|
HEARING AID FITTING/CHECKING
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS V5011
|
| Hospital Charge Code |
V5011
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$49.00
|
| Rate for Payer: Beech Street Commercial |
$47.50
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$48.50
|
| Rate for Payer: Cigna of WY Commercial |
$49.00
|
| Rate for Payer: First Choice Health Commercial |
$45.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$47.50
|
| Rate for Payer: HealthUtah PPO |
$50.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$48.50
|
| Rate for Payer: One Health Plan of WY PPO |
$49.00
|
| Rate for Payer: PacificSource Commercial |
$45.00
|
| Rate for Payer: PHCS PPO |
$47.50
|
| Rate for Payer: Three Rivers PPO |
$37.50
|
| Rate for Payer: United Healthcare Commercial |
$43.50
|
| Rate for Payer: WINHealth Partners Commercial |
$47.50
|
|
|
HEEL/ELBOW PROTECTOR LARGE
|
Facility
|
IP
|
$35.74
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$35.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.03
|
| Rate for Payer: Altius Auto/Workers Compensation |
$34.31
|
| Rate for Payer: Altius Commercial |
$34.31
|
| Rate for Payer: Beech Street Commercial |
$35.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.34
|
| Rate for Payer: Cash Price |
$25.01
|
| Rate for Payer: ChoiceCare Network Commercial |
$34.67
|
| Rate for Payer: Cigna of WY Commercial |
$35.03
|
| Rate for Payer: Entrust Commercial |
$33.95
|
| Rate for Payer: First Choice Health Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.59
|
| Rate for Payer: HealthUtah PPO |
$35.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$34.67
|
| Rate for Payer: Multiplan Medicare/VA |
$22.41
|
| Rate for Payer: One Health Plan of WY PPO |
$35.03
|
| Rate for Payer: PacificSource Commercial |
$32.17
|
| Rate for Payer: PHCS PPO |
$35.03
|
| Rate for Payer: Three Rivers PPO |
$26.80
|
| Rate for Payer: TriWest Veterans Administration |
$23.59
|
| Rate for Payer: United Healthcare Commercial |
$31.09
|
| Rate for Payer: United Healthcare Medicare |
$23.59
|
| Rate for Payer: WINHealth Partners Commercial |
$33.95
|
| Rate for Payer: Wise Provider Network Commercial |
$33.95
|
|
|
HEEL/ELBOW PROTECTOR LARGE
|
Facility
|
OP
|
$35.74
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$35.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.03
|
| Rate for Payer: Aetna of WY Medicare |
$23.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$34.31
|
| Rate for Payer: Altius Commercial |
$34.31
|
| Rate for Payer: Beech Street Commercial |
$35.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.34
|
| Rate for Payer: Cash Price |
$25.01
|
| Rate for Payer: ChoiceCare Network Commercial |
$34.67
|
| Rate for Payer: Cigna of WY Commercial |
$35.03
|
| Rate for Payer: Entrust Commercial |
$33.95
|
| Rate for Payer: First Choice Health Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$20.73
|
| Rate for Payer: HealthUtah PPO |
$35.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$34.67
|
| Rate for Payer: Multiplan Medicare/VA |
$19.69
|
| Rate for Payer: One Health Plan of WY PPO |
$35.03
|
| Rate for Payer: PacificSource Commercial |
$32.17
|
| Rate for Payer: PHCS PPO |
$35.03
|
| Rate for Payer: Three Rivers PPO |
$26.80
|
| Rate for Payer: TriWest Veterans Administration |
$20.73
|
| Rate for Payer: United Healthcare Commercial |
$31.09
|
| Rate for Payer: United Healthcare Medicare |
$20.73
|
| Rate for Payer: WINHealth Partners Commercial |
$35.03
|
| Rate for Payer: Wise Provider Network Commercial |
$33.95
|
|
|
HEEL/ELBOW PROTECTOR MED
|
Facility
|
IP
|
$36.44
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.85 |
| Max. Negotiated Rate |
$36.44 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.71
|
| Rate for Payer: Altius Auto/Workers Compensation |
$34.98
|
| Rate for Payer: Altius Commercial |
$34.98
|
| Rate for Payer: Beech Street Commercial |
$35.71
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.92
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.35
|
| Rate for Payer: Cigna of WY Commercial |
$35.71
|
| Rate for Payer: Entrust Commercial |
$34.62
|
| Rate for Payer: First Choice Health Commercial |
$34.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$34.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.05
|
| Rate for Payer: HealthUtah PPO |
$36.44
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.35
|
| Rate for Payer: Multiplan Medicare/VA |
$22.85
|
| Rate for Payer: One Health Plan of WY PPO |
$35.71
|
| Rate for Payer: PacificSource Commercial |
$32.80
|
| Rate for Payer: PHCS PPO |
$35.71
|
| Rate for Payer: Three Rivers PPO |
$27.33
|
| Rate for Payer: TriWest Veterans Administration |
$24.05
|
| Rate for Payer: United Healthcare Commercial |
$31.70
|
| Rate for Payer: United Healthcare Medicare |
$24.05
|
| Rate for Payer: WINHealth Partners Commercial |
$34.62
|
| Rate for Payer: Wise Provider Network Commercial |
$34.62
|
|
|
HEEL/ELBOW PROTECTOR MED
|
Facility
|
OP
|
$36.44
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.08 |
| Max. Negotiated Rate |
$36.44 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.71
|
| Rate for Payer: Aetna of WY Medicare |
$24.05
|
| Rate for Payer: Altius Auto/Workers Compensation |
$34.98
|
| Rate for Payer: Altius Commercial |
$34.98
|
| Rate for Payer: Beech Street Commercial |
$35.71
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.92
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.35
|
| Rate for Payer: Cigna of WY Commercial |
$35.71
|
| Rate for Payer: Entrust Commercial |
$34.62
|
| Rate for Payer: First Choice Health Commercial |
$34.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$34.62
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.14
|
| Rate for Payer: HealthUtah PPO |
$36.44
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.35
|
| Rate for Payer: Multiplan Medicare/VA |
$20.08
|
| Rate for Payer: One Health Plan of WY PPO |
$35.71
|
| Rate for Payer: PacificSource Commercial |
$32.80
|
| Rate for Payer: PHCS PPO |
$35.71
|
| Rate for Payer: Three Rivers PPO |
$27.33
|
| Rate for Payer: TriWest Veterans Administration |
$21.14
|
| Rate for Payer: United Healthcare Commercial |
$31.70
|
| Rate for Payer: United Healthcare Medicare |
$21.14
|
| Rate for Payer: WINHealth Partners Commercial |
$35.71
|
| Rate for Payer: Wise Provider Network Commercial |
$34.62
|
|
|
HEEL/ELBOW PROTECTOR UNIVERSAL
|
Facility
|
IP
|
$11.75
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.37 |
| Max. Negotiated Rate |
$11.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.52
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.28
|
| Rate for Payer: Altius Commercial |
$11.28
|
| Rate for Payer: Beech Street Commercial |
$11.52
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.65
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.40
|
| Rate for Payer: Cigna of WY Commercial |
$11.52
|
| Rate for Payer: Entrust Commercial |
$11.16
|
| Rate for Payer: First Choice Health Commercial |
$11.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.76
|
| Rate for Payer: HealthUtah PPO |
$11.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.40
|
| Rate for Payer: Multiplan Medicare/VA |
$7.37
|
| Rate for Payer: One Health Plan of WY PPO |
$11.52
|
| Rate for Payer: PacificSource Commercial |
$10.58
|
| Rate for Payer: PHCS PPO |
$11.52
|
| Rate for Payer: Three Rivers PPO |
$8.81
|
| Rate for Payer: TriWest Veterans Administration |
$7.76
|
| Rate for Payer: United Healthcare Commercial |
$10.22
|
| Rate for Payer: United Healthcare Medicare |
$7.76
|
| Rate for Payer: WINHealth Partners Commercial |
$11.16
|
| Rate for Payer: Wise Provider Network Commercial |
$11.16
|
|
|
HEEL/ELBOW PROTECTOR UNIVERSAL
|
Facility
|
OP
|
$11.75
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$11.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.52
|
| Rate for Payer: Aetna of WY Medicare |
$7.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.28
|
| Rate for Payer: Altius Commercial |
$11.28
|
| Rate for Payer: Beech Street Commercial |
$11.52
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.65
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.40
|
| Rate for Payer: Cigna of WY Commercial |
$11.52
|
| Rate for Payer: Entrust Commercial |
$11.16
|
| Rate for Payer: First Choice Health Commercial |
$11.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.16
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.82
|
| Rate for Payer: HealthUtah PPO |
$11.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.40
|
| Rate for Payer: Multiplan Medicare/VA |
$6.47
|
| Rate for Payer: One Health Plan of WY PPO |
$11.52
|
| Rate for Payer: PacificSource Commercial |
$10.58
|
| Rate for Payer: PHCS PPO |
$11.52
|
| Rate for Payer: Three Rivers PPO |
$8.81
|
| Rate for Payer: TriWest Veterans Administration |
$6.82
|
| Rate for Payer: United Healthcare Commercial |
$10.22
|
| Rate for Payer: United Healthcare Medicare |
$6.82
|
| Rate for Payer: WINHealth Partners Commercial |
$11.52
|
| Rate for Payer: Wise Provider Network Commercial |
$11.16
|
|
|
HEEL/ELBOW PROTECTOR XL
|
Facility
|
OP
|
$35.74
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$35.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.03
|
| Rate for Payer: Aetna of WY Medicare |
$23.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$34.31
|
| Rate for Payer: Altius Commercial |
$34.31
|
| Rate for Payer: Beech Street Commercial |
$35.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.34
|
| Rate for Payer: Cash Price |
$25.01
|
| Rate for Payer: ChoiceCare Network Commercial |
$34.67
|
| Rate for Payer: Cigna of WY Commercial |
$35.03
|
| Rate for Payer: Entrust Commercial |
$33.95
|
| Rate for Payer: First Choice Health Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$20.73
|
| Rate for Payer: HealthUtah PPO |
$35.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$34.67
|
| Rate for Payer: Multiplan Medicare/VA |
$19.69
|
| Rate for Payer: One Health Plan of WY PPO |
$35.03
|
| Rate for Payer: PacificSource Commercial |
$32.17
|
| Rate for Payer: PHCS PPO |
$35.03
|
| Rate for Payer: Three Rivers PPO |
$26.80
|
| Rate for Payer: TriWest Veterans Administration |
$20.73
|
| Rate for Payer: United Healthcare Commercial |
$31.09
|
| Rate for Payer: United Healthcare Medicare |
$20.73
|
| Rate for Payer: WINHealth Partners Commercial |
$35.03
|
| Rate for Payer: Wise Provider Network Commercial |
$33.95
|
|
|
HEEL/ELBOW PROTECTOR XL
|
Facility
|
IP
|
$35.74
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$35.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.03
|
| Rate for Payer: Altius Auto/Workers Compensation |
$34.31
|
| Rate for Payer: Altius Commercial |
$34.31
|
| Rate for Payer: Beech Street Commercial |
$35.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.34
|
| Rate for Payer: Cash Price |
$25.01
|
| Rate for Payer: ChoiceCare Network Commercial |
$34.67
|
| Rate for Payer: Cigna of WY Commercial |
$35.03
|
| Rate for Payer: Entrust Commercial |
$33.95
|
| Rate for Payer: First Choice Health Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$33.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.59
|
| Rate for Payer: HealthUtah PPO |
$35.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$34.67
|
| Rate for Payer: Multiplan Medicare/VA |
$22.41
|
| Rate for Payer: One Health Plan of WY PPO |
$35.03
|
| Rate for Payer: PacificSource Commercial |
$32.17
|
| Rate for Payer: PHCS PPO |
$35.03
|
| Rate for Payer: Three Rivers PPO |
$26.80
|
| Rate for Payer: TriWest Veterans Administration |
$23.59
|
| Rate for Payer: United Healthcare Commercial |
$31.09
|
| Rate for Payer: United Healthcare Medicare |
$23.59
|
| Rate for Payer: WINHealth Partners Commercial |
$33.95
|
| Rate for Payer: Wise Provider Network Commercial |
$33.95
|
|
|
HEEL/HAND PROTECTOR
|
Facility
|
OP
|
$267.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$147.24 |
| Max. Negotiated Rate |
$267.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$261.88
|
| Rate for Payer: Aetna of WY Medicare |
$176.37
|
| Rate for Payer: Altius Auto/Workers Compensation |
$256.53
|
| Rate for Payer: Altius Commercial |
$256.53
|
| Rate for Payer: Beech Street Commercial |
$261.88
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$219.39
|
| Rate for Payer: Cash Price |
$187.06
|
| Rate for Payer: ChoiceCare Network Commercial |
$259.20
|
| Rate for Payer: Cigna of WY Commercial |
$261.88
|
| Rate for Payer: Entrust Commercial |
$253.86
|
| Rate for Payer: First Choice Health Commercial |
$253.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$253.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$154.99
|
| Rate for Payer: HealthUtah PPO |
$267.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$259.20
|
| Rate for Payer: Multiplan Medicare/VA |
$147.24
|
| Rate for Payer: One Health Plan of WY PPO |
$261.88
|
| Rate for Payer: PacificSource Commercial |
$240.50
|
| Rate for Payer: PHCS PPO |
$261.88
|
| Rate for Payer: Three Rivers PPO |
$200.42
|
| Rate for Payer: TriWest Veterans Administration |
$154.99
|
| Rate for Payer: United Healthcare Commercial |
$232.48
|
| Rate for Payer: United Healthcare Medicare |
$154.99
|
| Rate for Payer: WINHealth Partners Commercial |
$261.88
|
| Rate for Payer: Wise Provider Network Commercial |
$253.86
|
|
|
HEEL/HAND PROTECTOR
|
Facility
|
IP
|
$267.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.55 |
| Max. Negotiated Rate |
$267.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$261.88
|
| Rate for Payer: Altius Auto/Workers Compensation |
$256.53
|
| Rate for Payer: Altius Commercial |
$256.53
|
| Rate for Payer: Beech Street Commercial |
$261.88
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$219.39
|
| Rate for Payer: Cash Price |
$187.06
|
| Rate for Payer: ChoiceCare Network Commercial |
$259.20
|
| Rate for Payer: Cigna of WY Commercial |
$261.88
|
| Rate for Payer: Entrust Commercial |
$253.86
|
| Rate for Payer: First Choice Health Commercial |
$253.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$253.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$176.37
|
| Rate for Payer: HealthUtah PPO |
$267.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$259.20
|
| Rate for Payer: Multiplan Medicare/VA |
$167.55
|
| Rate for Payer: One Health Plan of WY PPO |
$261.88
|
| Rate for Payer: PacificSource Commercial |
$240.50
|
| Rate for Payer: PHCS PPO |
$261.88
|
| Rate for Payer: Three Rivers PPO |
$200.42
|
| Rate for Payer: TriWest Veterans Administration |
$176.37
|
| Rate for Payer: United Healthcare Commercial |
$232.48
|
| Rate for Payer: United Healthcare Medicare |
$176.37
|
| Rate for Payer: WINHealth Partners Commercial |
$253.86
|
| Rate for Payer: Wise Provider Network Commercial |
$253.86
|
|
|
HEEL LIFT ADJ MED.
|
Facility
|
IP
|
$24.46
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$24.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.97
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.48
|
| Rate for Payer: Altius Commercial |
$23.48
|
| Rate for Payer: Beech Street Commercial |
$23.97
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.08
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.73
|
| Rate for Payer: Cigna of WY Commercial |
$23.97
|
| Rate for Payer: Entrust Commercial |
$23.24
|
| Rate for Payer: First Choice Health Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.14
|
| Rate for Payer: HealthUtah PPO |
$24.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.73
|
| Rate for Payer: Multiplan Medicare/VA |
$15.34
|
| Rate for Payer: One Health Plan of WY PPO |
$23.97
|
| Rate for Payer: PacificSource Commercial |
$22.01
|
| Rate for Payer: PHCS PPO |
$23.97
|
| Rate for Payer: Three Rivers PPO |
$18.34
|
| Rate for Payer: TriWest Veterans Administration |
$16.14
|
| Rate for Payer: United Healthcare Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare |
$16.14
|
| Rate for Payer: WINHealth Partners Commercial |
$23.24
|
| Rate for Payer: Wise Provider Network Commercial |
$23.24
|
|
|
HEEL LIFT ADJ MED.
|
Facility
|
OP
|
$24.46
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$24.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.97
|
| Rate for Payer: Aetna of WY Medicare |
$16.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.48
|
| Rate for Payer: Altius Commercial |
$23.48
|
| Rate for Payer: Beech Street Commercial |
$23.97
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.08
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.73
|
| Rate for Payer: Cigna of WY Commercial |
$23.97
|
| Rate for Payer: Entrust Commercial |
$23.24
|
| Rate for Payer: First Choice Health Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.19
|
| Rate for Payer: HealthUtah PPO |
$24.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.73
|
| Rate for Payer: Multiplan Medicare/VA |
$13.48
|
| Rate for Payer: One Health Plan of WY PPO |
$23.97
|
| Rate for Payer: PacificSource Commercial |
$22.01
|
| Rate for Payer: PHCS PPO |
$23.97
|
| Rate for Payer: Three Rivers PPO |
$18.34
|
| Rate for Payer: TriWest Veterans Administration |
$14.19
|
| Rate for Payer: United Healthcare Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare |
$14.19
|
| Rate for Payer: WINHealth Partners Commercial |
$23.97
|
| Rate for Payer: Wise Provider Network Commercial |
$23.24
|
|
|
HEEL LIFT ADJ SMALL
|
Facility
|
OP
|
$24.46
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$24.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.97
|
| Rate for Payer: Aetna of WY Medicare |
$16.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.48
|
| Rate for Payer: Altius Commercial |
$23.48
|
| Rate for Payer: Beech Street Commercial |
$23.97
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.08
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.73
|
| Rate for Payer: Cigna of WY Commercial |
$23.97
|
| Rate for Payer: Entrust Commercial |
$23.24
|
| Rate for Payer: First Choice Health Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.19
|
| Rate for Payer: HealthUtah PPO |
$24.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.73
|
| Rate for Payer: Multiplan Medicare/VA |
$13.48
|
| Rate for Payer: One Health Plan of WY PPO |
$23.97
|
| Rate for Payer: PacificSource Commercial |
$22.01
|
| Rate for Payer: PHCS PPO |
$23.97
|
| Rate for Payer: Three Rivers PPO |
$18.34
|
| Rate for Payer: TriWest Veterans Administration |
$14.19
|
| Rate for Payer: United Healthcare Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare |
$14.19
|
| Rate for Payer: WINHealth Partners Commercial |
$23.97
|
| Rate for Payer: Wise Provider Network Commercial |
$23.24
|
|
|
HEEL LIFT ADJ SMALL
|
Facility
|
IP
|
$24.46
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$24.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.97
|
| Rate for Payer: Altius Auto/Workers Compensation |
$23.48
|
| Rate for Payer: Altius Commercial |
$23.48
|
| Rate for Payer: Beech Street Commercial |
$23.97
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.08
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: ChoiceCare Network Commercial |
$23.73
|
| Rate for Payer: Cigna of WY Commercial |
$23.97
|
| Rate for Payer: Entrust Commercial |
$23.24
|
| Rate for Payer: First Choice Health Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.14
|
| Rate for Payer: HealthUtah PPO |
$24.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$23.73
|
| Rate for Payer: Multiplan Medicare/VA |
$15.34
|
| Rate for Payer: One Health Plan of WY PPO |
$23.97
|
| Rate for Payer: PacificSource Commercial |
$22.01
|
| Rate for Payer: PHCS PPO |
$23.97
|
| Rate for Payer: Three Rivers PPO |
$18.34
|
| Rate for Payer: TriWest Veterans Administration |
$16.14
|
| Rate for Payer: United Healthcare Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare |
$16.14
|
| Rate for Payer: WINHealth Partners Commercial |
$23.24
|
| Rate for Payer: Wise Provider Network Commercial |
$23.24
|
|
|
HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$5,845.00
|
|
|
Service Code
|
HCPCS 27125 80
|
| Hospital Charge Code |
27125
|
| Min. Negotiated Rate |
$925.16 |
| Max. Negotiated Rate |
$5,845.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,728.10
|
| Rate for Payer: Aetna of WY Medicare |
$1,088.42
|
| Rate for Payer: Beech Street Commercial |
$5,552.75
|
| Rate for Payer: Cash Price |
$4,091.50
|
| Rate for Payer: Cash Price |
$4,091.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,669.65
|
| Rate for Payer: Cigna of WY Commercial |
$5,728.10
|
| Rate for Payer: First Choice Health Commercial |
$5,260.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,552.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,088.42
|
| Rate for Payer: HealthUtah PPO |
$5,845.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,669.65
|
| Rate for Payer: Multiplan Medicare/VA |
$925.16
|
| Rate for Payer: One Health Plan of WY PPO |
$5,728.10
|
| Rate for Payer: PacificSource Commercial |
$5,260.50
|
| Rate for Payer: PHCS PPO |
$5,552.75
|
| Rate for Payer: Three Rivers PPO |
$4,383.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,088.42
|
| Rate for Payer: United Healthcare Commercial |
$5,085.15
|
| Rate for Payer: United Healthcare Medicare |
$1,088.42
|
| Rate for Payer: WINHealth Partners Commercial |
$4,968.25
|
|
|
HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$5,845.00
|
|
|
Service Code
|
HCPCS 27125
|
| Hospital Charge Code |
27125
|
| Min. Negotiated Rate |
$925.16 |
| Max. Negotiated Rate |
$5,845.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,728.10
|
| Rate for Payer: Aetna of WY Medicare |
$1,088.42
|
| Rate for Payer: Beech Street Commercial |
$5,552.75
|
| Rate for Payer: Cash Price |
$4,091.50
|
| Rate for Payer: Cash Price |
$4,091.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,669.65
|
| Rate for Payer: Cigna of WY Commercial |
$5,728.10
|
| Rate for Payer: First Choice Health Commercial |
$5,260.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,552.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,088.42
|
| Rate for Payer: HealthUtah PPO |
$5,845.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,669.65
|
| Rate for Payer: Multiplan Medicare/VA |
$925.16
|
| Rate for Payer: One Health Plan of WY PPO |
$5,728.10
|
| Rate for Payer: PacificSource Commercial |
$5,260.50
|
| Rate for Payer: PHCS PPO |
$5,552.75
|
| Rate for Payer: Three Rivers PPO |
$4,383.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,088.42
|
| Rate for Payer: United Healthcare Commercial |
$5,085.15
|
| Rate for Payer: United Healthcare Medicare |
$1,088.42
|
| Rate for Payer: WINHealth Partners Commercial |
$4,968.25
|
|
|
HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$5,845.00
|
|
|
Service Code
|
HCPCS 27125 AS
|
| Hospital Charge Code |
27125
|
| Min. Negotiated Rate |
$925.16 |
| Max. Negotiated Rate |
$5,845.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,728.10
|
| Rate for Payer: Aetna of WY Medicare |
$1,088.42
|
| Rate for Payer: Beech Street Commercial |
$5,552.75
|
| Rate for Payer: Cash Price |
$4,091.50
|
| Rate for Payer: Cash Price |
$4,091.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,669.65
|
| Rate for Payer: Cigna of WY Commercial |
$5,728.10
|
| Rate for Payer: First Choice Health Commercial |
$5,260.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,552.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,088.42
|
| Rate for Payer: HealthUtah PPO |
$5,845.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,669.65
|
| Rate for Payer: Multiplan Medicare/VA |
$925.16
|
| Rate for Payer: One Health Plan of WY PPO |
$5,728.10
|
| Rate for Payer: PacificSource Commercial |
$5,260.50
|
| Rate for Payer: PHCS PPO |
$5,552.75
|
| Rate for Payer: Three Rivers PPO |
$4,383.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,088.42
|
| Rate for Payer: United Healthcare Commercial |
$5,085.15
|
| Rate for Payer: United Healthcare Medicare |
$1,088.42
|
| Rate for Payer: WINHealth Partners Commercial |
$4,968.25
|
|
|
HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$6,289.00
|
|
|
Service Code
|
HCPCS 28160
|
| Hospital Charge Code |
28160
|
| Min. Negotiated Rate |
$222.76 |
| Max. Negotiated Rate |
$6,289.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,163.22
|
| Rate for Payer: Aetna of WY Medicare |
$262.07
|
| Rate for Payer: Beech Street Commercial |
$5,974.55
|
| Rate for Payer: Cash Price |
$4,402.30
|
| Rate for Payer: Cash Price |
$4,402.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,100.33
|
| Rate for Payer: Cigna of WY Commercial |
$6,163.22
|
| Rate for Payer: First Choice Health Commercial |
$5,660.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5,974.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$262.07
|
| Rate for Payer: HealthUtah PPO |
$6,289.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,100.33
|
| Rate for Payer: Multiplan Medicare/VA |
$222.76
|
| Rate for Payer: One Health Plan of WY PPO |
$6,163.22
|
| Rate for Payer: PacificSource Commercial |
$5,660.10
|
| Rate for Payer: PHCS PPO |
$5,974.55
|
| Rate for Payer: Three Rivers PPO |
$4,716.75
|
| Rate for Payer: TriWest Veterans Administration |
$262.07
|
| Rate for Payer: United Healthcare Commercial |
$5,471.43
|
| Rate for Payer: United Healthcare Medicare |
$262.07
|
| Rate for Payer: WINHealth Partners Commercial |
$5,345.65
|
|
|
HEMOCLIP MED BLUE
|
Facility
|
IP
|
$3.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$3.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.18
|
| Rate for Payer: Altius Auto/Workers Compensation |
$3.11
|
| Rate for Payer: Altius Commercial |
$3.11
|
| Rate for Payer: Beech Street Commercial |
$3.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.66
|
| Rate for Payer: Cash Price |
$2.27
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.14
|
| Rate for Payer: Cigna of WY Commercial |
$3.18
|
| Rate for Payer: Entrust Commercial |
$3.08
|
| Rate for Payer: First Choice Health Commercial |
$3.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.14
|
| Rate for Payer: HealthUtah PPO |
$3.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.14
|
| Rate for Payer: Multiplan Medicare/VA |
$2.03
|
| Rate for Payer: One Health Plan of WY PPO |
$3.18
|
| Rate for Payer: PacificSource Commercial |
$2.92
|
| Rate for Payer: PHCS PPO |
$3.18
|
| Rate for Payer: Three Rivers PPO |
$2.43
|
| Rate for Payer: TriWest Veterans Administration |
$2.14
|
| Rate for Payer: United Healthcare Commercial |
$2.82
|
| Rate for Payer: United Healthcare Medicare |
$2.14
|
| Rate for Payer: WINHealth Partners Commercial |
$3.08
|
| Rate for Payer: Wise Provider Network Commercial |
$3.08
|
|
|
HEMOCLIP MED BLUE
|
Facility
|
OP
|
$3.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$3.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.18
|
| Rate for Payer: Aetna of WY Medicare |
$2.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$3.11
|
| Rate for Payer: Altius Commercial |
$3.11
|
| Rate for Payer: Beech Street Commercial |
$3.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.66
|
| Rate for Payer: Cash Price |
$2.27
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.14
|
| Rate for Payer: Cigna of WY Commercial |
$3.18
|
| Rate for Payer: Entrust Commercial |
$3.08
|
| Rate for Payer: First Choice Health Commercial |
$3.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.88
|
| Rate for Payer: HealthUtah PPO |
$3.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.14
|
| Rate for Payer: Multiplan Medicare/VA |
$1.79
|
| Rate for Payer: One Health Plan of WY PPO |
$3.18
|
| Rate for Payer: PacificSource Commercial |
$2.92
|
| Rate for Payer: PHCS PPO |
$3.18
|
| Rate for Payer: Three Rivers PPO |
$2.43
|
| Rate for Payer: TriWest Veterans Administration |
$1.88
|
| Rate for Payer: United Healthcare Commercial |
$2.82
|
| Rate for Payer: United Healthcare Medicare |
$1.88
|
| Rate for Payer: WINHealth Partners Commercial |
$3.18
|
| Rate for Payer: Wise Provider Network Commercial |
$3.08
|
|
|
HEMOGLOBIN GLYCOSYLATED A1C
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 83036
|
| Hospital Charge Code |
83036
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$112.70
|
| Rate for Payer: Aetna of WY Medicare |
$9.71
|
| Rate for Payer: Beech Street Commercial |
$109.25
|
| Rate for Payer: Cash Price |
$80.50
|
| 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: First Choice Health Commercial |
$103.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$109.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.71
|
| Rate for Payer: HealthUtah PPO |
$115.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$111.55
|
| Rate for Payer: Multiplan Medicare/VA |
$8.25
|
| Rate for Payer: One Health Plan of WY PPO |
$112.70
|
| Rate for Payer: PacificSource Commercial |
$103.50
|
| Rate for Payer: PHCS PPO |
$109.25
|
| Rate for Payer: Three Rivers PPO |
$86.25
|
| Rate for Payer: TriWest Veterans Administration |
$9.71
|
| Rate for Payer: United Healthcare Commercial |
$100.05
|
| Rate for Payer: United Healthcare Medicare |
$9.71
|
| Rate for Payer: WINHealth Partners Commercial |
$109.25
|
|
|
HEMOLOK L PURPLE LIGATING CLIP
|
Facility
|
IP
|
$113.30
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.04 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$111.03
|
| Rate for Payer: Altius Auto/Workers Compensation |
$108.77
|
| Rate for Payer: Altius Commercial |
$108.77
|
| Rate for Payer: Beech Street Commercial |
$111.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$93.02
|
| Rate for Payer: Cash Price |
$79.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$109.90
|
| Rate for Payer: Cigna of WY Commercial |
$111.03
|
| Rate for Payer: Entrust Commercial |
$107.64
|
| Rate for Payer: First Choice Health Commercial |
$107.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$107.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$74.78
|
| Rate for Payer: HealthUtah PPO |
$113.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$109.90
|
| Rate for Payer: Multiplan Medicare/VA |
$71.04
|
| Rate for Payer: One Health Plan of WY PPO |
$111.03
|
| Rate for Payer: PacificSource Commercial |
$101.97
|
| Rate for Payer: PHCS PPO |
$111.03
|
| Rate for Payer: Three Rivers PPO |
$84.98
|
| Rate for Payer: TriWest Veterans Administration |
$74.78
|
| Rate for Payer: United Healthcare Commercial |
$98.57
|
| Rate for Payer: United Healthcare Medicare |
$74.78
|
| Rate for Payer: WINHealth Partners Commercial |
$107.64
|
| Rate for Payer: Wise Provider Network Commercial |
$107.64
|
|
|
HEMOLOK L PURPLE LIGATING CLIP
|
Facility
|
OP
|
$113.30
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$62.43 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$111.03
|
| Rate for Payer: Aetna of WY Medicare |
$74.78
|
| Rate for Payer: Altius Auto/Workers Compensation |
$108.77
|
| Rate for Payer: Altius Commercial |
$108.77
|
| Rate for Payer: Beech Street Commercial |
$111.03
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$93.02
|
| Rate for Payer: Cash Price |
$79.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$109.90
|
| Rate for Payer: Cigna of WY Commercial |
$111.03
|
| Rate for Payer: Entrust Commercial |
$107.64
|
| Rate for Payer: First Choice Health Commercial |
$107.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$107.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$65.71
|
| Rate for Payer: HealthUtah PPO |
$113.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$109.90
|
| Rate for Payer: Multiplan Medicare/VA |
$62.43
|
| Rate for Payer: One Health Plan of WY PPO |
$111.03
|
| Rate for Payer: PacificSource Commercial |
$101.97
|
| Rate for Payer: PHCS PPO |
$111.03
|
| Rate for Payer: Three Rivers PPO |
$84.98
|
| Rate for Payer: TriWest Veterans Administration |
$65.71
|
| Rate for Payer: United Healthcare Commercial |
$98.57
|
| Rate for Payer: United Healthcare Medicare |
$65.71
|
| Rate for Payer: WINHealth Partners Commercial |
$111.03
|
| Rate for Payer: Wise Provider Network Commercial |
$107.64
|
|
|
HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$158.89 |
| Max. Negotiated Rate |
$2,325.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,278.50
|
| Rate for Payer: Aetna of WY Medicare |
$186.93
|
| Rate for Payer: Beech Street Commercial |
$2,208.75
|
| Rate for Payer: Cash Price |
$1,627.50
|
| Rate for Payer: Cash Price |
$1,627.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,255.25
|
| Rate for Payer: Cigna of WY Commercial |
$2,278.50
|
| Rate for Payer: First Choice Health Commercial |
$2,092.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,208.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$186.93
|
| Rate for Payer: HealthUtah PPO |
$2,325.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,255.25
|
| Rate for Payer: Multiplan Medicare/VA |
$158.89
|
| Rate for Payer: One Health Plan of WY PPO |
$2,278.50
|
| Rate for Payer: PacificSource Commercial |
$2,092.50
|
| Rate for Payer: PHCS PPO |
$2,208.75
|
| Rate for Payer: Three Rivers PPO |
$1,743.75
|
| Rate for Payer: TriWest Veterans Administration |
$186.93
|
| Rate for Payer: United Healthcare Commercial |
$2,022.75
|
| Rate for Payer: United Healthcare Medicare |
$186.93
|
| Rate for Payer: WINHealth Partners Commercial |
$1,976.25
|
|
