|
HC PRO SHOULDER ARTHROSCOPY SLAP LESI
|
Professional
|
Both
|
$5,339.00
|
|
|
Service Code
|
HCPCS 29807
|
| Hospital Charge Code |
9832980701
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$849.04 |
| Max. Negotiated Rate |
$5,339.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,232.22
|
| Rate for Payer: Aetna of WY Medicare |
$998.87
|
| Rate for Payer: Beech Street Commercial |
$5,072.05
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: Cash Price |
$3,737.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,178.83
|
| Rate for Payer: Cigna of WY Commercial |
$5,232.22
|
| Rate for Payer: First Choice Health Commercial |
$4,805.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,072.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$998.87
|
| Rate for Payer: HealthUtah PPO |
$5,339.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,178.83
|
| Rate for Payer: Multiplan Medicare/VA |
$849.04
|
| Rate for Payer: One Health Plan of WY PPO |
$5,232.22
|
| Rate for Payer: PacificSource Commercial |
$4,805.10
|
| Rate for Payer: PHCS PPO |
$5,072.05
|
| Rate for Payer: Three Rivers PPO |
$4,004.25
|
| Rate for Payer: TriWest Veterans Administration |
$998.87
|
| Rate for Payer: United Healthcare Commercial |
$4,644.93
|
| Rate for Payer: United Healthcare Medicare |
$998.87
|
| Rate for Payer: WINHealth Partners Commercial |
$4,538.15
|
|
|
HC PRO SHOULDER ARTHROSCOPY/SURGERY
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 29825
|
| Hospital Charge Code |
9832982501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$3,024.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,963.52
|
| Rate for Payer: Aetna of WY Medicare |
$570.84
|
| Rate for Payer: Beech Street Commercial |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,933.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,963.52
|
| Rate for Payer: First Choice Health Commercial |
$2,721.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,872.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$570.84
|
| Rate for Payer: HealthUtah PPO |
$3,024.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,933.28
|
| Rate for Payer: Multiplan Medicare/VA |
$485.21
|
| Rate for Payer: One Health Plan of WY PPO |
$2,963.52
|
| Rate for Payer: PacificSource Commercial |
$2,721.60
|
| Rate for Payer: PHCS PPO |
$2,872.80
|
| Rate for Payer: Three Rivers PPO |
$2,268.00
|
| Rate for Payer: TriWest Veterans Administration |
$570.84
|
| Rate for Payer: United Healthcare Commercial |
$2,630.88
|
| Rate for Payer: United Healthcare Medicare |
$570.84
|
| Rate for Payer: WINHealth Partners Commercial |
$2,570.40
|
|
|
HC PRO SHOULDER ARTHRO/SURG SYNOVECTOMY
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 29820
|
| Hospital Charge Code |
9832982001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$441.63 |
| Max. Negotiated Rate |
$2,768.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,712.64
|
| Rate for Payer: Aetna of WY Medicare |
$519.56
|
| Rate for Payer: Beech Street Commercial |
$2,629.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,684.96
|
| Rate for Payer: Cigna of WY Commercial |
$2,712.64
|
| Rate for Payer: First Choice Health Commercial |
$2,491.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,629.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$519.56
|
| Rate for Payer: HealthUtah PPO |
$2,768.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,684.96
|
| Rate for Payer: Multiplan Medicare/VA |
$441.63
|
| Rate for Payer: One Health Plan of WY PPO |
$2,712.64
|
| Rate for Payer: PacificSource Commercial |
$2,491.20
|
| Rate for Payer: PHCS PPO |
$2,629.60
|
| Rate for Payer: Three Rivers PPO |
$2,076.00
|
| Rate for Payer: TriWest Veterans Administration |
$519.56
|
| Rate for Payer: United Healthcare Commercial |
$2,408.16
|
| Rate for Payer: United Healthcare Medicare |
$519.56
|
| Rate for Payer: WINHealth Partners Commercial |
$2,352.80
|
|
|
HC PRO SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 11312
|
| Hospital Charge Code |
9831131201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$60.21 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$296.94
|
| Rate for Payer: Aetna of WY Medicare |
$70.84
|
| Rate for Payer: Beech Street Commercial |
$287.85
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$293.91
|
| Rate for Payer: Cigna of WY Commercial |
$296.94
|
| Rate for Payer: First Choice Health Commercial |
$272.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$287.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$70.84
|
| Rate for Payer: HealthUtah PPO |
$303.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$293.91
|
| Rate for Payer: Multiplan Medicare/VA |
$60.21
|
| Rate for Payer: One Health Plan of WY PPO |
$296.94
|
| Rate for Payer: PacificSource Commercial |
$272.70
|
| Rate for Payer: PHCS PPO |
$287.85
|
| Rate for Payer: Three Rivers PPO |
$227.25
|
| Rate for Payer: TriWest Veterans Administration |
$70.84
|
| Rate for Payer: United Healthcare Commercial |
$263.61
|
| Rate for Payer: United Healthcare Medicare |
$70.84
|
| Rate for Payer: WINHealth Partners Commercial |
$257.55
|
|
|
HC PRO SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 11312 NONPBBPAYER
|
| Hospital Charge Code |
9831131201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$60.21 |
| Max. Negotiated Rate |
$379.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$371.42
|
| Rate for Payer: Aetna of WY Medicare |
$70.84
|
| Rate for Payer: Beech Street Commercial |
$360.05
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$367.63
|
| Rate for Payer: Cigna of WY Commercial |
$371.42
|
| Rate for Payer: First Choice Health Commercial |
$341.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$360.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$70.84
|
| Rate for Payer: HealthUtah PPO |
$379.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$367.63
|
| Rate for Payer: Multiplan Medicare/VA |
$60.21
|
| Rate for Payer: One Health Plan of WY PPO |
$371.42
|
| Rate for Payer: PacificSource Commercial |
$341.10
|
| Rate for Payer: PHCS PPO |
$360.05
|
| Rate for Payer: Three Rivers PPO |
$284.25
|
| Rate for Payer: TriWest Veterans Administration |
$70.84
|
| Rate for Payer: United Healthcare Commercial |
$329.73
|
| Rate for Payer: United Healthcare Medicare |
$70.84
|
| Rate for Payer: WINHealth Partners Commercial |
$322.15
|
|
|
HC PROSHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 11303 NONPBBPAYER
|
| Hospital Charge Code |
9831130301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$57.71 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$352.80
|
| Rate for Payer: Aetna of WY Medicare |
$67.89
|
| Rate for Payer: Beech Street Commercial |
$342.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$349.20
|
| Rate for Payer: Cigna of WY Commercial |
$352.80
|
| Rate for Payer: First Choice Health Commercial |
$324.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$342.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$67.89
|
| Rate for Payer: HealthUtah PPO |
$360.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$349.20
|
| Rate for Payer: Multiplan Medicare/VA |
$57.71
|
| Rate for Payer: One Health Plan of WY PPO |
$352.80
|
| Rate for Payer: PacificSource Commercial |
$324.00
|
| Rate for Payer: PHCS PPO |
$342.00
|
| Rate for Payer: Three Rivers PPO |
$270.00
|
| Rate for Payer: TriWest Veterans Administration |
$67.89
|
| Rate for Payer: United Healthcare Commercial |
$313.20
|
| Rate for Payer: United Healthcare Medicare |
$67.89
|
| Rate for Payer: WINHealth Partners Commercial |
$306.00
|
|
|
HC PROSHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
HCPCS 11303
|
| Hospital Charge Code |
9831130301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$57.71 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$282.24
|
| Rate for Payer: Aetna of WY Medicare |
$67.89
|
| Rate for Payer: Beech Street Commercial |
$273.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$279.36
|
| Rate for Payer: Cigna of WY Commercial |
$282.24
|
| Rate for Payer: First Choice Health Commercial |
$259.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$273.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$67.89
|
| Rate for Payer: HealthUtah PPO |
$288.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$279.36
|
| Rate for Payer: Multiplan Medicare/VA |
$57.71
|
| Rate for Payer: One Health Plan of WY PPO |
$282.24
|
| Rate for Payer: PacificSource Commercial |
$259.20
|
| Rate for Payer: PHCS PPO |
$273.60
|
| Rate for Payer: Three Rivers PPO |
$216.00
|
| Rate for Payer: TriWest Veterans Administration |
$67.89
|
| Rate for Payer: United Healthcare Commercial |
$250.56
|
| Rate for Payer: United Healthcare Medicare |
$67.89
|
| Rate for Payer: WINHealth Partners Commercial |
$244.80
|
|
|
HC PRO SIGMOIDOSCOPY,BIOPSY - ENDOSCOPY SIGMOID
|
Professional
|
Both
|
$1,177.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
9834533101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$58.75 |
| Max. Negotiated Rate |
$1,177.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,153.46
|
| Rate for Payer: Aetna of WY Medicare |
$69.12
|
| Rate for Payer: Beech Street Commercial |
$1,118.15
|
| Rate for Payer: Cash Price |
$823.90
|
| Rate for Payer: Cash Price |
$823.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,141.69
|
| Rate for Payer: Cigna of WY Commercial |
$1,153.46
|
| Rate for Payer: First Choice Health Commercial |
$1,059.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,118.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$69.12
|
| Rate for Payer: HealthUtah PPO |
$1,177.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,141.69
|
| Rate for Payer: Multiplan Medicare/VA |
$58.75
|
| Rate for Payer: One Health Plan of WY PPO |
$1,153.46
|
| Rate for Payer: PacificSource Commercial |
$1,059.30
|
| Rate for Payer: PHCS PPO |
$1,118.15
|
| Rate for Payer: Three Rivers PPO |
$882.75
|
| Rate for Payer: TriWest Veterans Administration |
$69.12
|
| Rate for Payer: United Healthcare Commercial |
$1,023.99
|
| Rate for Payer: United Healthcare Medicare |
$69.12
|
| Rate for Payer: WINHealth Partners Commercial |
$1,000.45
|
|
|
HC PRO SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
9834533001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$46.16 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$882.00
|
| Rate for Payer: Aetna of WY Medicare |
$54.31
|
| Rate for Payer: Beech Street Commercial |
$855.00
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$873.00
|
| Rate for Payer: Cigna of WY Commercial |
$882.00
|
| Rate for Payer: First Choice Health Commercial |
$810.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$855.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.31
|
| Rate for Payer: HealthUtah PPO |
$900.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$873.00
|
| Rate for Payer: Multiplan Medicare/VA |
$46.16
|
| Rate for Payer: One Health Plan of WY PPO |
$882.00
|
| Rate for Payer: PacificSource Commercial |
$810.00
|
| Rate for Payer: PHCS PPO |
$855.00
|
| Rate for Payer: Three Rivers PPO |
$675.00
|
| Rate for Payer: TriWest Veterans Administration |
$54.31
|
| Rate for Payer: United Healthcare Commercial |
$783.00
|
| Rate for Payer: United Healthcare Medicare |
$54.31
|
| Rate for Payer: WINHealth Partners Commercial |
$765.00
|
|
|
HC PRO SIGMOIDOSCOPY FLX TNDSC BALO DILAT
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 45340
|
| Hospital Charge Code |
9834534001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$63.55 |
| Max. Negotiated Rate |
$402.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$393.96
|
| Rate for Payer: Aetna of WY Medicare |
$74.76
|
| Rate for Payer: Beech Street Commercial |
$381.90
|
| Rate for Payer: Cash Price |
$281.40
|
| Rate for Payer: Cash Price |
$281.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$389.94
|
| Rate for Payer: Cigna of WY Commercial |
$393.96
|
| Rate for Payer: First Choice Health Commercial |
$361.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$381.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$74.76
|
| Rate for Payer: HealthUtah PPO |
$402.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$389.94
|
| Rate for Payer: Multiplan Medicare/VA |
$63.55
|
| Rate for Payer: One Health Plan of WY PPO |
$393.96
|
| Rate for Payer: PacificSource Commercial |
$361.80
|
| Rate for Payer: PHCS PPO |
$381.90
|
| Rate for Payer: Three Rivers PPO |
$301.50
|
| Rate for Payer: TriWest Veterans Administration |
$74.76
|
| Rate for Payer: United Healthcare Commercial |
$349.74
|
| Rate for Payer: United Healthcare Medicare |
$74.76
|
| Rate for Payer: WINHealth Partners Commercial |
$341.70
|
|
|
HC PRO SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 51725
|
| Hospital Charge Code |
9835172501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$188.78 |
| Max. Negotiated Rate |
$553.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$541.94
|
| Rate for Payer: Aetna of WY Medicare |
$222.10
|
| Rate for Payer: Beech Street Commercial |
$525.35
|
| Rate for Payer: Cash Price |
$387.10
|
| Rate for Payer: Cash Price |
$387.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$536.41
|
| Rate for Payer: Cigna of WY Commercial |
$541.94
|
| Rate for Payer: First Choice Health Commercial |
$497.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$525.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$222.10
|
| Rate for Payer: HealthUtah PPO |
$553.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$536.41
|
| Rate for Payer: Multiplan Medicare/VA |
$188.78
|
| Rate for Payer: One Health Plan of WY PPO |
$541.94
|
| Rate for Payer: PacificSource Commercial |
$497.70
|
| Rate for Payer: PHCS PPO |
$525.35
|
| Rate for Payer: Three Rivers PPO |
$414.75
|
| Rate for Payer: TriWest Veterans Administration |
$222.10
|
| Rate for Payer: United Healthcare Commercial |
$481.11
|
| Rate for Payer: United Healthcare Medicare |
$222.10
|
| Rate for Payer: WINHealth Partners Commercial |
$470.05
|
|
|
HC PRO SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 51725 NONPBBPAYER
|
| Hospital Charge Code |
9835172501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$188.78 |
| Max. Negotiated Rate |
$691.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$677.18
|
| Rate for Payer: Aetna of WY Medicare |
$222.10
|
| Rate for Payer: Beech Street Commercial |
$656.45
|
| Rate for Payer: Cash Price |
$483.70
|
| Rate for Payer: Cash Price |
$483.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$670.27
|
| Rate for Payer: Cigna of WY Commercial |
$677.18
|
| Rate for Payer: First Choice Health Commercial |
$621.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$656.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$222.10
|
| Rate for Payer: HealthUtah PPO |
$691.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$670.27
|
| Rate for Payer: Multiplan Medicare/VA |
$188.78
|
| Rate for Payer: One Health Plan of WY PPO |
$677.18
|
| Rate for Payer: PacificSource Commercial |
$621.90
|
| Rate for Payer: PHCS PPO |
$656.45
|
| Rate for Payer: Three Rivers PPO |
$518.25
|
| Rate for Payer: TriWest Veterans Administration |
$222.10
|
| Rate for Payer: United Healthcare Commercial |
$601.17
|
| Rate for Payer: United Healthcare Medicare |
$222.10
|
| Rate for Payer: WINHealth Partners Commercial |
$587.35
|
|
|
HC PRO SKIN TISSUE PROCEDURE UNLISTED
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 17999
|
| Hospital Charge Code |
9831799901
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$1,595.25 |
| Max. Negotiated Rate |
$2,127.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,084.46
|
| Rate for Payer: Beech Street Commercial |
$2,020.65
|
| Rate for Payer: Cash Price |
$1,488.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,063.19
|
| Rate for Payer: Cigna of WY Commercial |
$2,084.46
|
| Rate for Payer: First Choice Health Commercial |
$1,914.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,020.65
|
| Rate for Payer: HealthUtah PPO |
$2,127.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,063.19
|
| Rate for Payer: One Health Plan of WY PPO |
$2,084.46
|
| Rate for Payer: PacificSource Commercial |
$1,914.30
|
| Rate for Payer: PHCS PPO |
$2,020.65
|
| Rate for Payer: Three Rivers PPO |
$1,595.25
|
| Rate for Payer: United Healthcare Commercial |
$1,850.49
|
| Rate for Payer: WINHealth Partners Commercial |
$1,807.95
|
|
|
HC PRO SLING OPERATION STRESS INCONTINENCE
|
Professional
|
Both
|
$5,018.00
|
|
|
Service Code
|
HCPCS 57288
|
| Hospital Charge Code |
9835728801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$610.56 |
| Max. Negotiated Rate |
$5,018.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,917.64
|
| Rate for Payer: Aetna of WY Medicare |
$718.31
|
| Rate for Payer: Beech Street Commercial |
$4,767.10
|
| Rate for Payer: Cash Price |
$3,512.60
|
| Rate for Payer: Cash Price |
$3,512.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,867.46
|
| Rate for Payer: Cigna of WY Commercial |
$4,917.64
|
| Rate for Payer: First Choice Health Commercial |
$4,516.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,767.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$718.31
|
| Rate for Payer: HealthUtah PPO |
$5,018.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,867.46
|
| Rate for Payer: Multiplan Medicare/VA |
$610.56
|
| Rate for Payer: One Health Plan of WY PPO |
$4,917.64
|
| Rate for Payer: PacificSource Commercial |
$4,516.20
|
| Rate for Payer: PHCS PPO |
$4,767.10
|
| Rate for Payer: Three Rivers PPO |
$3,763.50
|
| Rate for Payer: TriWest Veterans Administration |
$718.31
|
| Rate for Payer: United Healthcare Commercial |
$4,365.66
|
| Rate for Payer: United Healthcare Medicare |
$718.31
|
| Rate for Payer: WINHealth Partners Commercial |
$4,265.30
|
|
|
HC PRO SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX
|
Professional
|
Both
|
$7,047.00
|
|
|
Service Code
|
HCPCS 46080
|
| Hospital Charge Code |
9834608001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$128.65 |
| Max. Negotiated Rate |
$7,047.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,906.06
|
| Rate for Payer: Aetna of WY Medicare |
$151.35
|
| Rate for Payer: Beech Street Commercial |
$6,694.65
|
| Rate for Payer: Cash Price |
$4,932.90
|
| Rate for Payer: Cash Price |
$4,932.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,835.59
|
| Rate for Payer: Cigna of WY Commercial |
$6,906.06
|
| Rate for Payer: First Choice Health Commercial |
$6,342.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,694.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$151.35
|
| Rate for Payer: HealthUtah PPO |
$7,047.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,835.59
|
| Rate for Payer: Multiplan Medicare/VA |
$128.65
|
| Rate for Payer: One Health Plan of WY PPO |
$6,906.06
|
| Rate for Payer: PacificSource Commercial |
$6,342.30
|
| Rate for Payer: PHCS PPO |
$6,694.65
|
| Rate for Payer: Three Rivers PPO |
$5,285.25
|
| Rate for Payer: TriWest Veterans Administration |
$151.35
|
| Rate for Payer: United Healthcare Commercial |
$6,130.89
|
| Rate for Payer: United Healthcare Medicare |
$151.35
|
| Rate for Payer: WINHealth Partners Commercial |
$5,989.95
|
|
|
HC PRO SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 62270
|
| Hospital Charge Code |
9836227001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$50.92 |
| Max. Negotiated Rate |
$321.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$314.58
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$551.74
|
| Rate for Payer: Aetna of WY Medicare |
$59.91
|
| Rate for Payer: Aetna of WY Medicare |
$59.91
|
| Rate for Payer: Beech Street Commercial |
$534.85
|
| Rate for Payer: Beech Street Commercial |
$304.95
|
| Rate for Payer: Cash Price |
$394.10
|
| Rate for Payer: Cash Price |
$224.70
|
| Rate for Payer: Cash Price |
$224.70
|
| Rate for Payer: Cash Price |
$394.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$546.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$311.37
|
| Rate for Payer: Cigna of WY Commercial |
$314.58
|
| Rate for Payer: Cigna of WY Commercial |
$551.74
|
| Rate for Payer: First Choice Health Commercial |
$506.70
|
| Rate for Payer: First Choice Health Commercial |
$288.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$304.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$534.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.91
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$59.91
|
| Rate for Payer: HealthUtah PPO |
$321.00
|
| Rate for Payer: HealthUtah PPO |
$563.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$546.11
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$311.37
|
| Rate for Payer: Multiplan Medicare/VA |
$50.92
|
| Rate for Payer: Multiplan Medicare/VA |
$50.92
|
| Rate for Payer: One Health Plan of WY PPO |
$551.74
|
| Rate for Payer: One Health Plan of WY PPO |
$314.58
|
| Rate for Payer: PacificSource Commercial |
$288.90
|
| Rate for Payer: PacificSource Commercial |
$506.70
|
| Rate for Payer: PHCS PPO |
$304.95
|
| Rate for Payer: PHCS PPO |
$534.85
|
| Rate for Payer: Three Rivers PPO |
$240.75
|
| Rate for Payer: Three Rivers PPO |
$422.25
|
| Rate for Payer: TriWest Veterans Administration |
$59.91
|
| Rate for Payer: TriWest Veterans Administration |
$59.91
|
| Rate for Payer: United Healthcare Commercial |
$489.81
|
| Rate for Payer: United Healthcare Commercial |
$279.27
|
| Rate for Payer: United Healthcare Medicare |
$59.91
|
| Rate for Payer: United Healthcare Medicare |
$59.91
|
| Rate for Payer: WINHealth Partners Commercial |
$272.85
|
| Rate for Payer: WINHealth Partners Commercial |
$478.55
|
|
|
HC PRO SPINAL PUNCTURE,THERAPEUTIC DRAINAGE
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
HCPCS 62272
|
| Hospital Charge Code |
9836227201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$452.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$442.96
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$571.34
|
| Rate for Payer: Aetna of WY Medicare |
$86.12
|
| Rate for Payer: Aetna of WY Medicare |
$86.12
|
| Rate for Payer: Beech Street Commercial |
$553.85
|
| Rate for Payer: Beech Street Commercial |
$429.40
|
| Rate for Payer: Cash Price |
$408.10
|
| Rate for Payer: Cash Price |
$316.40
|
| Rate for Payer: Cash Price |
$316.40
|
| Rate for Payer: Cash Price |
$408.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$565.51
|
| Rate for Payer: ChoiceCare Network Commercial |
$438.44
|
| Rate for Payer: Cigna of WY Commercial |
$442.96
|
| Rate for Payer: Cigna of WY Commercial |
$571.34
|
| Rate for Payer: First Choice Health Commercial |
$524.70
|
| Rate for Payer: First Choice Health Commercial |
$406.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$429.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$553.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$86.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$86.12
|
| Rate for Payer: HealthUtah PPO |
$452.00
|
| Rate for Payer: HealthUtah PPO |
$583.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$565.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$438.44
|
| Rate for Payer: Multiplan Medicare/VA |
$73.20
|
| Rate for Payer: Multiplan Medicare/VA |
$73.20
|
| Rate for Payer: One Health Plan of WY PPO |
$571.34
|
| Rate for Payer: One Health Plan of WY PPO |
$442.96
|
| Rate for Payer: PacificSource Commercial |
$406.80
|
| Rate for Payer: PacificSource Commercial |
$524.70
|
| Rate for Payer: PHCS PPO |
$429.40
|
| Rate for Payer: PHCS PPO |
$553.85
|
| Rate for Payer: Three Rivers PPO |
$339.00
|
| Rate for Payer: Three Rivers PPO |
$437.25
|
| Rate for Payer: TriWest Veterans Administration |
$86.12
|
| Rate for Payer: TriWest Veterans Administration |
$86.12
|
| Rate for Payer: United Healthcare Commercial |
$507.21
|
| Rate for Payer: United Healthcare Commercial |
$393.24
|
| Rate for Payer: United Healthcare Medicare |
$86.12
|
| Rate for Payer: United Healthcare Medicare |
$86.12
|
| Rate for Payer: WINHealth Partners Commercial |
$384.20
|
| Rate for Payer: WINHealth Partners Commercial |
$495.55
|
|
|
HC PRO SPLENECTOMY TOTAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$5,968.00
|
|
|
Service Code
|
HCPCS 38100
|
| Hospital Charge Code |
9833810001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$924.69 |
| Max. Negotiated Rate |
$5,968.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,848.64
|
| Rate for Payer: Aetna of WY Medicare |
$1,087.87
|
| Rate for Payer: Beech Street Commercial |
$5,669.60
|
| Rate for Payer: Cash Price |
$4,177.60
|
| Rate for Payer: Cash Price |
$4,177.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,788.96
|
| Rate for Payer: Cigna of WY Commercial |
$5,848.64
|
| Rate for Payer: First Choice Health Commercial |
$5,371.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,669.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,087.87
|
| Rate for Payer: HealthUtah PPO |
$5,968.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,788.96
|
| Rate for Payer: Multiplan Medicare/VA |
$924.69
|
| Rate for Payer: One Health Plan of WY PPO |
$5,848.64
|
| Rate for Payer: PacificSource Commercial |
$5,371.20
|
| Rate for Payer: PHCS PPO |
$5,669.60
|
| Rate for Payer: Three Rivers PPO |
$4,476.00
|
| Rate for Payer: TriWest Veterans Administration |
$1,087.87
|
| Rate for Payer: United Healthcare Commercial |
$5,192.16
|
| Rate for Payer: United Healthcare Medicare |
$1,087.87
|
| Rate for Payer: WINHealth Partners Commercial |
$5,072.80
|
|
|
HC PRO SPLIT GFT T/A/L 1ST 100SQ CM
|
Professional
|
Both
|
$2,995.00
|
|
|
Service Code
|
HCPCS 15100
|
| Hospital Charge Code |
9831510001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$584.66 |
| Max. Negotiated Rate |
$2,995.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,935.10
|
| Rate for Payer: Aetna of WY Medicare |
$687.83
|
| Rate for Payer: Beech Street Commercial |
$2,845.25
|
| Rate for Payer: Cash Price |
$2,096.50
|
| Rate for Payer: Cash Price |
$2,096.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,905.15
|
| Rate for Payer: Cigna of WY Commercial |
$2,935.10
|
| Rate for Payer: First Choice Health Commercial |
$2,695.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,845.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$687.83
|
| Rate for Payer: HealthUtah PPO |
$2,995.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,905.15
|
| Rate for Payer: Multiplan Medicare/VA |
$584.66
|
| Rate for Payer: One Health Plan of WY PPO |
$2,935.10
|
| Rate for Payer: PacificSource Commercial |
$2,695.50
|
| Rate for Payer: PHCS PPO |
$2,845.25
|
| Rate for Payer: Three Rivers PPO |
$2,246.25
|
| Rate for Payer: TriWest Veterans Administration |
$687.83
|
| Rate for Payer: United Healthcare Commercial |
$2,605.65
|
| Rate for Payer: United Healthcare Medicare |
$687.83
|
| Rate for Payer: WINHealth Partners Commercial |
$2,545.75
|
|
|
HC PRO STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS
|
Professional
|
Both
|
$1,684.00
|
|
|
Service Code
|
HCPCS 37766
|
| Hospital Charge Code |
9823776601
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$262.40 |
| Max. Negotiated Rate |
$1,684.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,650.32
|
| Rate for Payer: Aetna of WY Medicare |
$308.70
|
| Rate for Payer: Beech Street Commercial |
$1,599.80
|
| Rate for Payer: Cash Price |
$1,178.80
|
| Rate for Payer: Cash Price |
$1,178.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,633.48
|
| Rate for Payer: Cigna of WY Commercial |
$1,650.32
|
| Rate for Payer: First Choice Health Commercial |
$1,515.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,599.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$308.70
|
| Rate for Payer: HealthUtah PPO |
$1,684.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,633.48
|
| Rate for Payer: Multiplan Medicare/VA |
$262.40
|
| Rate for Payer: One Health Plan of WY PPO |
$1,650.32
|
| Rate for Payer: PacificSource Commercial |
$1,515.60
|
| Rate for Payer: PHCS PPO |
$1,599.80
|
| Rate for Payer: Three Rivers PPO |
$1,263.00
|
| Rate for Payer: TriWest Veterans Administration |
$308.70
|
| Rate for Payer: United Healthcare Commercial |
$1,465.08
|
| Rate for Payer: United Healthcare Medicare |
$308.70
|
| Rate for Payer: WINHealth Partners Commercial |
$1,431.40
|
|
|
HC PROSTATE BIOPSY, ANY MTHD
|
Professional
|
Both
|
$1,650.00
|
|
|
Service Code
|
HCPCS G0416
|
| Hospital Charge Code |
310G041601
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$302.29 |
| Max. Negotiated Rate |
$1,650.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,617.00
|
| Rate for Payer: Aetna of WY Medicare |
$355.64
|
| Rate for Payer: Beech Street Commercial |
$1,567.50
|
| Rate for Payer: Cash Price |
$1,155.00
|
| Rate for Payer: Cash Price |
$1,155.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,600.50
|
| Rate for Payer: Cigna of WY Commercial |
$1,617.00
|
| Rate for Payer: First Choice Health Commercial |
$1,485.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,567.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$355.64
|
| Rate for Payer: HealthUtah PPO |
$1,650.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,600.50
|
| Rate for Payer: Multiplan Medicare/VA |
$302.29
|
| Rate for Payer: One Health Plan of WY PPO |
$1,617.00
|
| Rate for Payer: PacificSource Commercial |
$1,485.00
|
| Rate for Payer: PHCS PPO |
$1,567.50
|
| Rate for Payer: Three Rivers PPO |
$1,237.50
|
| Rate for Payer: TriWest Veterans Administration |
$355.64
|
| Rate for Payer: United Healthcare Commercial |
$1,435.50
|
| Rate for Payer: United Healthcare Medicare |
$355.64
|
| Rate for Payer: WINHealth Partners Commercial |
$1,567.50
|
|
|
HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 84153
|
| Hospital Charge Code |
3018415301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.63 |
| Max. Negotiated Rate |
$145.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$142.10
|
| Rate for Payer: Aetna of WY Medicare |
$18.39
|
| Rate for Payer: Beech Street Commercial |
$137.75
|
| Rate for Payer: Cash Price |
$101.50
|
| Rate for Payer: Cash Price |
$101.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$140.65
|
| Rate for Payer: Cigna of WY Commercial |
$142.10
|
| Rate for Payer: First Choice Health Commercial |
$130.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$137.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.39
|
| Rate for Payer: HealthUtah PPO |
$145.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$140.65
|
| Rate for Payer: Multiplan Medicare/VA |
$15.63
|
| Rate for Payer: One Health Plan of WY PPO |
$142.10
|
| Rate for Payer: PacificSource Commercial |
$130.50
|
| Rate for Payer: PHCS PPO |
$137.75
|
| Rate for Payer: Three Rivers PPO |
$108.75
|
| Rate for Payer: TriWest Veterans Administration |
$18.39
|
| Rate for Payer: United Healthcare Commercial |
$126.15
|
| Rate for Payer: United Healthcare Medicare |
$18.39
|
| Rate for Payer: WINHealth Partners Commercial |
$137.75
|
|
|
HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 84153
|
| Hospital Charge Code |
3018415302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.63 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$191.10
|
| Rate for Payer: Aetna of WY Medicare |
$18.39
|
| Rate for Payer: Beech Street Commercial |
$185.25
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$189.15
|
| Rate for Payer: Cigna of WY Commercial |
$191.10
|
| Rate for Payer: First Choice Health Commercial |
$175.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$185.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.39
|
| Rate for Payer: HealthUtah PPO |
$195.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$189.15
|
| Rate for Payer: Multiplan Medicare/VA |
$15.63
|
| Rate for Payer: One Health Plan of WY PPO |
$191.10
|
| Rate for Payer: PacificSource Commercial |
$175.50
|
| Rate for Payer: PHCS PPO |
$185.25
|
| Rate for Payer: Three Rivers PPO |
$146.25
|
| Rate for Payer: TriWest Veterans Administration |
$18.39
|
| Rate for Payer: United Healthcare Commercial |
$169.65
|
| Rate for Payer: United Healthcare Medicare |
$18.39
|
| Rate for Payer: WINHealth Partners Commercial |
$185.25
|
|
|
HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 84153
|
| Hospital Charge Code |
3018415303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.63 |
| Max. Negotiated Rate |
$145.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$142.10
|
| Rate for Payer: Aetna of WY Medicare |
$18.39
|
| Rate for Payer: Beech Street Commercial |
$137.75
|
| Rate for Payer: Cash Price |
$101.50
|
| Rate for Payer: Cash Price |
$101.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$140.65
|
| Rate for Payer: Cigna of WY Commercial |
$142.10
|
| Rate for Payer: First Choice Health Commercial |
$130.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$137.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.39
|
| Rate for Payer: HealthUtah PPO |
$145.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$140.65
|
| Rate for Payer: Multiplan Medicare/VA |
$15.63
|
| Rate for Payer: One Health Plan of WY PPO |
$142.10
|
| Rate for Payer: PacificSource Commercial |
$130.50
|
| Rate for Payer: PHCS PPO |
$137.75
|
| Rate for Payer: Three Rivers PPO |
$108.75
|
| Rate for Payer: TriWest Veterans Administration |
$18.39
|
| Rate for Payer: United Healthcare Commercial |
$126.15
|
| Rate for Payer: United Healthcare Medicare |
$18.39
|
| Rate for Payer: WINHealth Partners Commercial |
$137.75
|
|
|
HC PRO STEREOTACTIC COMP ASSIST PROC,CRANIAL,EXTRADURAL
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 61782
|
| Hospital Charge Code |
9836178201
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$139.37 |
| Max. Negotiated Rate |
$896.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$878.08
|
| Rate for Payer: Aetna of WY Medicare |
$163.96
|
| Rate for Payer: Beech Street Commercial |
$851.20
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$869.12
|
| Rate for Payer: Cigna of WY Commercial |
$878.08
|
| Rate for Payer: First Choice Health Commercial |
$806.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$851.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$163.96
|
| Rate for Payer: HealthUtah PPO |
$896.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$869.12
|
| Rate for Payer: Multiplan Medicare/VA |
$139.37
|
| Rate for Payer: One Health Plan of WY PPO |
$878.08
|
| Rate for Payer: PacificSource Commercial |
$806.40
|
| Rate for Payer: PHCS PPO |
$851.20
|
| Rate for Payer: Three Rivers PPO |
$672.00
|
| Rate for Payer: TriWest Veterans Administration |
$163.96
|
| Rate for Payer: United Healthcare Commercial |
$779.52
|
| Rate for Payer: United Healthcare Medicare |
$163.96
|
| Rate for Payer: WINHealth Partners Commercial |
$761.60
|
|
