|
HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,1ST HR
|
Facility
|
OP
|
$380.00
|
|
|
Service Code
|
HCPCS 92607
|
| Hospital Charge Code |
4449260701
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$209.38 |
| Max. Negotiated Rate |
$380.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$372.40
|
| Rate for Payer: Aetna of WY Medicare |
$250.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$364.80
|
| Rate for Payer: Altius Commercial |
$364.80
|
| Rate for Payer: Beech Street Commercial |
$372.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$311.98
|
| Rate for Payer: Cash Price |
$266.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$368.60
|
| Rate for Payer: Cigna of WY Commercial |
$372.40
|
| Rate for Payer: Entrust Commercial |
$361.00
|
| Rate for Payer: First Choice Health Commercial |
$361.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$361.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$220.40
|
| Rate for Payer: HealthUtah PPO |
$380.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$368.60
|
| Rate for Payer: Multiplan Medicare/VA |
$209.38
|
| Rate for Payer: One Health Plan of WY PPO |
$372.40
|
| Rate for Payer: PacificSource Commercial |
$342.00
|
| Rate for Payer: PHCS PPO |
$372.40
|
| Rate for Payer: Three Rivers PPO |
$285.00
|
| Rate for Payer: TriWest Veterans Administration |
$220.40
|
| Rate for Payer: United Healthcare Commercial |
$330.60
|
| Rate for Payer: United Healthcare Medicare |
$220.40
|
| Rate for Payer: WINHealth Partners Commercial |
$372.40
|
| Rate for Payer: Wise Provider Network Commercial |
$361.00
|
|
|
HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,1ST HR
|
Facility
|
IP
|
$380.00
|
|
|
Service Code
|
HCPCS 92607
|
| Hospital Charge Code |
4449260701
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$238.26 |
| Max. Negotiated Rate |
$380.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$372.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$364.80
|
| Rate for Payer: Altius Commercial |
$364.80
|
| Rate for Payer: Beech Street Commercial |
$372.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$311.98
|
| Rate for Payer: Cash Price |
$266.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$368.60
|
| Rate for Payer: Cigna of WY Commercial |
$372.40
|
| Rate for Payer: Entrust Commercial |
$361.00
|
| Rate for Payer: First Choice Health Commercial |
$361.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$361.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$250.80
|
| Rate for Payer: HealthUtah PPO |
$380.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$368.60
|
| Rate for Payer: Multiplan Medicare/VA |
$238.26
|
| Rate for Payer: One Health Plan of WY PPO |
$372.40
|
| Rate for Payer: PacificSource Commercial |
$342.00
|
| Rate for Payer: PHCS PPO |
$372.40
|
| Rate for Payer: Three Rivers PPO |
$285.00
|
| Rate for Payer: TriWest Veterans Administration |
$250.80
|
| Rate for Payer: United Healthcare Commercial |
$330.60
|
| Rate for Payer: United Healthcare Medicare |
$250.80
|
| Rate for Payer: WINHealth Partners Commercial |
$361.00
|
| Rate for Payer: Wise Provider Network Commercial |
$361.00
|
|
|
HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,ADDL 30
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS 92608
|
| Hospital Charge Code |
4449260801
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$60.61 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$107.80
|
| Rate for Payer: Aetna of WY Medicare |
$72.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$105.60
|
| Rate for Payer: Altius Commercial |
$105.60
|
| Rate for Payer: Beech Street Commercial |
$107.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$90.31
|
| Rate for Payer: Cash Price |
$77.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$106.70
|
| Rate for Payer: Cigna of WY Commercial |
$107.80
|
| Rate for Payer: Entrust Commercial |
$104.50
|
| Rate for Payer: First Choice Health Commercial |
$104.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$104.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$63.80
|
| Rate for Payer: HealthUtah PPO |
$110.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$106.70
|
| Rate for Payer: Multiplan Medicare/VA |
$60.61
|
| Rate for Payer: One Health Plan of WY PPO |
$107.80
|
| Rate for Payer: PacificSource Commercial |
$99.00
|
| Rate for Payer: PHCS PPO |
$107.80
|
| Rate for Payer: Three Rivers PPO |
$82.50
|
| Rate for Payer: TriWest Veterans Administration |
$63.80
|
| Rate for Payer: United Healthcare Commercial |
$95.70
|
| Rate for Payer: United Healthcare Medicare |
$63.80
|
| Rate for Payer: WINHealth Partners Commercial |
$107.80
|
| Rate for Payer: Wise Provider Network Commercial |
$104.50
|
|
|
HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,ADDL 30
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS 92608
|
| Hospital Charge Code |
4449260801
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$68.97 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$107.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$105.60
|
| Rate for Payer: Altius Commercial |
$105.60
|
| Rate for Payer: Beech Street Commercial |
$107.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$90.31
|
| Rate for Payer: Cash Price |
$77.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$106.70
|
| Rate for Payer: Cigna of WY Commercial |
$107.80
|
| Rate for Payer: Entrust Commercial |
$104.50
|
| Rate for Payer: First Choice Health Commercial |
$104.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$104.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$72.60
|
| Rate for Payer: HealthUtah PPO |
$110.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$106.70
|
| Rate for Payer: Multiplan Medicare/VA |
$68.97
|
| Rate for Payer: One Health Plan of WY PPO |
$107.80
|
| Rate for Payer: PacificSource Commercial |
$99.00
|
| Rate for Payer: PHCS PPO |
$107.80
|
| Rate for Payer: Three Rivers PPO |
$82.50
|
| Rate for Payer: TriWest Veterans Administration |
$72.60
|
| Rate for Payer: United Healthcare Commercial |
$95.70
|
| Rate for Payer: United Healthcare Medicare |
$72.60
|
| Rate for Payer: WINHealth Partners Commercial |
$104.50
|
| Rate for Payer: Wise Provider Network Commercial |
$104.50
|
|
|
HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Facility
|
IP
|
$860.00
|
|
|
Service Code
|
HCPCS 92523
|
| Hospital Charge Code |
4449252301
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$539.22 |
| Max. Negotiated Rate |
$860.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$842.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$825.60
|
| Rate for Payer: Altius Commercial |
$825.60
|
| Rate for Payer: Beech Street Commercial |
$842.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$706.06
|
| Rate for Payer: Cash Price |
$602.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$834.20
|
| Rate for Payer: Cigna of WY Commercial |
$842.80
|
| Rate for Payer: Entrust Commercial |
$817.00
|
| Rate for Payer: First Choice Health Commercial |
$817.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$817.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$567.60
|
| Rate for Payer: HealthUtah PPO |
$860.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$834.20
|
| Rate for Payer: Multiplan Medicare/VA |
$539.22
|
| Rate for Payer: One Health Plan of WY PPO |
$842.80
|
| Rate for Payer: PacificSource Commercial |
$774.00
|
| Rate for Payer: PHCS PPO |
$842.80
|
| Rate for Payer: Three Rivers PPO |
$645.00
|
| Rate for Payer: TriWest Veterans Administration |
$567.60
|
| Rate for Payer: United Healthcare Commercial |
$748.20
|
| Rate for Payer: United Healthcare Medicare |
$567.60
|
| Rate for Payer: WINHealth Partners Commercial |
$817.00
|
| Rate for Payer: Wise Provider Network Commercial |
$817.00
|
|
|
HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Facility
|
OP
|
$860.00
|
|
|
Service Code
|
HCPCS 92523
|
| Hospital Charge Code |
4449252301
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$473.86 |
| Max. Negotiated Rate |
$860.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$842.80
|
| Rate for Payer: Aetna of WY Medicare |
$567.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$825.60
|
| Rate for Payer: Altius Commercial |
$825.60
|
| Rate for Payer: Beech Street Commercial |
$842.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$706.06
|
| Rate for Payer: Cash Price |
$602.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$834.20
|
| Rate for Payer: Cigna of WY Commercial |
$842.80
|
| Rate for Payer: Entrust Commercial |
$817.00
|
| Rate for Payer: First Choice Health Commercial |
$817.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$817.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$498.80
|
| Rate for Payer: HealthUtah PPO |
$860.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$834.20
|
| Rate for Payer: Multiplan Medicare/VA |
$473.86
|
| Rate for Payer: One Health Plan of WY PPO |
$842.80
|
| Rate for Payer: PacificSource Commercial |
$774.00
|
| Rate for Payer: PHCS PPO |
$842.80
|
| Rate for Payer: Three Rivers PPO |
$645.00
|
| Rate for Payer: TriWest Veterans Administration |
$498.80
|
| Rate for Payer: United Healthcare Commercial |
$748.20
|
| Rate for Payer: United Healthcare Medicare |
$498.80
|
| Rate for Payer: WINHealth Partners Commercial |
$842.80
|
| Rate for Payer: Wise Provider Network Commercial |
$817.00
|
|
|
HC SLP EVAL,SWALLOW FUNCTION,CINE/VIDEO RECORD
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS 92611
|
| Hospital Charge Code |
4449261101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$330.60 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$588.00
|
| Rate for Payer: Aetna of WY Medicare |
$396.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$576.00
|
| Rate for Payer: Altius Commercial |
$576.00
|
| Rate for Payer: Beech Street Commercial |
$588.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$492.60
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$582.00
|
| Rate for Payer: Cigna of WY Commercial |
$588.00
|
| Rate for Payer: Entrust Commercial |
$570.00
|
| Rate for Payer: First Choice Health Commercial |
$570.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$570.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$348.00
|
| Rate for Payer: HealthUtah PPO |
$600.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$582.00
|
| Rate for Payer: Multiplan Medicare/VA |
$330.60
|
| Rate for Payer: One Health Plan of WY PPO |
$588.00
|
| Rate for Payer: PacificSource Commercial |
$540.00
|
| Rate for Payer: PHCS PPO |
$588.00
|
| Rate for Payer: Three Rivers PPO |
$450.00
|
| Rate for Payer: TriWest Veterans Administration |
$348.00
|
| Rate for Payer: United Healthcare Commercial |
$522.00
|
| Rate for Payer: United Healthcare Medicare |
$348.00
|
| Rate for Payer: WINHealth Partners Commercial |
$588.00
|
| Rate for Payer: Wise Provider Network Commercial |
$570.00
|
|
|
HC SLP EVAL,SWALLOW FUNCTION,CINE/VIDEO RECORD
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
HCPCS 92611
|
| Hospital Charge Code |
9839261101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$197.50 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$308.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$302.40
|
| Rate for Payer: Altius Commercial |
$302.40
|
| Rate for Payer: Beech Street Commercial |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$258.62
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$305.55
|
| Rate for Payer: Cigna of WY Commercial |
$308.70
|
| Rate for Payer: Entrust Commercial |
$299.25
|
| Rate for Payer: First Choice Health Commercial |
$299.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$299.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$207.90
|
| Rate for Payer: HealthUtah PPO |
$315.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$305.55
|
| Rate for Payer: Multiplan Medicare/VA |
$197.50
|
| Rate for Payer: One Health Plan of WY PPO |
$308.70
|
| Rate for Payer: PacificSource Commercial |
$283.50
|
| Rate for Payer: PHCS PPO |
$308.70
|
| Rate for Payer: Three Rivers PPO |
$236.25
|
| Rate for Payer: TriWest Veterans Administration |
$207.90
|
| Rate for Payer: United Healthcare Commercial |
$274.05
|
| Rate for Payer: United Healthcare Medicare |
$207.90
|
| Rate for Payer: WINHealth Partners Commercial |
$299.25
|
| Rate for Payer: Wise Provider Network Commercial |
$299.25
|
|
|
HC SLP EVAL,SWALLOW FUNCTION,CINE/VIDEO RECORD
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
HCPCS 92611
|
| Hospital Charge Code |
9839261101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$173.56 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$308.70
|
| Rate for Payer: Aetna of WY Medicare |
$207.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$302.40
|
| Rate for Payer: Altius Commercial |
$302.40
|
| Rate for Payer: Beech Street Commercial |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$258.62
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$305.55
|
| Rate for Payer: Cigna of WY Commercial |
$308.70
|
| Rate for Payer: Entrust Commercial |
$299.25
|
| Rate for Payer: First Choice Health Commercial |
$299.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$299.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$182.70
|
| Rate for Payer: HealthUtah PPO |
$315.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$305.55
|
| Rate for Payer: Multiplan Medicare/VA |
$173.56
|
| Rate for Payer: One Health Plan of WY PPO |
$308.70
|
| Rate for Payer: PacificSource Commercial |
$283.50
|
| Rate for Payer: PHCS PPO |
$308.70
|
| Rate for Payer: Three Rivers PPO |
$236.25
|
| Rate for Payer: TriWest Veterans Administration |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$274.05
|
| Rate for Payer: United Healthcare Medicare |
$182.70
|
| Rate for Payer: WINHealth Partners Commercial |
$308.70
|
| Rate for Payer: Wise Provider Network Commercial |
$299.25
|
|
|
HC SLP EVAL,SWALLOW FUNCTION,CINE/VIDEO RECORD
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS 92611
|
| Hospital Charge Code |
4449261101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$588.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$576.00
|
| Rate for Payer: Altius Commercial |
$576.00
|
| Rate for Payer: Beech Street Commercial |
$588.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$492.60
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$582.00
|
| Rate for Payer: Cigna of WY Commercial |
$588.00
|
| Rate for Payer: Entrust Commercial |
$570.00
|
| Rate for Payer: First Choice Health Commercial |
$570.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$570.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$396.00
|
| Rate for Payer: HealthUtah PPO |
$600.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$582.00
|
| Rate for Payer: Multiplan Medicare/VA |
$376.20
|
| Rate for Payer: One Health Plan of WY PPO |
$588.00
|
| Rate for Payer: PacificSource Commercial |
$540.00
|
| Rate for Payer: PHCS PPO |
$588.00
|
| Rate for Payer: Three Rivers PPO |
$450.00
|
| Rate for Payer: TriWest Veterans Administration |
$396.00
|
| Rate for Payer: United Healthcare Commercial |
$522.00
|
| Rate for Payer: United Healthcare Medicare |
$396.00
|
| Rate for Payer: WINHealth Partners Commercial |
$570.00
|
| Rate for Payer: Wise Provider Network Commercial |
$570.00
|
|
|
HC SLP EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Facility
|
OP
|
$635.00
|
|
|
Service Code
|
HCPCS 92521
|
| Hospital Charge Code |
4449252101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$349.88 |
| Max. Negotiated Rate |
$635.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$622.30
|
| Rate for Payer: Aetna of WY Medicare |
$419.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$609.60
|
| Rate for Payer: Altius Commercial |
$609.60
|
| Rate for Payer: Beech Street Commercial |
$622.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$521.34
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$615.95
|
| Rate for Payer: Cigna of WY Commercial |
$622.30
|
| Rate for Payer: Entrust Commercial |
$603.25
|
| Rate for Payer: First Choice Health Commercial |
$603.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$603.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$368.30
|
| Rate for Payer: HealthUtah PPO |
$635.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$615.95
|
| Rate for Payer: Multiplan Medicare/VA |
$349.88
|
| Rate for Payer: One Health Plan of WY PPO |
$622.30
|
| Rate for Payer: PacificSource Commercial |
$571.50
|
| Rate for Payer: PHCS PPO |
$622.30
|
| Rate for Payer: Three Rivers PPO |
$476.25
|
| Rate for Payer: TriWest Veterans Administration |
$368.30
|
| Rate for Payer: United Healthcare Commercial |
$552.45
|
| Rate for Payer: United Healthcare Medicare |
$368.30
|
| Rate for Payer: WINHealth Partners Commercial |
$622.30
|
| Rate for Payer: Wise Provider Network Commercial |
$603.25
|
|
|
HC SLP EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Facility
|
IP
|
$635.00
|
|
|
Service Code
|
HCPCS 92521
|
| Hospital Charge Code |
4449252101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$398.14 |
| Max. Negotiated Rate |
$635.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$622.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$609.60
|
| Rate for Payer: Altius Commercial |
$609.60
|
| Rate for Payer: Beech Street Commercial |
$622.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$521.34
|
| Rate for Payer: Cash Price |
$444.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$615.95
|
| Rate for Payer: Cigna of WY Commercial |
$622.30
|
| Rate for Payer: Entrust Commercial |
$603.25
|
| Rate for Payer: First Choice Health Commercial |
$603.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$603.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$419.10
|
| Rate for Payer: HealthUtah PPO |
$635.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$615.95
|
| Rate for Payer: Multiplan Medicare/VA |
$398.14
|
| Rate for Payer: One Health Plan of WY PPO |
$622.30
|
| Rate for Payer: PacificSource Commercial |
$571.50
|
| Rate for Payer: PHCS PPO |
$622.30
|
| Rate for Payer: Three Rivers PPO |
$476.25
|
| Rate for Payer: TriWest Veterans Administration |
$419.10
|
| Rate for Payer: United Healthcare Commercial |
$552.45
|
| Rate for Payer: United Healthcare Medicare |
$419.10
|
| Rate for Payer: WINHealth Partners Commercial |
$603.25
|
| Rate for Payer: Wise Provider Network Commercial |
$603.25
|
|
|
HC SLP EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Facility
|
OP
|
$530.00
|
|
|
Service Code
|
HCPCS 92522
|
| Hospital Charge Code |
4449252201
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$292.03 |
| Max. Negotiated Rate |
$530.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$519.40
|
| Rate for Payer: Aetna of WY Medicare |
$349.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$508.80
|
| Rate for Payer: Altius Commercial |
$508.80
|
| Rate for Payer: Beech Street Commercial |
$519.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$435.13
|
| Rate for Payer: Cash Price |
$371.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$514.10
|
| Rate for Payer: Cigna of WY Commercial |
$519.40
|
| Rate for Payer: Entrust Commercial |
$503.50
|
| Rate for Payer: First Choice Health Commercial |
$503.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$503.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$307.40
|
| Rate for Payer: HealthUtah PPO |
$530.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$514.10
|
| Rate for Payer: Multiplan Medicare/VA |
$292.03
|
| Rate for Payer: One Health Plan of WY PPO |
$519.40
|
| Rate for Payer: PacificSource Commercial |
$477.00
|
| Rate for Payer: PHCS PPO |
$519.40
|
| Rate for Payer: Three Rivers PPO |
$397.50
|
| Rate for Payer: TriWest Veterans Administration |
$307.40
|
| Rate for Payer: United Healthcare Commercial |
$461.10
|
| Rate for Payer: United Healthcare Medicare |
$307.40
|
| Rate for Payer: WINHealth Partners Commercial |
$519.40
|
| Rate for Payer: Wise Provider Network Commercial |
$503.50
|
|
|
HC SLP EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Facility
|
IP
|
$530.00
|
|
|
Service Code
|
HCPCS 92522
|
| Hospital Charge Code |
4449252201
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$332.31 |
| Max. Negotiated Rate |
$530.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$519.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$508.80
|
| Rate for Payer: Altius Commercial |
$508.80
|
| Rate for Payer: Beech Street Commercial |
$519.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$435.13
|
| Rate for Payer: Cash Price |
$371.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$514.10
|
| Rate for Payer: Cigna of WY Commercial |
$519.40
|
| Rate for Payer: Entrust Commercial |
$503.50
|
| Rate for Payer: First Choice Health Commercial |
$503.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$503.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$349.80
|
| Rate for Payer: HealthUtah PPO |
$530.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$514.10
|
| Rate for Payer: Multiplan Medicare/VA |
$332.31
|
| Rate for Payer: One Health Plan of WY PPO |
$519.40
|
| Rate for Payer: PacificSource Commercial |
$477.00
|
| Rate for Payer: PHCS PPO |
$519.40
|
| Rate for Payer: Three Rivers PPO |
$397.50
|
| Rate for Payer: TriWest Veterans Administration |
$349.80
|
| Rate for Payer: United Healthcare Commercial |
$461.10
|
| Rate for Payer: United Healthcare Medicare |
$349.80
|
| Rate for Payer: WINHealth Partners Commercial |
$503.50
|
| Rate for Payer: Wise Provider Network Commercial |
$503.50
|
|
|
HC SLP SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
|
Facility
|
IP
|
$185.00
|
|
|
Service Code
|
HCPCS 97535
|
| Hospital Charge Code |
4409753501
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$185.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$181.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$177.60
|
| Rate for Payer: Altius Commercial |
$177.60
|
| Rate for Payer: Beech Street Commercial |
$181.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$151.88
|
| Rate for Payer: Cash Price |
$129.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$179.45
|
| Rate for Payer: Cigna of WY Commercial |
$181.30
|
| Rate for Payer: Entrust Commercial |
$175.75
|
| Rate for Payer: First Choice Health Commercial |
$175.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$175.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$122.10
|
| Rate for Payer: HealthUtah PPO |
$185.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$179.45
|
| Rate for Payer: Multiplan Medicare/VA |
$116.00
|
| Rate for Payer: One Health Plan of WY PPO |
$181.30
|
| Rate for Payer: PacificSource Commercial |
$166.50
|
| Rate for Payer: PHCS PPO |
$181.30
|
| Rate for Payer: Three Rivers PPO |
$138.75
|
| Rate for Payer: TriWest Veterans Administration |
$122.10
|
| Rate for Payer: United Healthcare Commercial |
$160.95
|
| Rate for Payer: United Healthcare Medicare |
$122.10
|
| Rate for Payer: WINHealth Partners Commercial |
$175.75
|
| Rate for Payer: Wise Provider Network Commercial |
$175.75
|
|
|
HC SLP SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
|
Facility
|
OP
|
$185.00
|
|
|
Service Code
|
HCPCS 97535
|
| Hospital Charge Code |
4409753501
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$101.94 |
| Max. Negotiated Rate |
$185.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$181.30
|
| Rate for Payer: Aetna of WY Medicare |
$122.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$177.60
|
| Rate for Payer: Altius Commercial |
$177.60
|
| Rate for Payer: Beech Street Commercial |
$181.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$151.88
|
| Rate for Payer: Cash Price |
$129.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$179.45
|
| Rate for Payer: Cigna of WY Commercial |
$181.30
|
| Rate for Payer: Entrust Commercial |
$175.75
|
| Rate for Payer: First Choice Health Commercial |
$175.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$175.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$107.30
|
| Rate for Payer: HealthUtah PPO |
$185.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$179.45
|
| Rate for Payer: Multiplan Medicare/VA |
$101.94
|
| Rate for Payer: One Health Plan of WY PPO |
$181.30
|
| Rate for Payer: PacificSource Commercial |
$166.50
|
| Rate for Payer: PHCS PPO |
$181.30
|
| Rate for Payer: Three Rivers PPO |
$138.75
|
| Rate for Payer: TriWest Veterans Administration |
$107.30
|
| Rate for Payer: United Healthcare Commercial |
$160.95
|
| Rate for Payer: United Healthcare Medicare |
$107.30
|
| Rate for Payer: WINHealth Partners Commercial |
$181.30
|
| Rate for Payer: Wise Provider Network Commercial |
$175.75
|
|
|
HC SLP SPEECH/HEARING THERAPY, GROUP
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
HCPCS 92508
|
| Hospital Charge Code |
4409250801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$77.14 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Aetna of WY Medicare |
$92.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$134.40
|
| Rate for Payer: Altius Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.94
|
| Rate for Payer: Cash Price |
$98.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$135.80
|
| Rate for Payer: Cigna of WY Commercial |
$137.20
|
| Rate for Payer: Entrust Commercial |
$133.00
|
| Rate for Payer: First Choice Health Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$81.20
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$77.14
|
| Rate for Payer: One Health Plan of WY PPO |
$137.20
|
| Rate for Payer: PacificSource Commercial |
$126.00
|
| Rate for Payer: PHCS PPO |
$137.20
|
| Rate for Payer: Three Rivers PPO |
$105.00
|
| Rate for Payer: TriWest Veterans Administration |
$81.20
|
| Rate for Payer: United Healthcare Commercial |
$121.80
|
| Rate for Payer: United Healthcare Medicare |
$81.20
|
| Rate for Payer: WINHealth Partners Commercial |
$137.20
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
HC SLP SPEECH/HEARING THERAPY, GROUP
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
HCPCS 92508
|
| Hospital Charge Code |
4409250801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$87.78 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$137.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$134.40
|
| Rate for Payer: Altius Commercial |
$134.40
|
| Rate for Payer: Beech Street Commercial |
$137.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$114.94
|
| Rate for Payer: Cash Price |
$98.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$135.80
|
| Rate for Payer: Cigna of WY Commercial |
$137.20
|
| Rate for Payer: Entrust Commercial |
$133.00
|
| Rate for Payer: First Choice Health Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$133.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$92.40
|
| Rate for Payer: HealthUtah PPO |
$140.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$135.80
|
| Rate for Payer: Multiplan Medicare/VA |
$87.78
|
| Rate for Payer: One Health Plan of WY PPO |
$137.20
|
| Rate for Payer: PacificSource Commercial |
$126.00
|
| Rate for Payer: PHCS PPO |
$137.20
|
| Rate for Payer: Three Rivers PPO |
$105.00
|
| Rate for Payer: TriWest Veterans Administration |
$92.40
|
| Rate for Payer: United Healthcare Commercial |
$121.80
|
| Rate for Payer: United Healthcare Medicare |
$92.40
|
| Rate for Payer: WINHealth Partners Commercial |
$133.00
|
| Rate for Payer: Wise Provider Network Commercial |
$133.00
|
|
|
HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL
|
Facility
|
OP
|
$365.00
|
|
|
Service Code
|
HCPCS 92507
|
| Hospital Charge Code |
4409250701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$201.12 |
| Max. Negotiated Rate |
$365.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$357.70
|
| Rate for Payer: Aetna of WY Medicare |
$240.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$350.40
|
| Rate for Payer: Altius Commercial |
$350.40
|
| Rate for Payer: Beech Street Commercial |
$357.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$299.66
|
| Rate for Payer: Cash Price |
$255.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$354.05
|
| Rate for Payer: Cigna of WY Commercial |
$357.70
|
| Rate for Payer: Entrust Commercial |
$346.75
|
| Rate for Payer: First Choice Health Commercial |
$346.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$346.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$211.70
|
| Rate for Payer: HealthUtah PPO |
$365.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$354.05
|
| Rate for Payer: Multiplan Medicare/VA |
$201.12
|
| Rate for Payer: One Health Plan of WY PPO |
$357.70
|
| Rate for Payer: PacificSource Commercial |
$328.50
|
| Rate for Payer: PHCS PPO |
$357.70
|
| Rate for Payer: Three Rivers PPO |
$273.75
|
| Rate for Payer: TriWest Veterans Administration |
$211.70
|
| Rate for Payer: United Healthcare Commercial |
$317.55
|
| Rate for Payer: United Healthcare Medicare |
$211.70
|
| Rate for Payer: WINHealth Partners Commercial |
$357.70
|
| Rate for Payer: Wise Provider Network Commercial |
$346.75
|
|
|
HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL
|
Facility
|
IP
|
$365.00
|
|
|
Service Code
|
HCPCS 92507
|
| Hospital Charge Code |
4409250701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$228.86 |
| Max. Negotiated Rate |
$365.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$357.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$350.40
|
| Rate for Payer: Altius Commercial |
$350.40
|
| Rate for Payer: Beech Street Commercial |
$357.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$299.66
|
| Rate for Payer: Cash Price |
$255.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$354.05
|
| Rate for Payer: Cigna of WY Commercial |
$357.70
|
| Rate for Payer: Entrust Commercial |
$346.75
|
| Rate for Payer: First Choice Health Commercial |
$346.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$346.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$240.90
|
| Rate for Payer: HealthUtah PPO |
$365.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$354.05
|
| Rate for Payer: Multiplan Medicare/VA |
$228.86
|
| Rate for Payer: One Health Plan of WY PPO |
$357.70
|
| Rate for Payer: PacificSource Commercial |
$328.50
|
| Rate for Payer: PHCS PPO |
$357.70
|
| Rate for Payer: Three Rivers PPO |
$273.75
|
| Rate for Payer: TriWest Veterans Administration |
$240.90
|
| Rate for Payer: United Healthcare Commercial |
$317.55
|
| Rate for Payer: United Healthcare Medicare |
$240.90
|
| Rate for Payer: WINHealth Partners Commercial |
$346.75
|
| Rate for Payer: Wise Provider Network Commercial |
$346.75
|
|
|
HC SLP STANDARDIZED COGNITIVE PERFORMANCE TESTING
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS 96125
|
| Hospital Charge Code |
4409612501
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$275.50 |
| Max. Negotiated Rate |
$500.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$490.00
|
| Rate for Payer: Aetna of WY Medicare |
$330.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$480.00
|
| Rate for Payer: Altius Commercial |
$480.00
|
| Rate for Payer: Beech Street Commercial |
$490.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$410.50
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$485.00
|
| Rate for Payer: Cigna of WY Commercial |
$490.00
|
| Rate for Payer: Entrust Commercial |
$475.00
|
| Rate for Payer: First Choice Health Commercial |
$475.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$475.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$290.00
|
| Rate for Payer: HealthUtah PPO |
$500.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$485.00
|
| Rate for Payer: Multiplan Medicare/VA |
$275.50
|
| Rate for Payer: One Health Plan of WY PPO |
$490.00
|
| Rate for Payer: PacificSource Commercial |
$450.00
|
| Rate for Payer: PHCS PPO |
$490.00
|
| Rate for Payer: Three Rivers PPO |
$375.00
|
| Rate for Payer: TriWest Veterans Administration |
$290.00
|
| Rate for Payer: United Healthcare Commercial |
$435.00
|
| Rate for Payer: United Healthcare Medicare |
$290.00
|
| Rate for Payer: WINHealth Partners Commercial |
$490.00
|
| Rate for Payer: Wise Provider Network Commercial |
$475.00
|
|
|
HC SLP STANDARDIZED COGNITIVE PERFORMANCE TESTING
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS 96125
|
| Hospital Charge Code |
4409612501
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$313.50 |
| Max. Negotiated Rate |
$500.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$490.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$480.00
|
| Rate for Payer: Altius Commercial |
$480.00
|
| Rate for Payer: Beech Street Commercial |
$490.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$410.50
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$485.00
|
| Rate for Payer: Cigna of WY Commercial |
$490.00
|
| Rate for Payer: Entrust Commercial |
$475.00
|
| Rate for Payer: First Choice Health Commercial |
$475.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$475.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$330.00
|
| Rate for Payer: HealthUtah PPO |
$500.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$485.00
|
| Rate for Payer: Multiplan Medicare/VA |
$313.50
|
| Rate for Payer: One Health Plan of WY PPO |
$490.00
|
| Rate for Payer: PacificSource Commercial |
$450.00
|
| Rate for Payer: PHCS PPO |
$490.00
|
| Rate for Payer: Three Rivers PPO |
$375.00
|
| Rate for Payer: TriWest Veterans Administration |
$330.00
|
| Rate for Payer: United Healthcare Commercial |
$435.00
|
| Rate for Payer: United Healthcare Medicare |
$330.00
|
| Rate for Payer: WINHealth Partners Commercial |
$475.00
|
| Rate for Payer: Wise Provider Network Commercial |
$475.00
|
|
|
HC SLP THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION
|
Facility
|
OP
|
$445.00
|
|
|
Service Code
|
HCPCS 97127
|
| Hospital Charge Code |
4409712701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$245.20 |
| Max. Negotiated Rate |
$445.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$436.10
|
| Rate for Payer: Aetna of WY Medicare |
$293.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$427.20
|
| Rate for Payer: Altius Commercial |
$427.20
|
| Rate for Payer: Beech Street Commercial |
$436.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$365.34
|
| Rate for Payer: Cash Price |
$311.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$431.65
|
| Rate for Payer: Cigna of WY Commercial |
$436.10
|
| Rate for Payer: Entrust Commercial |
$422.75
|
| Rate for Payer: First Choice Health Commercial |
$422.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$422.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$258.10
|
| Rate for Payer: HealthUtah PPO |
$445.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$431.65
|
| Rate for Payer: Multiplan Medicare/VA |
$245.20
|
| Rate for Payer: One Health Plan of WY PPO |
$436.10
|
| Rate for Payer: PacificSource Commercial |
$400.50
|
| Rate for Payer: PHCS PPO |
$436.10
|
| Rate for Payer: Three Rivers PPO |
$333.75
|
| Rate for Payer: TriWest Veterans Administration |
$258.10
|
| Rate for Payer: United Healthcare Commercial |
$387.15
|
| Rate for Payer: United Healthcare Medicare |
$258.10
|
| Rate for Payer: WINHealth Partners Commercial |
$436.10
|
| Rate for Payer: Wise Provider Network Commercial |
$422.75
|
|
|
HC SLP THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION
|
Facility
|
IP
|
$445.00
|
|
|
Service Code
|
HCPCS 97127
|
| Hospital Charge Code |
4409712701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$279.02 |
| Max. Negotiated Rate |
$445.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$436.10
|
| Rate for Payer: Altius Auto/Workers Compensation |
$427.20
|
| Rate for Payer: Altius Commercial |
$427.20
|
| Rate for Payer: Beech Street Commercial |
$436.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$365.34
|
| Rate for Payer: Cash Price |
$311.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$431.65
|
| Rate for Payer: Cigna of WY Commercial |
$436.10
|
| Rate for Payer: Entrust Commercial |
$422.75
|
| Rate for Payer: First Choice Health Commercial |
$422.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$422.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$293.70
|
| Rate for Payer: HealthUtah PPO |
$445.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$431.65
|
| Rate for Payer: Multiplan Medicare/VA |
$279.02
|
| Rate for Payer: One Health Plan of WY PPO |
$436.10
|
| Rate for Payer: PacificSource Commercial |
$400.50
|
| Rate for Payer: PHCS PPO |
$436.10
|
| Rate for Payer: Three Rivers PPO |
$333.75
|
| Rate for Payer: TriWest Veterans Administration |
$293.70
|
| Rate for Payer: United Healthcare Commercial |
$387.15
|
| Rate for Payer: United Healthcare Medicare |
$293.70
|
| Rate for Payer: WINHealth Partners Commercial |
$422.75
|
| Rate for Payer: Wise Provider Network Commercial |
$422.75
|
|
|
HC SLP THER SRVC, SPEECH GEN DEV USE, W/PROG
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
HCPCS 92609
|
| Hospital Charge Code |
4409260901
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$148.77 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$264.60
|
| Rate for Payer: Aetna of WY Medicare |
$178.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$259.20
|
| Rate for Payer: Altius Commercial |
$259.20
|
| Rate for Payer: Beech Street Commercial |
$264.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$221.67
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$261.90
|
| Rate for Payer: Cigna of WY Commercial |
$264.60
|
| Rate for Payer: Entrust Commercial |
$256.50
|
| Rate for Payer: First Choice Health Commercial |
$256.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$256.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$156.60
|
| Rate for Payer: HealthUtah PPO |
$270.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$261.90
|
| Rate for Payer: Multiplan Medicare/VA |
$148.77
|
| Rate for Payer: One Health Plan of WY PPO |
$264.60
|
| Rate for Payer: PacificSource Commercial |
$243.00
|
| Rate for Payer: PHCS PPO |
$264.60
|
| Rate for Payer: Three Rivers PPO |
$202.50
|
| Rate for Payer: TriWest Veterans Administration |
$156.60
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Medicare |
$156.60
|
| Rate for Payer: WINHealth Partners Commercial |
$264.60
|
| Rate for Payer: Wise Provider Network Commercial |
$256.50
|
|
