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Service Code HCPCS 97129
Hospital Charge Code 4409712901
Hospital Revenue Code 440
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
Service Code HCPCS 97129
Hospital Charge Code 4409712901
Hospital Revenue Code 440
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
Service Code HCPCS 99100
Hospital Charge Code 9649910001
Hospital Revenue Code 964
Min. Negotiated Rate $133.89
Max. Negotiated Rate $243.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $238.14
Rate for Payer: Aetna of WY Medicare $160.38
Rate for Payer: Altius Auto/Workers Compensation $233.28
Rate for Payer: Altius Commercial $233.28
Rate for Payer: Beech Street Commercial $238.14
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $199.50
Rate for Payer: Cash Price $170.10
Rate for Payer: ChoiceCare Network Commercial $235.71
Rate for Payer: Cigna of WY Commercial $238.14
Rate for Payer: Entrust Commercial $230.85
Rate for Payer: First Choice Health Commercial $230.85
Rate for Payer: Government Employees Health Association (GEHA) Commercial $230.85
Rate for Payer: Government Employees Health Association (GEHA) Medicare $140.94
Rate for Payer: HealthUtah PPO $243.00
Rate for Payer: Idaho Integrated Healthcare Commercial $235.71
Rate for Payer: Multiplan Medicare/VA $133.89
Rate for Payer: One Health Plan of WY PPO $238.14
Rate for Payer: PacificSource Commercial $218.70
Rate for Payer: PHCS PPO $238.14
Rate for Payer: Three Rivers PPO $182.25
Rate for Payer: TriWest Veterans Administration $140.94
Rate for Payer: United Healthcare Commercial $211.41
Rate for Payer: United Healthcare Medicare $140.94
Rate for Payer: WINHealth Partners Commercial $238.14
Rate for Payer: Wise Provider Network Commercial $230.85
Service Code HCPCS 99100
Hospital Charge Code 9649910001
Hospital Revenue Code 964
Min. Negotiated Rate $152.36
Max. Negotiated Rate $243.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $238.14
Rate for Payer: Altius Auto/Workers Compensation $233.28
Rate for Payer: Altius Commercial $233.28
Rate for Payer: Beech Street Commercial $238.14
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $199.50
Rate for Payer: Cash Price $170.10
Rate for Payer: ChoiceCare Network Commercial $235.71
Rate for Payer: Cigna of WY Commercial $238.14
Rate for Payer: Entrust Commercial $230.85
Rate for Payer: First Choice Health Commercial $230.85
Rate for Payer: Government Employees Health Association (GEHA) Commercial $230.85
Rate for Payer: Government Employees Health Association (GEHA) Medicare $160.38
Rate for Payer: HealthUtah PPO $243.00
Rate for Payer: Idaho Integrated Healthcare Commercial $235.71
Rate for Payer: Multiplan Medicare/VA $152.36
Rate for Payer: One Health Plan of WY PPO $238.14
Rate for Payer: PacificSource Commercial $218.70
Rate for Payer: PHCS PPO $238.14
Rate for Payer: Three Rivers PPO $182.25
Rate for Payer: TriWest Veterans Administration $160.38
Rate for Payer: United Healthcare Commercial $211.41
Rate for Payer: United Healthcare Medicare $160.38
Rate for Payer: WINHealth Partners Commercial $230.85
Rate for Payer: Wise Provider Network Commercial $230.85
Service Code HCPCS 88313
Hospital Charge Code 3128831301
Hospital Revenue Code 312
Min. Negotiated Rate $131.67
Max. Negotiated Rate $210.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $205.80
Rate for Payer: Altius Auto/Workers Compensation $201.60
Rate for Payer: Altius Commercial $201.60
Rate for Payer: Beech Street Commercial $205.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $172.41
Rate for Payer: Cash Price $147.00
Rate for Payer: ChoiceCare Network Commercial $203.70
Rate for Payer: Cigna of WY Commercial $205.80
Rate for Payer: Entrust Commercial $199.50
Rate for Payer: First Choice Health Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $138.60
Rate for Payer: HealthUtah PPO $210.00
Rate for Payer: Idaho Integrated Healthcare Commercial $203.70
Rate for Payer: Multiplan Medicare/VA $131.67
Rate for Payer: One Health Plan of WY PPO $205.80
Rate for Payer: PacificSource Commercial $189.00
Rate for Payer: PHCS PPO $205.80
Rate for Payer: Three Rivers PPO $157.50
Rate for Payer: TriWest Veterans Administration $138.60
Rate for Payer: United Healthcare Commercial $182.70
Rate for Payer: United Healthcare Medicare $138.60
Rate for Payer: WINHealth Partners Commercial $199.50
Rate for Payer: Wise Provider Network Commercial $199.50
Service Code HCPCS 88313
Hospital Charge Code 3128831301
Hospital Revenue Code 312
Min. Negotiated Rate $115.71
Max. Negotiated Rate $210.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $205.80
Rate for Payer: Aetna of WY Medicare $138.60
Rate for Payer: Altius Auto/Workers Compensation $201.60
Rate for Payer: Altius Commercial $201.60
Rate for Payer: Beech Street Commercial $205.80
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $172.41
Rate for Payer: Cash Price $147.00
Rate for Payer: ChoiceCare Network Commercial $203.70
Rate for Payer: Cigna of WY Commercial $205.80
Rate for Payer: Entrust Commercial $199.50
Rate for Payer: First Choice Health Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $199.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $121.80
Rate for Payer: HealthUtah PPO $210.00
Rate for Payer: Idaho Integrated Healthcare Commercial $203.70
Rate for Payer: Multiplan Medicare/VA $115.71
Rate for Payer: One Health Plan of WY PPO $205.80
Rate for Payer: PacificSource Commercial $189.00
Rate for Payer: PHCS PPO $205.80
Rate for Payer: Three Rivers PPO $157.50
Rate for Payer: TriWest Veterans Administration $121.80
Rate for Payer: United Healthcare Commercial $182.70
Rate for Payer: United Healthcare Medicare $121.80
Rate for Payer: WINHealth Partners Commercial $205.80
Rate for Payer: Wise Provider Network Commercial $199.50
Service Code HCPCS 88312
Hospital Charge Code 3108831201
Hospital Revenue Code 310
Min. Negotiated Rate $144.21
Max. Negotiated Rate $230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $225.40
Rate for Payer: Altius Auto/Workers Compensation $220.80
Rate for Payer: Altius Commercial $220.80
Rate for Payer: Beech Street Commercial $225.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $188.83
Rate for Payer: Cash Price $161.00
Rate for Payer: ChoiceCare Network Commercial $223.10
Rate for Payer: Cigna of WY Commercial $225.40
Rate for Payer: Entrust Commercial $218.50
Rate for Payer: First Choice Health Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $151.80
Rate for Payer: HealthUtah PPO $230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $223.10
Rate for Payer: Multiplan Medicare/VA $144.21
Rate for Payer: One Health Plan of WY PPO $225.40
Rate for Payer: PacificSource Commercial $207.00
Rate for Payer: PHCS PPO $225.40
Rate for Payer: Three Rivers PPO $172.50
Rate for Payer: TriWest Veterans Administration $151.80
Rate for Payer: United Healthcare Commercial $200.10
Rate for Payer: United Healthcare Medicare $151.80
Rate for Payer: WINHealth Partners Commercial $218.50
Rate for Payer: Wise Provider Network Commercial $218.50
Service Code HCPCS 88312
Hospital Charge Code 3128831201
Hospital Revenue Code 312
Min. Negotiated Rate $126.73
Max. Negotiated Rate $230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $225.40
Rate for Payer: Aetna of WY Medicare $151.80
Rate for Payer: Altius Auto/Workers Compensation $220.80
Rate for Payer: Altius Commercial $220.80
Rate for Payer: Beech Street Commercial $225.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $188.83
Rate for Payer: Cash Price $161.00
Rate for Payer: ChoiceCare Network Commercial $223.10
Rate for Payer: Cigna of WY Commercial $225.40
Rate for Payer: Entrust Commercial $218.50
Rate for Payer: First Choice Health Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $133.40
Rate for Payer: HealthUtah PPO $230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $223.10
Rate for Payer: Multiplan Medicare/VA $126.73
Rate for Payer: One Health Plan of WY PPO $225.40
Rate for Payer: PacificSource Commercial $207.00
Rate for Payer: PHCS PPO $225.40
Rate for Payer: Three Rivers PPO $172.50
Rate for Payer: TriWest Veterans Administration $133.40
Rate for Payer: United Healthcare Commercial $200.10
Rate for Payer: United Healthcare Medicare $133.40
Rate for Payer: WINHealth Partners Commercial $225.40
Rate for Payer: Wise Provider Network Commercial $218.50
Service Code HCPCS 88312
Hospital Charge Code 3128831201
Hospital Revenue Code 312
Min. Negotiated Rate $144.21
Max. Negotiated Rate $230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $225.40
Rate for Payer: Altius Auto/Workers Compensation $220.80
Rate for Payer: Altius Commercial $220.80
Rate for Payer: Beech Street Commercial $225.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $188.83
Rate for Payer: Cash Price $161.00
Rate for Payer: ChoiceCare Network Commercial $223.10
Rate for Payer: Cigna of WY Commercial $225.40
Rate for Payer: Entrust Commercial $218.50
Rate for Payer: First Choice Health Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $151.80
Rate for Payer: HealthUtah PPO $230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $223.10
Rate for Payer: Multiplan Medicare/VA $144.21
Rate for Payer: One Health Plan of WY PPO $225.40
Rate for Payer: PacificSource Commercial $207.00
Rate for Payer: PHCS PPO $225.40
Rate for Payer: Three Rivers PPO $172.50
Rate for Payer: TriWest Veterans Administration $151.80
Rate for Payer: United Healthcare Commercial $200.10
Rate for Payer: United Healthcare Medicare $151.80
Rate for Payer: WINHealth Partners Commercial $218.50
Rate for Payer: Wise Provider Network Commercial $218.50
Service Code HCPCS 88312
Hospital Charge Code 3108831201
Hospital Revenue Code 310
Min. Negotiated Rate $126.73
Max. Negotiated Rate $230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $225.40
Rate for Payer: Aetna of WY Medicare $151.80
Rate for Payer: Altius Auto/Workers Compensation $220.80
Rate for Payer: Altius Commercial $220.80
Rate for Payer: Beech Street Commercial $225.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $188.83
Rate for Payer: Cash Price $161.00
Rate for Payer: ChoiceCare Network Commercial $223.10
Rate for Payer: Cigna of WY Commercial $225.40
Rate for Payer: Entrust Commercial $218.50
Rate for Payer: First Choice Health Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $133.40
Rate for Payer: HealthUtah PPO $230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $223.10
Rate for Payer: Multiplan Medicare/VA $126.73
Rate for Payer: One Health Plan of WY PPO $225.40
Rate for Payer: PacificSource Commercial $207.00
Rate for Payer: PHCS PPO $225.40
Rate for Payer: Three Rivers PPO $172.50
Rate for Payer: TriWest Veterans Administration $133.40
Rate for Payer: United Healthcare Commercial $200.10
Rate for Payer: United Healthcare Medicare $133.40
Rate for Payer: WINHealth Partners Commercial $225.40
Rate for Payer: Wise Provider Network Commercial $218.50
Service Code HCPCS A0434
Hospital Charge Code 540A043401
Hospital Revenue Code 540
Min. Negotiated Rate $7,323.36
Max. Negotiated Rate $11,680.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $11,446.40
Rate for Payer: Altius Auto/Workers Compensation $11,212.80
Rate for Payer: Altius Commercial $11,212.80
Rate for Payer: Beech Street Commercial $11,446.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $9,589.28
Rate for Payer: Cash Price $8,176.00
Rate for Payer: ChoiceCare Network Commercial $11,329.60
Rate for Payer: Cigna of WY Commercial $11,446.40
Rate for Payer: Entrust Commercial $11,096.00
Rate for Payer: First Choice Health Commercial $11,096.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $11,096.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $7,708.80
Rate for Payer: HealthUtah PPO $11,680.00
Rate for Payer: Idaho Integrated Healthcare Commercial $11,329.60
Rate for Payer: Multiplan Medicare/VA $7,323.36
Rate for Payer: One Health Plan of WY PPO $11,446.40
Rate for Payer: PacificSource Commercial $10,512.00
Rate for Payer: PHCS PPO $11,446.40
Rate for Payer: Three Rivers PPO $8,760.00
Rate for Payer: TriWest Veterans Administration $7,708.80
Rate for Payer: United Healthcare Commercial $10,161.60
Rate for Payer: United Healthcare Medicare $7,708.80
Rate for Payer: WINHealth Partners Commercial $11,096.00
Rate for Payer: Wise Provider Network Commercial $11,096.00
Service Code HCPCS A0434
Hospital Charge Code 540A043401
Hospital Revenue Code 540
Min. Negotiated Rate $6,435.68
Max. Negotiated Rate $11,680.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $11,446.40
Rate for Payer: Aetna of WY Medicare $7,708.80
Rate for Payer: Altius Auto/Workers Compensation $11,212.80
Rate for Payer: Altius Commercial $11,212.80
Rate for Payer: Beech Street Commercial $11,446.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $9,589.28
Rate for Payer: Cash Price $8,176.00
Rate for Payer: ChoiceCare Network Commercial $11,329.60
Rate for Payer: Cigna of WY Commercial $11,446.40
Rate for Payer: Entrust Commercial $11,096.00
Rate for Payer: First Choice Health Commercial $11,096.00
Rate for Payer: Government Employees Health Association (GEHA) Commercial $11,096.00
Rate for Payer: Government Employees Health Association (GEHA) Medicare $6,774.40
Rate for Payer: HealthUtah PPO $11,680.00
Rate for Payer: Idaho Integrated Healthcare Commercial $11,329.60
Rate for Payer: Multiplan Medicare/VA $6,435.68
Rate for Payer: One Health Plan of WY PPO $11,446.40
Rate for Payer: PacificSource Commercial $10,512.00
Rate for Payer: PHCS PPO $11,446.40
Rate for Payer: Three Rivers PPO $8,760.00
Rate for Payer: TriWest Veterans Administration $6,774.40
Rate for Payer: United Healthcare Commercial $10,161.60
Rate for Payer: United Healthcare Medicare $6,774.40
Rate for Payer: WINHealth Partners Commercial $11,446.40
Rate for Payer: Wise Provider Network Commercial $11,096.00
Service Code HCPCS G2023
Hospital Charge Code 300G202301
Hospital Revenue Code 300
Min. Negotiated Rate $126.73
Max. Negotiated Rate $230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $225.40
Rate for Payer: Aetna of WY Medicare $151.80
Rate for Payer: Altius Auto/Workers Compensation $220.80
Rate for Payer: Altius Commercial $220.80
Rate for Payer: Beech Street Commercial $225.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $188.83
Rate for Payer: Cash Price $161.00
Rate for Payer: ChoiceCare Network Commercial $223.10
Rate for Payer: Cigna of WY Commercial $225.40
Rate for Payer: Entrust Commercial $218.50
Rate for Payer: First Choice Health Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $133.40
Rate for Payer: HealthUtah PPO $230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $223.10
Rate for Payer: Multiplan Medicare/VA $126.73
Rate for Payer: One Health Plan of WY PPO $225.40
Rate for Payer: PacificSource Commercial $207.00
Rate for Payer: PHCS PPO $225.40
Rate for Payer: Three Rivers PPO $172.50
Rate for Payer: TriWest Veterans Administration $133.40
Rate for Payer: United Healthcare Commercial $200.10
Rate for Payer: United Healthcare Medicare $133.40
Rate for Payer: WINHealth Partners Commercial $225.40
Rate for Payer: Wise Provider Network Commercial $218.50
Service Code HCPCS G2023
Hospital Charge Code 300G202301
Hospital Revenue Code 300
Min. Negotiated Rate $144.21
Max. Negotiated Rate $230.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $225.40
Rate for Payer: Altius Auto/Workers Compensation $220.80
Rate for Payer: Altius Commercial $220.80
Rate for Payer: Beech Street Commercial $225.40
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $188.83
Rate for Payer: Cash Price $161.00
Rate for Payer: ChoiceCare Network Commercial $223.10
Rate for Payer: Cigna of WY Commercial $225.40
Rate for Payer: Entrust Commercial $218.50
Rate for Payer: First Choice Health Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $218.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $151.80
Rate for Payer: HealthUtah PPO $230.00
Rate for Payer: Idaho Integrated Healthcare Commercial $223.10
Rate for Payer: Multiplan Medicare/VA $144.21
Rate for Payer: One Health Plan of WY PPO $225.40
Rate for Payer: PacificSource Commercial $207.00
Rate for Payer: PHCS PPO $225.40
Rate for Payer: Three Rivers PPO $172.50
Rate for Payer: TriWest Veterans Administration $151.80
Rate for Payer: United Healthcare Commercial $200.10
Rate for Payer: United Healthcare Medicare $151.80
Rate for Payer: WINHealth Partners Commercial $218.50
Rate for Payer: Wise Provider Network Commercial $218.50
Service Code HCPCS 87015
Hospital Charge Code 3068701502
Hospital Revenue Code 306
Min. Negotiated Rate $59.56
Max. Negotiated Rate $95.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $93.10
Rate for Payer: Altius Auto/Workers Compensation $91.20
Rate for Payer: Altius Commercial $91.20
Rate for Payer: Beech Street Commercial $93.10
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $78.00
Rate for Payer: Cash Price $66.50
Rate for Payer: ChoiceCare Network Commercial $92.15
Rate for Payer: Cigna of WY Commercial $93.10
Rate for Payer: Entrust Commercial $90.25
Rate for Payer: First Choice Health Commercial $90.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $90.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $62.70
Rate for Payer: HealthUtah PPO $95.00
Rate for Payer: Idaho Integrated Healthcare Commercial $92.15
Rate for Payer: Multiplan Medicare/VA $59.56
Rate for Payer: One Health Plan of WY PPO $93.10
Rate for Payer: PacificSource Commercial $85.50
Rate for Payer: PHCS PPO $93.10
Rate for Payer: Three Rivers PPO $71.25
Rate for Payer: TriWest Veterans Administration $62.70
Rate for Payer: United Healthcare Commercial $82.65
Rate for Payer: United Healthcare Medicare $62.70
Rate for Payer: WINHealth Partners Commercial $90.25
Rate for Payer: Wise Provider Network Commercial $90.25
Service Code HCPCS 87015
Hospital Charge Code 3068701502
Hospital Revenue Code 306
Min. Negotiated Rate $52.34
Max. Negotiated Rate $95.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $93.10
Rate for Payer: Aetna of WY Medicare $62.70
Rate for Payer: Altius Auto/Workers Compensation $91.20
Rate for Payer: Altius Commercial $91.20
Rate for Payer: Beech Street Commercial $93.10
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $78.00
Rate for Payer: Cash Price $66.50
Rate for Payer: ChoiceCare Network Commercial $92.15
Rate for Payer: Cigna of WY Commercial $93.10
Rate for Payer: Entrust Commercial $90.25
Rate for Payer: First Choice Health Commercial $90.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $90.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $55.10
Rate for Payer: HealthUtah PPO $95.00
Rate for Payer: Idaho Integrated Healthcare Commercial $92.15
Rate for Payer: Multiplan Medicare/VA $52.34
Rate for Payer: One Health Plan of WY PPO $93.10
Rate for Payer: PacificSource Commercial $85.50
Rate for Payer: PHCS PPO $93.10
Rate for Payer: Three Rivers PPO $71.25
Rate for Payer: TriWest Veterans Administration $55.10
Rate for Payer: United Healthcare Commercial $82.65
Rate for Payer: United Healthcare Medicare $55.10
Rate for Payer: WINHealth Partners Commercial $93.10
Rate for Payer: Wise Provider Network Commercial $90.25
Service Code HCPCS 84311
Hospital Charge Code 3018431103
Hospital Revenue Code 301
Min. Negotiated Rate $72.10
Max. Negotiated Rate $115.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $112.70
Rate for Payer: Altius Auto/Workers Compensation $110.40
Rate for Payer: Altius Commercial $110.40
Rate for Payer: Beech Street Commercial $112.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $94.42
Rate for Payer: Cash Price $80.50
Rate for Payer: ChoiceCare Network Commercial $111.55
Rate for Payer: Cigna of WY Commercial $112.70
Rate for Payer: Entrust Commercial $109.25
Rate for Payer: First Choice Health Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $75.90
Rate for Payer: HealthUtah PPO $115.00
Rate for Payer: Idaho Integrated Healthcare Commercial $111.55
Rate for Payer: Multiplan Medicare/VA $72.10
Rate for Payer: One Health Plan of WY PPO $112.70
Rate for Payer: PacificSource Commercial $103.50
Rate for Payer: PHCS PPO $112.70
Rate for Payer: Three Rivers PPO $86.25
Rate for Payer: TriWest Veterans Administration $75.90
Rate for Payer: United Healthcare Commercial $100.05
Rate for Payer: United Healthcare Medicare $75.90
Rate for Payer: WINHealth Partners Commercial $109.25
Rate for Payer: Wise Provider Network Commercial $109.25
Service Code HCPCS 84311
Hospital Charge Code 3018431103
Hospital Revenue Code 301
Min. Negotiated Rate $63.36
Max. Negotiated Rate $115.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $112.70
Rate for Payer: Aetna of WY Medicare $75.90
Rate for Payer: Altius Auto/Workers Compensation $110.40
Rate for Payer: Altius Commercial $110.40
Rate for Payer: Beech Street Commercial $112.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $94.42
Rate for Payer: Cash Price $80.50
Rate for Payer: ChoiceCare Network Commercial $111.55
Rate for Payer: Cigna of WY Commercial $112.70
Rate for Payer: Entrust Commercial $109.25
Rate for Payer: First Choice Health Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $66.70
Rate for Payer: HealthUtah PPO $115.00
Rate for Payer: Idaho Integrated Healthcare Commercial $111.55
Rate for Payer: Multiplan Medicare/VA $63.36
Rate for Payer: One Health Plan of WY PPO $112.70
Rate for Payer: PacificSource Commercial $103.50
Rate for Payer: PHCS PPO $112.70
Rate for Payer: Three Rivers PPO $86.25
Rate for Payer: TriWest Veterans Administration $66.70
Rate for Payer: United Healthcare Commercial $100.05
Rate for Payer: United Healthcare Medicare $66.70
Rate for Payer: WINHealth Partners Commercial $112.70
Rate for Payer: Wise Provider Network Commercial $109.25
Service Code HCPCS 84311
Hospital Charge Code 3018431104
Hospital Revenue Code 301
Min. Negotiated Rate $104.69
Max. Negotiated Rate $190.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $186.20
Rate for Payer: Aetna of WY Medicare $125.40
Rate for Payer: Altius Auto/Workers Compensation $182.40
Rate for Payer: Altius Commercial $182.40
Rate for Payer: Beech Street Commercial $186.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $155.99
Rate for Payer: Cash Price $133.00
Rate for Payer: ChoiceCare Network Commercial $184.30
Rate for Payer: Cigna of WY Commercial $186.20
Rate for Payer: Entrust Commercial $180.50
Rate for Payer: First Choice Health Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $110.20
Rate for Payer: HealthUtah PPO $190.00
Rate for Payer: Idaho Integrated Healthcare Commercial $184.30
Rate for Payer: Multiplan Medicare/VA $104.69
Rate for Payer: One Health Plan of WY PPO $186.20
Rate for Payer: PacificSource Commercial $171.00
Rate for Payer: PHCS PPO $186.20
Rate for Payer: Three Rivers PPO $142.50
Rate for Payer: TriWest Veterans Administration $110.20
Rate for Payer: United Healthcare Commercial $165.30
Rate for Payer: United Healthcare Medicare $110.20
Rate for Payer: WINHealth Partners Commercial $186.20
Rate for Payer: Wise Provider Network Commercial $180.50
Service Code HCPCS 84311
Hospital Charge Code 3018431104
Hospital Revenue Code 301
Min. Negotiated Rate $119.13
Max. Negotiated Rate $190.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $186.20
Rate for Payer: Altius Auto/Workers Compensation $182.40
Rate for Payer: Altius Commercial $182.40
Rate for Payer: Beech Street Commercial $186.20
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $155.99
Rate for Payer: Cash Price $133.00
Rate for Payer: ChoiceCare Network Commercial $184.30
Rate for Payer: Cigna of WY Commercial $186.20
Rate for Payer: Entrust Commercial $180.50
Rate for Payer: First Choice Health Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $180.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $125.40
Rate for Payer: HealthUtah PPO $190.00
Rate for Payer: Idaho Integrated Healthcare Commercial $184.30
Rate for Payer: Multiplan Medicare/VA $119.13
Rate for Payer: One Health Plan of WY PPO $186.20
Rate for Payer: PacificSource Commercial $171.00
Rate for Payer: PHCS PPO $186.20
Rate for Payer: Three Rivers PPO $142.50
Rate for Payer: TriWest Veterans Administration $125.40
Rate for Payer: United Healthcare Commercial $165.30
Rate for Payer: United Healthcare Medicare $125.40
Rate for Payer: WINHealth Partners Commercial $180.50
Rate for Payer: Wise Provider Network Commercial $180.50
Service Code HCPCS 84311
Hospital Charge Code 3018431101
Hospital Revenue Code 301
Min. Negotiated Rate $72.10
Max. Negotiated Rate $115.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $112.70
Rate for Payer: Altius Auto/Workers Compensation $110.40
Rate for Payer: Altius Commercial $110.40
Rate for Payer: Beech Street Commercial $112.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $94.42
Rate for Payer: Cash Price $80.50
Rate for Payer: ChoiceCare Network Commercial $111.55
Rate for Payer: Cigna of WY Commercial $112.70
Rate for Payer: Entrust Commercial $109.25
Rate for Payer: First Choice Health Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $75.90
Rate for Payer: HealthUtah PPO $115.00
Rate for Payer: Idaho Integrated Healthcare Commercial $111.55
Rate for Payer: Multiplan Medicare/VA $72.10
Rate for Payer: One Health Plan of WY PPO $112.70
Rate for Payer: PacificSource Commercial $103.50
Rate for Payer: PHCS PPO $112.70
Rate for Payer: Three Rivers PPO $86.25
Rate for Payer: TriWest Veterans Administration $75.90
Rate for Payer: United Healthcare Commercial $100.05
Rate for Payer: United Healthcare Medicare $75.90
Rate for Payer: WINHealth Partners Commercial $109.25
Rate for Payer: Wise Provider Network Commercial $109.25
Service Code HCPCS 84311
Hospital Charge Code 3018431101
Hospital Revenue Code 301
Min. Negotiated Rate $63.36
Max. Negotiated Rate $115.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $112.70
Rate for Payer: Aetna of WY Medicare $75.90
Rate for Payer: Altius Auto/Workers Compensation $110.40
Rate for Payer: Altius Commercial $110.40
Rate for Payer: Beech Street Commercial $112.70
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $94.42
Rate for Payer: Cash Price $80.50
Rate for Payer: ChoiceCare Network Commercial $111.55
Rate for Payer: Cigna of WY Commercial $112.70
Rate for Payer: Entrust Commercial $109.25
Rate for Payer: First Choice Health Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Commercial $109.25
Rate for Payer: Government Employees Health Association (GEHA) Medicare $66.70
Rate for Payer: HealthUtah PPO $115.00
Rate for Payer: Idaho Integrated Healthcare Commercial $111.55
Rate for Payer: Multiplan Medicare/VA $63.36
Rate for Payer: One Health Plan of WY PPO $112.70
Rate for Payer: PacificSource Commercial $103.50
Rate for Payer: PHCS PPO $112.70
Rate for Payer: Three Rivers PPO $86.25
Rate for Payer: TriWest Veterans Administration $66.70
Rate for Payer: United Healthcare Commercial $100.05
Rate for Payer: United Healthcare Medicare $66.70
Rate for Payer: WINHealth Partners Commercial $112.70
Rate for Payer: Wise Provider Network Commercial $109.25
Service Code HCPCS 89325
Hospital Charge Code 3008932501
Hospital Revenue Code 300
Min. Negotiated Rate $43.89
Max. Negotiated Rate $70.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $68.60
Rate for Payer: Altius Auto/Workers Compensation $67.20
Rate for Payer: Altius Commercial $67.20
Rate for Payer: Beech Street Commercial $68.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $57.47
Rate for Payer: Cash Price $49.00
Rate for Payer: ChoiceCare Network Commercial $67.90
Rate for Payer: Cigna of WY Commercial $68.60
Rate for Payer: Entrust Commercial $66.50
Rate for Payer: First Choice Health Commercial $66.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $66.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $46.20
Rate for Payer: HealthUtah PPO $70.00
Rate for Payer: Idaho Integrated Healthcare Commercial $67.90
Rate for Payer: Multiplan Medicare/VA $43.89
Rate for Payer: One Health Plan of WY PPO $68.60
Rate for Payer: PacificSource Commercial $63.00
Rate for Payer: PHCS PPO $68.60
Rate for Payer: Three Rivers PPO $52.50
Rate for Payer: TriWest Veterans Administration $46.20
Rate for Payer: United Healthcare Commercial $60.90
Rate for Payer: United Healthcare Medicare $46.20
Rate for Payer: WINHealth Partners Commercial $66.50
Rate for Payer: Wise Provider Network Commercial $66.50
Service Code HCPCS 89325
Hospital Charge Code 3008932501
Hospital Revenue Code 300
Min. Negotiated Rate $38.57
Max. Negotiated Rate $70.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $68.60
Rate for Payer: Aetna of WY Medicare $46.20
Rate for Payer: Altius Auto/Workers Compensation $67.20
Rate for Payer: Altius Commercial $67.20
Rate for Payer: Beech Street Commercial $68.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $57.47
Rate for Payer: Cash Price $49.00
Rate for Payer: ChoiceCare Network Commercial $67.90
Rate for Payer: Cigna of WY Commercial $68.60
Rate for Payer: Entrust Commercial $66.50
Rate for Payer: First Choice Health Commercial $66.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $66.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $40.60
Rate for Payer: HealthUtah PPO $70.00
Rate for Payer: Idaho Integrated Healthcare Commercial $67.90
Rate for Payer: Multiplan Medicare/VA $38.57
Rate for Payer: One Health Plan of WY PPO $68.60
Rate for Payer: PacificSource Commercial $63.00
Rate for Payer: PHCS PPO $68.60
Rate for Payer: Three Rivers PPO $52.50
Rate for Payer: TriWest Veterans Administration $40.60
Rate for Payer: United Healthcare Commercial $60.90
Rate for Payer: United Healthcare Medicare $40.60
Rate for Payer: WINHealth Partners Commercial $68.60
Rate for Payer: Wise Provider Network Commercial $66.50
Service Code HCPCS 89325
Hospital Charge Code 3008932502
Hospital Revenue Code 300
Min. Negotiated Rate $38.57
Max. Negotiated Rate $70.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $68.60
Rate for Payer: Aetna of WY Medicare $46.20
Rate for Payer: Altius Auto/Workers Compensation $67.20
Rate for Payer: Altius Commercial $67.20
Rate for Payer: Beech Street Commercial $68.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $57.47
Rate for Payer: Cash Price $49.00
Rate for Payer: ChoiceCare Network Commercial $67.90
Rate for Payer: Cigna of WY Commercial $68.60
Rate for Payer: Entrust Commercial $66.50
Rate for Payer: First Choice Health Commercial $66.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $66.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $40.60
Rate for Payer: HealthUtah PPO $70.00
Rate for Payer: Idaho Integrated Healthcare Commercial $67.90
Rate for Payer: Multiplan Medicare/VA $38.57
Rate for Payer: One Health Plan of WY PPO $68.60
Rate for Payer: PacificSource Commercial $63.00
Rate for Payer: PHCS PPO $68.60
Rate for Payer: Three Rivers PPO $52.50
Rate for Payer: TriWest Veterans Administration $40.60
Rate for Payer: United Healthcare Commercial $60.90
Rate for Payer: United Healthcare Medicare $40.60
Rate for Payer: WINHealth Partners Commercial $68.60
Rate for Payer: Wise Provider Network Commercial $66.50