three Rivers PPO |
$527.25
|
| Rate for Payer: TriWest Veterans Administration |
$79.57
|
| Rate for Payer: United Healthcare Commercial |
$611.61
|
| Rate for Payer: United Healthcare Medicare |
$79.57
|
| Rate for Payer: WINHealth Partners Commercial |
$597.55
|
|
|
HC PRO INSERT PICC W/O SUB-Q PORT W/IMAGE GUIDE >5 Y/O
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
9833657301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$1,508.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,477.84
|
| Rate for Payer: Aetna of WY Medicare |
$78.44
|
| Rate for Payer: Beech Street Commercial |
$1,432.60
|
| Rate for Payer: Cash Price |
$1,055.60
|
| Rate for Payer: Cash Price |
$1,055.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,462.76
|
| Rate for Payer: Cigna of WY Commercial |
$1,477.84
|
| Rate for Payer: First Choice Health Commercial |
$1,357.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,432.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.44
|
| Rate for Payer: HealthUtah PPO |
$1,508.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,462.76
|
| Rate for Payer: Multiplan Medicare/VA |
$66.67
|
| Rate for Payer: One Health Plan of WY PPO |
$1,477.84
|
| Rate for Payer: PacificSource Commercial |
$1,357.20
|
| Rate for Payer: PHCS PPO |
$1,432.60
|
| Rate for Payer: Three Rivers PPO |
$1,131.00
|
| Rate for Payer: TriWest Veterans Administration |
$78.44
|
| Rate for Payer: United Healthcare Commercial |
$1,311.96
|
| Rate for Payer: United Healthcare Medicare |
$78.44
|
| Rate for Payer: WINHealth Partners Commercial |
$1,281.80
|
|
|
HC PRO INSERT PICC W/O SUB-Q PORT W/O IMAGE GUIDE >5 Y/O
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 36569 NONPBBPAYER
|
| Hospital Charge Code |
9833656901
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$75.55 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$481.18
|
| Rate for Payer: Aetna of WY Medicare |
$88.88
|
| Rate for Payer: Beech Street Commercial |
$466.45
|
| Rate for Payer: Cash Price |
$343.70
|
| Rate for Payer: Cash Price |
$343.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$476.27
|
| Rate for Payer: Cigna of WY Commercial |
$481.18
|
| Rate for Payer: First Choice Health Commercial |
$441.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$466.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.88
|
| Rate for Payer: HealthUtah PPO |
$491.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$476.27
|
| Rate for Payer: Multiplan Medicare/VA |
$75.55
|
| Rate for Payer: One Health Plan of WY PPO |
$481.18
|
| Rate for Payer: PacificSource Commercial |
$441.90
|
| Rate for Payer: PHCS PPO |
$466.45
|
| Rate for Payer: Three Rivers PPO |
$368.25
|
| Rate for Payer: TriWest Veterans Administration |
$88.88
|
| Rate for Payer: United Healthcare Commercial |
$427.17
|
| Rate for Payer: United Healthcare Medicare |
$88.88
|
| Rate for Payer: WINHealth Partners Commercial |
$417.35
|
|
|
HC PRO INSERT PICC W/O SUB-Q PORT W/O IMAGE GUIDE >5 Y/O
|
Professional
|
Both
|
$393.00
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
9833656901
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$75.55 |
| Max. Negotiated Rate |
$393.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$385.14
|
| Rate for Payer: Aetna of WY Medicare |
$88.88
|
| Rate for Payer: Beech Street Commercial |
$373.35
|
| Rate for Payer: Cash Price |
$275.10
|
| Rate for Payer: Cash Price |
$275.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$381.21
|
| Rate for Payer: Cigna of WY Commercial |
$385.14
|
| Rate for Payer: First Choice Health Commercial |
$353.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$373.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.88
|
| Rate for Payer: HealthUtah PPO |
$393.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$381.21
|
| Rate for Payer: Multiplan Medicare/VA |
$75.55
|
| Rate for Payer: One Health Plan of WY PPO |
$385.14
|
| Rate for Payer: PacificSource Commercial |
$353.70
|
| Rate for Payer: PHCS PPO |
$373.35
|
| Rate for Payer: Three Rivers PPO |
$294.75
|
| Rate for Payer: TriWest Veterans Administration |
$88.88
|
| Rate for Payer: United Healthcare Commercial |
$341.91
|
| Rate for Payer: United Healthcare Medicare |
$88.88
|
| Rate for Payer: WINHealth Partners Commercial |
$334.05
|
|
|
HC PRO INSERT,TEMP INDWELLING BLAD CATH,SIMPLE
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 51702 NONPBBPAYER
|
| Hospital Charge Code |
9835170201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$20.44 |
| Max. Negotiated Rate |
$133.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$130.34
|
| Rate for Payer: Aetna of WY Medicare |
$24.05
|
| Rate for Payer: Beech Street Commercial |
$126.35
|
| Rate for Payer: Cash Price |
$93.10
|
| Rate for Payer: Cash Price |
$93.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$129.01
|
| Rate for Payer: Cigna of WY Commercial |
$130.34
|
| Rate for Payer: First Choice Health Commercial |
$119.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$126.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.05
|
| Rate for Payer: HealthUtah PPO |
$133.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$129.01
|
| Rate for Payer: Multiplan Medicare/VA |
$20.44
|
| Rate for Payer: One Health Plan of WY PPO |
$130.34
|
| Rate for Payer: PacificSource Commercial |
$119.70
|
| Rate for Payer: PHCS PPO |
$126.35
|
| Rate for Payer: Three Rivers PPO |
$99.75
|
| Rate for Payer: TriWest Veterans Administration |
$24.05
|
| Rate for Payer: United Healthcare Commercial |
$115.71
|
| Rate for Payer: United Healthcare Medicare |
$24.05
|
| Rate for Payer: WINHealth Partners Commercial |
$113.05
|
|
|
HC PRO INSERT,TEMP INDWELLING BLAD CATH,SIMPLE
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
9835170201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$20.44 |
| Max. Negotiated Rate |
$209.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$204.82
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$103.88
|
| Rate for Payer: Aetna of WY Medicare |
$24.05
|
| Rate for Payer: Aetna of WY Medicare |
$24.05
|
| Rate for Payer: Beech Street Commercial |
$100.70
|
| Rate for Payer: Beech Street Commercial |
$198.55
|
| Rate for Payer: Cash Price |
$74.20
|
| Rate for Payer: Cash Price |
$74.20
|
| Rate for Payer: Cash Price |
$146.30
|
| Rate for Payer: Cash Price |
$146.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$202.73
|
| Rate for Payer: ChoiceCare Network Commercial |
$102.82
|
| Rate for Payer: Cigna of WY Commercial |
$103.88
|
| Rate for Payer: Cigna of WY Commercial |
$204.82
|
| Rate for Payer: First Choice Health Commercial |
$95.40
|
| Rate for Payer: First Choice Health Commercial |
$188.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$198.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$100.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.05
|
| Rate for Payer: HealthUtah PPO |
$209.00
|
| Rate for Payer: HealthUtah PPO |
$106.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$202.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$102.82
|
| Rate for Payer: Multiplan Medicare/VA |
$20.44
|
| Rate for Payer: Multiplan Medicare/VA |
$20.44
|
| Rate for Payer: One Health Plan of WY PPO |
$204.82
|
| Rate for Payer: One Health Plan of WY PPO |
$103.88
|
| Rate for Payer: PacificSource Commercial |
$95.40
|
| Rate for Payer: PacificSource Commercial |
$188.10
|
| Rate for Payer: PHCS PPO |
$198.55
|
| Rate for Payer: PHCS PPO |
$100.70
|
| Rate for Payer: Three Rivers PPO |
$156.75
|
| Rate for Payer: Three Rivers PPO |
$79.50
|
| Rate for Payer: TriWest Veterans Administration |
$24.05
|
| Rate for Payer: TriWest Veterans Administration |
$24.05
|
| Rate for Payer: United Healthcare Commercial |
$92.22
|
| Rate for Payer: United Healthcare Commercial |
$181.83
|
| Rate for Payer: United Healthcare Medicare |
$24.05
|
| Rate for Payer: United Healthcare Medicare |
$24.05
|
| Rate for Payer: WINHealth Partners Commercial |
$177.65
|
| Rate for Payer: WINHealth Partners Commercial |
$90.10
|
|
|
HC PRO INSERT TUNNELED CV CATH W/O PORT OR PUMP
|
Professional
|
Both
|
$1,081.00
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
9833655801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$207.71 |
| Max. Negotiated Rate |
$1,081.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,059.38
|
| Rate for Payer: Aetna of WY Medicare |
$244.37
|
| Rate for Payer: Beech Street Commercial |
$1,026.95
|
| Rate for Payer: Cash Price |
$756.70
|
| Rate for Payer: Cash Price |
$756.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,048.57
|
| Rate for Payer: Cigna of WY Commercial |
$1,059.38
|
| Rate for Payer: First Choice Health Commercial |
$972.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,026.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$244.37
|
| Rate for Payer: HealthUtah PPO |
$1,081.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,048.57
|
| Rate for Payer: Multiplan Medicare/VA |
$207.71
|
| Rate for Payer: One Health Plan of WY PPO |
$1,059.38
|
| Rate for Payer: PacificSource Commercial |
$972.90
|
| Rate for Payer: PHCS PPO |
$1,026.95
|
| Rate for Payer: Three Rivers PPO |
$810.75
|
| Rate for Payer: TriWest Veterans Administration |
$244.37
|
| Rate for Payer: United Healthcare Commercial |
$940.47
|
| Rate for Payer: United Healthcare Medicare |
$244.37
|
| Rate for Payer: WINHealth Partners Commercial |
$918.85
|
|
|
HC PRO INSERT TUNNELED CV CATH W/O PORT OR PUMP
|
Professional
|
Both
|
$1,351.00
|
|
|
Service Code
|
HCPCS 36558 NONPBBPAYER
|
| Hospital Charge Code |
9833655801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$207.71 |
| Max. Negotiated Rate |
$1,351.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,323.98
|
| Rate for Payer: Aetna of WY Medicare |
$244.37
|
| Rate for Payer: Beech Street Commercial |
$1,283.45
|
| Rate for Payer: Cash Price |
$945.70
|
| Rate for Payer: Cash Price |
$945.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,310.47
|
| Rate for Payer: Cigna of WY Commercial |
$1,323.98
|
| Rate for Payer: First Choice Health Commercial |
$1,215.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,283.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$244.37
|
| Rate for Payer: HealthUtah PPO |
$1,351.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,310.47
|
| Rate for Payer: Multiplan Medicare/VA |
$207.71
|
| Rate for Payer: One Health Plan of WY PPO |
$1,323.98
|
| Rate for Payer: PacificSource Commercial |
$1,215.90
|
| Rate for Payer: PHCS PPO |
$1,283.45
|
| Rate for Payer: Three Rivers PPO |
$1,013.25
|
| Rate for Payer: TriWest Veterans Administration |
$244.37
|
| Rate for Payer: United Healthcare Commercial |
$1,175.37
|
| Rate for Payer: United Healthcare Medicare |
$244.37
|
| Rate for Payer: WINHealth Partners Commercial |
$1,148.35
|
|
|
HC PRO INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD
|
Professional
|
Both
|
$859.00
|
|
|
Service Code
|
HCPCS 22853
|
| Hospital Charge Code |
9832285301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$204.58 |
| Max. Negotiated Rate |
$859.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$841.82
|
| Rate for Payer: Aetna of WY Medicare |
$240.68
|
| Rate for Payer: Beech Street Commercial |
$816.05
|
| Rate for Payer: Cash Price |
$601.30
|
| Rate for Payer: Cash Price |
$601.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$833.23
|
| Rate for Payer: Cigna of WY Commercial |
$841.82
|
| Rate for Payer: First Choice Health Commercial |
$773.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$816.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$240.68
|
| Rate for Payer: HealthUtah PPO |
$859.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$833.23
|
| Rate for Payer: Multiplan Medicare/VA |
$204.58
|
| Rate for Payer: One Health Plan of WY PPO |
$841.82
|
| Rate for Payer: PacificSource Commercial |
$773.10
|
| Rate for Payer: PHCS PPO |
$816.05
|
| Rate for Payer: Three Rivers PPO |
$644.25
|
| Rate for Payer: TriWest Veterans Administration |
$240.68
|
| Rate for Payer: United Healthcare Commercial |
$747.33
|
| Rate for Payer: United Healthcare Medicare |
$240.68
|
| Rate for Payer: WINHealth Partners Commercial |
$730.15
|
|
|
HC PRO INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE
|
Professional
|
Both
|
$725.00
|
|
|
Service Code
|
HCPCS 57267
|
| Hospital Charge Code |
9835726701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$202.18 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$710.50
|
| Rate for Payer: Aetna of WY Medicare |
$237.86
|
| Rate for Payer: Beech Street Commercial |
$688.75
|
| Rate for Payer: Cash Price |
$507.50
|
| Rate for Payer: Cash Price |
$507.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$703.25
|
| Rate for Payer: Cigna of WY Commercial |
$710.50
|
| Rate for Payer: First Choice Health Commercial |
$652.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$688.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$237.86
|
| Rate for Payer: HealthUtah PPO |
$725.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$703.25
|
| Rate for Payer: Multiplan Medicare/VA |
$202.18
|
| Rate for Payer: One Health Plan of WY PPO |
$710.50
|
| Rate for Payer: PacificSource Commercial |
$652.50
|
| Rate for Payer: PHCS PPO |
$688.75
|
| Rate for Payer: Three Rivers PPO |
$543.75
|
| Rate for Payer: TriWest Veterans Administration |
$237.86
|
| Rate for Payer: United Healthcare Commercial |
$630.75
|
| Rate for Payer: United Healthcare Medicare |
$237.86
|
| Rate for Payer: WINHealth Partners Commercial |
$616.25
|
|
|
HC PRO INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 63685
|
| Hospital Charge Code |
9836368501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$278.05 |
| Max. Negotiated Rate |
$1,853.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,815.94
|
| Rate for Payer: Aetna of WY Medicare |
$327.12
|
| Rate for Payer: Beech Street Commercial |
$1,760.35
|
| Rate for Payer: Cash Price |
$1,297.10
|
| Rate for Payer: Cash Price |
$1,297.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,797.41
|
| Rate for Payer: Cigna of WY Commercial |
$1,815.94
|
| Rate for Payer: First Choice Health Commercial |
$1,667.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,760.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$327.12
|
| Rate for Payer: HealthUtah PPO |
$1,853.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,797.41
|
| Rate for Payer: Multiplan Medicare/VA |
$278.05
|
| Rate for Payer: One Health Plan of WY PPO |
$1,815.94
|
| Rate for Payer: PacificSource Commercial |
$1,667.70
|
| Rate for Payer: PHCS PPO |
$1,760.35
|
| Rate for Payer: Three Rivers PPO |
$1,389.75
|
| Rate for Payer: TriWest Veterans Administration |
$327.12
|
| Rate for Payer: United Healthcare Commercial |
$1,612.11
|
| Rate for Payer: United Healthcare Medicare |
$327.12
|
| Rate for Payer: WINHealth Partners Commercial |
$1,575.05
|
|
|
HC PRO INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING
|
Professional
|
Both
|
$3,168.00
|
|
|
Service Code
|
HCPCS 63685 50
|
| Hospital Charge Code |
9836368501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$278.05 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,104.64
|
| Rate for Payer: Aetna of WY Medicare |
$327.12
|
| Rate for Payer: Beech Street Commercial |
$3,009.60
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,072.96
|
| Rate for Payer: Cigna of WY Commercial |
$3,104.64
|
| Rate for Payer: First Choice Health Commercial |
$2,851.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,009.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$327.12
|
| Rate for Payer: HealthUtah PPO |
$3,168.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,072.96
|
| Rate for Payer: Multiplan Medicare/VA |
$278.05
|
| Rate for Payer: One Health Plan of WY PPO |
$3,104.64
|
| Rate for Payer: PacificSource Commercial |
$2,851.20
|
| Rate for Payer: PHCS PPO |
$3,009.60
|
| Rate for Payer: Three Rivers PPO |
$2,376.00
|
| Rate for Payer: TriWest Veterans Administration |
$327.12
|
| Rate for Payer: United Healthcare Commercial |
$2,756.16
|
| Rate for Payer: United Healthcare Medicare |
$327.12
|
| Rate for Payer: WINHealth Partners Commercial |
$2,692.80
|
|
|
HC PRO INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 46945
|
| Hospital Charge Code |
9834694501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$281.61 |
| Max. Negotiated Rate |
$1,729.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,694.42
|
| Rate for Payer: Aetna of WY Medicare |
$331.31
|
| Rate for Payer: Beech Street Commercial |
$1,642.55
|
| Rate for Payer: Cash Price |
$1,210.30
|
| Rate for Payer: Cash Price |
$1,210.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,677.13
|
| Rate for Payer: Cigna of WY Commercial |
$1,694.42
|
| Rate for Payer: First Choice Health Commercial |
$1,556.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,642.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$331.31
|
| Rate for Payer: HealthUtah PPO |
$1,729.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,677.13
|
| Rate for Payer: Multiplan Medicare/VA |
$281.61
|
| Rate for Payer: One Health Plan of WY PPO |
$1,694.42
|
| Rate for Payer: PacificSource Commercial |
$1,556.10
|
| Rate for Payer: PHCS PPO |
$1,642.55
|
| Rate for Payer: Three Rivers PPO |
$1,296.75
|
| Rate for Payer: TriWest Veterans Administration |
$331.31
|
| Rate for Payer: United Healthcare Commercial |
$1,504.23
|
| Rate for Payer: United Healthcare Medicare |
$331.31
|
| Rate for Payer: WINHealth Partners Commercial |
$1,469.65
|
|
|
HC PRO INTRAOP ID SENTINEL LYMPH NODE DYE
|
Professional
|
Both
|
$3,847.00
|
|
|
Service Code
|
HCPCS 38900
|
| Hospital Charge Code |
9833890001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$109.55 |
| Max. Negotiated Rate |
$3,847.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,770.06
|
| Rate for Payer: Aetna of WY Medicare |
$128.88
|
| Rate for Payer: Beech Street Commercial |
$3,654.65
|
| Rate for Payer: Cash Price |
$2,692.90
|
| Rate for Payer: Cash Price |
$2,692.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,731.59
|
| Rate for Payer: Cigna of WY Commercial |
$3,770.06
|
| Rate for Payer: First Choice Health Commercial |
$3,462.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,654.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$128.88
|
| Rate for Payer: HealthUtah PPO |
$3,847.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,731.59
|
| Rate for Payer: Multiplan Medicare/VA |
$109.55
|
| Rate for Payer: One Health Plan of WY PPO |
$3,770.06
|
| Rate for Payer: PacificSource Commercial |
$3,462.30
|
| Rate for Payer: PHCS PPO |
$3,654.65
|
| Rate for Payer: Three Rivers PPO |
$2,885.25
|
| Rate for Payer: TriWest Veterans Administration |
$128.88
|
| Rate for Payer: United Healthcare Commercial |
$3,346.89
|
| Rate for Payer: United Healthcare Medicare |
$128.88
|
| Rate for Payer: WINHealth Partners Commercial |
$3,269.95
|
|
|
HC PRO IRRIGAT CORPUS CAVERN,PRIAPISM
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 54220
|
| Hospital Charge Code |
9835422001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$108.98 |
| Max. Negotiated Rate |
$813.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$796.74
|
| Rate for Payer: Aetna of WY Medicare |
$128.21
|
| Rate for Payer: Beech Street Commercial |
$772.35
|
| Rate for Payer: Cash Price |
$569.10
|
| Rate for Payer: Cash Price |
$569.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$788.61
|
| Rate for Payer: Cigna of WY Commercial |
$796.74
|
| Rate for Payer: First Choice Health Commercial |
$731.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$772.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$128.21
|
| Rate for Payer: HealthUtah PPO |
$813.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$788.61
|
| Rate for Payer: Multiplan Medicare/VA |
$108.98
|
| Rate for Payer: One Health Plan of WY PPO |
$796.74
|
| Rate for Payer: PacificSource Commercial |
$731.70
|
| Rate for Payer: PHCS PPO |
$772.35
|
| Rate for Payer: Three Rivers PPO |
$609.75
|
| Rate for Payer: TriWest Veterans Administration |
$128.21
|
| Rate for Payer: United Healthcare Commercial |
$707.31
|
| Rate for Payer: United Healthcare Medicare |
$128.21
|
| Rate for Payer: WINHealth Partners Commercial |
$691.05
|
|
|
HC PRO KNEE ARTHROSCOPY SURGERY
|
Professional
|
Both
|
$2,560.00
|
|
|
Service Code
|
HCPCS 29875
|
| Hospital Charge Code |
9832987501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$412.22 |
| Max. Negotiated Rate |
$2,560.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,508.80
|
| Rate for Payer: Aetna of WY Medicare |
$484.96
|
| Rate for Payer: Beech Street Commercial |
$2,432.00
|
| Rate for Payer: Cash Price |
$1,792.00
|
| Rate for Payer: Cash Price |
$1,792.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,483.20
|
| Rate for Payer: Cigna of WY Commercial |
$2,508.80
|
| Rate for Payer: First Choice Health Commercial |
$2,304.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,432.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$484.96
|
| Rate for Payer: HealthUtah PPO |
$2,560.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,483.20
|
| Rate for Payer: Multiplan Medicare/VA |
$412.22
|
| Rate for Payer: One Health Plan of WY PPO |
$2,508.80
|
| Rate for Payer: PacificSource Commercial |
$2,304.00
|
| Rate for Payer: PHCS PPO |
$2,432.00
|
| Rate for Payer: Three Rivers PPO |
$1,920.00
|
| Rate for Payer: TriWest Veterans Administration |
$484.96
|
| Rate for Payer: United Healthcare Commercial |
$2,227.20
|
| Rate for Payer: United Healthcare Medicare |
$484.96
|
| Rate for Payer: WINHealth Partners Commercial |
$2,176.00
|
|
|
HC PRO KNEE ARTHROSCOPY SURGERY
|
Professional
|
Both
|
$2,730.00
|
|
|
Service Code
|
HCPCS 29873
|
| Hospital Charge Code |
9832987301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$448.42 |
| Max. Negotiated Rate |
$2,730.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,675.40
|
| Rate for Payer: Aetna of WY Medicare |
$527.55
|
| Rate for Payer: Beech Street Commercial |
$2,593.50
|
| Rate for Payer: Cash Price |
$1,911.00
|
| Rate for Payer: Cash Price |
$1,911.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,648.10
|
| Rate for Payer: Cigna of WY Commercial |
$2,675.40
|
| Rate for Payer: First Choice Health Commercial |
$2,457.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,593.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$527.55
|
| Rate for Payer: HealthUtah PPO |
$2,730.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,648.10
|
| Rate for Payer: Multiplan Medicare/VA |
$448.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2,675.40
|
| Rate for Payer: PacificSource Commercial |
$2,457.00
|
| Rate for Payer: PHCS PPO |
$2,593.50
|
| Rate for Payer: Three Rivers PPO |
$2,047.50
|
| Rate for Payer: TriWest Veterans Administration |
$527.55
|
| Rate for Payer: United Healthcare Commercial |
$2,375.10
|
| Rate for Payer: United Healthcare Medicare |
$527.55
|
| Rate for Payer: WINHealth Partners Commercial |
$2,320.50
|
|
|
HC PRO KNEE ARTHROSCOPY SURGERY
|
Professional
|
Both
|
$5,459.00
|
|
|
Service Code
|
HCPCS 29873 50
|
| Hospital Charge Code |
9832987301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$448.42 |
| Max. Negotiated Rate |
$5,459.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,349.82
|
| Rate for Payer: Aetna of WY Medicare |
$527.55
|
| Rate for Payer: Beech Street Commercial |
$5,186.05
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: Cash Price |
$3,821.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,295.23
|
| Rate for Payer: Cigna of WY Commercial |
$5,349.82
|
| Rate for Payer: First Choice Health Commercial |
$4,913.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,186.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$527.55
|
| Rate for Payer: HealthUtah PPO |
$5,459.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,295.23
|
| Rate for Payer: Multiplan Medicare/VA |
$448.42
|
| Rate for Payer: One Health Plan of WY PPO |
$5,349.82
|
| Rate for Payer: PacificSource Commercial |
$4,913.10
|
| Rate for Payer: PHCS PPO |
$5,186.05
|
| Rate for Payer: Three Rivers PPO |
$4,094.25
|
| Rate for Payer: TriWest Veterans Administration |
$527.55
|
| Rate for Payer: United Healthcare Commercial |
$4,749.33
|
| Rate for Payer: United Healthcare Medicare |
$527.55
|
| Rate for Payer: WINHealth Partners Commercial |
$4,640.15
|
|
|
HC PRO KNEE ARTHROSCOPY/SURGERY
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 29881
|
| Hospital Charge Code |
9832988101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$2,792.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,736.16
|
| Rate for Payer: Aetna of WY Medicare |
$528.31
|
| Rate for Payer: Beech Street Commercial |
$2,652.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: Cash Price |
$1,954.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,708.24
|
| Rate for Payer: Cigna of WY Commercial |
$2,736.16
|
| Rate for Payer: First Choice Health Commercial |
$2,512.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,652.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$528.31
|
| Rate for Payer: HealthUtah PPO |
$2,792.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,708.24
|
| Rate for Payer: Multiplan Medicare/VA |
$449.06
|
| Rate for Payer: One Health Plan of WY PPO |
$2,736.16
|
| Rate for Payer: PacificSource Commercial |
$2,512.80
|
| Rate for Payer: PHCS PPO |
$2,652.40
|
| Rate for Payer: Three Rivers PPO |
$2,094.00
|
| Rate for Payer: TriWest Veterans Administration |
$528.31
|
| Rate for Payer: United Healthcare Commercial |
$2,429.04
|
| Rate for Payer: United Healthcare Medicare |
$528.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,373.20
|
|
