|
BAG DECANTER
|
Facility
|
OP
|
$3.38
|
|
| Hospital Charge Code |
2650041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.31
|
| Rate for Payer: Aetna of WY Medicare |
$2.23
|
| Rate for Payer: Altius Commercial |
$3.24
|
| Rate for Payer: Beech Street Commercial |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.28
|
| Rate for Payer: Cash Price |
$2.36
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.28
|
| Rate for Payer: Cigna of WY Commercial |
$3.31
|
| Rate for Payer: Entrust Commercial |
$3.21
|
| Rate for Payer: First Choice Health Commercial |
$3.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.93
|
| Rate for Payer: HealthUtah PPO |
$3.38
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.28
|
| Rate for Payer: Multiplan Medicare/VA |
$1.83
|
| Rate for Payer: One Health Plan of WY PPO |
$3.31
|
| Rate for Payer: PacificSource Commercial |
$3.04
|
| Rate for Payer: PHCS PPO |
$3.31
|
| Rate for Payer: Three Rivers PPO |
$2.54
|
| Rate for Payer: TriWest Veterans Administration |
$1.93
|
| Rate for Payer: United Healthcare Commercial |
$3.23
|
| Rate for Payer: United Healthcare Medicare |
$1.93
|
| Rate for Payer: WINHealth Partners Commercial |
$3.31
|
| Rate for Payer: Wise Provider Network Commercial |
$3.21
|
|
|
BAG DECANTER
|
Facility
|
IP
|
$3.38
|
|
| Hospital Charge Code |
2650041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.31
|
| Rate for Payer: Aetna of WY Medicare |
$2.16
|
| Rate for Payer: Altius Commercial |
$3.24
|
| Rate for Payer: Beech Street Commercial |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.28
|
| Rate for Payer: Cash Price |
$2.36
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.28
|
| Rate for Payer: Cigna of WY Commercial |
$3.31
|
| Rate for Payer: Entrust Commercial |
$3.21
|
| Rate for Payer: First Choice Health Commercial |
$3.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.06
|
| Rate for Payer: HealthUtah PPO |
$3.38
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.28
|
| Rate for Payer: Multiplan Medicare/VA |
$1.96
|
| Rate for Payer: One Health Plan of WY PPO |
$3.31
|
| Rate for Payer: PacificSource Commercial |
$3.04
|
| Rate for Payer: PHCS PPO |
$3.31
|
| Rate for Payer: Three Rivers PPO |
$2.54
|
| Rate for Payer: TriWest Veterans Administration |
$2.06
|
| Rate for Payer: United Healthcare Commercial |
$3.23
|
| Rate for Payer: United Healthcare Medicare |
$2.06
|
| Rate for Payer: WINHealth Partners Commercial |
$3.21
|
| Rate for Payer: Wise Provider Network Commercial |
$3.21
|
|
|
BAG URINE DRAINAGE 2L 154002
|
Facility
|
IP
|
$7.77
|
|
| Hospital Charge Code |
2750010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$7.77 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.61
|
| Rate for Payer: Aetna of WY Medicare |
$4.97
|
| Rate for Payer: Altius Commercial |
$7.46
|
| Rate for Payer: Beech Street Commercial |
$7.61
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.54
|
| Rate for Payer: Cash Price |
$5.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.54
|
| Rate for Payer: Cigna of WY Commercial |
$7.61
|
| Rate for Payer: Entrust Commercial |
$7.38
|
| Rate for Payer: First Choice Health Commercial |
$7.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.74
|
| Rate for Payer: HealthUtah PPO |
$7.77
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.54
|
| Rate for Payer: Multiplan Medicare/VA |
$4.50
|
| Rate for Payer: One Health Plan of WY PPO |
$7.61
|
| Rate for Payer: PacificSource Commercial |
$6.99
|
| Rate for Payer: PHCS PPO |
$7.61
|
| Rate for Payer: Three Rivers PPO |
$5.83
|
| Rate for Payer: TriWest Veterans Administration |
$4.74
|
| Rate for Payer: United Healthcare Commercial |
$7.42
|
| Rate for Payer: United Healthcare Medicare |
$4.74
|
| Rate for Payer: WINHealth Partners Commercial |
$7.38
|
| Rate for Payer: Wise Provider Network Commercial |
$7.38
|
|
|
BAG URINE DRAINAGE 2L 154002
|
Facility
|
OP
|
$7.77
|
|
| Hospital Charge Code |
2750010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$7.77 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.61
|
| Rate for Payer: Aetna of WY Medicare |
$5.13
|
| Rate for Payer: Altius Commercial |
$7.46
|
| Rate for Payer: Beech Street Commercial |
$7.61
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.54
|
| Rate for Payer: Cash Price |
$5.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.54
|
| Rate for Payer: Cigna of WY Commercial |
$7.61
|
| Rate for Payer: Entrust Commercial |
$7.38
|
| Rate for Payer: First Choice Health Commercial |
$7.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.43
|
| Rate for Payer: HealthUtah PPO |
$7.77
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.54
|
| Rate for Payer: Multiplan Medicare/VA |
$4.21
|
| Rate for Payer: One Health Plan of WY PPO |
$7.61
|
| Rate for Payer: PacificSource Commercial |
$6.99
|
| Rate for Payer: PHCS PPO |
$7.61
|
| Rate for Payer: Three Rivers PPO |
$5.83
|
| Rate for Payer: TriWest Veterans Administration |
$4.43
|
| Rate for Payer: United Healthcare Commercial |
$7.42
|
| Rate for Payer: United Healthcare Medicare |
$4.43
|
| Rate for Payer: WINHealth Partners Commercial |
$7.61
|
| Rate for Payer: Wise Provider Network Commercial |
$7.38
|
|
|
BAG URINE WEE PEE
|
Facility
|
OP
|
$2.22
|
|
| Hospital Charge Code |
2750011
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.18
|
| Rate for Payer: Aetna of WY Medicare |
$1.47
|
| Rate for Payer: Altius Commercial |
$2.13
|
| Rate for Payer: Beech Street Commercial |
$2.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.15
|
| Rate for Payer: Cash Price |
$1.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.15
|
| Rate for Payer: Cigna of WY Commercial |
$2.18
|
| Rate for Payer: Entrust Commercial |
$2.11
|
| Rate for Payer: First Choice Health Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.27
|
| Rate for Payer: HealthUtah PPO |
$2.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.15
|
| Rate for Payer: Multiplan Medicare/VA |
$1.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2.18
|
| Rate for Payer: PacificSource Commercial |
$2.00
|
| Rate for Payer: PHCS PPO |
$2.18
|
| Rate for Payer: Three Rivers PPO |
$1.66
|
| Rate for Payer: TriWest Veterans Administration |
$1.27
|
| Rate for Payer: United Healthcare Commercial |
$2.12
|
| Rate for Payer: United Healthcare Medicare |
$1.27
|
| Rate for Payer: WINHealth Partners Commercial |
$2.18
|
| Rate for Payer: Wise Provider Network Commercial |
$2.11
|
|
|
BAG URINE WEE PEE
|
Facility
|
IP
|
$2.22
|
|
| Hospital Charge Code |
2750011
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.18
|
| Rate for Payer: Aetna of WY Medicare |
$1.42
|
| Rate for Payer: Altius Commercial |
$2.13
|
| Rate for Payer: Beech Street Commercial |
$2.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.15
|
| Rate for Payer: Cash Price |
$1.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.15
|
| Rate for Payer: Cigna of WY Commercial |
$2.18
|
| Rate for Payer: Entrust Commercial |
$2.11
|
| Rate for Payer: First Choice Health Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.35
|
| Rate for Payer: HealthUtah PPO |
$2.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.15
|
| Rate for Payer: Multiplan Medicare/VA |
$1.29
|
| Rate for Payer: One Health Plan of WY PPO |
$2.18
|
| Rate for Payer: PacificSource Commercial |
$2.00
|
| Rate for Payer: PHCS PPO |
$2.18
|
| Rate for Payer: Three Rivers PPO |
$1.66
|
| Rate for Payer: TriWest Veterans Administration |
$1.35
|
| Rate for Payer: United Healthcare Commercial |
$2.12
|
| Rate for Payer: United Healthcare Medicare |
$1.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2.11
|
| Rate for Payer: Wise Provider Network Commercial |
$2.11
|
|
|
BAIR HUGGER FULL BODY
|
Facility
|
OP
|
$16.34
|
|
| Hospital Charge Code |
2500004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$16.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.01
|
| Rate for Payer: Aetna of WY Medicare |
$10.78
|
| Rate for Payer: Altius Commercial |
$15.69
|
| Rate for Payer: Beech Street Commercial |
$16.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.85
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.85
|
| Rate for Payer: Cigna of WY Commercial |
$16.01
|
| Rate for Payer: Entrust Commercial |
$15.52
|
| Rate for Payer: First Choice Health Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.31
|
| Rate for Payer: HealthUtah PPO |
$16.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.85
|
| Rate for Payer: Multiplan Medicare/VA |
$8.85
|
| Rate for Payer: One Health Plan of WY PPO |
$16.01
|
| Rate for Payer: PacificSource Commercial |
$14.71
|
| Rate for Payer: PHCS PPO |
$16.01
|
| Rate for Payer: Three Rivers PPO |
$12.26
|
| Rate for Payer: TriWest Veterans Administration |
$9.31
|
| Rate for Payer: United Healthcare Commercial |
$15.60
|
| Rate for Payer: United Healthcare Medicare |
$9.31
|
| Rate for Payer: WINHealth Partners Commercial |
$16.01
|
| Rate for Payer: Wise Provider Network Commercial |
$15.52
|
|
|
BAIR HUGGER FULL BODY
|
Facility
|
IP
|
$16.34
|
|
| Hospital Charge Code |
2500004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$16.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.01
|
| Rate for Payer: Aetna of WY Medicare |
$10.46
|
| Rate for Payer: Altius Commercial |
$15.69
|
| Rate for Payer: Beech Street Commercial |
$16.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.85
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.85
|
| Rate for Payer: Cigna of WY Commercial |
$16.01
|
| Rate for Payer: Entrust Commercial |
$15.52
|
| Rate for Payer: First Choice Health Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.97
|
| Rate for Payer: HealthUtah PPO |
$16.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.85
|
| Rate for Payer: Multiplan Medicare/VA |
$9.47
|
| Rate for Payer: One Health Plan of WY PPO |
$16.01
|
| Rate for Payer: PacificSource Commercial |
$14.71
|
| Rate for Payer: PHCS PPO |
$16.01
|
| Rate for Payer: Three Rivers PPO |
$12.26
|
| Rate for Payer: TriWest Veterans Administration |
$9.97
|
| Rate for Payer: United Healthcare Commercial |
$15.60
|
| Rate for Payer: United Healthcare Medicare |
$9.97
|
| Rate for Payer: WINHealth Partners Commercial |
$15.52
|
| Rate for Payer: Wise Provider Network Commercial |
$15.52
|
|
|
BAIR HUGGER FULL UNDER BODY
|
Facility
|
IP
|
$84.03
|
|
| Hospital Charge Code |
2500159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.70 |
| Max. Negotiated Rate |
$84.03 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.35
|
| Rate for Payer: Aetna of WY Medicare |
$53.78
|
| Rate for Payer: Altius Commercial |
$80.67
|
| Rate for Payer: Beech Street Commercial |
$82.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.51
|
| Rate for Payer: Cash Price |
$58.82
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.51
|
| Rate for Payer: Cigna of WY Commercial |
$82.35
|
| Rate for Payer: Entrust Commercial |
$79.83
|
| Rate for Payer: First Choice Health Commercial |
$79.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.26
|
| Rate for Payer: HealthUtah PPO |
$84.03
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.51
|
| Rate for Payer: Multiplan Medicare/VA |
$48.70
|
| Rate for Payer: One Health Plan of WY PPO |
$82.35
|
| Rate for Payer: PacificSource Commercial |
$75.63
|
| Rate for Payer: PHCS PPO |
$82.35
|
| Rate for Payer: Three Rivers PPO |
$63.02
|
| Rate for Payer: TriWest Veterans Administration |
$51.26
|
| Rate for Payer: United Healthcare Commercial |
$80.25
|
| Rate for Payer: United Healthcare Medicare |
$51.26
|
| Rate for Payer: WINHealth Partners Commercial |
$79.83
|
| Rate for Payer: Wise Provider Network Commercial |
$79.83
|
|
|
BAIR HUGGER FULL UNDER BODY
|
Facility
|
OP
|
$84.03
|
|
| Hospital Charge Code |
2500159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$84.03 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.35
|
| Rate for Payer: Aetna of WY Medicare |
$55.46
|
| Rate for Payer: Altius Commercial |
$80.67
|
| Rate for Payer: Beech Street Commercial |
$82.35
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.51
|
| Rate for Payer: Cash Price |
$58.82
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.51
|
| Rate for Payer: Cigna of WY Commercial |
$82.35
|
| Rate for Payer: Entrust Commercial |
$79.83
|
| Rate for Payer: First Choice Health Commercial |
$79.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$47.90
|
| Rate for Payer: HealthUtah PPO |
$84.03
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.51
|
| Rate for Payer: Multiplan Medicare/VA |
$45.50
|
| Rate for Payer: One Health Plan of WY PPO |
$82.35
|
| Rate for Payer: PacificSource Commercial |
$75.63
|
| Rate for Payer: PHCS PPO |
$82.35
|
| Rate for Payer: Three Rivers PPO |
$63.02
|
| Rate for Payer: TriWest Veterans Administration |
$47.90
|
| Rate for Payer: United Healthcare Commercial |
$80.25
|
| Rate for Payer: United Healthcare Medicare |
$47.90
|
| Rate for Payer: WINHealth Partners Commercial |
$82.35
|
| Rate for Payer: Wise Provider Network Commercial |
$79.83
|
|
|
BAIR HUGGER HOSE REPLACEMENT
|
Facility
|
OP
|
$95.76
|
|
| Hospital Charge Code |
2500211
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.85 |
| Max. Negotiated Rate |
$95.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.84
|
| Rate for Payer: Aetna of WY Medicare |
$63.20
|
| Rate for Payer: Altius Commercial |
$91.93
|
| Rate for Payer: Beech Street Commercial |
$93.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.89
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.89
|
| Rate for Payer: Cigna of WY Commercial |
$93.84
|
| Rate for Payer: Entrust Commercial |
$90.97
|
| Rate for Payer: First Choice Health Commercial |
$90.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.58
|
| Rate for Payer: HealthUtah PPO |
$95.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.89
|
| Rate for Payer: Multiplan Medicare/VA |
$51.85
|
| Rate for Payer: One Health Plan of WY PPO |
$93.84
|
| Rate for Payer: PacificSource Commercial |
$86.18
|
| Rate for Payer: PHCS PPO |
$93.84
|
| Rate for Payer: Three Rivers PPO |
$71.82
|
| Rate for Payer: TriWest Veterans Administration |
$54.58
|
| Rate for Payer: United Healthcare Commercial |
$91.45
|
| Rate for Payer: United Healthcare Medicare |
$54.58
|
| Rate for Payer: WINHealth Partners Commercial |
$93.84
|
| Rate for Payer: Wise Provider Network Commercial |
$90.97
|
|
|
BAIR HUGGER HOSE REPLACEMENT
|
Facility
|
IP
|
$95.76
|
|
| Hospital Charge Code |
2500211
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55.49 |
| Max. Negotiated Rate |
$95.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.84
|
| Rate for Payer: Aetna of WY Medicare |
$61.29
|
| Rate for Payer: Altius Commercial |
$91.93
|
| Rate for Payer: Beech Street Commercial |
$93.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.89
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.89
|
| Rate for Payer: Cigna of WY Commercial |
$93.84
|
| Rate for Payer: Entrust Commercial |
$90.97
|
| Rate for Payer: First Choice Health Commercial |
$90.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.41
|
| Rate for Payer: HealthUtah PPO |
$95.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.89
|
| Rate for Payer: Multiplan Medicare/VA |
$55.49
|
| Rate for Payer: One Health Plan of WY PPO |
$93.84
|
| Rate for Payer: PacificSource Commercial |
$86.18
|
| Rate for Payer: PHCS PPO |
$93.84
|
| Rate for Payer: Three Rivers PPO |
$71.82
|
| Rate for Payer: TriWest Veterans Administration |
$58.41
|
| Rate for Payer: United Healthcare Commercial |
$91.45
|
| Rate for Payer: United Healthcare Medicare |
$58.41
|
| Rate for Payer: WINHealth Partners Commercial |
$90.97
|
| Rate for Payer: Wise Provider Network Commercial |
$90.97
|
|
|
BAIR HUGGER LOWER BODY
|
Facility
|
OP
|
$15.77
|
|
| Hospital Charge Code |
2500005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$15.77 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.45
|
| Rate for Payer: Aetna of WY Medicare |
$10.41
|
| Rate for Payer: Altius Commercial |
$15.14
|
| Rate for Payer: Beech Street Commercial |
$15.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.30
|
| Rate for Payer: Cash Price |
$11.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.30
|
| Rate for Payer: Cigna of WY Commercial |
$15.45
|
| Rate for Payer: Entrust Commercial |
$14.98
|
| Rate for Payer: First Choice Health Commercial |
$14.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.99
|
| Rate for Payer: HealthUtah PPO |
$15.77
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.30
|
| Rate for Payer: Multiplan Medicare/VA |
$8.54
|
| Rate for Payer: One Health Plan of WY PPO |
$15.45
|
| Rate for Payer: PacificSource Commercial |
$14.19
|
| Rate for Payer: PHCS PPO |
$15.45
|
| Rate for Payer: Three Rivers PPO |
$11.83
|
| Rate for Payer: TriWest Veterans Administration |
$8.99
|
| Rate for Payer: United Healthcare Commercial |
$15.06
|
| Rate for Payer: United Healthcare Medicare |
$8.99
|
| Rate for Payer: WINHealth Partners Commercial |
$15.45
|
| Rate for Payer: Wise Provider Network Commercial |
$14.98
|
|
|
BAIR HUGGER LOWER BODY
|
Facility
|
IP
|
$15.77
|
|
| Hospital Charge Code |
2500005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$15.77 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.45
|
| Rate for Payer: Aetna of WY Medicare |
$10.09
|
| Rate for Payer: Altius Commercial |
$15.14
|
| Rate for Payer: Beech Street Commercial |
$15.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.30
|
| Rate for Payer: Cash Price |
$11.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.30
|
| Rate for Payer: Cigna of WY Commercial |
$15.45
|
| Rate for Payer: Entrust Commercial |
$14.98
|
| Rate for Payer: First Choice Health Commercial |
$14.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.62
|
| Rate for Payer: HealthUtah PPO |
$15.77
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.30
|
| Rate for Payer: Multiplan Medicare/VA |
$9.14
|
| Rate for Payer: One Health Plan of WY PPO |
$15.45
|
| Rate for Payer: PacificSource Commercial |
$14.19
|
| Rate for Payer: PHCS PPO |
$15.45
|
| Rate for Payer: Three Rivers PPO |
$11.83
|
| Rate for Payer: TriWest Veterans Administration |
$9.62
|
| Rate for Payer: United Healthcare Commercial |
$15.06
|
| Rate for Payer: United Healthcare Medicare |
$9.62
|
| Rate for Payer: WINHealth Partners Commercial |
$14.98
|
| Rate for Payer: Wise Provider Network Commercial |
$14.98
|
|
|
BAIR HUGGER UPPER BODY
|
Facility
|
IP
|
$20.59
|
|
| Hospital Charge Code |
2500007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$20.59 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.18
|
| Rate for Payer: Aetna of WY Medicare |
$13.18
|
| Rate for Payer: Altius Commercial |
$19.77
|
| Rate for Payer: Beech Street Commercial |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$19.97
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.97
|
| Rate for Payer: Cigna of WY Commercial |
$20.18
|
| Rate for Payer: Entrust Commercial |
$19.56
|
| Rate for Payer: First Choice Health Commercial |
$19.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.56
|
| Rate for Payer: HealthUtah PPO |
$20.59
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.97
|
| Rate for Payer: Multiplan Medicare/VA |
$11.93
|
| Rate for Payer: One Health Plan of WY PPO |
$20.18
|
| Rate for Payer: PacificSource Commercial |
$18.53
|
| Rate for Payer: PHCS PPO |
$20.18
|
| Rate for Payer: Three Rivers PPO |
$15.44
|
| Rate for Payer: TriWest Veterans Administration |
$12.56
|
| Rate for Payer: United Healthcare Commercial |
$19.66
|
| Rate for Payer: United Healthcare Medicare |
$12.56
|
| Rate for Payer: WINHealth Partners Commercial |
$19.56
|
| Rate for Payer: Wise Provider Network Commercial |
$19.56
|
|
|
BAIR HUGGER UPPER BODY
|
Facility
|
OP
|
$20.59
|
|
| Hospital Charge Code |
2500007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$20.59 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.18
|
| Rate for Payer: Aetna of WY Medicare |
$13.59
|
| Rate for Payer: Altius Commercial |
$19.77
|
| Rate for Payer: Beech Street Commercial |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$19.97
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.97
|
| Rate for Payer: Cigna of WY Commercial |
$20.18
|
| Rate for Payer: Entrust Commercial |
$19.56
|
| Rate for Payer: First Choice Health Commercial |
$19.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.74
|
| Rate for Payer: HealthUtah PPO |
$20.59
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.97
|
| Rate for Payer: Multiplan Medicare/VA |
$11.15
|
| Rate for Payer: One Health Plan of WY PPO |
$20.18
|
| Rate for Payer: PacificSource Commercial |
$18.53
|
| Rate for Payer: PHCS PPO |
$20.18
|
| Rate for Payer: Three Rivers PPO |
$15.44
|
| Rate for Payer: TriWest Veterans Administration |
$11.74
|
| Rate for Payer: United Healthcare Commercial |
$19.66
|
| Rate for Payer: United Healthcare Medicare |
$11.74
|
| Rate for Payer: WINHealth Partners Commercial |
$20.18
|
| Rate for Payer: Wise Provider Network Commercial |
$19.56
|
|
|
BAKRI BALLOON POSTPARTUM
|
Facility
|
IP
|
$979.12
|
|
| Hospital Charge Code |
2450044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$567.40 |
| Max. Negotiated Rate |
$979.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$959.54
|
| Rate for Payer: Aetna of WY Medicare |
$626.64
|
| Rate for Payer: Altius Commercial |
$939.96
|
| Rate for Payer: Beech Street Commercial |
$959.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$949.75
|
| Rate for Payer: Cash Price |
$685.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$949.75
|
| Rate for Payer: Cigna of WY Commercial |
$959.54
|
| Rate for Payer: Entrust Commercial |
$930.16
|
| Rate for Payer: First Choice Health Commercial |
$930.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$930.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$597.26
|
| Rate for Payer: HealthUtah PPO |
$979.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$949.75
|
| Rate for Payer: Multiplan Medicare/VA |
$567.40
|
| Rate for Payer: One Health Plan of WY PPO |
$959.54
|
| Rate for Payer: PacificSource Commercial |
$881.21
|
| Rate for Payer: PHCS PPO |
$959.54
|
| Rate for Payer: Three Rivers PPO |
$734.34
|
| Rate for Payer: TriWest Veterans Administration |
$597.26
|
| Rate for Payer: United Healthcare Commercial |
$935.06
|
| Rate for Payer: United Healthcare Medicare |
$597.26
|
| Rate for Payer: WINHealth Partners Commercial |
$930.16
|
| Rate for Payer: Wise Provider Network Commercial |
$930.16
|
|
|
BAKRI BALLOON POSTPARTUM
|
Facility
|
OP
|
$979.12
|
|
| Hospital Charge Code |
2450044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$530.19 |
| Max. Negotiated Rate |
$979.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$959.54
|
| Rate for Payer: Aetna of WY Medicare |
$646.22
|
| Rate for Payer: Altius Commercial |
$939.96
|
| Rate for Payer: Beech Street Commercial |
$959.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$949.75
|
| Rate for Payer: Cash Price |
$685.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$949.75
|
| Rate for Payer: Cigna of WY Commercial |
$959.54
|
| Rate for Payer: Entrust Commercial |
$930.16
|
| Rate for Payer: First Choice Health Commercial |
$930.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$930.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$558.10
|
| Rate for Payer: HealthUtah PPO |
$979.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$949.75
|
| Rate for Payer: Multiplan Medicare/VA |
$530.19
|
| Rate for Payer: One Health Plan of WY PPO |
$959.54
|
| Rate for Payer: PacificSource Commercial |
$881.21
|
| Rate for Payer: PHCS PPO |
$959.54
|
| Rate for Payer: Three Rivers PPO |
$734.34
|
| Rate for Payer: TriWest Veterans Administration |
$558.10
|
| Rate for Payer: United Healthcare Commercial |
$935.06
|
| Rate for Payer: United Healthcare Medicare |
$558.10
|
| Rate for Payer: WINHealth Partners Commercial |
$959.54
|
| Rate for Payer: Wise Provider Network Commercial |
$930.16
|
|
|
BALLOON EUSTACHIAN EU061655
|
Facility
|
OP
|
$5,867.19
|
|
| Hospital Charge Code |
3002428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,177.08 |
| Max. Negotiated Rate |
$5,867.19 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,749.85
|
| Rate for Payer: Aetna of WY Medicare |
$3,872.35
|
| Rate for Payer: Altius Commercial |
$5,632.50
|
| Rate for Payer: Beech Street Commercial |
$5,749.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5,691.17
|
| Rate for Payer: Cash Price |
$4,107.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,691.17
|
| Rate for Payer: Cigna of WY Commercial |
$5,749.85
|
| Rate for Payer: Entrust Commercial |
$5,573.83
|
| Rate for Payer: First Choice Health Commercial |
$5,573.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,573.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3,344.30
|
| Rate for Payer: HealthUtah PPO |
$5,867.19
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,691.17
|
| Rate for Payer: Multiplan Medicare/VA |
$3,177.08
|
| Rate for Payer: One Health Plan of WY PPO |
$5,749.85
|
| Rate for Payer: PacificSource Commercial |
$5,280.47
|
| Rate for Payer: PHCS PPO |
$5,749.85
|
| Rate for Payer: Three Rivers PPO |
$4,400.39
|
| Rate for Payer: TriWest Veterans Administration |
$3,344.30
|
| Rate for Payer: United Healthcare Commercial |
$5,603.17
|
| Rate for Payer: United Healthcare Medicare |
$3,344.30
|
| Rate for Payer: WINHealth Partners Commercial |
$5,749.85
|
| Rate for Payer: Wise Provider Network Commercial |
$5,573.83
|
|
|
BALLOON EUSTACHIAN EU061655
|
Facility
|
IP
|
$5,867.19
|
|
| Hospital Charge Code |
3002428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,400.04 |
| Max. Negotiated Rate |
$5,867.19 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,749.85
|
| Rate for Payer: Aetna of WY Medicare |
$3,755.00
|
| Rate for Payer: Altius Commercial |
$5,632.50
|
| Rate for Payer: Beech Street Commercial |
$5,749.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5,691.17
|
| Rate for Payer: Cash Price |
$4,107.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,691.17
|
| Rate for Payer: Cigna of WY Commercial |
$5,749.85
|
| Rate for Payer: Entrust Commercial |
$5,573.83
|
| Rate for Payer: First Choice Health Commercial |
$5,573.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,573.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3,578.99
|
| Rate for Payer: HealthUtah PPO |
$5,867.19
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,691.17
|
| Rate for Payer: Multiplan Medicare/VA |
$3,400.04
|
| Rate for Payer: One Health Plan of WY PPO |
$5,749.85
|
| Rate for Payer: PacificSource Commercial |
$5,280.47
|
| Rate for Payer: PHCS PPO |
$5,749.85
|
| Rate for Payer: Three Rivers PPO |
$4,400.39
|
| Rate for Payer: TriWest Veterans Administration |
$3,578.99
|
| Rate for Payer: United Healthcare Commercial |
$5,603.17
|
| Rate for Payer: United Healthcare Medicare |
$3,578.99
|
| Rate for Payer: WINHealth Partners Commercial |
$5,573.83
|
| Rate for Payer: Wise Provider Network Commercial |
$5,573.83
|
|
|
BALLOON EXTRACTOR KATZ BEX7001
|
Facility
|
IP
|
$122.33
|
|
| Hospital Charge Code |
2400060
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.89 |
| Max. Negotiated Rate |
$122.33 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$119.88
|
| Rate for Payer: Aetna of WY Medicare |
$78.29
|
| Rate for Payer: Altius Commercial |
$117.44
|
| Rate for Payer: Beech Street Commercial |
$119.88
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$118.66
|
| Rate for Payer: Cash Price |
$85.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$118.66
|
| Rate for Payer: Cigna of WY Commercial |
$119.88
|
| Rate for Payer: Entrust Commercial |
$116.21
|
| Rate for Payer: First Choice Health Commercial |
$116.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$116.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$74.62
|
| Rate for Payer: HealthUtah PPO |
$122.33
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$118.66
|
| Rate for Payer: Multiplan Medicare/VA |
$70.89
|
| Rate for Payer: One Health Plan of WY PPO |
$119.88
|
| Rate for Payer: PacificSource Commercial |
$110.10
|
| Rate for Payer: PHCS PPO |
$119.88
|
| Rate for Payer: Three Rivers PPO |
$91.75
|
| Rate for Payer: TriWest Veterans Administration |
$74.62
|
| Rate for Payer: United Healthcare Commercial |
$116.83
|
| Rate for Payer: United Healthcare Medicare |
$74.62
|
| Rate for Payer: WINHealth Partners Commercial |
$116.21
|
| Rate for Payer: Wise Provider Network Commercial |
$116.21
|
|
|
BALLOON EXTRACTOR KATZ BEX7001
|
Facility
|
OP
|
$122.33
|
|
| Hospital Charge Code |
2400060
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$122.33 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$119.88
|
| Rate for Payer: Aetna of WY Medicare |
$80.74
|
| Rate for Payer: Altius Commercial |
$117.44
|
| Rate for Payer: Beech Street Commercial |
$119.88
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$118.66
|
| Rate for Payer: Cash Price |
$85.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$118.66
|
| Rate for Payer: Cigna of WY Commercial |
$119.88
|
| Rate for Payer: Entrust Commercial |
$116.21
|
| Rate for Payer: First Choice Health Commercial |
$116.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$116.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$69.73
|
| Rate for Payer: HealthUtah PPO |
$122.33
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$118.66
|
| Rate for Payer: Multiplan Medicare/VA |
$66.24
|
| Rate for Payer: One Health Plan of WY PPO |
$119.88
|
| Rate for Payer: PacificSource Commercial |
$110.10
|
| Rate for Payer: PHCS PPO |
$119.88
|
| Rate for Payer: Three Rivers PPO |
$91.75
|
| Rate for Payer: TriWest Veterans Administration |
$69.73
|
| Rate for Payer: United Healthcare Commercial |
$116.83
|
| Rate for Payer: United Healthcare Medicare |
$69.73
|
| Rate for Payer: WINHealth Partners Commercial |
$119.88
|
| Rate for Payer: Wise Provider Network Commercial |
$116.21
|
|
|
BALLOON SEEKER 70° 7X17MM
|
Facility
|
IP
|
$3,071.25
|
|
| Hospital Charge Code |
2700013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,779.79 |
| Max. Negotiated Rate |
$3,071.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,009.82
|
| Rate for Payer: Aetna of WY Medicare |
$1,965.60
|
| Rate for Payer: Altius Commercial |
$2,948.40
|
| Rate for Payer: Beech Street Commercial |
$3,009.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,979.11
|
| Rate for Payer: Cash Price |
$2,149.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,979.11
|
| Rate for Payer: Cigna of WY Commercial |
$3,009.82
|
| Rate for Payer: Entrust Commercial |
$2,917.69
|
| Rate for Payer: First Choice Health Commercial |
$2,917.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,917.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,873.46
|
| Rate for Payer: HealthUtah PPO |
$3,071.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,979.11
|
| Rate for Payer: Multiplan Medicare/VA |
$1,779.79
|
| Rate for Payer: One Health Plan of WY PPO |
$3,009.82
|
| Rate for Payer: PacificSource Commercial |
$2,764.12
|
| Rate for Payer: PHCS PPO |
$3,009.82
|
| Rate for Payer: Three Rivers PPO |
$2,303.44
|
| Rate for Payer: TriWest Veterans Administration |
$1,873.46
|
| Rate for Payer: United Healthcare Commercial |
$2,933.04
|
| Rate for Payer: United Healthcare Medicare |
$1,873.46
|
| Rate for Payer: WINHealth Partners Commercial |
$2,917.69
|
| Rate for Payer: Wise Provider Network Commercial |
$2,917.69
|
|
|
BALLOON SEEKER 70° 7X17MM
|
Facility
|
OP
|
$3,071.25
|
|
| Hospital Charge Code |
2700013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,663.08 |
| Max. Negotiated Rate |
$3,071.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,009.82
|
| Rate for Payer: Aetna of WY Medicare |
$2,027.02
|
| Rate for Payer: Altius Commercial |
$2,948.40
|
| Rate for Payer: Beech Street Commercial |
$3,009.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,979.11
|
| Rate for Payer: Cash Price |
$2,149.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,979.11
|
| Rate for Payer: Cigna of WY Commercial |
$3,009.82
|
| Rate for Payer: Entrust Commercial |
$2,917.69
|
| Rate for Payer: First Choice Health Commercial |
$2,917.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,917.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,750.61
|
| Rate for Payer: HealthUtah PPO |
$3,071.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,979.11
|
| Rate for Payer: Multiplan Medicare/VA |
$1,663.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,009.82
|
| Rate for Payer: PacificSource Commercial |
$2,764.12
|
| Rate for Payer: PHCS PPO |
$3,009.82
|
| Rate for Payer: Three Rivers PPO |
$2,303.44
|
| Rate for Payer: TriWest Veterans Administration |
$1,750.61
|
| Rate for Payer: United Healthcare Commercial |
$2,933.04
|
| Rate for Payer: United Healthcare Medicare |
$1,750.61
|
| Rate for Payer: WINHealth Partners Commercial |
$3,009.82
|
| Rate for Payer: Wise Provider Network Commercial |
$2,917.69
|
|
|
BALOXAVIR MARBOXIL 40 MG TABLET [154455]
|
Facility
|
OP
|
$253.71
|
|
|
Service Code
|
NDC 5009041040
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$137.38 |
| Max. Negotiated Rate |
$253.71 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$248.64
|
| Rate for Payer: Aetna of WY Medicare |
$167.45
|
| Rate for Payer: Altius Commercial |
$243.56
|
| Rate for Payer: Beech Street Commercial |
$248.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$246.10
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$246.10
|
| Rate for Payer: Cigna of WY Commercial |
$248.64
|
| Rate for Payer: Entrust Commercial |
$241.02
|
| Rate for Payer: First Choice Health Commercial |
$241.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$241.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$144.61
|
| Rate for Payer: HealthUtah PPO |
$253.71
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$246.10
|
| Rate for Payer: Multiplan Medicare/VA |
$137.38
|
| Rate for Payer: One Health Plan of WY PPO |
$248.64
|
| Rate for Payer: PacificSource Commercial |
$228.34
|
| Rate for Payer: PHCS PPO |
$248.64
|
| Rate for Payer: Three Rivers PPO |
$190.28
|
| Rate for Payer: TriWest Veterans Administration |
$144.61
|
| Rate for Payer: United Healthcare Commercial |
$242.29
|
| Rate for Payer: United Healthcare Medicare |
$144.61
|
| Rate for Payer: WINHealth Partners Commercial |
$248.64
|
| Rate for Payer: Wise Provider Network Commercial |
$241.02
|
|
