|
HC STRAPPING ELBOW/WRIST
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS 29260
|
| Hospital Charge Code |
7612926001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.75 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Aetna of WY Medicare |
$100.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.16
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$83.75
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$88.16
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$88.16
|
| Rate for Payer: WINHealth Partners Commercial |
$148.96
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING ELBOW/WRIST
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
HCPCS 29260
|
| Hospital Charge Code |
5102926001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.60
|
| Rate for Payer: Aetna of WY Medicare |
$13.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.20
|
| Rate for Payer: Altius Commercial |
$19.20
|
| Rate for Payer: Beech Street Commercial |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.42
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.40
|
| Rate for Payer: Cigna of WY Commercial |
$19.60
|
| Rate for Payer: Entrust Commercial |
$19.00
|
| Rate for Payer: First Choice Health Commercial |
$19.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.60
|
| Rate for Payer: HealthUtah PPO |
$20.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.40
|
| Rate for Payer: Multiplan Medicare/VA |
$11.02
|
| Rate for Payer: One Health Plan of WY PPO |
$19.60
|
| Rate for Payer: PacificSource Commercial |
$18.00
|
| Rate for Payer: PHCS PPO |
$19.60
|
| Rate for Payer: Three Rivers PPO |
$15.00
|
| Rate for Payer: TriWest Veterans Administration |
$11.60
|
| Rate for Payer: United Healthcare Commercial |
$17.40
|
| Rate for Payer: United Healthcare Medicare |
$11.60
|
| Rate for Payer: WINHealth Partners Commercial |
$19.60
|
| Rate for Payer: Wise Provider Network Commercial |
$19.00
|
|
|
HC STRAPPING HAND/FINGER
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
5102928001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.17 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.58
|
| Rate for Payer: Altius Auto/Workers Compensation |
$20.16
|
| Rate for Payer: Altius Commercial |
$20.16
|
| Rate for Payer: Beech Street Commercial |
$20.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.24
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.37
|
| Rate for Payer: Cigna of WY Commercial |
$20.58
|
| Rate for Payer: Entrust Commercial |
$19.95
|
| Rate for Payer: First Choice Health Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.86
|
| Rate for Payer: HealthUtah PPO |
$21.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.37
|
| Rate for Payer: Multiplan Medicare/VA |
$13.17
|
| Rate for Payer: One Health Plan of WY PPO |
$20.58
|
| Rate for Payer: PacificSource Commercial |
$18.90
|
| Rate for Payer: PHCS PPO |
$20.58
|
| Rate for Payer: Three Rivers PPO |
$15.75
|
| Rate for Payer: TriWest Veterans Administration |
$13.86
|
| Rate for Payer: United Healthcare Commercial |
$18.27
|
| Rate for Payer: United Healthcare Medicare |
$13.86
|
| Rate for Payer: WINHealth Partners Commercial |
$19.95
|
| Rate for Payer: Wise Provider Network Commercial |
$19.95
|
|
|
HC STRAPPING HAND/FINGER
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
7612928001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.75 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Aetna of WY Medicare |
$100.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.16
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$83.75
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$88.16
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$88.16
|
| Rate for Payer: WINHealth Partners Commercial |
$148.96
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING HAND/FINGER
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
7612928001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.30 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.32
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$95.30
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.32
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$100.32
|
| Rate for Payer: WINHealth Partners Commercial |
$144.40
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING HAND/FINGER
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
5102928001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$11.57 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.58
|
| Rate for Payer: Aetna of WY Medicare |
$13.86
|
| Rate for Payer: Altius Auto/Workers Compensation |
$20.16
|
| Rate for Payer: Altius Commercial |
$20.16
|
| Rate for Payer: Beech Street Commercial |
$20.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.24
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.37
|
| Rate for Payer: Cigna of WY Commercial |
$20.58
|
| Rate for Payer: Entrust Commercial |
$19.95
|
| Rate for Payer: First Choice Health Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.18
|
| Rate for Payer: HealthUtah PPO |
$21.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.37
|
| Rate for Payer: Multiplan Medicare/VA |
$11.57
|
| Rate for Payer: One Health Plan of WY PPO |
$20.58
|
| Rate for Payer: PacificSource Commercial |
$18.90
|
| Rate for Payer: PHCS PPO |
$20.58
|
| Rate for Payer: Three Rivers PPO |
$15.75
|
| Rate for Payer: TriWest Veterans Administration |
$12.18
|
| Rate for Payer: United Healthcare Commercial |
$18.27
|
| Rate for Payer: United Healthcare Medicare |
$12.18
|
| Rate for Payer: WINHealth Partners Commercial |
$20.58
|
| Rate for Payer: Wise Provider Network Commercial |
$19.95
|
|
|
HC STRAPPING HIP
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
HCPCS 29520
|
| Hospital Charge Code |
5102952001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.52
|
| Rate for Payer: Aetna of WY Medicare |
$15.84
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.04
|
| Rate for Payer: Altius Commercial |
$23.04
|
| Rate for Payer: Beech Street Commercial |
$23.52
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$19.70
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.28
|
| Rate for Payer: Cigna of WY Commercial |
$23.52
|
| Rate for Payer: Entrust Commercial |
$22.80
|
| Rate for Payer: First Choice Health Commercial |
$22.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$22.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.92
|
| Rate for Payer: HealthUtah PPO |
$24.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.28
|
| Rate for Payer: Multiplan Medicare/VA |
$13.22
|
| Rate for Payer: One Health Plan of WY PPO |
$23.52
|
| Rate for Payer: PacificSource Commercial |
$21.60
|
| Rate for Payer: PHCS PPO |
$23.52
|
| Rate for Payer: Three Rivers PPO |
$18.00
|
| Rate for Payer: TriWest Veterans Administration |
$13.92
|
| Rate for Payer: United Healthcare Commercial |
$20.88
|
| Rate for Payer: United Healthcare Medicare |
$13.92
|
| Rate for Payer: WINHealth Partners Commercial |
$23.52
|
| Rate for Payer: Wise Provider Network Commercial |
$22.80
|
|
|
HC STRAPPING HIP
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
HCPCS 29520
|
| Hospital Charge Code |
5102952001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.52
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.04
|
| Rate for Payer: Altius Commercial |
$23.04
|
| Rate for Payer: Beech Street Commercial |
$23.52
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$19.70
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.28
|
| Rate for Payer: Cigna of WY Commercial |
$23.52
|
| Rate for Payer: Entrust Commercial |
$22.80
|
| Rate for Payer: First Choice Health Commercial |
$22.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$22.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$15.84
|
| Rate for Payer: HealthUtah PPO |
$24.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.28
|
| Rate for Payer: Multiplan Medicare/VA |
$15.05
|
| Rate for Payer: One Health Plan of WY PPO |
$23.52
|
| Rate for Payer: PacificSource Commercial |
$21.60
|
| Rate for Payer: PHCS PPO |
$23.52
|
| Rate for Payer: Three Rivers PPO |
$18.00
|
| Rate for Payer: TriWest Veterans Administration |
$15.84
|
| Rate for Payer: United Healthcare Commercial |
$20.88
|
| Rate for Payer: United Healthcare Medicare |
$15.84
|
| Rate for Payer: WINHealth Partners Commercial |
$22.80
|
| Rate for Payer: Wise Provider Network Commercial |
$22.80
|
|
|
HC STRAPPING KNEE
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
5102953001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.54 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.20
|
| Rate for Payer: Altius Commercial |
$19.20
|
| Rate for Payer: Beech Street Commercial |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.42
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.40
|
| Rate for Payer: Cigna of WY Commercial |
$19.60
|
| Rate for Payer: Entrust Commercial |
$19.00
|
| Rate for Payer: First Choice Health Commercial |
$19.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.20
|
| Rate for Payer: HealthUtah PPO |
$20.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.40
|
| Rate for Payer: Multiplan Medicare/VA |
$12.54
|
| Rate for Payer: One Health Plan of WY PPO |
$19.60
|
| Rate for Payer: PacificSource Commercial |
$18.00
|
| Rate for Payer: PHCS PPO |
$19.60
|
| Rate for Payer: Three Rivers PPO |
$15.00
|
| Rate for Payer: TriWest Veterans Administration |
$13.20
|
| Rate for Payer: United Healthcare Commercial |
$17.40
|
| Rate for Payer: United Healthcare Medicare |
$13.20
|
| Rate for Payer: WINHealth Partners Commercial |
$19.00
|
| Rate for Payer: Wise Provider Network Commercial |
$19.00
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
5102953001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.60
|
| Rate for Payer: Aetna of WY Medicare |
$13.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.20
|
| Rate for Payer: Altius Commercial |
$19.20
|
| Rate for Payer: Beech Street Commercial |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.42
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.40
|
| Rate for Payer: Cigna of WY Commercial |
$19.60
|
| Rate for Payer: Entrust Commercial |
$19.00
|
| Rate for Payer: First Choice Health Commercial |
$19.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.60
|
| Rate for Payer: HealthUtah PPO |
$20.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.40
|
| Rate for Payer: Multiplan Medicare/VA |
$11.02
|
| Rate for Payer: One Health Plan of WY PPO |
$19.60
|
| Rate for Payer: PacificSource Commercial |
$18.00
|
| Rate for Payer: PHCS PPO |
$19.60
|
| Rate for Payer: Three Rivers PPO |
$15.00
|
| Rate for Payer: TriWest Veterans Administration |
$11.60
|
| Rate for Payer: United Healthcare Commercial |
$17.40
|
| Rate for Payer: United Healthcare Medicare |
$11.60
|
| Rate for Payer: WINHealth Partners Commercial |
$19.60
|
| Rate for Payer: Wise Provider Network Commercial |
$19.00
|
|
|
HC STRAPPING OF KNEE
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
7612953001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.75 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Aetna of WY Medicare |
$100.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.16
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$83.75
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$88.16
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$88.16
|
| Rate for Payer: WINHealth Partners Commercial |
$148.96
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING OF KNEE
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
7612953001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.30 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.32
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$95.30
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.32
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$100.32
|
| Rate for Payer: WINHealth Partners Commercial |
$144.40
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING SHOULDER
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
7612924001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.75 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Aetna of WY Medicare |
$100.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.16
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$83.75
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$88.16
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$88.16
|
| Rate for Payer: WINHealth Partners Commercial |
$148.96
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING SHOULDER
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
7612924001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.30 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.32
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$95.30
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.32
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$100.32
|
| Rate for Payer: WINHealth Partners Commercial |
$144.40
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING SHOULDER
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
5102924001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.17 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.58
|
| Rate for Payer: Altius Auto/Workers Compensation |
$20.16
|
| Rate for Payer: Altius Commercial |
$20.16
|
| Rate for Payer: Beech Street Commercial |
$20.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.24
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.37
|
| Rate for Payer: Cigna of WY Commercial |
$20.58
|
| Rate for Payer: Entrust Commercial |
$19.95
|
| Rate for Payer: First Choice Health Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.86
|
| Rate for Payer: HealthUtah PPO |
$21.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.37
|
| Rate for Payer: Multiplan Medicare/VA |
$13.17
|
| Rate for Payer: One Health Plan of WY PPO |
$20.58
|
| Rate for Payer: PacificSource Commercial |
$18.90
|
| Rate for Payer: PHCS PPO |
$20.58
|
| Rate for Payer: Three Rivers PPO |
$15.75
|
| Rate for Payer: TriWest Veterans Administration |
$13.86
|
| Rate for Payer: United Healthcare Commercial |
$18.27
|
| Rate for Payer: United Healthcare Medicare |
$13.86
|
| Rate for Payer: WINHealth Partners Commercial |
$19.95
|
| Rate for Payer: Wise Provider Network Commercial |
$19.95
|
|
|
HC STRAPPING SHOULDER
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
5102924001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$11.57 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.58
|
| Rate for Payer: Aetna of WY Medicare |
$13.86
|
| Rate for Payer: Altius Auto/Workers Compensation |
$20.16
|
| Rate for Payer: Altius Commercial |
$20.16
|
| Rate for Payer: Beech Street Commercial |
$20.58
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.24
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.37
|
| Rate for Payer: Cigna of WY Commercial |
$20.58
|
| Rate for Payer: Entrust Commercial |
$19.95
|
| Rate for Payer: First Choice Health Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.18
|
| Rate for Payer: HealthUtah PPO |
$21.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.37
|
| Rate for Payer: Multiplan Medicare/VA |
$11.57
|
| Rate for Payer: One Health Plan of WY PPO |
$20.58
|
| Rate for Payer: PacificSource Commercial |
$18.90
|
| Rate for Payer: PHCS PPO |
$20.58
|
| Rate for Payer: Three Rivers PPO |
$15.75
|
| Rate for Payer: TriWest Veterans Administration |
$12.18
|
| Rate for Payer: United Healthcare Commercial |
$18.27
|
| Rate for Payer: United Healthcare Medicare |
$12.18
|
| Rate for Payer: WINHealth Partners Commercial |
$20.58
|
| Rate for Payer: Wise Provider Network Commercial |
$19.95
|
|
|
HC STRAPPING TOES
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
HCPCS 29550
|
| Hospital Charge Code |
5102955001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.74
|
| Rate for Payer: Aetna of WY Medicare |
$8.58
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.48
|
| Rate for Payer: Altius Commercial |
$12.48
|
| Rate for Payer: Beech Street Commercial |
$12.74
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.67
|
| Rate for Payer: Cash Price |
$9.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.61
|
| Rate for Payer: Cigna of WY Commercial |
$12.74
|
| Rate for Payer: Entrust Commercial |
$12.35
|
| Rate for Payer: First Choice Health Commercial |
$12.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.54
|
| Rate for Payer: HealthUtah PPO |
$13.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.61
|
| Rate for Payer: Multiplan Medicare/VA |
$7.16
|
| Rate for Payer: One Health Plan of WY PPO |
$12.74
|
| Rate for Payer: PacificSource Commercial |
$11.70
|
| Rate for Payer: PHCS PPO |
$12.74
|
| Rate for Payer: Three Rivers PPO |
$9.75
|
| Rate for Payer: TriWest Veterans Administration |
$7.54
|
| Rate for Payer: United Healthcare Commercial |
$11.31
|
| Rate for Payer: United Healthcare Medicare |
$7.54
|
| Rate for Payer: WINHealth Partners Commercial |
$12.74
|
| Rate for Payer: Wise Provider Network Commercial |
$12.35
|
|
|
HC STRAPPING TOES
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
HCPCS 29550
|
| Hospital Charge Code |
5102955001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.74
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.48
|
| Rate for Payer: Altius Commercial |
$12.48
|
| Rate for Payer: Beech Street Commercial |
$12.74
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.67
|
| Rate for Payer: Cash Price |
$9.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.61
|
| Rate for Payer: Cigna of WY Commercial |
$12.74
|
| Rate for Payer: Entrust Commercial |
$12.35
|
| Rate for Payer: First Choice Health Commercial |
$12.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.58
|
| Rate for Payer: HealthUtah PPO |
$13.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.61
|
| Rate for Payer: Multiplan Medicare/VA |
$8.15
|
| Rate for Payer: One Health Plan of WY PPO |
$12.74
|
| Rate for Payer: PacificSource Commercial |
$11.70
|
| Rate for Payer: PHCS PPO |
$12.74
|
| Rate for Payer: Three Rivers PPO |
$9.75
|
| Rate for Payer: TriWest Veterans Administration |
$8.58
|
| Rate for Payer: United Healthcare Commercial |
$11.31
|
| Rate for Payer: United Healthcare Medicare |
$8.58
|
| Rate for Payer: WINHealth Partners Commercial |
$12.35
|
| Rate for Payer: Wise Provider Network Commercial |
$12.35
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
HCPCS 29580 50
|
| Hospital Charge Code |
5102958001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$95.06
|
| Rate for Payer: Aetna of WY Medicare |
$64.02
|
| Rate for Payer: Altius Auto/Workers Compensation |
$93.12
|
| Rate for Payer: Altius Commercial |
$93.12
|
| Rate for Payer: Beech Street Commercial |
$95.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$79.64
|
| Rate for Payer: Cash Price |
$67.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$94.09
|
| Rate for Payer: Cigna of WY Commercial |
$95.06
|
| Rate for Payer: Entrust Commercial |
$92.15
|
| Rate for Payer: First Choice Health Commercial |
$92.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$92.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$56.26
|
| Rate for Payer: HealthUtah PPO |
$97.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$94.09
|
| Rate for Payer: Multiplan Medicare/VA |
$53.45
|
| Rate for Payer: One Health Plan of WY PPO |
$95.06
|
| Rate for Payer: PacificSource Commercial |
$87.30
|
| Rate for Payer: PHCS PPO |
$95.06
|
| Rate for Payer: Three Rivers PPO |
$72.75
|
| Rate for Payer: TriWest Veterans Administration |
$56.26
|
| Rate for Payer: United Healthcare Commercial |
$84.39
|
| Rate for Payer: United Healthcare Medicare |
$56.26
|
| Rate for Payer: WINHealth Partners Commercial |
$95.06
|
| Rate for Payer: Wise Provider Network Commercial |
$92.15
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
HCPCS 29580 50
|
| Hospital Charge Code |
5102958001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.82 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$95.06
|
| Rate for Payer: Altius Auto/Workers Compensation |
$93.12
|
| Rate for Payer: Altius Commercial |
$93.12
|
| Rate for Payer: Beech Street Commercial |
$95.06
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$79.64
|
| Rate for Payer: Cash Price |
$67.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$94.09
|
| Rate for Payer: Cigna of WY Commercial |
$95.06
|
| Rate for Payer: Entrust Commercial |
$92.15
|
| Rate for Payer: First Choice Health Commercial |
$92.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$92.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$64.02
|
| Rate for Payer: HealthUtah PPO |
$97.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$94.09
|
| Rate for Payer: Multiplan Medicare/VA |
$60.82
|
| Rate for Payer: One Health Plan of WY PPO |
$95.06
|
| Rate for Payer: PacificSource Commercial |
$87.30
|
| Rate for Payer: PHCS PPO |
$95.06
|
| Rate for Payer: Three Rivers PPO |
$72.75
|
| Rate for Payer: TriWest Veterans Administration |
$64.02
|
| Rate for Payer: United Healthcare Commercial |
$84.39
|
| Rate for Payer: United Healthcare Medicare |
$64.02
|
| Rate for Payer: WINHealth Partners Commercial |
$92.15
|
| Rate for Payer: Wise Provider Network Commercial |
$92.15
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
|
OP
|
$1,445.00
|
|
|
Service Code
|
HCPCS 29580
|
| Hospital Charge Code |
4202958001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$796.20 |
| Max. Negotiated Rate |
$1,445.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,416.10
|
| Rate for Payer: Aetna of WY Medicare |
$953.70
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,387.20
|
| Rate for Payer: Altius Commercial |
$1,387.20
|
| Rate for Payer: Beech Street Commercial |
$1,416.10
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,186.34
|
| Rate for Payer: Cash Price |
$1,011.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,401.65
|
| Rate for Payer: Cigna of WY Commercial |
$1,416.10
|
| Rate for Payer: Entrust Commercial |
$1,372.75
|
| Rate for Payer: First Choice Health Commercial |
$1,372.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,372.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$838.10
|
| Rate for Payer: HealthUtah PPO |
$1,445.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,401.65
|
| Rate for Payer: Multiplan Medicare/VA |
$796.20
|
| Rate for Payer: One Health Plan of WY PPO |
$1,416.10
|
| Rate for Payer: PacificSource Commercial |
$1,300.50
|
| Rate for Payer: PHCS PPO |
$1,416.10
|
| Rate for Payer: Three Rivers PPO |
$1,083.75
|
| Rate for Payer: TriWest Veterans Administration |
$838.10
|
| Rate for Payer: United Healthcare Commercial |
$1,257.15
|
| Rate for Payer: United Healthcare Medicare |
$838.10
|
| Rate for Payer: WINHealth Partners Commercial |
$1,416.10
|
| Rate for Payer: Wise Provider Network Commercial |
$1,372.75
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS 29580
|
| Hospital Charge Code |
7612958001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.75 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Aetna of WY Medicare |
$100.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.16
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$83.75
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$88.16
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$88.16
|
| Rate for Payer: WINHealth Partners Commercial |
$148.96
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
HCPCS 29580
|
| Hospital Charge Code |
7612958001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.30 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$148.96
|
| Rate for Payer: Altius Auto/Workers Compensation |
$145.92
|
| Rate for Payer: Altius Commercial |
$145.92
|
| Rate for Payer: Beech Street Commercial |
$148.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$124.79
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$147.44
|
| Rate for Payer: Cigna of WY Commercial |
$148.96
|
| Rate for Payer: Entrust Commercial |
$144.40
|
| Rate for Payer: First Choice Health Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$144.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.32
|
| Rate for Payer: HealthUtah PPO |
$152.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$147.44
|
| Rate for Payer: Multiplan Medicare/VA |
$95.30
|
| Rate for Payer: One Health Plan of WY PPO |
$148.96
|
| Rate for Payer: PacificSource Commercial |
$136.80
|
| Rate for Payer: PHCS PPO |
$148.96
|
| Rate for Payer: Three Rivers PPO |
$114.00
|
| Rate for Payer: TriWest Veterans Administration |
$100.32
|
| Rate for Payer: United Healthcare Commercial |
$132.24
|
| Rate for Payer: United Healthcare Medicare |
$100.32
|
| Rate for Payer: WINHealth Partners Commercial |
$144.40
|
| Rate for Payer: Wise Provider Network Commercial |
$144.40
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
HCPCS 29580
|
| Hospital Charge Code |
5102958001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$48.02
|
| Rate for Payer: Aetna of WY Medicare |
$32.34
|
| Rate for Payer: Altius Auto/Workers Compensation |
$47.04
|
| Rate for Payer: Altius Commercial |
$47.04
|
| Rate for Payer: Beech Street Commercial |
$48.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$40.23
|
| Rate for Payer: Cash Price |
$34.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$47.53
|
| Rate for Payer: Cigna of WY Commercial |
$48.02
|
| Rate for Payer: Entrust Commercial |
$46.55
|
| Rate for Payer: First Choice Health Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$28.42
|
| Rate for Payer: HealthUtah PPO |
$49.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$47.53
|
| Rate for Payer: Multiplan Medicare/VA |
$27.00
|
| Rate for Payer: One Health Plan of WY PPO |
$48.02
|
| Rate for Payer: PacificSource Commercial |
$44.10
|
| Rate for Payer: PHCS PPO |
$48.02
|
| Rate for Payer: Three Rivers PPO |
$36.75
|
| Rate for Payer: TriWest Veterans Administration |
$28.42
|
| Rate for Payer: United Healthcare Commercial |
$42.63
|
| Rate for Payer: United Healthcare Medicare |
$28.42
|
| Rate for Payer: WINHealth Partners Commercial |
$48.02
|
| Rate for Payer: Wise Provider Network Commercial |
$46.55
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
HCPCS 29580
|
| Hospital Charge Code |
5102958001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.72 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$48.02
|
| Rate for Payer: Altius Auto/Workers Compensation |
$47.04
|
| Rate for Payer: Altius Commercial |
$47.04
|
| Rate for Payer: Beech Street Commercial |
$48.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$40.23
|
| Rate for Payer: Cash Price |
$34.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$47.53
|
| Rate for Payer: Cigna of WY Commercial |
$48.02
|
| Rate for Payer: Entrust Commercial |
$46.55
|
| Rate for Payer: First Choice Health Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$46.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$32.34
|
| Rate for Payer: HealthUtah PPO |
$49.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$47.53
|
| Rate for Payer: Multiplan Medicare/VA |
$30.72
|
| Rate for Payer: One Health Plan of WY PPO |
$48.02
|
| Rate for Payer: PacificSource Commercial |
$44.10
|
| Rate for Payer: PHCS PPO |
$48.02
|
| Rate for Payer: Three Rivers PPO |
$36.75
|
| Rate for Payer: TriWest Veterans Administration |
$32.34
|
| Rate for Payer: United Healthcare Commercial |
$42.63
|
| Rate for Payer: United Healthcare Medicare |
$32.34
|
| Rate for Payer: WINHealth Partners Commercial |
$46.55
|
| Rate for Payer: Wise Provider Network Commercial |
$46.55
|
|
