|
HC PRO MEDIAL MALLEOLUS FX / MAN
|
Professional
|
Both
|
$1,789.00
|
|
|
Service Code
|
HCPCS 27762
|
| Hospital Charge Code |
9832776201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$371.99 |
| Max. Negotiated Rate |
$1,789.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,753.22
|
| Rate for Payer: Aetna of WY Medicare |
$437.63
|
| Rate for Payer: Beech Street Commercial |
$1,699.55
|
| Rate for Payer: Cash Price |
$1,252.30
|
| Rate for Payer: Cash Price |
$1,252.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,735.33
|
| Rate for Payer: Cigna of WY Commercial |
$1,753.22
|
| Rate for Payer: First Choice Health Commercial |
$1,610.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,699.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$437.63
|
| Rate for Payer: HealthUtah PPO |
$1,789.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,735.33
|
| Rate for Payer: Multiplan Medicare/VA |
$371.99
|
| Rate for Payer: One Health Plan of WY PPO |
$1,753.22
|
| Rate for Payer: PacificSource Commercial |
$1,610.10
|
| Rate for Payer: PHCS PPO |
$1,699.55
|
| Rate for Payer: Three Rivers PPO |
$1,341.75
|
| Rate for Payer: TriWest Veterans Administration |
$437.63
|
| Rate for Payer: United Healthcare Commercial |
$1,556.43
|
| Rate for Payer: United Healthcare Medicare |
$437.63
|
| Rate for Payer: WINHealth Partners Commercial |
$1,520.65
|
|
|
HC PRO MEDIAL MALLEOLUS FX / MAN
|
Professional
|
Both
|
$2,236.00
|
|
|
Service Code
|
HCPCS 27762 NONPBBPAYER
|
| Hospital Charge Code |
9832776201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$371.99 |
| Max. Negotiated Rate |
$2,236.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,191.28
|
| Rate for Payer: Aetna of WY Medicare |
$437.63
|
| Rate for Payer: Beech Street Commercial |
$2,124.20
|
| Rate for Payer: Cash Price |
$1,565.20
|
| Rate for Payer: Cash Price |
$1,565.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,168.92
|
| Rate for Payer: Cigna of WY Commercial |
$2,191.28
|
| Rate for Payer: First Choice Health Commercial |
$2,012.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,124.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$437.63
|
| Rate for Payer: HealthUtah PPO |
$2,236.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,168.92
|
| Rate for Payer: Multiplan Medicare/VA |
$371.99
|
| Rate for Payer: One Health Plan of WY PPO |
$2,191.28
|
| Rate for Payer: PacificSource Commercial |
$2,012.40
|
| Rate for Payer: PHCS PPO |
$2,124.20
|
| Rate for Payer: Three Rivers PPO |
$1,677.00
|
| Rate for Payer: TriWest Veterans Administration |
$437.63
|
| Rate for Payer: United Healthcare Commercial |
$1,945.32
|
| Rate for Payer: United Healthcare Medicare |
$437.63
|
| Rate for Payer: WINHealth Partners Commercial |
$1,900.60
|
|
|
HC PRO MED NUTR THER, SUBSQ, INDIV, EA 15 MIN
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 97803
|
| Hospital Charge Code |
9839780301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$22.47 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$129.36
|
| Rate for Payer: Aetna of WY Medicare |
$26.44
|
| Rate for Payer: Beech Street Commercial |
$125.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$128.04
|
| Rate for Payer: Cigna of WY Commercial |
$129.36
|
| Rate for Payer: First Choice Health Commercial |
$118.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$125.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.44
|
| Rate for Payer: HealthUtah PPO |
$132.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$128.04
|
| Rate for Payer: Multiplan Medicare/VA |
$22.47
|
| Rate for Payer: One Health Plan of WY PPO |
$129.36
|
| Rate for Payer: PacificSource Commercial |
$118.80
|
| Rate for Payer: PHCS PPO |
$125.40
|
| Rate for Payer: Three Rivers PPO |
$99.00
|
| Rate for Payer: TriWest Veterans Administration |
$26.44
|
| Rate for Payer: United Healthcare Commercial |
$114.84
|
| Rate for Payer: United Healthcare Medicare |
$26.44
|
| Rate for Payer: WINHealth Partners Commercial |
$125.40
|
|
|
HC PRO ML LAYER CLOSURE HAND/FOOT
|
Professional
|
Both
|
$589.00
|
|
|
Service Code
|
HCPCS 12041
|
| Hospital Charge Code |
9831204102
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$119.19 |
| Max. Negotiated Rate |
$589.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$577.22
|
| Rate for Payer: Aetna of WY Medicare |
$140.22
|
| Rate for Payer: Beech Street Commercial |
$559.55
|
| Rate for Payer: Cash Price |
$412.30
|
| Rate for Payer: Cash Price |
$412.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$571.33
|
| Rate for Payer: Cigna of WY Commercial |
$577.22
|
| Rate for Payer: First Choice Health Commercial |
$530.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$559.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$140.22
|
| Rate for Payer: HealthUtah PPO |
$589.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$571.33
|
| Rate for Payer: Multiplan Medicare/VA |
$119.19
|
| Rate for Payer: One Health Plan of WY PPO |
$577.22
|
| Rate for Payer: PacificSource Commercial |
$530.10
|
| Rate for Payer: PHCS PPO |
$559.55
|
| Rate for Payer: Three Rivers PPO |
$441.75
|
| Rate for Payer: TriWest Veterans Administration |
$140.22
|
| Rate for Payer: United Healthcare Commercial |
$512.43
|
| Rate for Payer: United Healthcare Medicare |
$140.22
|
| Rate for Payer: WINHealth Partners Commercial |
$500.65
|
|
|
HC PRO ML LAYER CLOSURE HAND/FOOT
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 12041 NONPBBPAYER
|
| Hospital Charge Code |
9831204102
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$119.19 |
| Max. Negotiated Rate |
$736.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$721.28
|
| Rate for Payer: Aetna of WY Medicare |
$140.22
|
| 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 |
$140.22
|
| Rate for Payer: HealthUtah PPO |
$736.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$713.92
|
| Rate for Payer: Multiplan Medicare/VA |
$119.19
|
| 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 |
$140.22
|
| Rate for Payer: United Healthcare Commercial |
$640.32
|
| Rate for Payer: United Healthcare Medicare |
$140.22
|
| Rate for Payer: WINHealth Partners Commercial |
$625.60
|
|
|
HC PRO MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT
|
Professional
|
Both
|
$626.00
|
|
|
Service Code
|
HCPCS 44139
|
| Hospital Charge Code |
9754413901
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.46 |
| Max. Negotiated Rate |
$626.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$613.48
|
| Rate for Payer: Aetna of WY Medicare |
$112.30
|
| Rate for Payer: Beech Street Commercial |
$594.70
|
| Rate for Payer: Cash Price |
$438.20
|
| Rate for Payer: Cash Price |
$438.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$607.22
|
| Rate for Payer: Cigna of WY Commercial |
$613.48
|
| Rate for Payer: First Choice Health Commercial |
$563.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$594.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$112.30
|
| Rate for Payer: HealthUtah PPO |
$626.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$607.22
|
| Rate for Payer: Multiplan Medicare/VA |
$95.46
|
| Rate for Payer: One Health Plan of WY PPO |
$613.48
|
| Rate for Payer: PacificSource Commercial |
$563.40
|
| Rate for Payer: PHCS PPO |
$594.70
|
| Rate for Payer: Three Rivers PPO |
$469.50
|
| Rate for Payer: TriWest Veterans Administration |
$112.30
|
| Rate for Payer: United Healthcare Commercial |
$544.62
|
| Rate for Payer: United Healthcare Medicare |
$112.30
|
| Rate for Payer: WINHealth Partners Commercial |
$532.10
|
|
|
HC PRO MODERATE SEDATION EA ADD 15 MN
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 99153
|
| Hospital Charge Code |
9839915301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$44.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$43.12
|
| Rate for Payer: Aetna of WY Medicare |
$11.29
|
| Rate for Payer: Beech Street Commercial |
$41.80
|
| Rate for Payer: Cash Price |
$30.80
|
| Rate for Payer: Cash Price |
$30.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$42.68
|
| Rate for Payer: Cigna of WY Commercial |
$43.12
|
| Rate for Payer: First Choice Health Commercial |
$39.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$41.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.29
|
| Rate for Payer: HealthUtah PPO |
$44.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$42.68
|
| Rate for Payer: Multiplan Medicare/VA |
$9.60
|
| Rate for Payer: One Health Plan of WY PPO |
$43.12
|
| Rate for Payer: PacificSource Commercial |
$39.60
|
| Rate for Payer: PHCS PPO |
$41.80
|
| Rate for Payer: Three Rivers PPO |
$33.00
|
| Rate for Payer: TriWest Veterans Administration |
$11.29
|
| Rate for Payer: United Healthcare Commercial |
$38.28
|
| Rate for Payer: United Healthcare Medicare |
$11.29
|
| Rate for Payer: WINHealth Partners Commercial |
$41.80
|
|
|
HC PRO MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 99152
|
| Hospital Charge Code |
9839915201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$188.16
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$49.98
|
| Rate for Payer: Aetna of WY Medicare |
$11.53
|
| Rate for Payer: Aetna of WY Medicare |
$11.53
|
| Rate for Payer: Beech Street Commercial |
$48.45
|
| Rate for Payer: Beech Street Commercial |
$182.40
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.47
|
| Rate for Payer: ChoiceCare Network Commercial |
$186.24
|
| Rate for Payer: Cigna of WY Commercial |
$188.16
|
| Rate for Payer: Cigna of WY Commercial |
$49.98
|
| Rate for Payer: First Choice Health Commercial |
$45.90
|
| Rate for Payer: First Choice Health Commercial |
$172.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$182.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.53
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.53
|
| Rate for Payer: HealthUtah PPO |
$192.00
|
| Rate for Payer: HealthUtah PPO |
$51.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.47
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$186.24
|
| Rate for Payer: Multiplan Medicare/VA |
$9.80
|
| Rate for Payer: Multiplan Medicare/VA |
$9.80
|
| Rate for Payer: One Health Plan of WY PPO |
$49.98
|
| Rate for Payer: One Health Plan of WY PPO |
$188.16
|
| Rate for Payer: PacificSource Commercial |
$172.80
|
| Rate for Payer: PacificSource Commercial |
$45.90
|
| Rate for Payer: PHCS PPO |
$182.40
|
| Rate for Payer: PHCS PPO |
$48.45
|
| Rate for Payer: Three Rivers PPO |
$144.00
|
| Rate for Payer: Three Rivers PPO |
$38.25
|
| Rate for Payer: TriWest Veterans Administration |
$11.53
|
| Rate for Payer: TriWest Veterans Administration |
$11.53
|
| Rate for Payer: United Healthcare Commercial |
$44.37
|
| Rate for Payer: United Healthcare Commercial |
$167.04
|
| Rate for Payer: United Healthcare Medicare |
$11.53
|
| Rate for Payer: United Healthcare Medicare |
$11.53
|
| Rate for Payer: WINHealth Partners Commercial |
$182.40
|
| Rate for Payer: WINHealth Partners Commercial |
$48.45
|
|
|
HC PRO MULTIPLE NERVE BLOCK INJECTIONS RIB NERVES
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 64421
|
| Hospital Charge Code |
9836442101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$20.23 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$129.36
|
| Rate for Payer: Aetna of WY Medicare |
$23.80
|
| Rate for Payer: Beech Street Commercial |
$125.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$128.04
|
| Rate for Payer: Cigna of WY Commercial |
$129.36
|
| Rate for Payer: First Choice Health Commercial |
$118.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$125.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.80
|
| Rate for Payer: HealthUtah PPO |
$132.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$128.04
|
| Rate for Payer: Multiplan Medicare/VA |
$20.23
|
| Rate for Payer: One Health Plan of WY PPO |
$129.36
|
| Rate for Payer: PacificSource Commercial |
$118.80
|
| Rate for Payer: PHCS PPO |
$125.40
|
| Rate for Payer: Three Rivers PPO |
$99.00
|
| Rate for Payer: TriWest Veterans Administration |
$23.80
|
| Rate for Payer: United Healthcare Commercial |
$114.84
|
| Rate for Payer: United Healthcare Medicare |
$23.80
|
| Rate for Payer: WINHealth Partners Commercial |
$112.20
|
|
|
HC PRO MULTIPLE NERVE BLOCK INJECTIONS RIB NERVES
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 64421 50
|
| Hospital Charge Code |
9836442101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$20.23 |
| Max. Negotiated Rate |
$264.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$258.72
|
| Rate for Payer: Aetna of WY Medicare |
$23.80
|
| Rate for Payer: Beech Street Commercial |
$250.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$256.08
|
| Rate for Payer: Cigna of WY Commercial |
$258.72
|
| Rate for Payer: First Choice Health Commercial |
$237.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$250.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.80
|
| Rate for Payer: HealthUtah PPO |
$264.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$256.08
|
| Rate for Payer: Multiplan Medicare/VA |
$20.23
|
| Rate for Payer: One Health Plan of WY PPO |
$258.72
|
| Rate for Payer: PacificSource Commercial |
$237.60
|
| Rate for Payer: PHCS PPO |
$250.80
|
| Rate for Payer: Three Rivers PPO |
$198.00
|
| Rate for Payer: TriWest Veterans Administration |
$23.80
|
| Rate for Payer: United Healthcare Commercial |
$229.68
|
| Rate for Payer: United Healthcare Medicare |
$23.80
|
| Rate for Payer: WINHealth Partners Commercial |
$224.40
|
|
|
HC PRO MYOCARDIAL SPECT MULTIPLE STUDIES
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 78452 26
|
| Hospital Charge Code |
9747845201
|
|
Hospital Revenue Code
|
974
|
| Min. Negotiated Rate |
$61.63 |
| Max. Negotiated Rate |
$1,556.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,524.88
|
| Rate for Payer: Aetna of WY Medicare |
$72.51
|
| Rate for Payer: Beech Street Commercial |
$1,478.20
|
| Rate for Payer: Cash Price |
$1,089.20
|
| Rate for Payer: Cash Price |
$1,089.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,509.32
|
| Rate for Payer: Cigna of WY Commercial |
$1,524.88
|
| Rate for Payer: First Choice Health Commercial |
$1,400.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,478.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$72.51
|
| Rate for Payer: HealthUtah PPO |
$1,556.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,509.32
|
| Rate for Payer: Multiplan Medicare/VA |
$61.63
|
| Rate for Payer: One Health Plan of WY PPO |
$1,524.88
|
| Rate for Payer: PacificSource Commercial |
$1,400.40
|
| Rate for Payer: PHCS PPO |
$1,478.20
|
| Rate for Payer: Three Rivers PPO |
$1,167.00
|
| Rate for Payer: TriWest Veterans Administration |
$72.51
|
| Rate for Payer: United Healthcare Commercial |
$1,353.72
|
| Rate for Payer: United Healthcare Medicare |
$72.51
|
| Rate for Payer: WINHealth Partners Commercial |
$1,478.20
|
|
|
HC PRO MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR
|
Professional
|
Both
|
$4,655.00
|
|
|
Service Code
|
HCPCS 58140
|
| Hospital Charge Code |
9755814001
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$753.72 |
| Max. Negotiated Rate |
$4,655.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,561.90
|
| Rate for Payer: Aetna of WY Medicare |
$886.73
|
| Rate for Payer: Beech Street Commercial |
$4,422.25
|
| Rate for Payer: Cash Price |
$3,258.50
|
| Rate for Payer: Cash Price |
$3,258.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,515.35
|
| Rate for Payer: Cigna of WY Commercial |
$4,561.90
|
| Rate for Payer: First Choice Health Commercial |
$4,189.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,422.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$886.73
|
| Rate for Payer: HealthUtah PPO |
$4,655.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,515.35
|
| Rate for Payer: Multiplan Medicare/VA |
$753.72
|
| Rate for Payer: One Health Plan of WY PPO |
$4,561.90
|
| Rate for Payer: PacificSource Commercial |
$4,189.50
|
| Rate for Payer: PHCS PPO |
$4,422.25
|
| Rate for Payer: Three Rivers PPO |
$3,491.25
|
| Rate for Payer: TriWest Veterans Administration |
$886.73
|
| Rate for Payer: United Healthcare Commercial |
$4,049.85
|
| Rate for Payer: United Healthcare Medicare |
$886.73
|
| Rate for Payer: WINHealth Partners Commercial |
$3,956.75
|
|
|
HC PRO NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
HCPCS 31231
|
| Hospital Charge Code |
9833123101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$52.56 |
| Max. Negotiated Rate |
$605.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$592.90
|
| Rate for Payer: Aetna of WY Medicare |
$61.83
|
| Rate for Payer: Beech Street Commercial |
$574.75
|
| Rate for Payer: Cash Price |
$423.50
|
| Rate for Payer: Cash Price |
$423.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$586.85
|
| Rate for Payer: Cigna of WY Commercial |
$592.90
|
| Rate for Payer: First Choice Health Commercial |
$544.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$574.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$61.83
|
| Rate for Payer: HealthUtah PPO |
$605.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$586.85
|
| Rate for Payer: Multiplan Medicare/VA |
$52.56
|
| Rate for Payer: One Health Plan of WY PPO |
$592.90
|
| Rate for Payer: PacificSource Commercial |
$544.50
|
| Rate for Payer: PHCS PPO |
$574.75
|
| Rate for Payer: Three Rivers PPO |
$453.75
|
| Rate for Payer: TriWest Veterans Administration |
$61.83
|
| Rate for Payer: United Healthcare Commercial |
$526.35
|
| Rate for Payer: United Healthcare Medicare |
$61.83
|
| Rate for Payer: WINHealth Partners Commercial |
$514.25
|
|
|
HC PRO NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 31231 NONPBBPAYER
|
| Hospital Charge Code |
9833123101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$52.56 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$740.88
|
| Rate for Payer: Aetna of WY Medicare |
$61.83
|
| Rate for Payer: Beech Street Commercial |
$718.20
|
| Rate for Payer: Cash Price |
$529.20
|
| Rate for Payer: Cash Price |
$529.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$733.32
|
| Rate for Payer: Cigna of WY Commercial |
$740.88
|
| Rate for Payer: First Choice Health Commercial |
$680.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$718.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$61.83
|
| Rate for Payer: HealthUtah PPO |
$756.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$733.32
|
| Rate for Payer: Multiplan Medicare/VA |
$52.56
|
| Rate for Payer: One Health Plan of WY PPO |
$740.88
|
| Rate for Payer: PacificSource Commercial |
$680.40
|
| Rate for Payer: PHCS PPO |
$718.20
|
| Rate for Payer: Three Rivers PPO |
$567.00
|
| Rate for Payer: TriWest Veterans Administration |
$61.83
|
| Rate for Payer: United Healthcare Commercial |
$657.72
|
| Rate for Payer: United Healthcare Medicare |
$61.83
|
| Rate for Payer: WINHealth Partners Commercial |
$642.60
|
|
|
HC PRO NASAL/SINUS ENDOSCOPY,RMV TISS MAXILL SINUS BILAT
|
Professional
|
Both
|
$1,809.00
|
|
|
Service Code
|
HCPCS 31267 50
|
| Hospital Charge Code |
9833126701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$215.42 |
| Max. Negotiated Rate |
$1,809.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,772.82
|
| Rate for Payer: Aetna of WY Medicare |
$253.44
|
| Rate for Payer: Beech Street Commercial |
$1,718.55
|
| Rate for Payer: Cash Price |
$1,266.30
|
| Rate for Payer: Cash Price |
$1,266.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,754.73
|
| Rate for Payer: Cigna of WY Commercial |
$1,772.82
|
| Rate for Payer: First Choice Health Commercial |
$1,628.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,718.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$253.44
|
| Rate for Payer: HealthUtah PPO |
$1,809.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,754.73
|
| Rate for Payer: Multiplan Medicare/VA |
$215.42
|
| Rate for Payer: One Health Plan of WY PPO |
$1,772.82
|
| Rate for Payer: PacificSource Commercial |
$1,628.10
|
| Rate for Payer: PHCS PPO |
$1,718.55
|
| Rate for Payer: Three Rivers PPO |
$1,356.75
|
| Rate for Payer: TriWest Veterans Administration |
$253.44
|
| Rate for Payer: United Healthcare Commercial |
$1,573.83
|
| Rate for Payer: United Healthcare Medicare |
$253.44
|
| Rate for Payer: WINHealth Partners Commercial |
$1,537.65
|
|
|
HC PRO NASAL/SINUS ENDOSCOPY,RMV TISS MAXILL SINUS BILAT
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 31267
|
| Hospital Charge Code |
9833126701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$215.42 |
| Max. Negotiated Rate |
$904.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$885.92
|
| Rate for Payer: Aetna of WY Medicare |
$253.44
|
| Rate for Payer: Beech Street Commercial |
$858.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$876.88
|
| Rate for Payer: Cigna of WY Commercial |
$885.92
|
| Rate for Payer: First Choice Health Commercial |
$813.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$858.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$253.44
|
| Rate for Payer: HealthUtah PPO |
$904.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$876.88
|
| Rate for Payer: Multiplan Medicare/VA |
$215.42
|
| Rate for Payer: One Health Plan of WY PPO |
$885.92
|
| Rate for Payer: PacificSource Commercial |
$813.60
|
| Rate for Payer: PHCS PPO |
$858.80
|
| Rate for Payer: Three Rivers PPO |
$678.00
|
| Rate for Payer: TriWest Veterans Administration |
$253.44
|
| Rate for Payer: United Healthcare Commercial |
$786.48
|
| Rate for Payer: United Healthcare Medicare |
$253.44
|
| Rate for Payer: WINHealth Partners Commercial |
$768.40
|
|
|
HC PRO NASAL SINUS ENDOSCOPY WITH ETHMOIDECTOMY BILAT
|
Professional
|
Both
|
$1,602.00
|
|
|
Service Code
|
HCPCS 31259
|
| Hospital Charge Code |
9833125901
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$381.56 |
| Max. Negotiated Rate |
$1,602.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,569.96
|
| Rate for Payer: Aetna of WY Medicare |
$448.89
|
| Rate for Payer: Beech Street Commercial |
$1,521.90
|
| Rate for Payer: Cash Price |
$1,121.40
|
| Rate for Payer: Cash Price |
$1,121.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,553.94
|
| Rate for Payer: Cigna of WY Commercial |
$1,569.96
|
| Rate for Payer: First Choice Health Commercial |
$1,441.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,521.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$448.89
|
| Rate for Payer: HealthUtah PPO |
$1,602.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,553.94
|
| Rate for Payer: Multiplan Medicare/VA |
$381.56
|
| Rate for Payer: One Health Plan of WY PPO |
$1,569.96
|
| Rate for Payer: PacificSource Commercial |
$1,441.80
|
| Rate for Payer: PHCS PPO |
$1,521.90
|
| Rate for Payer: Three Rivers PPO |
$1,201.50
|
| Rate for Payer: TriWest Veterans Administration |
$448.89
|
| Rate for Payer: United Healthcare Commercial |
$1,393.74
|
| Rate for Payer: United Healthcare Medicare |
$448.89
|
| Rate for Payer: WINHealth Partners Commercial |
$1,361.70
|
|
|
HC PRO NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 31256
|
| Hospital Charge Code |
9833125601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$146.27 |
| Max. Negotiated Rate |
$614.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$601.72
|
| Rate for Payer: Aetna of WY Medicare |
$172.08
|
| Rate for Payer: Beech Street Commercial |
$583.30
|
| Rate for Payer: Cash Price |
$429.80
|
| Rate for Payer: Cash Price |
$429.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$595.58
|
| Rate for Payer: Cigna of WY Commercial |
$601.72
|
| Rate for Payer: First Choice Health Commercial |
$552.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$583.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$172.08
|
| Rate for Payer: HealthUtah PPO |
$614.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$595.58
|
| Rate for Payer: Multiplan Medicare/VA |
$146.27
|
| Rate for Payer: One Health Plan of WY PPO |
$601.72
|
| Rate for Payer: PacificSource Commercial |
$552.60
|
| Rate for Payer: PHCS PPO |
$583.30
|
| Rate for Payer: Three Rivers PPO |
$460.50
|
| Rate for Payer: TriWest Veterans Administration |
$172.08
|
| Rate for Payer: United Healthcare Commercial |
$534.18
|
| Rate for Payer: United Healthcare Medicare |
$172.08
|
| Rate for Payer: WINHealth Partners Commercial |
$521.90
|
|
|
HC PRO NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY
|
Professional
|
Both
|
$1,229.00
|
|
|
Service Code
|
HCPCS 31256 50
|
| Hospital Charge Code |
9833125601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$146.27 |
| Max. Negotiated Rate |
$1,229.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,204.42
|
| Rate for Payer: Aetna of WY Medicare |
$172.08
|
| Rate for Payer: Beech Street Commercial |
$1,167.55
|
| Rate for Payer: Cash Price |
$860.30
|
| Rate for Payer: Cash Price |
$860.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,192.13
|
| Rate for Payer: Cigna of WY Commercial |
$1,204.42
|
| Rate for Payer: First Choice Health Commercial |
$1,106.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,167.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$172.08
|
| Rate for Payer: HealthUtah PPO |
$1,229.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,192.13
|
| Rate for Payer: Multiplan Medicare/VA |
$146.27
|
| Rate for Payer: One Health Plan of WY PPO |
$1,204.42
|
| Rate for Payer: PacificSource Commercial |
$1,106.10
|
| Rate for Payer: PHCS PPO |
$1,167.55
|
| Rate for Payer: Three Rivers PPO |
$921.75
|
| Rate for Payer: TriWest Veterans Administration |
$172.08
|
| Rate for Payer: United Healthcare Commercial |
$1,069.23
|
| Rate for Payer: United Healthcare Medicare |
$172.08
|
| Rate for Payer: WINHealth Partners Commercial |
$1,044.65
|
|
|
HC PRO NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 31238
|
| Hospital Charge Code |
9833123801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$136.54 |
| Max. Negotiated Rate |
$867.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$849.66
|
| Rate for Payer: Aetna of WY Medicare |
$160.63
|
| Rate for Payer: Beech Street Commercial |
$823.65
|
| Rate for Payer: Cash Price |
$606.90
|
| Rate for Payer: Cash Price |
$606.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$840.99
|
| Rate for Payer: Cigna of WY Commercial |
$849.66
|
| Rate for Payer: First Choice Health Commercial |
$780.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$823.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$160.63
|
| Rate for Payer: HealthUtah PPO |
$867.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$840.99
|
| Rate for Payer: Multiplan Medicare/VA |
$136.54
|
| Rate for Payer: One Health Plan of WY PPO |
$849.66
|
| Rate for Payer: PacificSource Commercial |
$780.30
|
| Rate for Payer: PHCS PPO |
$823.65
|
| Rate for Payer: Three Rivers PPO |
$650.25
|
| Rate for Payer: TriWest Veterans Administration |
$160.63
|
| Rate for Payer: United Healthcare Commercial |
$754.29
|
| Rate for Payer: United Healthcare Medicare |
$160.63
|
| Rate for Payer: WINHealth Partners Commercial |
$736.95
|
|
|
HC PRO NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY BILAT
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
HCPCS 31254
|
| Hospital Charge Code |
9833125401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$197.35 |
| Max. Negotiated Rate |
$1,515.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,484.70
|
| Rate for Payer: Aetna of WY Medicare |
$232.18
|
| Rate for Payer: Beech Street Commercial |
$1,439.25
|
| Rate for Payer: Cash Price |
$1,060.50
|
| Rate for Payer: Cash Price |
$1,060.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,469.55
|
| Rate for Payer: Cigna of WY Commercial |
$1,484.70
|
| Rate for Payer: First Choice Health Commercial |
$1,363.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,439.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$232.18
|
| Rate for Payer: HealthUtah PPO |
$1,515.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,469.55
|
| Rate for Payer: Multiplan Medicare/VA |
$197.35
|
| Rate for Payer: One Health Plan of WY PPO |
$1,484.70
|
| Rate for Payer: PacificSource Commercial |
$1,363.50
|
| Rate for Payer: PHCS PPO |
$1,439.25
|
| Rate for Payer: Three Rivers PPO |
$1,136.25
|
| Rate for Payer: TriWest Veterans Administration |
$232.18
|
| Rate for Payer: United Healthcare Commercial |
$1,318.05
|
| Rate for Payer: United Healthcare Medicare |
$232.18
|
| Rate for Payer: WINHealth Partners Commercial |
$1,287.75
|
|
|
HC PRO NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY BILAT
|
Professional
|
Both
|
$3,030.00
|
|
|
Service Code
|
HCPCS 31254 50
|
| Hospital Charge Code |
9833125401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$197.35 |
| Max. Negotiated Rate |
$3,030.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,969.40
|
| Rate for Payer: Aetna of WY Medicare |
$232.18
|
| Rate for Payer: Beech Street Commercial |
$2,878.50
|
| Rate for Payer: Cash Price |
$2,121.00
|
| Rate for Payer: Cash Price |
$2,121.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,939.10
|
| Rate for Payer: Cigna of WY Commercial |
$2,969.40
|
| Rate for Payer: First Choice Health Commercial |
$2,727.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,878.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$232.18
|
| Rate for Payer: HealthUtah PPO |
$3,030.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,939.10
|
| Rate for Payer: Multiplan Medicare/VA |
$197.35
|
| Rate for Payer: One Health Plan of WY PPO |
$2,969.40
|
| Rate for Payer: PacificSource Commercial |
$2,727.00
|
| Rate for Payer: PHCS PPO |
$2,878.50
|
| Rate for Payer: Three Rivers PPO |
$2,272.50
|
| Rate for Payer: TriWest Veterans Administration |
$232.18
|
| Rate for Payer: United Healthcare Commercial |
$2,636.10
|
| Rate for Payer: United Healthcare Medicare |
$232.18
|
| Rate for Payer: WINHealth Partners Commercial |
$2,575.50
|
|
|
HC PRO NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
Professional
|
Both
|
$1,287.00
|
|
|
Service Code
|
HCPCS 31276
|
| Hospital Charge Code |
9833127601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$306.48 |
| Max. Negotiated Rate |
$1,287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,261.26
|
| Rate for Payer: Aetna of WY Medicare |
$360.57
|
| Rate for Payer: Beech Street Commercial |
$1,222.65
|
| Rate for Payer: Cash Price |
$900.90
|
| Rate for Payer: Cash Price |
$900.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,248.39
|
| Rate for Payer: Cigna of WY Commercial |
$1,261.26
|
| Rate for Payer: First Choice Health Commercial |
$1,158.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,222.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$360.57
|
| Rate for Payer: HealthUtah PPO |
$1,287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,248.39
|
| Rate for Payer: Multiplan Medicare/VA |
$306.48
|
| Rate for Payer: One Health Plan of WY PPO |
$1,261.26
|
| Rate for Payer: PacificSource Commercial |
$1,158.30
|
| Rate for Payer: PHCS PPO |
$1,222.65
|
| Rate for Payer: Three Rivers PPO |
$965.25
|
| Rate for Payer: TriWest Veterans Administration |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$1,119.69
|
| Rate for Payer: United Healthcare Medicare |
$360.57
|
| Rate for Payer: WINHealth Partners Commercial |
$1,093.95
|
|
|
HC PRO NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 31276 50
|
| Hospital Charge Code |
9833127601
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$306.48 |
| Max. Negotiated Rate |
$2,574.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,522.52
|
| Rate for Payer: Aetna of WY Medicare |
$360.57
|
| Rate for Payer: Beech Street Commercial |
$2,445.30
|
| Rate for Payer: Cash Price |
$1,801.80
|
| Rate for Payer: Cash Price |
$1,801.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,496.78
|
| Rate for Payer: Cigna of WY Commercial |
$2,522.52
|
| Rate for Payer: First Choice Health Commercial |
$2,316.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,445.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$360.57
|
| Rate for Payer: HealthUtah PPO |
$2,574.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,496.78
|
| Rate for Payer: Multiplan Medicare/VA |
$306.48
|
| Rate for Payer: One Health Plan of WY PPO |
$2,522.52
|
| Rate for Payer: PacificSource Commercial |
$2,316.60
|
| Rate for Payer: PHCS PPO |
$2,445.30
|
| Rate for Payer: Three Rivers PPO |
$1,930.50
|
| Rate for Payer: TriWest Veterans Administration |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$2,239.38
|
| Rate for Payer: United Healthcare Medicare |
$360.57
|
| Rate for Payer: WINHealth Partners Commercial |
$2,187.90
|
|
|
HC PRO NASAL/SINUS TOTAL ETHOIDECTOM BILAT
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 31255 50
|
| Hospital Charge Code |
9833125501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,156.00
|
| Rate for Payer: Aetna of WY Medicare |
$308.23
|
| Rate for Payer: Beech Street Commercial |
$2,090.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,134.00
|
| Rate for Payer: Cigna of WY Commercial |
$2,156.00
|
| Rate for Payer: First Choice Health Commercial |
$1,980.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,090.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$308.23
|
| Rate for Payer: HealthUtah PPO |
$2,200.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,134.00
|
| Rate for Payer: Multiplan Medicare/VA |
$262.00
|
| Rate for Payer: One Health Plan of WY PPO |
$2,156.00
|
| Rate for Payer: PacificSource Commercial |
$1,980.00
|
| Rate for Payer: PHCS PPO |
$2,090.00
|
| Rate for Payer: Three Rivers PPO |
$1,650.00
|
| Rate for Payer: TriWest Veterans Administration |
$308.23
|
| Rate for Payer: United Healthcare Commercial |
$1,914.00
|
| Rate for Payer: United Healthcare Medicare |
$308.23
|
| Rate for Payer: WINHealth Partners Commercial |
$1,870.00
|
|
