|
BLADE QUADCUT ROTATEABLE 4.3MM
|
Facility
|
OP
|
$773.63
|
|
| Hospital Charge Code |
2700005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$418.92 |
| Max. Negotiated Rate |
$773.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$758.16
|
| Rate for Payer: Aetna of WY Medicare |
$510.60
|
| Rate for Payer: Altius Commercial |
$742.68
|
| Rate for Payer: Beech Street Commercial |
$758.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$750.42
|
| Rate for Payer: Cash Price |
$541.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$750.42
|
| Rate for Payer: Cigna of WY Commercial |
$758.16
|
| Rate for Payer: Entrust Commercial |
$734.95
|
| Rate for Payer: First Choice Health Commercial |
$734.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$734.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$440.97
|
| Rate for Payer: HealthUtah PPO |
$773.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$750.42
|
| Rate for Payer: Multiplan Medicare/VA |
$418.92
|
| Rate for Payer: One Health Plan of WY PPO |
$758.16
|
| Rate for Payer: PacificSource Commercial |
$696.27
|
| Rate for Payer: PHCS PPO |
$758.16
|
| Rate for Payer: Three Rivers PPO |
$580.22
|
| Rate for Payer: TriWest Veterans Administration |
$440.97
|
| Rate for Payer: United Healthcare Commercial |
$738.82
|
| Rate for Payer: United Healthcare Medicare |
$440.97
|
| Rate for Payer: WINHealth Partners Commercial |
$758.16
|
| Rate for Payer: Wise Provider Network Commercial |
$734.95
|
|
|
BLADE QUADCUT ROTATEABLE 4.3MM
|
Facility
|
IP
|
$773.63
|
|
| Hospital Charge Code |
2700005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$448.32 |
| Max. Negotiated Rate |
$773.63 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$758.16
|
| Rate for Payer: Aetna of WY Medicare |
$495.12
|
| Rate for Payer: Altius Commercial |
$742.68
|
| Rate for Payer: Beech Street Commercial |
$758.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$750.42
|
| Rate for Payer: Cash Price |
$541.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$750.42
|
| Rate for Payer: Cigna of WY Commercial |
$758.16
|
| Rate for Payer: Entrust Commercial |
$734.95
|
| Rate for Payer: First Choice Health Commercial |
$734.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$734.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$471.91
|
| Rate for Payer: HealthUtah PPO |
$773.63
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$750.42
|
| Rate for Payer: Multiplan Medicare/VA |
$448.32
|
| Rate for Payer: One Health Plan of WY PPO |
$758.16
|
| Rate for Payer: PacificSource Commercial |
$696.27
|
| Rate for Payer: PHCS PPO |
$758.16
|
| Rate for Payer: Three Rivers PPO |
$580.22
|
| Rate for Payer: TriWest Veterans Administration |
$471.91
|
| Rate for Payer: United Healthcare Commercial |
$738.82
|
| Rate for Payer: United Healthcare Medicare |
$471.91
|
| Rate for Payer: WINHealth Partners Commercial |
$734.95
|
| Rate for Payer: Wise Provider Network Commercial |
$734.95
|
|
|
BLADE QUAD TENDON STRIP 10 MM
|
Facility
|
IP
|
$612.50
|
|
| Hospital Charge Code |
3003026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$354.94 |
| Max. Negotiated Rate |
$612.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$600.25
|
| Rate for Payer: Aetna of WY Medicare |
$392.00
|
| Rate for Payer: Altius Commercial |
$588.00
|
| Rate for Payer: Beech Street Commercial |
$600.25
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$594.12
|
| Rate for Payer: Cash Price |
$428.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$594.12
|
| Rate for Payer: Cigna of WY Commercial |
$600.25
|
| Rate for Payer: Entrust Commercial |
$581.88
|
| Rate for Payer: First Choice Health Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$373.62
|
| Rate for Payer: HealthUtah PPO |
$612.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$594.12
|
| Rate for Payer: Multiplan Medicare/VA |
$354.94
|
| Rate for Payer: One Health Plan of WY PPO |
$600.25
|
| Rate for Payer: PacificSource Commercial |
$551.25
|
| Rate for Payer: PHCS PPO |
$600.25
|
| Rate for Payer: Three Rivers PPO |
$459.38
|
| Rate for Payer: TriWest Veterans Administration |
$373.62
|
| Rate for Payer: United Healthcare Commercial |
$584.94
|
| Rate for Payer: United Healthcare Medicare |
$373.62
|
| Rate for Payer: WINHealth Partners Commercial |
$581.88
|
| Rate for Payer: Wise Provider Network Commercial |
$581.88
|
|
|
BLADE QUAD TENDON STRIP 10 MM
|
Facility
|
OP
|
$612.50
|
|
| Hospital Charge Code |
3003026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$331.67 |
| Max. Negotiated Rate |
$612.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$600.25
|
| Rate for Payer: Aetna of WY Medicare |
$404.25
|
| Rate for Payer: Altius Commercial |
$588.00
|
| Rate for Payer: Beech Street Commercial |
$600.25
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$594.12
|
| Rate for Payer: Cash Price |
$428.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$594.12
|
| Rate for Payer: Cigna of WY Commercial |
$600.25
|
| Rate for Payer: Entrust Commercial |
$581.88
|
| Rate for Payer: First Choice Health Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$581.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$349.12
|
| Rate for Payer: HealthUtah PPO |
$612.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$594.12
|
| Rate for Payer: Multiplan Medicare/VA |
$331.67
|
| Rate for Payer: One Health Plan of WY PPO |
$600.25
|
| Rate for Payer: PacificSource Commercial |
$551.25
|
| Rate for Payer: PHCS PPO |
$600.25
|
| Rate for Payer: Three Rivers PPO |
$459.38
|
| Rate for Payer: TriWest Veterans Administration |
$349.12
|
| Rate for Payer: United Healthcare Commercial |
$584.94
|
| Rate for Payer: United Healthcare Medicare |
$349.12
|
| Rate for Payer: WINHealth Partners Commercial |
$600.25
|
| Rate for Payer: Wise Provider Network Commercial |
$581.88
|
|
|
BLADE RAD40 CURVED MEDTRONIC
|
Facility
|
IP
|
$993.69
|
|
| Hospital Charge Code |
3003041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.84 |
| Max. Negotiated Rate |
$993.69 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$973.82
|
| Rate for Payer: Aetna of WY Medicare |
$635.96
|
| Rate for Payer: Altius Commercial |
$953.94
|
| Rate for Payer: Beech Street Commercial |
$973.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$963.88
|
| Rate for Payer: Cash Price |
$695.58
|
| Rate for Payer: ChoiceCare Network Commercial |
$963.88
|
| Rate for Payer: Cigna of WY Commercial |
$973.82
|
| Rate for Payer: Entrust Commercial |
$944.01
|
| Rate for Payer: First Choice Health Commercial |
$944.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$944.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$606.15
|
| Rate for Payer: HealthUtah PPO |
$993.69
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$963.88
|
| Rate for Payer: Multiplan Medicare/VA |
$575.84
|
| Rate for Payer: One Health Plan of WY PPO |
$973.82
|
| Rate for Payer: PacificSource Commercial |
$894.32
|
| Rate for Payer: PHCS PPO |
$973.82
|
| Rate for Payer: Three Rivers PPO |
$745.27
|
| Rate for Payer: TriWest Veterans Administration |
$606.15
|
| Rate for Payer: United Healthcare Commercial |
$948.97
|
| Rate for Payer: United Healthcare Medicare |
$606.15
|
| Rate for Payer: WINHealth Partners Commercial |
$944.01
|
| Rate for Payer: Wise Provider Network Commercial |
$944.01
|
|
|
BLADE RAD40 CURVED MEDTRONIC
|
Facility
|
OP
|
$993.69
|
|
| Hospital Charge Code |
3003041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$538.08 |
| Max. Negotiated Rate |
$993.69 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$973.82
|
| Rate for Payer: Aetna of WY Medicare |
$655.84
|
| Rate for Payer: Altius Commercial |
$953.94
|
| Rate for Payer: Beech Street Commercial |
$973.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$963.88
|
| Rate for Payer: Cash Price |
$695.58
|
| Rate for Payer: ChoiceCare Network Commercial |
$963.88
|
| Rate for Payer: Cigna of WY Commercial |
$973.82
|
| Rate for Payer: Entrust Commercial |
$944.01
|
| Rate for Payer: First Choice Health Commercial |
$944.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$944.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$566.40
|
| Rate for Payer: HealthUtah PPO |
$993.69
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$963.88
|
| Rate for Payer: Multiplan Medicare/VA |
$538.08
|
| Rate for Payer: One Health Plan of WY PPO |
$973.82
|
| Rate for Payer: PacificSource Commercial |
$894.32
|
| Rate for Payer: PHCS PPO |
$973.82
|
| Rate for Payer: Three Rivers PPO |
$745.27
|
| Rate for Payer: TriWest Veterans Administration |
$566.40
|
| Rate for Payer: United Healthcare Commercial |
$948.97
|
| Rate for Payer: United Healthcare Medicare |
$566.40
|
| Rate for Payer: WINHealth Partners Commercial |
$973.82
|
| Rate for Payer: Wise Provider Network Commercial |
$944.01
|
|
|
BLADE RECIPROCATING 75X8X1MM
|
Facility
|
OP
|
$1,102.50
|
|
| Hospital Charge Code |
3002737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$597.00 |
| Max. Negotiated Rate |
$1,102.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,080.45
|
| Rate for Payer: Aetna of WY Medicare |
$727.65
|
| Rate for Payer: Altius Commercial |
$1,058.40
|
| Rate for Payer: Beech Street Commercial |
$1,080.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,069.42
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,069.42
|
| Rate for Payer: Cigna of WY Commercial |
$1,080.45
|
| Rate for Payer: Entrust Commercial |
$1,047.38
|
| Rate for Payer: First Choice Health Commercial |
$1,047.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,047.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$628.42
|
| Rate for Payer: HealthUtah PPO |
$1,102.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,069.42
|
| Rate for Payer: Multiplan Medicare/VA |
$597.00
|
| Rate for Payer: One Health Plan of WY PPO |
$1,080.45
|
| Rate for Payer: PacificSource Commercial |
$992.25
|
| Rate for Payer: PHCS PPO |
$1,080.45
|
| Rate for Payer: Three Rivers PPO |
$826.88
|
| Rate for Payer: TriWest Veterans Administration |
$628.42
|
| Rate for Payer: United Healthcare Commercial |
$1,052.89
|
| Rate for Payer: United Healthcare Medicare |
$628.42
|
| Rate for Payer: WINHealth Partners Commercial |
$1,080.45
|
| Rate for Payer: Wise Provider Network Commercial |
$1,047.38
|
|
|
BLADE RECIPROCATING 75X8X1MM
|
Facility
|
IP
|
$1,102.50
|
|
| Hospital Charge Code |
3002737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$638.90 |
| Max. Negotiated Rate |
$1,102.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,080.45
|
| Rate for Payer: Aetna of WY Medicare |
$705.60
|
| Rate for Payer: Altius Commercial |
$1,058.40
|
| Rate for Payer: Beech Street Commercial |
$1,080.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,069.42
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,069.42
|
| Rate for Payer: Cigna of WY Commercial |
$1,080.45
|
| Rate for Payer: Entrust Commercial |
$1,047.38
|
| Rate for Payer: First Choice Health Commercial |
$1,047.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,047.38
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$672.52
|
| Rate for Payer: HealthUtah PPO |
$1,102.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,069.42
|
| Rate for Payer: Multiplan Medicare/VA |
$638.90
|
| Rate for Payer: One Health Plan of WY PPO |
$1,080.45
|
| Rate for Payer: PacificSource Commercial |
$992.25
|
| Rate for Payer: PHCS PPO |
$1,080.45
|
| Rate for Payer: Three Rivers PPO |
$826.88
|
| Rate for Payer: TriWest Veterans Administration |
$672.52
|
| Rate for Payer: United Healthcare Commercial |
$1,052.89
|
| Rate for Payer: United Healthcare Medicare |
$672.52
|
| Rate for Payer: WINHealth Partners Commercial |
$1,047.38
|
| Rate for Payer: Wise Provider Network Commercial |
$1,047.38
|
|
|
BLADE RECIPROC TK 277-96-276
|
Facility
|
OP
|
$83.96
|
|
| Hospital Charge Code |
2650245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.46 |
| Max. Negotiated Rate |
$83.96 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.28
|
| Rate for Payer: Aetna of WY Medicare |
$55.41
|
| Rate for Payer: Altius Commercial |
$80.60
|
| Rate for Payer: Beech Street Commercial |
$82.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.44
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.44
|
| Rate for Payer: Cigna of WY Commercial |
$82.28
|
| Rate for Payer: Entrust Commercial |
$79.76
|
| Rate for Payer: First Choice Health Commercial |
$79.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$47.86
|
| Rate for Payer: HealthUtah PPO |
$83.96
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.44
|
| Rate for Payer: Multiplan Medicare/VA |
$45.46
|
| Rate for Payer: One Health Plan of WY PPO |
$82.28
|
| Rate for Payer: PacificSource Commercial |
$75.56
|
| Rate for Payer: PHCS PPO |
$82.28
|
| Rate for Payer: Three Rivers PPO |
$62.97
|
| Rate for Payer: TriWest Veterans Administration |
$47.86
|
| Rate for Payer: United Healthcare Commercial |
$80.18
|
| Rate for Payer: United Healthcare Medicare |
$47.86
|
| Rate for Payer: WINHealth Partners Commercial |
$82.28
|
| Rate for Payer: Wise Provider Network Commercial |
$79.76
|
|
|
BLADE RECIPROC TK 277-96-276
|
Facility
|
IP
|
$83.96
|
|
| Hospital Charge Code |
2650245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.65 |
| Max. Negotiated Rate |
$83.96 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$82.28
|
| Rate for Payer: Aetna of WY Medicare |
$53.73
|
| Rate for Payer: Altius Commercial |
$80.60
|
| Rate for Payer: Beech Street Commercial |
$82.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$81.44
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: ChoiceCare Network Commercial |
$81.44
|
| Rate for Payer: Cigna of WY Commercial |
$82.28
|
| Rate for Payer: Entrust Commercial |
$79.76
|
| Rate for Payer: First Choice Health Commercial |
$79.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$79.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$51.22
|
| Rate for Payer: HealthUtah PPO |
$83.96
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$81.44
|
| Rate for Payer: Multiplan Medicare/VA |
$48.65
|
| Rate for Payer: One Health Plan of WY PPO |
$82.28
|
| Rate for Payer: PacificSource Commercial |
$75.56
|
| Rate for Payer: PHCS PPO |
$82.28
|
| Rate for Payer: Three Rivers PPO |
$62.97
|
| Rate for Payer: TriWest Veterans Administration |
$51.22
|
| Rate for Payer: United Healthcare Commercial |
$80.18
|
| Rate for Payer: United Healthcare Medicare |
$51.22
|
| Rate for Payer: WINHealth Partners Commercial |
$79.76
|
| Rate for Payer: Wise Provider Network Commercial |
$79.76
|
|
|
BLADE SAGITAL SAW 90 DEG ANGLE
|
Facility
|
IP
|
$108.67
|
|
| Hospital Charge Code |
2650905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.97 |
| Max. Negotiated Rate |
$108.67 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$106.50
|
| Rate for Payer: Aetna of WY Medicare |
$69.55
|
| Rate for Payer: Altius Commercial |
$104.32
|
| Rate for Payer: Beech Street Commercial |
$106.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$105.41
|
| Rate for Payer: Cash Price |
$76.07
|
| Rate for Payer: ChoiceCare Network Commercial |
$105.41
|
| Rate for Payer: Cigna of WY Commercial |
$106.50
|
| Rate for Payer: Entrust Commercial |
$103.24
|
| Rate for Payer: First Choice Health Commercial |
$103.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$103.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$66.29
|
| Rate for Payer: HealthUtah PPO |
$108.67
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$105.41
|
| Rate for Payer: Multiplan Medicare/VA |
$62.97
|
| Rate for Payer: One Health Plan of WY PPO |
$106.50
|
| Rate for Payer: PacificSource Commercial |
$97.80
|
| Rate for Payer: PHCS PPO |
$106.50
|
| Rate for Payer: Three Rivers PPO |
$81.50
|
| Rate for Payer: TriWest Veterans Administration |
$66.29
|
| Rate for Payer: United Healthcare Commercial |
$103.78
|
| Rate for Payer: United Healthcare Medicare |
$66.29
|
| Rate for Payer: WINHealth Partners Commercial |
$103.24
|
| Rate for Payer: Wise Provider Network Commercial |
$103.24
|
|
|
BLADE SAGITAL SAW 90 DEG ANGLE
|
Facility
|
OP
|
$108.67
|
|
| Hospital Charge Code |
2650905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.84 |
| Max. Negotiated Rate |
$108.67 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$106.50
|
| Rate for Payer: Aetna of WY Medicare |
$71.72
|
| Rate for Payer: Altius Commercial |
$104.32
|
| Rate for Payer: Beech Street Commercial |
$106.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$105.41
|
| Rate for Payer: Cash Price |
$76.07
|
| Rate for Payer: ChoiceCare Network Commercial |
$105.41
|
| Rate for Payer: Cigna of WY Commercial |
$106.50
|
| Rate for Payer: Entrust Commercial |
$103.24
|
| Rate for Payer: First Choice Health Commercial |
$103.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$103.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$61.94
|
| Rate for Payer: HealthUtah PPO |
$108.67
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$105.41
|
| Rate for Payer: Multiplan Medicare/VA |
$58.84
|
| Rate for Payer: One Health Plan of WY PPO |
$106.50
|
| Rate for Payer: PacificSource Commercial |
$97.80
|
| Rate for Payer: PHCS PPO |
$106.50
|
| Rate for Payer: Three Rivers PPO |
$81.50
|
| Rate for Payer: TriWest Veterans Administration |
$61.94
|
| Rate for Payer: United Healthcare Commercial |
$103.78
|
| Rate for Payer: United Healthcare Medicare |
$61.94
|
| Rate for Payer: WINHealth Partners Commercial |
$106.50
|
| Rate for Payer: Wise Provider Network Commercial |
$103.24
|
|
|
BLADE SAGITTAL 61X48.5/.64-.99
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
2650765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$224.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$213.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$202.82
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$213.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$213.50
|
| Rate for Payer: WINHealth Partners Commercial |
$332.50
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
BLADE SAGITTAL 61X48.5/.64-.99
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
2650765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$343.00
|
| Rate for Payer: Aetna of WY Medicare |
$231.00
|
| Rate for Payer: Altius Commercial |
$336.00
|
| Rate for Payer: Beech Street Commercial |
$343.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$339.50
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$339.50
|
| Rate for Payer: Cigna of WY Commercial |
$343.00
|
| Rate for Payer: Entrust Commercial |
$332.50
|
| Rate for Payer: First Choice Health Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$332.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$199.50
|
| Rate for Payer: HealthUtah PPO |
$350.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$339.50
|
| Rate for Payer: Multiplan Medicare/VA |
$189.52
|
| Rate for Payer: One Health Plan of WY PPO |
$343.00
|
| Rate for Payer: PacificSource Commercial |
$315.00
|
| Rate for Payer: PHCS PPO |
$343.00
|
| Rate for Payer: Three Rivers PPO |
$262.50
|
| Rate for Payer: TriWest Veterans Administration |
$199.50
|
| Rate for Payer: United Healthcare Commercial |
$334.25
|
| Rate for Payer: United Healthcare Medicare |
$199.50
|
| Rate for Payer: WINHealth Partners Commercial |
$343.00
|
| Rate for Payer: Wise Provider Network Commercial |
$332.50
|
|
|
BLADE SELF DRIVER VARIAX
|
Facility
|
IP
|
$737.52
|
|
| Hospital Charge Code |
3100120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$427.39 |
| Max. Negotiated Rate |
$737.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$722.77
|
| Rate for Payer: Aetna of WY Medicare |
$472.01
|
| Rate for Payer: Altius Commercial |
$708.02
|
| Rate for Payer: Beech Street Commercial |
$722.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$715.39
|
| Rate for Payer: Cash Price |
$516.26
|
| Rate for Payer: ChoiceCare Network Commercial |
$715.39
|
| Rate for Payer: Cigna of WY Commercial |
$722.77
|
| Rate for Payer: Entrust Commercial |
$700.64
|
| Rate for Payer: First Choice Health Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$449.89
|
| Rate for Payer: HealthUtah PPO |
$737.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$715.39
|
| Rate for Payer: Multiplan Medicare/VA |
$427.39
|
| Rate for Payer: One Health Plan of WY PPO |
$722.77
|
| Rate for Payer: PacificSource Commercial |
$663.77
|
| Rate for Payer: PHCS PPO |
$722.77
|
| Rate for Payer: Three Rivers PPO |
$553.14
|
| Rate for Payer: TriWest Veterans Administration |
$449.89
|
| Rate for Payer: United Healthcare Commercial |
$704.33
|
| Rate for Payer: United Healthcare Medicare |
$449.89
|
| Rate for Payer: WINHealth Partners Commercial |
$700.64
|
| Rate for Payer: Wise Provider Network Commercial |
$700.64
|
|
|
BLADE SELF DRIVER VARIAX
|
Facility
|
OP
|
$737.52
|
|
| Hospital Charge Code |
3100120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$399.37 |
| Max. Negotiated Rate |
$737.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$722.77
|
| Rate for Payer: Aetna of WY Medicare |
$486.76
|
| Rate for Payer: Altius Commercial |
$708.02
|
| Rate for Payer: Beech Street Commercial |
$722.77
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$715.39
|
| Rate for Payer: Cash Price |
$516.26
|
| Rate for Payer: ChoiceCare Network Commercial |
$715.39
|
| Rate for Payer: Cigna of WY Commercial |
$722.77
|
| Rate for Payer: Entrust Commercial |
$700.64
|
| Rate for Payer: First Choice Health Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$700.64
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$420.39
|
| Rate for Payer: HealthUtah PPO |
$737.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$715.39
|
| Rate for Payer: Multiplan Medicare/VA |
$399.37
|
| Rate for Payer: One Health Plan of WY PPO |
$722.77
|
| Rate for Payer: PacificSource Commercial |
$663.77
|
| Rate for Payer: PHCS PPO |
$722.77
|
| Rate for Payer: Three Rivers PPO |
$553.14
|
| Rate for Payer: TriWest Veterans Administration |
$420.39
|
| Rate for Payer: United Healthcare Commercial |
$704.33
|
| Rate for Payer: United Healthcare Medicare |
$420.39
|
| Rate for Payer: WINHealth Partners Commercial |
$722.77
|
| Rate for Payer: Wise Provider Network Commercial |
$700.64
|
|
|
BLADES IRIS SCISS 22MM 360-110
|
Facility
|
IP
|
$71.71
|
|
| Hospital Charge Code |
3000101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.56 |
| Max. Negotiated Rate |
$71.71 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$70.28
|
| Rate for Payer: Aetna of WY Medicare |
$45.89
|
| Rate for Payer: Altius Commercial |
$68.84
|
| Rate for Payer: Beech Street Commercial |
$70.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$69.56
|
| Rate for Payer: Cash Price |
$50.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$69.56
|
| Rate for Payer: Cigna of WY Commercial |
$70.28
|
| Rate for Payer: Entrust Commercial |
$68.12
|
| Rate for Payer: First Choice Health Commercial |
$68.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$68.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.74
|
| Rate for Payer: HealthUtah PPO |
$71.71
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$69.56
|
| Rate for Payer: Multiplan Medicare/VA |
$41.56
|
| Rate for Payer: One Health Plan of WY PPO |
$70.28
|
| Rate for Payer: PacificSource Commercial |
$64.54
|
| Rate for Payer: PHCS PPO |
$70.28
|
| Rate for Payer: Three Rivers PPO |
$53.78
|
| Rate for Payer: TriWest Veterans Administration |
$43.74
|
| Rate for Payer: United Healthcare Commercial |
$68.48
|
| Rate for Payer: United Healthcare Medicare |
$43.74
|
| Rate for Payer: WINHealth Partners Commercial |
$68.12
|
| Rate for Payer: Wise Provider Network Commercial |
$68.12
|
|
|
BLADES IRIS SCISS 22MM 360-110
|
Facility
|
OP
|
$71.71
|
|
| Hospital Charge Code |
3000101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.83 |
| Max. Negotiated Rate |
$71.71 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$70.28
|
| Rate for Payer: Aetna of WY Medicare |
$47.33
|
| Rate for Payer: Altius Commercial |
$68.84
|
| Rate for Payer: Beech Street Commercial |
$70.28
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$69.56
|
| Rate for Payer: Cash Price |
$50.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$69.56
|
| Rate for Payer: Cigna of WY Commercial |
$70.28
|
| Rate for Payer: Entrust Commercial |
$68.12
|
| Rate for Payer: First Choice Health Commercial |
$68.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$68.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$40.87
|
| Rate for Payer: HealthUtah PPO |
$71.71
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$69.56
|
| Rate for Payer: Multiplan Medicare/VA |
$38.83
|
| Rate for Payer: One Health Plan of WY PPO |
$70.28
|
| Rate for Payer: PacificSource Commercial |
$64.54
|
| Rate for Payer: PHCS PPO |
$70.28
|
| Rate for Payer: Three Rivers PPO |
$53.78
|
| Rate for Payer: TriWest Veterans Administration |
$40.87
|
| Rate for Payer: United Healthcare Commercial |
$68.48
|
| Rate for Payer: United Healthcare Medicare |
$40.87
|
| Rate for Payer: WINHealth Partners Commercial |
$70.28
|
| Rate for Payer: Wise Provider Network Commercial |
$68.12
|
|
|
BLADES IRIS SCISS 22MM 360-111
|
Facility
|
OP
|
$73.67
|
|
| Hospital Charge Code |
3000102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.89 |
| Max. Negotiated Rate |
$73.67 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$72.20
|
| Rate for Payer: Aetna of WY Medicare |
$48.62
|
| Rate for Payer: Altius Commercial |
$70.72
|
| Rate for Payer: Beech Street Commercial |
$72.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.46
|
| Rate for Payer: Cash Price |
$51.57
|
| Rate for Payer: ChoiceCare Network Commercial |
$71.46
|
| Rate for Payer: Cigna of WY Commercial |
$72.20
|
| Rate for Payer: Entrust Commercial |
$69.99
|
| Rate for Payer: First Choice Health Commercial |
$69.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.99
|
| Rate for Payer: HealthUtah PPO |
$73.67
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$71.46
|
| Rate for Payer: Multiplan Medicare/VA |
$39.89
|
| Rate for Payer: One Health Plan of WY PPO |
$72.20
|
| Rate for Payer: PacificSource Commercial |
$66.30
|
| Rate for Payer: PHCS PPO |
$72.20
|
| Rate for Payer: Three Rivers PPO |
$55.25
|
| Rate for Payer: TriWest Veterans Administration |
$41.99
|
| Rate for Payer: United Healthcare Commercial |
$70.35
|
| Rate for Payer: United Healthcare Medicare |
$41.99
|
| Rate for Payer: WINHealth Partners Commercial |
$72.20
|
| Rate for Payer: Wise Provider Network Commercial |
$69.99
|
|
|
BLADES IRIS SCISS 22MM 360-111
|
Facility
|
IP
|
$73.67
|
|
| Hospital Charge Code |
3000102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.69 |
| Max. Negotiated Rate |
$73.67 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$72.20
|
| Rate for Payer: Aetna of WY Medicare |
$47.15
|
| Rate for Payer: Altius Commercial |
$70.72
|
| Rate for Payer: Beech Street Commercial |
$72.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.46
|
| Rate for Payer: Cash Price |
$51.57
|
| Rate for Payer: ChoiceCare Network Commercial |
$71.46
|
| Rate for Payer: Cigna of WY Commercial |
$72.20
|
| Rate for Payer: Entrust Commercial |
$69.99
|
| Rate for Payer: First Choice Health Commercial |
$69.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$69.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$44.94
|
| Rate for Payer: HealthUtah PPO |
$73.67
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$71.46
|
| Rate for Payer: Multiplan Medicare/VA |
$42.69
|
| Rate for Payer: One Health Plan of WY PPO |
$72.20
|
| Rate for Payer: PacificSource Commercial |
$66.30
|
| Rate for Payer: PHCS PPO |
$72.20
|
| Rate for Payer: Three Rivers PPO |
$55.25
|
| Rate for Payer: TriWest Veterans Administration |
$44.94
|
| Rate for Payer: United Healthcare Commercial |
$70.35
|
| Rate for Payer: United Healthcare Medicare |
$44.94
|
| Rate for Payer: WINHealth Partners Commercial |
$69.99
|
| Rate for Payer: Wise Provider Network Commercial |
$69.99
|
|
|
BLADE STERNALOC SAW
|
Facility
|
IP
|
$1,074.50
|
|
| Hospital Charge Code |
3004162
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$622.67 |
| Max. Negotiated Rate |
$1,074.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,053.01
|
| Rate for Payer: Aetna of WY Medicare |
$687.68
|
| Rate for Payer: Altius Commercial |
$1,031.52
|
| Rate for Payer: Beech Street Commercial |
$1,053.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,042.26
|
| Rate for Payer: Cash Price |
$752.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,042.26
|
| Rate for Payer: Cigna of WY Commercial |
$1,053.01
|
| Rate for Payer: Entrust Commercial |
$1,020.78
|
| Rate for Payer: First Choice Health Commercial |
$1,020.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,020.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$655.44
|
| Rate for Payer: HealthUtah PPO |
$1,074.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,042.26
|
| Rate for Payer: Multiplan Medicare/VA |
$622.67
|
| Rate for Payer: One Health Plan of WY PPO |
$1,053.01
|
| Rate for Payer: PacificSource Commercial |
$967.05
|
| Rate for Payer: PHCS PPO |
$1,053.01
|
| Rate for Payer: Three Rivers PPO |
$805.88
|
| Rate for Payer: TriWest Veterans Administration |
$655.44
|
| Rate for Payer: United Healthcare Commercial |
$1,026.15
|
| Rate for Payer: United Healthcare Medicare |
$655.44
|
| Rate for Payer: WINHealth Partners Commercial |
$1,020.78
|
| Rate for Payer: Wise Provider Network Commercial |
$1,020.78
|
|
|
BLADE STERNALOC SAW
|
Facility
|
OP
|
$1,074.50
|
|
| Hospital Charge Code |
3004162
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$581.84 |
| Max. Negotiated Rate |
$1,074.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,053.01
|
| Rate for Payer: Aetna of WY Medicare |
$709.17
|
| Rate for Payer: Altius Commercial |
$1,031.52
|
| Rate for Payer: Beech Street Commercial |
$1,053.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,042.26
|
| Rate for Payer: Cash Price |
$752.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,042.26
|
| Rate for Payer: Cigna of WY Commercial |
$1,053.01
|
| Rate for Payer: Entrust Commercial |
$1,020.78
|
| Rate for Payer: First Choice Health Commercial |
$1,020.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,020.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$612.46
|
| Rate for Payer: HealthUtah PPO |
$1,074.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,042.26
|
| Rate for Payer: Multiplan Medicare/VA |
$581.84
|
| Rate for Payer: One Health Plan of WY PPO |
$1,053.01
|
| Rate for Payer: PacificSource Commercial |
$967.05
|
| Rate for Payer: PHCS PPO |
$1,053.01
|
| Rate for Payer: Three Rivers PPO |
$805.88
|
| Rate for Payer: TriWest Veterans Administration |
$612.46
|
| Rate for Payer: United Healthcare Commercial |
$1,026.15
|
| Rate for Payer: United Healthcare Medicare |
$612.46
|
| Rate for Payer: WINHealth Partners Commercial |
$1,053.01
|
| Rate for Payer: Wise Provider Network Commercial |
$1,020.78
|
|
|
BLADE STERNALOC SCREWDRIVER
|
Facility
|
OP
|
$455.00
|
|
| Hospital Charge Code |
3004163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$246.38 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Aetna of WY Medicare |
$300.30
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$441.35
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$259.35
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$246.38
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$259.35
|
| Rate for Payer: United Healthcare Commercial |
$434.52
|
| Rate for Payer: United Healthcare Medicare |
$259.35
|
| Rate for Payer: WINHealth Partners Commercial |
$445.90
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
BLADE STERNALOC SCREWDRIVER
|
Facility
|
IP
|
$455.00
|
|
| Hospital Charge Code |
3004163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$263.67 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Aetna of WY Medicare |
$291.20
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$441.35
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$277.55
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$263.67
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$277.55
|
| Rate for Payer: United Healthcare Commercial |
$434.52
|
| Rate for Payer: United Healthcare Medicare |
$277.55
|
| Rate for Payer: WINHealth Partners Commercial |
$432.25
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
BLADE SURGICAL #10
|
Facility
|
IP
|
$1.09
|
|
| Hospital Charge Code |
2300002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$1.09 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.07
|
| Rate for Payer: Aetna of WY Medicare |
$0.70
|
| Rate for Payer: Altius Commercial |
$1.05
|
| Rate for Payer: Beech Street Commercial |
$1.07
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.06
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.06
|
| Rate for Payer: Cigna of WY Commercial |
$1.07
|
| Rate for Payer: Entrust Commercial |
$1.04
|
| Rate for Payer: First Choice Health Commercial |
$1.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.66
|
| Rate for Payer: HealthUtah PPO |
$1.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.06
|
| Rate for Payer: Multiplan Medicare/VA |
$0.63
|
| Rate for Payer: One Health Plan of WY PPO |
$1.07
|
| Rate for Payer: PacificSource Commercial |
$0.98
|
| Rate for Payer: PHCS PPO |
$1.07
|
| Rate for Payer: Three Rivers PPO |
$0.82
|
| Rate for Payer: TriWest Veterans Administration |
$0.66
|
| Rate for Payer: United Healthcare Commercial |
$1.04
|
| Rate for Payer: United Healthcare Medicare |
$0.66
|
| Rate for Payer: WINHealth Partners Commercial |
$1.04
|
| Rate for Payer: Wise Provider Network Commercial |
$1.04
|
|
