|
BOSTON SCI DIAGNOSTIC FL4 5FR X 100CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FL4 5FR X 100CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FL4 5FR X 125CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FL4 5FR X 125CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR4 5FR X 100CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR4 5FR X 100CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR4 5FR X 125CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR4 5FR X 125CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR5 5FR X 100CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR5 5FR X 100CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR5 5FR X 125CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC FR5 5FR X 125CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC IM 5FR X 100CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC IM 5FR X 100CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC IM 5FR X 125CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC IM 5FR X 125CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC LCB 5FR X 100CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC LCB 5FR X 100CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC MPA2 SH 5FR X 100CM
|
Facility
|
IP
|
$28.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.18 |
| Max. Negotiated Rate |
$28.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$28.41
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.83
|
| Rate for Payer: Altius Commercial |
$27.83
|
| Rate for Payer: Beech Street Commercial |
$28.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.80
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$28.12
|
| Rate for Payer: Cigna of WY Commercial |
$28.41
|
| Rate for Payer: Entrust Commercial |
$27.54
|
| Rate for Payer: First Choice Health Commercial |
$27.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$19.13
|
| Rate for Payer: HealthUtah PPO |
$28.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$28.12
|
| Rate for Payer: Multiplan Medicare/VA |
$18.18
|
| Rate for Payer: One Health Plan of WY PPO |
$28.41
|
| Rate for Payer: PacificSource Commercial |
$26.09
|
| Rate for Payer: PHCS PPO |
$28.41
|
| Rate for Payer: Three Rivers PPO |
$21.74
|
| Rate for Payer: TriWest Veterans Administration |
$19.13
|
| Rate for Payer: United Healthcare Commercial |
$25.22
|
| Rate for Payer: United Healthcare Medicare |
$19.13
|
| Rate for Payer: WINHealth Partners Commercial |
$27.54
|
| Rate for Payer: Wise Provider Network Commercial |
$27.54
|
|
|
BOSTON SCI DIAGNOSTIC MPA2 SH 5FR X 100CM
|
Facility
|
OP
|
$28.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.97 |
| Max. Negotiated Rate |
$28.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$28.41
|
| Rate for Payer: Aetna of WY Medicare |
$19.13
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.83
|
| Rate for Payer: Altius Commercial |
$27.83
|
| Rate for Payer: Beech Street Commercial |
$28.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.80
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$28.12
|
| Rate for Payer: Cigna of WY Commercial |
$28.41
|
| Rate for Payer: Entrust Commercial |
$27.54
|
| Rate for Payer: First Choice Health Commercial |
$27.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.81
|
| Rate for Payer: HealthUtah PPO |
$28.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$28.12
|
| Rate for Payer: Multiplan Medicare/VA |
$15.97
|
| Rate for Payer: One Health Plan of WY PPO |
$28.41
|
| Rate for Payer: PacificSource Commercial |
$26.09
|
| Rate for Payer: PHCS PPO |
$28.41
|
| Rate for Payer: Three Rivers PPO |
$21.74
|
| Rate for Payer: TriWest Veterans Administration |
$16.81
|
| Rate for Payer: United Healthcare Commercial |
$25.22
|
| Rate for Payer: United Healthcare Medicare |
$16.81
|
| Rate for Payer: WINHealth Partners Commercial |
$28.41
|
| Rate for Payer: Wise Provider Network Commercial |
$27.54
|
|
|
BOSTON SCI DIAGNOSTIC MPA2 SH 5FR X 125CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC MPA2 SH 5FR X 125CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC MPB2 SH 5FR X 100CM
|
Facility
|
IP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.17
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$15.36
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$16.17
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$16.17
|
| Rate for Payer: WINHealth Partners Commercial |
$23.28
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC MPB2 SH 5FR X 100CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
|
BOSTON SCI DIAGNOSTIC PIG 145 5FR X 100CM
|
Facility
|
OP
|
$24.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.01
|
| Rate for Payer: Aetna of WY Medicare |
$16.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.52
|
| Rate for Payer: Altius Commercial |
$23.52
|
| Rate for Payer: Beech Street Commercial |
$24.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.76
|
| Rate for Payer: Cigna of WY Commercial |
$24.01
|
| Rate for Payer: Entrust Commercial |
$23.28
|
| Rate for Payer: First Choice Health Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.21
|
| Rate for Payer: HealthUtah PPO |
$24.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.76
|
| Rate for Payer: Multiplan Medicare/VA |
$13.50
|
| Rate for Payer: One Health Plan of WY PPO |
$24.01
|
| Rate for Payer: PacificSource Commercial |
$22.05
|
| Rate for Payer: PHCS PPO |
$24.01
|
| Rate for Payer: Three Rivers PPO |
$18.38
|
| Rate for Payer: TriWest Veterans Administration |
$14.21
|
| Rate for Payer: United Healthcare Commercial |
$21.32
|
| Rate for Payer: United Healthcare Medicare |
$14.21
|
| Rate for Payer: WINHealth Partners Commercial |
$24.01
|
| Rate for Payer: Wise Provider Network Commercial |
$23.28
|
|
