|
LARYN BLADE MILLER 1 DISP
|
Facility
|
IP
|
$13.51
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.97
|
| Rate for Payer: Altius Commercial |
$12.97
|
| Rate for Payer: Beech Street Commercial |
$13.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$9.46
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.10
|
| Rate for Payer: Cigna of WY Commercial |
$13.24
|
| Rate for Payer: Entrust Commercial |
$12.83
|
| Rate for Payer: First Choice Health Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.92
|
| Rate for Payer: HealthUtah PPO |
$13.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.10
|
| Rate for Payer: Multiplan Medicare/VA |
$8.47
|
| Rate for Payer: One Health Plan of WY PPO |
$13.24
|
| Rate for Payer: PacificSource Commercial |
$12.16
|
| Rate for Payer: PHCS PPO |
$13.24
|
| Rate for Payer: Three Rivers PPO |
$10.13
|
| Rate for Payer: TriWest Veterans Administration |
$8.92
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$8.92
|
| Rate for Payer: WINHealth Partners Commercial |
$12.83
|
| Rate for Payer: Wise Provider Network Commercial |
$12.83
|
|
|
LARYN BLADE MILLER 2 DISP
|
Facility
|
OP
|
$13.51
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.24
|
| Rate for Payer: Aetna of WY Medicare |
$8.92
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.97
|
| Rate for Payer: Altius Commercial |
$12.97
|
| Rate for Payer: Beech Street Commercial |
$13.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$9.46
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.10
|
| Rate for Payer: Cigna of WY Commercial |
$13.24
|
| Rate for Payer: Entrust Commercial |
$12.83
|
| Rate for Payer: First Choice Health Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.84
|
| Rate for Payer: HealthUtah PPO |
$13.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.10
|
| Rate for Payer: Multiplan Medicare/VA |
$7.44
|
| Rate for Payer: One Health Plan of WY PPO |
$13.24
|
| Rate for Payer: PacificSource Commercial |
$12.16
|
| Rate for Payer: PHCS PPO |
$13.24
|
| Rate for Payer: Three Rivers PPO |
$10.13
|
| Rate for Payer: TriWest Veterans Administration |
$7.84
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$7.84
|
| Rate for Payer: WINHealth Partners Commercial |
$13.24
|
| Rate for Payer: Wise Provider Network Commercial |
$12.83
|
|
|
LARYN BLADE MILLER 2 DISP
|
Facility
|
IP
|
$13.51
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.97
|
| Rate for Payer: Altius Commercial |
$12.97
|
| Rate for Payer: Beech Street Commercial |
$13.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$9.46
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.10
|
| Rate for Payer: Cigna of WY Commercial |
$13.24
|
| Rate for Payer: Entrust Commercial |
$12.83
|
| Rate for Payer: First Choice Health Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.92
|
| Rate for Payer: HealthUtah PPO |
$13.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.10
|
| Rate for Payer: Multiplan Medicare/VA |
$8.47
|
| Rate for Payer: One Health Plan of WY PPO |
$13.24
|
| Rate for Payer: PacificSource Commercial |
$12.16
|
| Rate for Payer: PHCS PPO |
$13.24
|
| Rate for Payer: Three Rivers PPO |
$10.13
|
| Rate for Payer: TriWest Veterans Administration |
$8.92
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$8.92
|
| Rate for Payer: WINHealth Partners Commercial |
$12.83
|
| Rate for Payer: Wise Provider Network Commercial |
$12.83
|
|
|
LARYN BLADE MILLER 3 DISP
|
Facility
|
IP
|
$13.51
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.97
|
| Rate for Payer: Altius Commercial |
$12.97
|
| Rate for Payer: Beech Street Commercial |
$13.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$9.46
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.10
|
| Rate for Payer: Cigna of WY Commercial |
$13.24
|
| Rate for Payer: Entrust Commercial |
$12.83
|
| Rate for Payer: First Choice Health Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.92
|
| Rate for Payer: HealthUtah PPO |
$13.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.10
|
| Rate for Payer: Multiplan Medicare/VA |
$8.47
|
| Rate for Payer: One Health Plan of WY PPO |
$13.24
|
| Rate for Payer: PacificSource Commercial |
$12.16
|
| Rate for Payer: PHCS PPO |
$13.24
|
| Rate for Payer: Three Rivers PPO |
$10.13
|
| Rate for Payer: TriWest Veterans Administration |
$8.92
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$8.92
|
| Rate for Payer: WINHealth Partners Commercial |
$12.83
|
| Rate for Payer: Wise Provider Network Commercial |
$12.83
|
|
|
LARYN BLADE MILLER 3 DISP
|
Facility
|
OP
|
$13.51
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.24
|
| Rate for Payer: Aetna of WY Medicare |
$8.92
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.97
|
| Rate for Payer: Altius Commercial |
$12.97
|
| Rate for Payer: Beech Street Commercial |
$13.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$9.46
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.10
|
| Rate for Payer: Cigna of WY Commercial |
$13.24
|
| Rate for Payer: Entrust Commercial |
$12.83
|
| Rate for Payer: First Choice Health Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.84
|
| Rate for Payer: HealthUtah PPO |
$13.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.10
|
| Rate for Payer: Multiplan Medicare/VA |
$7.44
|
| Rate for Payer: One Health Plan of WY PPO |
$13.24
|
| Rate for Payer: PacificSource Commercial |
$12.16
|
| Rate for Payer: PHCS PPO |
$13.24
|
| Rate for Payer: Three Rivers PPO |
$10.13
|
| Rate for Payer: TriWest Veterans Administration |
$7.84
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$7.84
|
| Rate for Payer: WINHealth Partners Commercial |
$13.24
|
| Rate for Payer: Wise Provider Network Commercial |
$12.83
|
|
|
LARYN BLADE MILLER 4 DISP
|
Facility
|
OP
|
$13.51
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.24
|
| Rate for Payer: Aetna of WY Medicare |
$8.92
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.97
|
| Rate for Payer: Altius Commercial |
$12.97
|
| Rate for Payer: Beech Street Commercial |
$13.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$9.46
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.10
|
| Rate for Payer: Cigna of WY Commercial |
$13.24
|
| Rate for Payer: Entrust Commercial |
$12.83
|
| Rate for Payer: First Choice Health Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.84
|
| Rate for Payer: HealthUtah PPO |
$13.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.10
|
| Rate for Payer: Multiplan Medicare/VA |
$7.44
|
| Rate for Payer: One Health Plan of WY PPO |
$13.24
|
| Rate for Payer: PacificSource Commercial |
$12.16
|
| Rate for Payer: PHCS PPO |
$13.24
|
| Rate for Payer: Three Rivers PPO |
$10.13
|
| Rate for Payer: TriWest Veterans Administration |
$7.84
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$7.84
|
| Rate for Payer: WINHealth Partners Commercial |
$13.24
|
| Rate for Payer: Wise Provider Network Commercial |
$12.83
|
|
|
LARYN BLADE MILLER 4 DISP
|
Facility
|
IP
|
$13.51
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.97
|
| Rate for Payer: Altius Commercial |
$12.97
|
| Rate for Payer: Beech Street Commercial |
$13.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$9.46
|
| Rate for Payer: ChoiceCare Network Commercial |
$13.10
|
| Rate for Payer: Cigna of WY Commercial |
$13.24
|
| Rate for Payer: Entrust Commercial |
$12.83
|
| Rate for Payer: First Choice Health Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.92
|
| Rate for Payer: HealthUtah PPO |
$13.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13.10
|
| Rate for Payer: Multiplan Medicare/VA |
$8.47
|
| Rate for Payer: One Health Plan of WY PPO |
$13.24
|
| Rate for Payer: PacificSource Commercial |
$12.16
|
| Rate for Payer: PHCS PPO |
$13.24
|
| Rate for Payer: Three Rivers PPO |
$10.13
|
| Rate for Payer: TriWest Veterans Administration |
$8.92
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$8.92
|
| Rate for Payer: WINHealth Partners Commercial |
$12.83
|
| Rate for Payer: Wise Provider Network Commercial |
$12.83
|
|
|
LARYN. BL MAC 2 DISP
|
Facility
|
IP
|
$12.63
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$12.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.38
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.12
|
| Rate for Payer: Altius Commercial |
$12.12
|
| Rate for Payer: Beech Street Commercial |
$12.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.37
|
| Rate for Payer: Cash Price |
$8.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.25
|
| Rate for Payer: Cigna of WY Commercial |
$12.38
|
| Rate for Payer: Entrust Commercial |
$12.00
|
| Rate for Payer: First Choice Health Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.34
|
| Rate for Payer: HealthUtah PPO |
$12.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.25
|
| Rate for Payer: Multiplan Medicare/VA |
$7.92
|
| Rate for Payer: One Health Plan of WY PPO |
$12.38
|
| Rate for Payer: PacificSource Commercial |
$11.37
|
| Rate for Payer: PHCS PPO |
$12.38
|
| Rate for Payer: Three Rivers PPO |
$9.47
|
| Rate for Payer: TriWest Veterans Administration |
$8.34
|
| Rate for Payer: United Healthcare Commercial |
$10.99
|
| Rate for Payer: United Healthcare Medicare |
$8.34
|
| Rate for Payer: WINHealth Partners Commercial |
$12.00
|
| Rate for Payer: Wise Provider Network Commercial |
$12.00
|
|
|
LARYN. BL MAC 2 DISP
|
Facility
|
OP
|
$12.63
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$12.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.38
|
| Rate for Payer: Aetna of WY Medicare |
$8.34
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.12
|
| Rate for Payer: Altius Commercial |
$12.12
|
| Rate for Payer: Beech Street Commercial |
$12.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.37
|
| Rate for Payer: Cash Price |
$8.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.25
|
| Rate for Payer: Cigna of WY Commercial |
$12.38
|
| Rate for Payer: Entrust Commercial |
$12.00
|
| Rate for Payer: First Choice Health Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.33
|
| Rate for Payer: HealthUtah PPO |
$12.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.25
|
| Rate for Payer: Multiplan Medicare/VA |
$6.96
|
| Rate for Payer: One Health Plan of WY PPO |
$12.38
|
| Rate for Payer: PacificSource Commercial |
$11.37
|
| Rate for Payer: PHCS PPO |
$12.38
|
| Rate for Payer: Three Rivers PPO |
$9.47
|
| Rate for Payer: TriWest Veterans Administration |
$7.33
|
| Rate for Payer: United Healthcare Commercial |
$10.99
|
| Rate for Payer: United Healthcare Medicare |
$7.33
|
| Rate for Payer: WINHealth Partners Commercial |
$12.38
|
| Rate for Payer: Wise Provider Network Commercial |
$12.00
|
|
|
LARYN. BL MAC 3 DISP
|
Facility
|
IP
|
$12.63
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$12.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.38
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.12
|
| Rate for Payer: Altius Commercial |
$12.12
|
| Rate for Payer: Beech Street Commercial |
$12.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.37
|
| Rate for Payer: Cash Price |
$8.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.25
|
| Rate for Payer: Cigna of WY Commercial |
$12.38
|
| Rate for Payer: Entrust Commercial |
$12.00
|
| Rate for Payer: First Choice Health Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.34
|
| Rate for Payer: HealthUtah PPO |
$12.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.25
|
| Rate for Payer: Multiplan Medicare/VA |
$7.92
|
| Rate for Payer: One Health Plan of WY PPO |
$12.38
|
| Rate for Payer: PacificSource Commercial |
$11.37
|
| Rate for Payer: PHCS PPO |
$12.38
|
| Rate for Payer: Three Rivers PPO |
$9.47
|
| Rate for Payer: TriWest Veterans Administration |
$8.34
|
| Rate for Payer: United Healthcare Commercial |
$10.99
|
| Rate for Payer: United Healthcare Medicare |
$8.34
|
| Rate for Payer: WINHealth Partners Commercial |
$12.00
|
| Rate for Payer: Wise Provider Network Commercial |
$12.00
|
|
|
LARYN. BL MAC 3 DISP
|
Facility
|
OP
|
$12.63
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$12.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.38
|
| Rate for Payer: Aetna of WY Medicare |
$8.34
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.12
|
| Rate for Payer: Altius Commercial |
$12.12
|
| Rate for Payer: Beech Street Commercial |
$12.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.37
|
| Rate for Payer: Cash Price |
$8.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.25
|
| Rate for Payer: Cigna of WY Commercial |
$12.38
|
| Rate for Payer: Entrust Commercial |
$12.00
|
| Rate for Payer: First Choice Health Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.33
|
| Rate for Payer: HealthUtah PPO |
$12.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.25
|
| Rate for Payer: Multiplan Medicare/VA |
$6.96
|
| Rate for Payer: One Health Plan of WY PPO |
$12.38
|
| Rate for Payer: PacificSource Commercial |
$11.37
|
| Rate for Payer: PHCS PPO |
$12.38
|
| Rate for Payer: Three Rivers PPO |
$9.47
|
| Rate for Payer: TriWest Veterans Administration |
$7.33
|
| Rate for Payer: United Healthcare Commercial |
$10.99
|
| Rate for Payer: United Healthcare Medicare |
$7.33
|
| Rate for Payer: WINHealth Partners Commercial |
$12.38
|
| Rate for Payer: Wise Provider Network Commercial |
$12.00
|
|
|
LARYN. BL MAC 4 DISP
|
Facility
|
IP
|
$12.63
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$12.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.38
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.12
|
| Rate for Payer: Altius Commercial |
$12.12
|
| Rate for Payer: Beech Street Commercial |
$12.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.37
|
| Rate for Payer: Cash Price |
$8.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.25
|
| Rate for Payer: Cigna of WY Commercial |
$12.38
|
| Rate for Payer: Entrust Commercial |
$12.00
|
| Rate for Payer: First Choice Health Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.34
|
| Rate for Payer: HealthUtah PPO |
$12.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.25
|
| Rate for Payer: Multiplan Medicare/VA |
$7.92
|
| Rate for Payer: One Health Plan of WY PPO |
$12.38
|
| Rate for Payer: PacificSource Commercial |
$11.37
|
| Rate for Payer: PHCS PPO |
$12.38
|
| Rate for Payer: Three Rivers PPO |
$9.47
|
| Rate for Payer: TriWest Veterans Administration |
$8.34
|
| Rate for Payer: United Healthcare Commercial |
$10.99
|
| Rate for Payer: United Healthcare Medicare |
$8.34
|
| Rate for Payer: WINHealth Partners Commercial |
$12.00
|
| Rate for Payer: Wise Provider Network Commercial |
$12.00
|
|
|
LARYN. BL MAC 4 DISP
|
Facility
|
OP
|
$12.63
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$12.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.38
|
| Rate for Payer: Aetna of WY Medicare |
$8.34
|
| Rate for Payer: Altius Auto/Workers Compensation |
$12.12
|
| Rate for Payer: Altius Commercial |
$12.12
|
| Rate for Payer: Beech Street Commercial |
$12.38
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.37
|
| Rate for Payer: Cash Price |
$8.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.25
|
| Rate for Payer: Cigna of WY Commercial |
$12.38
|
| Rate for Payer: Entrust Commercial |
$12.00
|
| Rate for Payer: First Choice Health Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.33
|
| Rate for Payer: HealthUtah PPO |
$12.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.25
|
| Rate for Payer: Multiplan Medicare/VA |
$6.96
|
| Rate for Payer: One Health Plan of WY PPO |
$12.38
|
| Rate for Payer: PacificSource Commercial |
$11.37
|
| Rate for Payer: PHCS PPO |
$12.38
|
| Rate for Payer: Three Rivers PPO |
$9.47
|
| Rate for Payer: TriWest Veterans Administration |
$7.33
|
| Rate for Payer: United Healthcare Commercial |
$10.99
|
| Rate for Payer: United Healthcare Medicare |
$7.33
|
| Rate for Payer: WINHealth Partners Commercial |
$12.38
|
| Rate for Payer: Wise Provider Network Commercial |
$12.00
|
|
|
LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 31570
|
| Hospital Charge Code |
31570
|
| Min. Negotiated Rate |
$185.67 |
| Max. Negotiated Rate |
$1,715.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,680.70
|
| Rate for Payer: Aetna of WY Medicare |
$218.43
|
| Rate for Payer: Beech Street Commercial |
$1,629.25
|
| Rate for Payer: Cash Price |
$1,200.50
|
| Rate for Payer: Cash Price |
$1,200.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,663.55
|
| Rate for Payer: Cigna of WY Commercial |
$1,680.70
|
| Rate for Payer: First Choice Health Commercial |
$1,543.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,629.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$218.43
|
| Rate for Payer: HealthUtah PPO |
$1,715.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,663.55
|
| Rate for Payer: Multiplan Medicare/VA |
$185.67
|
| Rate for Payer: One Health Plan of WY PPO |
$1,680.70
|
| Rate for Payer: PacificSource Commercial |
$1,543.50
|
| Rate for Payer: PHCS PPO |
$1,629.25
|
| Rate for Payer: Three Rivers PPO |
$1,286.25
|
| Rate for Payer: TriWest Veterans Administration |
$218.43
|
| Rate for Payer: United Healthcare Commercial |
$1,492.05
|
| Rate for Payer: United Healthcare Medicare |
$218.43
|
| Rate for Payer: WINHealth Partners Commercial |
$1,457.75
|
|
|
LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 31570 59
|
| Hospital Charge Code |
31570
|
| Min. Negotiated Rate |
$185.67 |
| Max. Negotiated Rate |
$1,715.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,680.70
|
| Rate for Payer: Aetna of WY Medicare |
$218.43
|
| Rate for Payer: Beech Street Commercial |
$1,629.25
|
| Rate for Payer: Cash Price |
$1,200.50
|
| Rate for Payer: Cash Price |
$1,200.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,663.55
|
| Rate for Payer: Cigna of WY Commercial |
$1,680.70
|
| Rate for Payer: First Choice Health Commercial |
$1,543.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,629.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$218.43
|
| Rate for Payer: HealthUtah PPO |
$1,715.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,663.55
|
| Rate for Payer: Multiplan Medicare/VA |
$185.67
|
| Rate for Payer: One Health Plan of WY PPO |
$1,680.70
|
| Rate for Payer: PacificSource Commercial |
$1,543.50
|
| Rate for Payer: PHCS PPO |
$1,629.25
|
| Rate for Payer: Three Rivers PPO |
$1,286.25
|
| Rate for Payer: TriWest Veterans Administration |
$218.43
|
| Rate for Payer: United Healthcare Commercial |
$1,492.05
|
| Rate for Payer: United Healthcare Medicare |
$218.43
|
| Rate for Payer: WINHealth Partners Commercial |
$1,457.75
|
|
|
LARYNGOSCOPE PENLIGHT DISPOSABLE
|
Facility
|
OP
|
$16.48
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$16.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.15
|
| Rate for Payer: Aetna of WY Medicare |
$10.88
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15.82
|
| Rate for Payer: Altius Commercial |
$15.82
|
| Rate for Payer: Beech Street Commercial |
$16.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.53
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.99
|
| Rate for Payer: Cigna of WY Commercial |
$16.15
|
| Rate for Payer: Entrust Commercial |
$15.66
|
| Rate for Payer: First Choice Health Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.56
|
| Rate for Payer: HealthUtah PPO |
$16.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.99
|
| Rate for Payer: Multiplan Medicare/VA |
$9.08
|
| Rate for Payer: One Health Plan of WY PPO |
$16.15
|
| Rate for Payer: PacificSource Commercial |
$14.83
|
| Rate for Payer: PHCS PPO |
$16.15
|
| Rate for Payer: Three Rivers PPO |
$12.36
|
| Rate for Payer: TriWest Veterans Administration |
$9.56
|
| Rate for Payer: United Healthcare Commercial |
$14.34
|
| Rate for Payer: United Healthcare Medicare |
$9.56
|
| Rate for Payer: WINHealth Partners Commercial |
$16.15
|
| Rate for Payer: Wise Provider Network Commercial |
$15.66
|
|
|
LARYNGOSCOPE PENLIGHT DISPOSABLE
|
Facility
|
IP
|
$16.48
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$16.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.15
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15.82
|
| Rate for Payer: Altius Commercial |
$15.82
|
| Rate for Payer: Beech Street Commercial |
$16.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.53
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.99
|
| Rate for Payer: Cigna of WY Commercial |
$16.15
|
| Rate for Payer: Entrust Commercial |
$15.66
|
| Rate for Payer: First Choice Health Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.88
|
| Rate for Payer: HealthUtah PPO |
$16.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.99
|
| Rate for Payer: Multiplan Medicare/VA |
$10.33
|
| Rate for Payer: One Health Plan of WY PPO |
$16.15
|
| Rate for Payer: PacificSource Commercial |
$14.83
|
| Rate for Payer: PHCS PPO |
$16.15
|
| Rate for Payer: Three Rivers PPO |
$12.36
|
| Rate for Payer: TriWest Veterans Administration |
$10.88
|
| Rate for Payer: United Healthcare Commercial |
$14.34
|
| Rate for Payer: United Healthcare Medicare |
$10.88
|
| Rate for Payer: WINHealth Partners Commercial |
$15.66
|
| Rate for Payer: Wise Provider Network Commercial |
$15.66
|
|
|
LARYNGOSCOPE STANDARD DISPOSABLE
|
Facility
|
OP
|
$16.48
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$16.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.15
|
| Rate for Payer: Aetna of WY Medicare |
$10.88
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15.82
|
| Rate for Payer: Altius Commercial |
$15.82
|
| Rate for Payer: Beech Street Commercial |
$16.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.53
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.99
|
| Rate for Payer: Cigna of WY Commercial |
$16.15
|
| Rate for Payer: Entrust Commercial |
$15.66
|
| Rate for Payer: First Choice Health Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.56
|
| Rate for Payer: HealthUtah PPO |
$16.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.99
|
| Rate for Payer: Multiplan Medicare/VA |
$9.08
|
| Rate for Payer: One Health Plan of WY PPO |
$16.15
|
| Rate for Payer: PacificSource Commercial |
$14.83
|
| Rate for Payer: PHCS PPO |
$16.15
|
| Rate for Payer: Three Rivers PPO |
$12.36
|
| Rate for Payer: TriWest Veterans Administration |
$9.56
|
| Rate for Payer: United Healthcare Commercial |
$14.34
|
| Rate for Payer: United Healthcare Medicare |
$9.56
|
| Rate for Payer: WINHealth Partners Commercial |
$16.15
|
| Rate for Payer: Wise Provider Network Commercial |
$15.66
|
|
|
LARYNGOSCOPE STANDARD DISPOSABLE
|
Facility
|
IP
|
$16.48
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$16.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.15
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15.82
|
| Rate for Payer: Altius Commercial |
$15.82
|
| Rate for Payer: Beech Street Commercial |
$16.15
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.53
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.99
|
| Rate for Payer: Cigna of WY Commercial |
$16.15
|
| Rate for Payer: Entrust Commercial |
$15.66
|
| Rate for Payer: First Choice Health Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.88
|
| Rate for Payer: HealthUtah PPO |
$16.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.99
|
| Rate for Payer: Multiplan Medicare/VA |
$10.33
|
| Rate for Payer: One Health Plan of WY PPO |
$16.15
|
| Rate for Payer: PacificSource Commercial |
$14.83
|
| Rate for Payer: PHCS PPO |
$16.15
|
| Rate for Payer: Three Rivers PPO |
$12.36
|
| Rate for Payer: TriWest Veterans Administration |
$10.88
|
| Rate for Payer: United Healthcare Commercial |
$14.34
|
| Rate for Payer: United Healthcare Medicare |
$10.88
|
| Rate for Payer: WINHealth Partners Commercial |
$15.66
|
| Rate for Payer: Wise Provider Network Commercial |
$15.66
|
|
|
LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY
|
Professional
|
Both
|
$1,239.00
|
|
|
Service Code
|
HCPCS 31560
|
| Hospital Charge Code |
31560
|
| Min. Negotiated Rate |
$252.54 |
| Max. Negotiated Rate |
$1,239.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,214.22
|
| Rate for Payer: Aetna of WY Medicare |
$297.11
|
| Rate for Payer: Beech Street Commercial |
$1,177.05
|
| Rate for Payer: Cash Price |
$867.30
|
| Rate for Payer: Cash Price |
$867.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,201.83
|
| Rate for Payer: Cigna of WY Commercial |
$1,214.22
|
| Rate for Payer: First Choice Health Commercial |
$1,115.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,177.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$297.11
|
| Rate for Payer: HealthUtah PPO |
$1,239.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,201.83
|
| Rate for Payer: Multiplan Medicare/VA |
$252.54
|
| Rate for Payer: One Health Plan of WY PPO |
$1,214.22
|
| Rate for Payer: PacificSource Commercial |
$1,115.10
|
| Rate for Payer: PHCS PPO |
$1,177.05
|
| Rate for Payer: Three Rivers PPO |
$929.25
|
| Rate for Payer: TriWest Veterans Administration |
$297.11
|
| Rate for Payer: United Healthcare Commercial |
$1,077.93
|
| Rate for Payer: United Healthcare Medicare |
$297.11
|
| Rate for Payer: WINHealth Partners Commercial |
$1,053.15
|
|
|
LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY
|
Professional
|
Both
|
$963.00
|
|
|
Service Code
|
HCPCS 31535
|
| Hospital Charge Code |
31535
|
| Min. Negotiated Rate |
$153.64 |
| Max. Negotiated Rate |
$963.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$943.74
|
| Rate for Payer: Aetna of WY Medicare |
$180.75
|
| Rate for Payer: Beech Street Commercial |
$914.85
|
| Rate for Payer: Cash Price |
$674.10
|
| Rate for Payer: Cash Price |
$674.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$934.11
|
| Rate for Payer: Cigna of WY Commercial |
$943.74
|
| Rate for Payer: First Choice Health Commercial |
$866.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$914.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$180.75
|
| Rate for Payer: HealthUtah PPO |
$963.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$934.11
|
| Rate for Payer: Multiplan Medicare/VA |
$153.64
|
| Rate for Payer: One Health Plan of WY PPO |
$943.74
|
| Rate for Payer: PacificSource Commercial |
$866.70
|
| Rate for Payer: PHCS PPO |
$914.85
|
| Rate for Payer: Three Rivers PPO |
$722.25
|
| Rate for Payer: TriWest Veterans Administration |
$180.75
|
| Rate for Payer: United Healthcare Commercial |
$837.81
|
| Rate for Payer: United Healthcare Medicare |
$180.75
|
| Rate for Payer: WINHealth Partners Commercial |
$818.55
|
|
|
LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT
|
Professional
|
Both
|
$1,234.00
|
|
|
Service Code
|
HCPCS 31540
|
| Hospital Charge Code |
31540
|
| Min. Negotiated Rate |
$195.48 |
| Max. Negotiated Rate |
$1,234.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,209.32
|
| Rate for Payer: Aetna of WY Medicare |
$229.98
|
| Rate for Payer: Beech Street Commercial |
$1,172.30
|
| Rate for Payer: Cash Price |
$863.80
|
| Rate for Payer: Cash Price |
$863.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,196.98
|
| Rate for Payer: Cigna of WY Commercial |
$1,209.32
|
| Rate for Payer: First Choice Health Commercial |
$1,110.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,172.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$229.98
|
| Rate for Payer: HealthUtah PPO |
$1,234.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,196.98
|
| Rate for Payer: Multiplan Medicare/VA |
$195.48
|
| Rate for Payer: One Health Plan of WY PPO |
$1,209.32
|
| Rate for Payer: PacificSource Commercial |
$1,110.60
|
| Rate for Payer: PHCS PPO |
$1,172.30
|
| Rate for Payer: Three Rivers PPO |
$925.50
|
| Rate for Payer: TriWest Veterans Administration |
$229.98
|
| Rate for Payer: United Healthcare Commercial |
$1,073.58
|
| Rate for Payer: United Healthcare Medicare |
$229.98
|
| Rate for Payer: WINHealth Partners Commercial |
$1,048.90
|
|
|
LARYNGOSCOPY FLEXIBLE DIAGNOSTIC
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
31575
|
| Min. Negotiated Rate |
$56.32 |
| Max. Negotiated Rate |
$340.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$333.20
|
| Rate for Payer: Aetna of WY Medicare |
$66.26
|
| Rate for Payer: Beech Street Commercial |
$323.00
|
| Rate for Payer: Cash Price |
$238.00
|
| Rate for Payer: Cash Price |
$238.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$329.80
|
| Rate for Payer: Cigna of WY Commercial |
$333.20
|
| Rate for Payer: First Choice Health Commercial |
$306.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$323.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$66.26
|
| Rate for Payer: HealthUtah PPO |
$340.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$329.80
|
| Rate for Payer: Multiplan Medicare/VA |
$56.32
|
| Rate for Payer: One Health Plan of WY PPO |
$333.20
|
| Rate for Payer: PacificSource Commercial |
$306.00
|
| Rate for Payer: PHCS PPO |
$323.00
|
| Rate for Payer: Three Rivers PPO |
$255.00
|
| Rate for Payer: TriWest Veterans Administration |
$66.26
|
| Rate for Payer: United Healthcare Commercial |
$295.80
|
| Rate for Payer: United Healthcare Medicare |
$66.26
|
| Rate for Payer: WINHealth Partners Commercial |
$289.00
|
|
|
LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 31578
|
| Hospital Charge Code |
31578
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$1,471.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,441.58
|
| Rate for Payer: Aetna of WY Medicare |
$143.29
|
| Rate for Payer: Beech Street Commercial |
$1,397.45
|
| Rate for Payer: Cash Price |
$1,029.70
|
| Rate for Payer: Cash Price |
$1,029.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,426.87
|
| Rate for Payer: Cigna of WY Commercial |
$1,441.58
|
| Rate for Payer: First Choice Health Commercial |
$1,323.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,397.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$143.29
|
| Rate for Payer: HealthUtah PPO |
$1,471.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,426.87
|
| Rate for Payer: Multiplan Medicare/VA |
$121.80
|
| Rate for Payer: One Health Plan of WY PPO |
$1,441.58
|
| Rate for Payer: PacificSource Commercial |
$1,323.90
|
| Rate for Payer: PHCS PPO |
$1,397.45
|
| Rate for Payer: Three Rivers PPO |
$1,103.25
|
| Rate for Payer: TriWest Veterans Administration |
$143.29
|
| Rate for Payer: United Healthcare Commercial |
$1,279.77
|
| Rate for Payer: United Healthcare Medicare |
$143.29
|
| Rate for Payer: WINHealth Partners Commercial |
$1,250.35
|
|
|
LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
31505
|
| Min. Negotiated Rate |
$40.89 |
| Max. Negotiated Rate |
$314.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$307.72
|
| Rate for Payer: Aetna of WY Medicare |
$48.11
|
| Rate for Payer: Beech Street Commercial |
$298.30
|
| Rate for Payer: Cash Price |
$219.80
|
| Rate for Payer: Cash Price |
$219.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$304.58
|
| Rate for Payer: Cigna of WY Commercial |
$307.72
|
| Rate for Payer: First Choice Health Commercial |
$282.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$298.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$48.11
|
| Rate for Payer: HealthUtah PPO |
$314.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$304.58
|
| Rate for Payer: Multiplan Medicare/VA |
$40.89
|
| Rate for Payer: One Health Plan of WY PPO |
$307.72
|
| Rate for Payer: PacificSource Commercial |
$282.60
|
| Rate for Payer: PHCS PPO |
$298.30
|
| Rate for Payer: Three Rivers PPO |
$235.50
|
| Rate for Payer: TriWest Veterans Administration |
$48.11
|
| Rate for Payer: United Healthcare Commercial |
$273.18
|
| Rate for Payer: United Healthcare Medicare |
$48.11
|
| Rate for Payer: WINHealth Partners Commercial |
$266.90
|
|
