|
HC PROTEIN TOT XCPT REFRACTOMETRY SERUM - PROTEIN TOTAL
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 84155
|
| Hospital Charge Code |
3018415501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$49.00
|
| Rate for Payer: Aetna of WY Medicare |
$3.67
|
| Rate for Payer: Beech Street Commercial |
$47.50
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$48.50
|
| Rate for Payer: Cigna of WY Commercial |
$49.00
|
| Rate for Payer: First Choice Health Commercial |
$45.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$47.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.67
|
| Rate for Payer: HealthUtah PPO |
$50.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$48.50
|
| Rate for Payer: Multiplan Medicare/VA |
$3.12
|
| Rate for Payer: One Health Plan of WY PPO |
$49.00
|
| Rate for Payer: PacificSource Commercial |
$45.00
|
| Rate for Payer: PHCS PPO |
$47.50
|
| Rate for Payer: Three Rivers PPO |
$37.50
|
| Rate for Payer: TriWest Veterans Administration |
$3.67
|
| Rate for Payer: United Healthcare Commercial |
$43.50
|
| Rate for Payer: United Healthcare Medicare |
$3.67
|
| Rate for Payer: WINHealth Partners Commercial |
$47.50
|
|
|
HC PROTEIN TOT XCPT REFRACTOMETRY URINE - PROTEIN 24 HOUR URINE
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 84156
|
| Hospital Charge Code |
3018415603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$145.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$142.10
|
| Rate for Payer: Aetna of WY Medicare |
$3.67
|
| 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 |
$3.67
|
| Rate for Payer: HealthUtah PPO |
$145.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$140.65
|
| Rate for Payer: Multiplan Medicare/VA |
$3.12
|
| 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 |
$3.67
|
| Rate for Payer: United Healthcare Commercial |
$126.15
|
| Rate for Payer: United Healthcare Medicare |
$3.67
|
| Rate for Payer: WINHealth Partners Commercial |
$137.75
|
|
|
HC PROTEIN TOT XCPT REFRACTOMETRY URINE - PROTEIN / CREATININE RATIO, U
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 84156
|
| Hospital Charge Code |
3018415604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$196.00
|
| Rate for Payer: Aetna of WY Medicare |
$3.67
|
| Rate for Payer: Beech Street Commercial |
$190.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$194.00
|
| Rate for Payer: Cigna of WY Commercial |
$196.00
|
| Rate for Payer: First Choice Health Commercial |
$180.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$190.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.67
|
| Rate for Payer: HealthUtah PPO |
$200.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$194.00
|
| Rate for Payer: Multiplan Medicare/VA |
$3.12
|
| Rate for Payer: One Health Plan of WY PPO |
$196.00
|
| Rate for Payer: PacificSource Commercial |
$180.00
|
| Rate for Payer: PHCS PPO |
$190.00
|
| Rate for Payer: Three Rivers PPO |
$150.00
|
| Rate for Payer: TriWest Veterans Administration |
$3.67
|
| Rate for Payer: United Healthcare Commercial |
$174.00
|
| Rate for Payer: United Healthcare Medicare |
$3.67
|
| Rate for Payer: WINHealth Partners Commercial |
$190.00
|
|
|
HC PROTEIN TOT XCPT REFRACTOMETRY URINE - PROTEIN RANDOM URINE
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 84156
|
| Hospital Charge Code |
3018415601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$147.00
|
| Rate for Payer: Aetna of WY Medicare |
$3.67
|
| Rate for Payer: Beech Street Commercial |
$142.50
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$145.50
|
| Rate for Payer: Cigna of WY Commercial |
$147.00
|
| Rate for Payer: First Choice Health Commercial |
$135.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$142.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.67
|
| Rate for Payer: HealthUtah PPO |
$150.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$145.50
|
| Rate for Payer: Multiplan Medicare/VA |
$3.12
|
| Rate for Payer: One Health Plan of WY PPO |
$147.00
|
| Rate for Payer: PacificSource Commercial |
$135.00
|
| Rate for Payer: PHCS PPO |
$142.50
|
| Rate for Payer: Three Rivers PPO |
$112.50
|
| Rate for Payer: TriWest Veterans Administration |
$3.67
|
| Rate for Payer: United Healthcare Commercial |
$130.50
|
| Rate for Payer: United Healthcare Medicare |
$3.67
|
| Rate for Payer: WINHealth Partners Commercial |
$142.50
|
|
|
HC PRO TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$5,308.00
|
|
|
Service Code
|
HCPCS 26483
|
| Hospital Charge Code |
9832648301
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$724.75 |
| Max. Negotiated Rate |
$5,308.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,201.84
|
| Rate for Payer: Aetna of WY Medicare |
$852.65
|
| Rate for Payer: Beech Street Commercial |
$5,042.60
|
| Rate for Payer: Cash Price |
$3,715.60
|
| Rate for Payer: Cash Price |
$3,715.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,148.76
|
| Rate for Payer: Cigna of WY Commercial |
$5,201.84
|
| Rate for Payer: First Choice Health Commercial |
$4,777.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,042.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$852.65
|
| Rate for Payer: HealthUtah PPO |
$5,308.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,148.76
|
| Rate for Payer: Multiplan Medicare/VA |
$724.75
|
| Rate for Payer: One Health Plan of WY PPO |
$5,201.84
|
| Rate for Payer: PacificSource Commercial |
$4,777.20
|
| Rate for Payer: PHCS PPO |
$5,042.60
|
| Rate for Payer: Three Rivers PPO |
$3,981.00
|
| Rate for Payer: TriWest Veterans Administration |
$852.65
|
| Rate for Payer: United Healthcare Commercial |
$4,617.96
|
| Rate for Payer: United Healthcare Medicare |
$852.65
|
| Rate for Payer: WINHealth Partners Commercial |
$4,511.80
|
|
|
HC PRO TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 24340
|
| Hospital Charge Code |
9832434001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$496.71 |
| Max. Negotiated Rate |
$2,085.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,043.30
|
| Rate for Payer: Aetna of WY Medicare |
$584.36
|
| Rate for Payer: Beech Street Commercial |
$1,980.75
|
| Rate for Payer: Cash Price |
$1,459.50
|
| Rate for Payer: Cash Price |
$1,459.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,022.45
|
| Rate for Payer: Cigna of WY Commercial |
$2,043.30
|
| Rate for Payer: First Choice Health Commercial |
$1,876.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,980.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$584.36
|
| Rate for Payer: HealthUtah PPO |
$2,085.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,022.45
|
| Rate for Payer: Multiplan Medicare/VA |
$496.71
|
| Rate for Payer: One Health Plan of WY PPO |
$2,043.30
|
| Rate for Payer: PacificSource Commercial |
$1,876.50
|
| Rate for Payer: PHCS PPO |
$1,980.75
|
| Rate for Payer: Three Rivers PPO |
$1,563.75
|
| Rate for Payer: TriWest Veterans Administration |
$584.36
|
| Rate for Payer: United Healthcare Commercial |
$1,813.95
|
| Rate for Payer: United Healthcare Medicare |
$584.36
|
| Rate for Payer: WINHealth Partners Commercial |
$1,772.25
|
|
|
HC PRO TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 24340
|
| Hospital Charge Code |
9822434001
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$496.71 |
| Max. Negotiated Rate |
$2,085.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,043.30
|
| Rate for Payer: Aetna of WY Medicare |
$584.36
|
| Rate for Payer: Beech Street Commercial |
$1,980.75
|
| Rate for Payer: Cash Price |
$1,459.50
|
| Rate for Payer: Cash Price |
$1,459.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,022.45
|
| Rate for Payer: Cigna of WY Commercial |
$2,043.30
|
| Rate for Payer: First Choice Health Commercial |
$1,876.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,980.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$584.36
|
| Rate for Payer: HealthUtah PPO |
$2,085.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,022.45
|
| Rate for Payer: Multiplan Medicare/VA |
$496.71
|
| Rate for Payer: One Health Plan of WY PPO |
$2,043.30
|
| Rate for Payer: PacificSource Commercial |
$1,876.50
|
| Rate for Payer: PHCS PPO |
$1,980.75
|
| Rate for Payer: Three Rivers PPO |
$1,563.75
|
| Rate for Payer: TriWest Veterans Administration |
$584.36
|
| Rate for Payer: United Healthcare Commercial |
$1,813.95
|
| Rate for Payer: United Healthcare Medicare |
$584.36
|
| Rate for Payer: WINHealth Partners Commercial |
$1,772.25
|
|
|
HC PRO TENODESIS WRIST EXTENSORS FINGERS
|
Professional
|
Both
|
$3,043.00
|
|
|
Service Code
|
HCPCS 25301
|
| Hospital Charge Code |
9832530101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$535.07 |
| Max. Negotiated Rate |
$3,043.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,982.14
|
| Rate for Payer: Aetna of WY Medicare |
$629.49
|
| Rate for Payer: Beech Street Commercial |
$2,890.85
|
| Rate for Payer: Cash Price |
$2,130.10
|
| Rate for Payer: Cash Price |
$2,130.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,951.71
|
| Rate for Payer: Cigna of WY Commercial |
$2,982.14
|
| Rate for Payer: First Choice Health Commercial |
$2,738.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,890.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$629.49
|
| Rate for Payer: HealthUtah PPO |
$3,043.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,951.71
|
| Rate for Payer: Multiplan Medicare/VA |
$535.07
|
| Rate for Payer: One Health Plan of WY PPO |
$2,982.14
|
| Rate for Payer: PacificSource Commercial |
$2,738.70
|
| Rate for Payer: PHCS PPO |
$2,890.85
|
| Rate for Payer: Three Rivers PPO |
$2,282.25
|
| Rate for Payer: TriWest Veterans Administration |
$629.49
|
| Rate for Payer: United Healthcare Commercial |
$2,647.41
|
| Rate for Payer: United Healthcare Medicare |
$629.49
|
| Rate for Payer: WINHealth Partners Commercial |
$2,586.55
|
|
|
HC PRO TENOLYSIS EXT TENDON,HAND/FINGER,EA
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 26445
|
| Hospital Charge Code |
9832644501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$505.54 |
| 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 |
$594.75
|
| 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 |
$594.75
|
| Rate for Payer: HealthUtah PPO |
$3,024.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,933.28
|
| Rate for Payer: Multiplan Medicare/VA |
$505.54
|
| 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 |
$594.75
|
| Rate for Payer: United Healthcare Commercial |
$2,630.88
|
| Rate for Payer: United Healthcare Medicare |
$594.75
|
| Rate for Payer: WINHealth Partners Commercial |
$2,570.40
|
|
|
HC PRO TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON
|
Professional
|
Both
|
$3,946.00
|
|
|
Service Code
|
HCPCS 26440
|
| Hospital Charge Code |
9832644001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$543.48 |
| Max. Negotiated Rate |
$3,946.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,867.08
|
| Rate for Payer: Aetna of WY Medicare |
$639.39
|
| Rate for Payer: Beech Street Commercial |
$3,748.70
|
| Rate for Payer: Cash Price |
$2,762.20
|
| Rate for Payer: Cash Price |
$2,762.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,827.62
|
| Rate for Payer: Cigna of WY Commercial |
$3,867.08
|
| Rate for Payer: First Choice Health Commercial |
$3,551.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,748.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$639.39
|
| Rate for Payer: HealthUtah PPO |
$3,946.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,827.62
|
| Rate for Payer: Multiplan Medicare/VA |
$543.48
|
| Rate for Payer: One Health Plan of WY PPO |
$3,867.08
|
| Rate for Payer: PacificSource Commercial |
$3,551.40
|
| Rate for Payer: PHCS PPO |
$3,748.70
|
| Rate for Payer: Three Rivers PPO |
$2,959.50
|
| Rate for Payer: TriWest Veterans Administration |
$639.39
|
| Rate for Payer: United Healthcare Commercial |
$3,433.02
|
| Rate for Payer: United Healthcare Medicare |
$639.39
|
| Rate for Payer: WINHealth Partners Commercial |
$3,354.10
|
|
|
HC PRO TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
Both
|
$2,714.00
|
|
|
Service Code
|
HCPCS 24358
|
| Hospital Charge Code |
9832435801
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$442.35 |
| Max. Negotiated Rate |
$2,714.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,659.72
|
| Rate for Payer: Aetna of WY Medicare |
$520.41
|
| Rate for Payer: Beech Street Commercial |
$2,578.30
|
| Rate for Payer: Cash Price |
$1,899.80
|
| Rate for Payer: Cash Price |
$1,899.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,632.58
|
| Rate for Payer: Cigna of WY Commercial |
$2,659.72
|
| Rate for Payer: First Choice Health Commercial |
$2,442.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,578.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$520.41
|
| Rate for Payer: HealthUtah PPO |
$2,714.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,632.58
|
| Rate for Payer: Multiplan Medicare/VA |
$442.35
|
| Rate for Payer: One Health Plan of WY PPO |
$2,659.72
|
| Rate for Payer: PacificSource Commercial |
$2,442.60
|
| Rate for Payer: PHCS PPO |
$2,578.30
|
| Rate for Payer: Three Rivers PPO |
$2,035.50
|
| Rate for Payer: TriWest Veterans Administration |
$520.41
|
| Rate for Payer: United Healthcare Commercial |
$2,361.18
|
| Rate for Payer: United Healthcare Medicare |
$520.41
|
| Rate for Payer: WINHealth Partners Commercial |
$2,306.90
|
|
|
HC PRO TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$3,415.00
|
|
|
Service Code
|
HCPCS 24359
|
| Hospital Charge Code |
9832435901
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$550.62 |
| Max. Negotiated Rate |
$3,415.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,346.70
|
| Rate for Payer: Aetna of WY Medicare |
$647.79
|
| Rate for Payer: Beech Street Commercial |
$3,244.25
|
| Rate for Payer: Cash Price |
$2,390.50
|
| Rate for Payer: Cash Price |
$2,390.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,312.55
|
| Rate for Payer: Cigna of WY Commercial |
$3,346.70
|
| Rate for Payer: First Choice Health Commercial |
$3,073.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,244.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$647.79
|
| Rate for Payer: HealthUtah PPO |
$3,415.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,312.55
|
| Rate for Payer: Multiplan Medicare/VA |
$550.62
|
| Rate for Payer: One Health Plan of WY PPO |
$3,346.70
|
| Rate for Payer: PacificSource Commercial |
$3,073.50
|
| Rate for Payer: PHCS PPO |
$3,244.25
|
| Rate for Payer: Three Rivers PPO |
$2,561.25
|
| Rate for Payer: TriWest Veterans Administration |
$647.79
|
| Rate for Payer: United Healthcare Commercial |
$2,971.05
|
| Rate for Payer: United Healthcare Medicare |
$647.79
|
| Rate for Payer: WINHealth Partners Commercial |
$2,902.75
|
|
|
HC PRO TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 24357
|
| Hospital Charge Code |
9822435701
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$348.94 |
| Max. Negotiated Rate |
$1,618.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,585.64
|
| Rate for Payer: Aetna of WY Medicare |
$410.52
|
| Rate for Payer: Beech Street Commercial |
$1,537.10
|
| Rate for Payer: Cash Price |
$1,132.60
|
| Rate for Payer: Cash Price |
$1,132.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,569.46
|
| Rate for Payer: Cigna of WY Commercial |
$1,585.64
|
| Rate for Payer: First Choice Health Commercial |
$1,456.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,537.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$410.52
|
| Rate for Payer: HealthUtah PPO |
$1,618.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,569.46
|
| Rate for Payer: Multiplan Medicare/VA |
$348.94
|
| Rate for Payer: One Health Plan of WY PPO |
$1,585.64
|
| Rate for Payer: PacificSource Commercial |
$1,456.20
|
| Rate for Payer: PHCS PPO |
$1,537.10
|
| Rate for Payer: Three Rivers PPO |
$1,213.50
|
| Rate for Payer: TriWest Veterans Administration |
$410.52
|
| Rate for Payer: United Healthcare Commercial |
$1,407.66
|
| Rate for Payer: United Healthcare Medicare |
$410.52
|
| Rate for Payer: WINHealth Partners Commercial |
$1,375.30
|
|
|
HC PRO TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON
|
Professional
|
Both
|
$3,228.00
|
|
|
Service Code
|
HCPCS 28234
|
| Hospital Charge Code |
9832823401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$225.62 |
| Max. Negotiated Rate |
$3,228.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,163.44
|
| Rate for Payer: Aetna of WY Medicare |
$265.43
|
| Rate for Payer: Beech Street Commercial |
$3,066.60
|
| Rate for Payer: Cash Price |
$2,259.60
|
| Rate for Payer: Cash Price |
$2,259.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,131.16
|
| Rate for Payer: Cigna of WY Commercial |
$3,163.44
|
| Rate for Payer: First Choice Health Commercial |
$2,905.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,066.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$265.43
|
| Rate for Payer: HealthUtah PPO |
$3,228.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,131.16
|
| Rate for Payer: Multiplan Medicare/VA |
$225.62
|
| Rate for Payer: One Health Plan of WY PPO |
$3,163.44
|
| Rate for Payer: PacificSource Commercial |
$2,905.20
|
| Rate for Payer: PHCS PPO |
$3,066.60
|
| Rate for Payer: Three Rivers PPO |
$2,421.00
|
| Rate for Payer: TriWest Veterans Administration |
$265.43
|
| Rate for Payer: United Healthcare Commercial |
$2,808.36
|
| Rate for Payer: United Healthcare Medicare |
$265.43
|
| Rate for Payer: WINHealth Partners Commercial |
$2,743.80
|
|
|
HC PRO TENOTOMY SHOULDER AREA 1 TENDON
|
Professional
|
Both
|
$3,175.00
|
|
|
Service Code
|
HCPCS 23405
|
| Hospital Charge Code |
9832340501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$509.49 |
| Max. Negotiated Rate |
$3,175.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,111.50
|
| Rate for Payer: Aetna of WY Medicare |
$599.40
|
| Rate for Payer: Beech Street Commercial |
$3,016.25
|
| Rate for Payer: Cash Price |
$2,222.50
|
| Rate for Payer: Cash Price |
$2,222.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,079.75
|
| Rate for Payer: Cigna of WY Commercial |
$3,111.50
|
| Rate for Payer: First Choice Health Commercial |
$2,857.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,016.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$599.40
|
| Rate for Payer: HealthUtah PPO |
$3,175.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,079.75
|
| Rate for Payer: Multiplan Medicare/VA |
$509.49
|
| Rate for Payer: One Health Plan of WY PPO |
$3,111.50
|
| Rate for Payer: PacificSource Commercial |
$2,857.50
|
| Rate for Payer: PHCS PPO |
$3,016.25
|
| Rate for Payer: Three Rivers PPO |
$2,381.25
|
| Rate for Payer: TriWest Veterans Administration |
$599.40
|
| Rate for Payer: United Healthcare Commercial |
$2,762.25
|
| Rate for Payer: United Healthcare Medicare |
$599.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2,698.75
|
|
|
HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING
|
Professional
|
Both
|
$832.00
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
9833255501
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$87.46 |
| Max. Negotiated Rate |
$832.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$815.36
|
| Rate for Payer: Aetna of WY Medicare |
$102.90
|
| Rate for Payer: Beech Street Commercial |
$790.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$807.04
|
| Rate for Payer: Cigna of WY Commercial |
$815.36
|
| Rate for Payer: First Choice Health Commercial |
$748.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$790.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$102.90
|
| Rate for Payer: HealthUtah PPO |
$832.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$807.04
|
| Rate for Payer: Multiplan Medicare/VA |
$87.46
|
| Rate for Payer: One Health Plan of WY PPO |
$815.36
|
| Rate for Payer: PacificSource Commercial |
$748.80
|
| Rate for Payer: PHCS PPO |
$790.40
|
| Rate for Payer: Three Rivers PPO |
$624.00
|
| Rate for Payer: TriWest Veterans Administration |
$102.90
|
| Rate for Payer: United Healthcare Commercial |
$723.84
|
| Rate for Payer: United Healthcare Medicare |
$102.90
|
| Rate for Payer: WINHealth Partners Commercial |
$707.20
|
|
|
HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 32554 50
|
| Hospital Charge Code |
9833255401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$71.12 |
| Max. Negotiated Rate |
$742.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$727.16
|
| Rate for Payer: Aetna of WY Medicare |
$83.67
|
| Rate for Payer: Beech Street Commercial |
$704.90
|
| Rate for Payer: Cash Price |
$519.40
|
| Rate for Payer: Cash Price |
$519.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$719.74
|
| Rate for Payer: Cigna of WY Commercial |
$727.16
|
| Rate for Payer: First Choice Health Commercial |
$667.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$704.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.67
|
| Rate for Payer: HealthUtah PPO |
$742.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$719.74
|
| Rate for Payer: Multiplan Medicare/VA |
$71.12
|
| Rate for Payer: One Health Plan of WY PPO |
$727.16
|
| Rate for Payer: PacificSource Commercial |
$667.80
|
| Rate for Payer: PHCS PPO |
$704.90
|
| Rate for Payer: Three Rivers PPO |
$556.50
|
| Rate for Payer: TriWest Veterans Administration |
$83.67
|
| Rate for Payer: United Healthcare Commercial |
$645.54
|
| Rate for Payer: United Healthcare Medicare |
$83.67
|
| Rate for Payer: WINHealth Partners Commercial |
$630.70
|
|
|
HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 32554 50,NONPBBPAYER
|
| Hospital Charge Code |
9833255401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$71.12 |
| Max. Negotiated Rate |
$928.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$909.44
|
| Rate for Payer: Aetna of WY Medicare |
$83.67
|
| Rate for Payer: Beech Street Commercial |
$881.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$900.16
|
| Rate for Payer: Cigna of WY Commercial |
$909.44
|
| Rate for Payer: First Choice Health Commercial |
$835.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$881.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.67
|
| Rate for Payer: HealthUtah PPO |
$928.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$900.16
|
| Rate for Payer: Multiplan Medicare/VA |
$71.12
|
| Rate for Payer: One Health Plan of WY PPO |
$909.44
|
| Rate for Payer: PacificSource Commercial |
$835.20
|
| Rate for Payer: PHCS PPO |
$881.60
|
| Rate for Payer: Three Rivers PPO |
$696.00
|
| Rate for Payer: TriWest Veterans Administration |
$83.67
|
| Rate for Payer: United Healthcare Commercial |
$807.36
|
| Rate for Payer: United Healthcare Medicare |
$83.67
|
| Rate for Payer: WINHealth Partners Commercial |
$788.80
|
|
|
HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$597.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
9833255401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$71.12 |
| Max. Negotiated Rate |
$597.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$585.06
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$363.58
|
| Rate for Payer: Aetna of WY Medicare |
$83.67
|
| Rate for Payer: Aetna of WY Medicare |
$83.67
|
| Rate for Payer: Beech Street Commercial |
$352.45
|
| Rate for Payer: Beech Street Commercial |
$567.15
|
| Rate for Payer: Cash Price |
$259.70
|
| Rate for Payer: Cash Price |
$259.70
|
| Rate for Payer: Cash Price |
$417.90
|
| Rate for Payer: Cash Price |
$417.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$579.09
|
| Rate for Payer: ChoiceCare Network Commercial |
$359.87
|
| Rate for Payer: Cigna of WY Commercial |
$363.58
|
| Rate for Payer: Cigna of WY Commercial |
$585.06
|
| Rate for Payer: First Choice Health Commercial |
$333.90
|
| Rate for Payer: First Choice Health Commercial |
$537.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$567.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$352.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.67
|
| Rate for Payer: HealthUtah PPO |
$597.00
|
| Rate for Payer: HealthUtah PPO |
$371.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$579.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$359.87
|
| Rate for Payer: Multiplan Medicare/VA |
$71.12
|
| Rate for Payer: Multiplan Medicare/VA |
$71.12
|
| Rate for Payer: One Health Plan of WY PPO |
$585.06
|
| Rate for Payer: One Health Plan of WY PPO |
$363.58
|
| Rate for Payer: PacificSource Commercial |
$333.90
|
| Rate for Payer: PacificSource Commercial |
$537.30
|
| Rate for Payer: PHCS PPO |
$567.15
|
| Rate for Payer: PHCS PPO |
$352.45
|
| Rate for Payer: Three Rivers PPO |
$447.75
|
| Rate for Payer: Three Rivers PPO |
$278.25
|
| Rate for Payer: TriWest Veterans Administration |
$83.67
|
| Rate for Payer: TriWest Veterans Administration |
$83.67
|
| Rate for Payer: United Healthcare Commercial |
$322.77
|
| Rate for Payer: United Healthcare Commercial |
$519.39
|
| Rate for Payer: United Healthcare Medicare |
$83.67
|
| Rate for Payer: United Healthcare Medicare |
$83.67
|
| Rate for Payer: WINHealth Partners Commercial |
$507.45
|
| Rate for Payer: WINHealth Partners Commercial |
$315.35
|
|
|
HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 32554 NONPBBPAYER
|
| Hospital Charge Code |
9833255401
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$71.12 |
| Max. Negotiated Rate |
$464.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$454.72
|
| Rate for Payer: Aetna of WY Medicare |
$83.67
|
| Rate for Payer: Beech Street Commercial |
$440.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$450.08
|
| Rate for Payer: Cigna of WY Commercial |
$454.72
|
| Rate for Payer: First Choice Health Commercial |
$417.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$440.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.67
|
| Rate for Payer: HealthUtah PPO |
$464.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$450.08
|
| Rate for Payer: Multiplan Medicare/VA |
$71.12
|
| Rate for Payer: One Health Plan of WY PPO |
$454.72
|
| Rate for Payer: PacificSource Commercial |
$417.60
|
| Rate for Payer: PHCS PPO |
$440.80
|
| Rate for Payer: Three Rivers PPO |
$348.00
|
| Rate for Payer: TriWest Veterans Administration |
$83.67
|
| Rate for Payer: United Healthcare Commercial |
$403.68
|
| Rate for Payer: United Healthcare Medicare |
$83.67
|
| Rate for Payer: WINHealth Partners Commercial |
$394.40
|
|
|
HC PROTHROMBIN TIME - PROTIME-INR
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 85610
|
| Hospital Charge Code |
3058561001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$73.50
|
| Rate for Payer: Aetna of WY Medicare |
$4.29
|
| Rate for Payer: Beech Street Commercial |
$71.25
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$72.75
|
| Rate for Payer: Cigna of WY Commercial |
$73.50
|
| Rate for Payer: First Choice Health Commercial |
$67.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$71.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.29
|
| Rate for Payer: HealthUtah PPO |
$75.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$72.75
|
| Rate for Payer: Multiplan Medicare/VA |
$3.65
|
| Rate for Payer: One Health Plan of WY PPO |
$73.50
|
| Rate for Payer: PacificSource Commercial |
$67.50
|
| Rate for Payer: PHCS PPO |
$71.25
|
| Rate for Payer: Three Rivers PPO |
$56.25
|
| Rate for Payer: TriWest Veterans Administration |
$4.29
|
| Rate for Payer: United Healthcare Commercial |
$65.25
|
| Rate for Payer: United Healthcare Medicare |
$4.29
|
| Rate for Payer: WINHealth Partners Commercial |
$71.25
|
|
|
HC PROTHROMBIN TIME - PROTIME-INR, FINGERSTICK
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 85610
|
| Hospital Charge Code |
3058561003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$73.50
|
| Rate for Payer: Aetna of WY Medicare |
$4.29
|
| Rate for Payer: Beech Street Commercial |
$71.25
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$72.75
|
| Rate for Payer: Cigna of WY Commercial |
$73.50
|
| Rate for Payer: First Choice Health Commercial |
$67.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$71.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.29
|
| Rate for Payer: HealthUtah PPO |
$75.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$72.75
|
| Rate for Payer: Multiplan Medicare/VA |
$3.65
|
| Rate for Payer: One Health Plan of WY PPO |
$73.50
|
| Rate for Payer: PacificSource Commercial |
$67.50
|
| Rate for Payer: PHCS PPO |
$71.25
|
| Rate for Payer: Three Rivers PPO |
$56.25
|
| Rate for Payer: TriWest Veterans Administration |
$4.29
|
| Rate for Payer: United Healthcare Commercial |
$65.25
|
| Rate for Payer: United Healthcare Medicare |
$4.29
|
| Rate for Payer: WINHealth Partners Commercial |
$71.25
|
|
|
HC PRO THYROIDECTOMY
|
Professional
|
Both
|
$4,733.00
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
9836024001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$745.75 |
| Max. Negotiated Rate |
$4,733.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,638.34
|
| Rate for Payer: Aetna of WY Medicare |
$877.35
|
| Rate for Payer: Beech Street Commercial |
$4,496.35
|
| Rate for Payer: Cash Price |
$3,313.10
|
| Rate for Payer: Cash Price |
$3,313.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,591.01
|
| Rate for Payer: Cigna of WY Commercial |
$4,638.34
|
| Rate for Payer: First Choice Health Commercial |
$4,259.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,496.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$877.35
|
| Rate for Payer: HealthUtah PPO |
$4,733.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,591.01
|
| Rate for Payer: Multiplan Medicare/VA |
$745.75
|
| Rate for Payer: One Health Plan of WY PPO |
$4,638.34
|
| Rate for Payer: PacificSource Commercial |
$4,259.70
|
| Rate for Payer: PHCS PPO |
$4,496.35
|
| Rate for Payer: Three Rivers PPO |
$3,549.75
|
| Rate for Payer: TriWest Veterans Administration |
$877.35
|
| Rate for Payer: United Healthcare Commercial |
$4,117.71
|
| Rate for Payer: United Healthcare Medicare |
$877.35
|
| Rate for Payer: WINHealth Partners Commercial |
$4,023.05
|
|
|
HC PRO THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH
|
Professional
|
Both
|
$3,539.00
|
|
|
Service Code
|
HCPCS 60271
|
| Hospital Charge Code |
9756027101
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$856.95 |
| Max. Negotiated Rate |
$3,539.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,468.22
|
| Rate for Payer: Aetna of WY Medicare |
$1,008.18
|
| Rate for Payer: Beech Street Commercial |
$3,362.05
|
| Rate for Payer: Cash Price |
$2,477.30
|
| Rate for Payer: Cash Price |
$2,477.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,432.83
|
| Rate for Payer: Cigna of WY Commercial |
$3,468.22
|
| Rate for Payer: First Choice Health Commercial |
$3,185.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,362.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,008.18
|
| Rate for Payer: HealthUtah PPO |
$3,539.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,432.83
|
| Rate for Payer: Multiplan Medicare/VA |
$856.95
|
| Rate for Payer: One Health Plan of WY PPO |
$3,468.22
|
| Rate for Payer: PacificSource Commercial |
$3,185.10
|
| Rate for Payer: PHCS PPO |
$3,362.05
|
| Rate for Payer: Three Rivers PPO |
$2,654.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,008.18
|
| Rate for Payer: United Healthcare Commercial |
$3,078.93
|
| Rate for Payer: United Healthcare Medicare |
$1,008.18
|
| Rate for Payer: WINHealth Partners Commercial |
$3,008.15
|
|
|
HC PRO TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$3,194.00
|
|
|
Service Code
|
HCPCS 25295
|
| Hospital Charge Code |
9822529501
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$439.99 |
| Max. Negotiated Rate |
$3,194.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,130.12
|
| Rate for Payer: Aetna of WY Medicare |
$517.64
|
| Rate for Payer: Beech Street Commercial |
$3,034.30
|
| Rate for Payer: Cash Price |
$2,235.80
|
| Rate for Payer: Cash Price |
$2,235.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,098.18
|
| Rate for Payer: Cigna of WY Commercial |
$3,130.12
|
| Rate for Payer: First Choice Health Commercial |
$2,874.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,034.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$517.64
|
| Rate for Payer: HealthUtah PPO |
$3,194.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,098.18
|
| Rate for Payer: Multiplan Medicare/VA |
$439.99
|
| Rate for Payer: One Health Plan of WY PPO |
$3,130.12
|
| Rate for Payer: PacificSource Commercial |
$2,874.60
|
| Rate for Payer: PHCS PPO |
$3,034.30
|
| Rate for Payer: Three Rivers PPO |
$2,395.50
|
| Rate for Payer: TriWest Veterans Administration |
$517.64
|
| Rate for Payer: United Healthcare Commercial |
$2,778.78
|
| Rate for Payer: United Healthcare Medicare |
$517.64
|
| Rate for Payer: WINHealth Partners Commercial |
$2,714.90
|
|
