|
NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 31253
|
| Hospital Charge Code |
31253
|
| Min. Negotiated Rate |
$404.63 |
| Max. Negotiated Rate |
$2,287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,241.26
|
| Rate for Payer: Aetna of WY Medicare |
$476.04
|
| Rate for Payer: Beech Street Commercial |
$2,172.65
|
| Rate for Payer: Cash Price |
$1,600.90
|
| Rate for Payer: Cash Price |
$1,600.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,218.39
|
| Rate for Payer: Cigna of WY Commercial |
$2,241.26
|
| Rate for Payer: First Choice Health Commercial |
$2,058.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,172.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$476.04
|
| Rate for Payer: HealthUtah PPO |
$2,287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,218.39
|
| Rate for Payer: Multiplan Medicare/VA |
$404.63
|
| Rate for Payer: One Health Plan of WY PPO |
$2,241.26
|
| Rate for Payer: PacificSource Commercial |
$2,058.30
|
| Rate for Payer: PHCS PPO |
$2,172.65
|
| Rate for Payer: Three Rivers PPO |
$1,715.25
|
| Rate for Payer: TriWest Veterans Administration |
$476.04
|
| Rate for Payer: United Healthcare Commercial |
$1,989.69
|
| Rate for Payer: United Healthcare Medicare |
$476.04
|
| Rate for Payer: WINHealth Partners Commercial |
$1,943.95
|
|
|
NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL
|
Professional
|
Both
|
$1,602.00
|
|
|
Service Code
|
HCPCS 31259
|
| Hospital Charge Code |
31259
|
| Min. Negotiated Rate |
$381.56 |
| Max. Negotiated Rate |
$1,602.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,569.96
|
| Rate for Payer: Aetna of WY Medicare |
$448.89
|
| Rate for Payer: Beech Street Commercial |
$1,521.90
|
| Rate for Payer: Cash Price |
$1,121.40
|
| Rate for Payer: Cash Price |
$1,121.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,553.94
|
| Rate for Payer: Cigna of WY Commercial |
$1,569.96
|
| Rate for Payer: First Choice Health Commercial |
$1,441.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,521.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$448.89
|
| Rate for Payer: HealthUtah PPO |
$1,602.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,553.94
|
| Rate for Payer: Multiplan Medicare/VA |
$381.56
|
| Rate for Payer: One Health Plan of WY PPO |
$1,569.96
|
| Rate for Payer: PacificSource Commercial |
$1,441.80
|
| Rate for Payer: PHCS PPO |
$1,521.90
|
| Rate for Payer: Three Rivers PPO |
$1,201.50
|
| Rate for Payer: TriWest Veterans Administration |
$448.89
|
| Rate for Payer: United Healthcare Commercial |
$1,393.74
|
| Rate for Payer: United Healthcare Medicare |
$448.89
|
| Rate for Payer: WINHealth Partners Commercial |
$1,361.70
|
|
|
NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
HCPCS 31254
|
| Hospital Charge Code |
31254
|
| Min. Negotiated Rate |
$197.35 |
| Max. Negotiated Rate |
$1,515.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,484.70
|
| Rate for Payer: Aetna of WY Medicare |
$232.18
|
| Rate for Payer: Beech Street Commercial |
$1,439.25
|
| Rate for Payer: Cash Price |
$1,060.50
|
| Rate for Payer: Cash Price |
$1,060.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,469.55
|
| Rate for Payer: Cigna of WY Commercial |
$1,484.70
|
| Rate for Payer: First Choice Health Commercial |
$1,363.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,439.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$232.18
|
| Rate for Payer: HealthUtah PPO |
$1,515.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,469.55
|
| Rate for Payer: Multiplan Medicare/VA |
$197.35
|
| Rate for Payer: One Health Plan of WY PPO |
$1,484.70
|
| Rate for Payer: PacificSource Commercial |
$1,363.50
|
| Rate for Payer: PHCS PPO |
$1,439.25
|
| Rate for Payer: Three Rivers PPO |
$1,136.25
|
| Rate for Payer: TriWest Veterans Administration |
$232.18
|
| Rate for Payer: United Healthcare Commercial |
$1,318.05
|
| Rate for Payer: United Healthcare Medicare |
$232.18
|
| Rate for Payer: WINHealth Partners Commercial |
$1,287.75
|
|
|
NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
Professional
|
Both
|
$3,030.00
|
|
|
Service Code
|
HCPCS 31254 50
|
| Hospital Charge Code |
31254
|
| Min. Negotiated Rate |
$197.35 |
| Max. Negotiated Rate |
$3,030.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,969.40
|
| Rate for Payer: Aetna of WY Medicare |
$232.18
|
| Rate for Payer: Beech Street Commercial |
$2,878.50
|
| Rate for Payer: Cash Price |
$2,121.00
|
| Rate for Payer: Cash Price |
$2,121.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,939.10
|
| Rate for Payer: Cigna of WY Commercial |
$2,969.40
|
| Rate for Payer: First Choice Health Commercial |
$2,727.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,878.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$232.18
|
| Rate for Payer: HealthUtah PPO |
$3,030.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,939.10
|
| Rate for Payer: Multiplan Medicare/VA |
$197.35
|
| Rate for Payer: One Health Plan of WY PPO |
$2,969.40
|
| Rate for Payer: PacificSource Commercial |
$2,727.00
|
| Rate for Payer: PHCS PPO |
$2,878.50
|
| Rate for Payer: Three Rivers PPO |
$2,272.50
|
| Rate for Payer: TriWest Veterans Administration |
$232.18
|
| Rate for Payer: United Healthcare Commercial |
$2,636.10
|
| Rate for Payer: United Healthcare Medicare |
$232.18
|
| Rate for Payer: WINHealth Partners Commercial |
$2,575.50
|
|
|
NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
Professional
|
Both
|
$1,287.00
|
|
|
Service Code
|
HCPCS 31276
|
| Hospital Charge Code |
31276
|
| Min. Negotiated Rate |
$306.48 |
| Max. Negotiated Rate |
$1,287.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,261.26
|
| Rate for Payer: Aetna of WY Medicare |
$360.57
|
| Rate for Payer: Beech Street Commercial |
$1,222.65
|
| Rate for Payer: Cash Price |
$900.90
|
| Rate for Payer: Cash Price |
$900.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,248.39
|
| Rate for Payer: Cigna of WY Commercial |
$1,261.26
|
| Rate for Payer: First Choice Health Commercial |
$1,158.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,222.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$360.57
|
| Rate for Payer: HealthUtah PPO |
$1,287.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,248.39
|
| Rate for Payer: Multiplan Medicare/VA |
$306.48
|
| Rate for Payer: One Health Plan of WY PPO |
$1,261.26
|
| Rate for Payer: PacificSource Commercial |
$1,158.30
|
| Rate for Payer: PHCS PPO |
$1,222.65
|
| Rate for Payer: Three Rivers PPO |
$965.25
|
| Rate for Payer: TriWest Veterans Administration |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$1,119.69
|
| Rate for Payer: United Healthcare Medicare |
$360.57
|
| Rate for Payer: WINHealth Partners Commercial |
$1,093.95
|
|
|
NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 31276 50
|
| Hospital Charge Code |
31276
|
| Min. Negotiated Rate |
$306.48 |
| Max. Negotiated Rate |
$2,574.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,522.52
|
| Rate for Payer: Aetna of WY Medicare |
$360.57
|
| Rate for Payer: Beech Street Commercial |
$2,445.30
|
| Rate for Payer: Cash Price |
$1,801.80
|
| Rate for Payer: Cash Price |
$1,801.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,496.78
|
| Rate for Payer: Cigna of WY Commercial |
$2,522.52
|
| Rate for Payer: First Choice Health Commercial |
$2,316.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,445.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$360.57
|
| Rate for Payer: HealthUtah PPO |
$2,574.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,496.78
|
| Rate for Payer: Multiplan Medicare/VA |
$306.48
|
| Rate for Payer: One Health Plan of WY PPO |
$2,522.52
|
| Rate for Payer: PacificSource Commercial |
$2,316.60
|
| Rate for Payer: PHCS PPO |
$2,445.30
|
| Rate for Payer: Three Rivers PPO |
$1,930.50
|
| Rate for Payer: TriWest Veterans Administration |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$2,239.38
|
| Rate for Payer: United Healthcare Medicare |
$360.57
|
| Rate for Payer: WINHealth Partners Commercial |
$2,187.90
|
|
|
NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 31255
|
| Hospital Charge Code |
31255
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,078.00
|
| Rate for Payer: Aetna of WY Medicare |
$308.23
|
| Rate for Payer: Beech Street Commercial |
$1,045.00
|
| Rate for Payer: Cash Price |
$770.00
|
| Rate for Payer: Cash Price |
$770.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,067.00
|
| Rate for Payer: Cigna of WY Commercial |
$1,078.00
|
| Rate for Payer: First Choice Health Commercial |
$990.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,045.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$308.23
|
| Rate for Payer: HealthUtah PPO |
$1,100.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,067.00
|
| Rate for Payer: Multiplan Medicare/VA |
$262.00
|
| Rate for Payer: One Health Plan of WY PPO |
$1,078.00
|
| Rate for Payer: PacificSource Commercial |
$990.00
|
| Rate for Payer: PHCS PPO |
$1,045.00
|
| Rate for Payer: Three Rivers PPO |
$825.00
|
| Rate for Payer: TriWest Veterans Administration |
$308.23
|
| Rate for Payer: United Healthcare Commercial |
$957.00
|
| Rate for Payer: United Healthcare Medicare |
$308.23
|
| Rate for Payer: WINHealth Partners Commercial |
$935.00
|
|
|
NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 31255 50
|
| Hospital Charge Code |
31255
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,156.00
|
| Rate for Payer: Aetna of WY Medicare |
$308.23
|
| Rate for Payer: Beech Street Commercial |
$2,090.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,134.00
|
| Rate for Payer: Cigna of WY Commercial |
$2,156.00
|
| Rate for Payer: First Choice Health Commercial |
$1,980.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,090.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$308.23
|
| Rate for Payer: HealthUtah PPO |
$2,200.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,134.00
|
| Rate for Payer: Multiplan Medicare/VA |
$262.00
|
| Rate for Payer: One Health Plan of WY PPO |
$2,156.00
|
| Rate for Payer: PacificSource Commercial |
$1,980.00
|
| Rate for Payer: PHCS PPO |
$2,090.00
|
| Rate for Payer: Three Rivers PPO |
$1,650.00
|
| Rate for Payer: TriWest Veterans Administration |
$308.23
|
| Rate for Payer: United Healthcare Commercial |
$1,914.00
|
| Rate for Payer: United Healthcare Medicare |
$308.23
|
| Rate for Payer: WINHealth Partners Commercial |
$1,870.00
|
|
|
NASAL SPLINT DENVER
|
Facility
|
IP
|
$110.82
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.48 |
| Max. Negotiated Rate |
$110.82 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$108.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$106.39
|
| Rate for Payer: Altius Commercial |
$106.39
|
| Rate for Payer: Beech Street Commercial |
$108.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$90.98
|
| Rate for Payer: Cash Price |
$77.58
|
| Rate for Payer: ChoiceCare Network Commercial |
$107.50
|
| Rate for Payer: Cigna of WY Commercial |
$108.60
|
| Rate for Payer: Entrust Commercial |
$105.28
|
| Rate for Payer: First Choice Health Commercial |
$105.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$105.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$73.14
|
| Rate for Payer: HealthUtah PPO |
$110.82
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$107.50
|
| Rate for Payer: Multiplan Medicare/VA |
$69.48
|
| Rate for Payer: One Health Plan of WY PPO |
$108.60
|
| Rate for Payer: PacificSource Commercial |
$99.74
|
| Rate for Payer: PHCS PPO |
$108.60
|
| Rate for Payer: Three Rivers PPO |
$83.12
|
| Rate for Payer: TriWest Veterans Administration |
$73.14
|
| Rate for Payer: United Healthcare Commercial |
$96.41
|
| Rate for Payer: United Healthcare Medicare |
$73.14
|
| Rate for Payer: WINHealth Partners Commercial |
$105.28
|
| Rate for Payer: Wise Provider Network Commercial |
$105.28
|
|
|
NASAL SPLINT DENVER
|
Facility
|
OP
|
$110.82
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.06 |
| Max. Negotiated Rate |
$110.82 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$108.60
|
| Rate for Payer: Aetna of WY Medicare |
$73.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$106.39
|
| Rate for Payer: Altius Commercial |
$106.39
|
| Rate for Payer: Beech Street Commercial |
$108.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$90.98
|
| Rate for Payer: Cash Price |
$77.58
|
| Rate for Payer: ChoiceCare Network Commercial |
$107.50
|
| Rate for Payer: Cigna of WY Commercial |
$108.60
|
| Rate for Payer: Entrust Commercial |
$105.28
|
| Rate for Payer: First Choice Health Commercial |
$105.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$105.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$64.28
|
| Rate for Payer: HealthUtah PPO |
$110.82
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$107.50
|
| Rate for Payer: Multiplan Medicare/VA |
$61.06
|
| Rate for Payer: One Health Plan of WY PPO |
$108.60
|
| Rate for Payer: PacificSource Commercial |
$99.74
|
| Rate for Payer: PHCS PPO |
$108.60
|
| Rate for Payer: Three Rivers PPO |
$83.12
|
| Rate for Payer: TriWest Veterans Administration |
$64.28
|
| Rate for Payer: United Healthcare Commercial |
$96.41
|
| Rate for Payer: United Healthcare Medicare |
$64.28
|
| Rate for Payer: WINHealth Partners Commercial |
$108.60
|
| Rate for Payer: Wise Provider Network Commercial |
$105.28
|
|
|
NASAL SPLINT DOYLE
|
Facility
|
IP
|
$118.92
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.56 |
| Max. Negotiated Rate |
$118.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$116.54
|
| Rate for Payer: Altius Auto/Workers Compensation |
$114.16
|
| Rate for Payer: Altius Commercial |
$114.16
|
| Rate for Payer: Beech Street Commercial |
$116.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$97.63
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$115.35
|
| Rate for Payer: Cigna of WY Commercial |
$116.54
|
| Rate for Payer: Entrust Commercial |
$112.97
|
| Rate for Payer: First Choice Health Commercial |
$112.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$112.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.49
|
| Rate for Payer: HealthUtah PPO |
$118.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$115.35
|
| Rate for Payer: Multiplan Medicare/VA |
$74.56
|
| Rate for Payer: One Health Plan of WY PPO |
$116.54
|
| Rate for Payer: PacificSource Commercial |
$107.03
|
| Rate for Payer: PHCS PPO |
$116.54
|
| Rate for Payer: Three Rivers PPO |
$89.19
|
| Rate for Payer: TriWest Veterans Administration |
$78.49
|
| Rate for Payer: United Healthcare Commercial |
$103.46
|
| Rate for Payer: United Healthcare Medicare |
$78.49
|
| Rate for Payer: WINHealth Partners Commercial |
$112.97
|
| Rate for Payer: Wise Provider Network Commercial |
$112.97
|
|
|
NASAL SPLINT DOYLE
|
Facility
|
OP
|
$118.92
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$65.52 |
| Max. Negotiated Rate |
$118.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$116.54
|
| Rate for Payer: Aetna of WY Medicare |
$78.49
|
| Rate for Payer: Altius Auto/Workers Compensation |
$114.16
|
| Rate for Payer: Altius Commercial |
$114.16
|
| Rate for Payer: Beech Street Commercial |
$116.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$97.63
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$115.35
|
| Rate for Payer: Cigna of WY Commercial |
$116.54
|
| Rate for Payer: Entrust Commercial |
$112.97
|
| Rate for Payer: First Choice Health Commercial |
$112.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$112.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$68.97
|
| Rate for Payer: HealthUtah PPO |
$118.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$115.35
|
| Rate for Payer: Multiplan Medicare/VA |
$65.52
|
| Rate for Payer: One Health Plan of WY PPO |
$116.54
|
| Rate for Payer: PacificSource Commercial |
$107.03
|
| Rate for Payer: PHCS PPO |
$116.54
|
| Rate for Payer: Three Rivers PPO |
$89.19
|
| Rate for Payer: TriWest Veterans Administration |
$68.97
|
| Rate for Payer: United Healthcare Commercial |
$103.46
|
| Rate for Payer: United Healthcare Medicare |
$68.97
|
| Rate for Payer: WINHealth Partners Commercial |
$116.54
|
| Rate for Payer: Wise Provider Network Commercial |
$112.97
|
|
|
NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 43752
|
| Hospital Charge Code |
43752
|
| Min. Negotiated Rate |
$32.11 |
| Max. Negotiated Rate |
$213.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$208.74
|
| Rate for Payer: Aetna of WY Medicare |
$37.78
|
| Rate for Payer: Beech Street Commercial |
$202.35
|
| Rate for Payer: Cash Price |
$149.10
|
| Rate for Payer: Cash Price |
$149.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$206.61
|
| Rate for Payer: Cigna of WY Commercial |
$208.74
|
| Rate for Payer: First Choice Health Commercial |
$191.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$202.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$37.78
|
| Rate for Payer: HealthUtah PPO |
$213.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$206.61
|
| Rate for Payer: Multiplan Medicare/VA |
$32.11
|
| Rate for Payer: One Health Plan of WY PPO |
$208.74
|
| Rate for Payer: PacificSource Commercial |
$191.70
|
| Rate for Payer: PHCS PPO |
$202.35
|
| Rate for Payer: Three Rivers PPO |
$159.75
|
| Rate for Payer: TriWest Veterans Administration |
$37.78
|
| Rate for Payer: United Healthcare Commercial |
$185.31
|
| Rate for Payer: United Healthcare Medicare |
$37.78
|
| Rate for Payer: WINHealth Partners Commercial |
$181.05
|
|
|
NASOPHAR AIRWAY 20FR
|
Facility
|
OP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.01 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Aetna of WY Medicare |
$13.19
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.59
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$11.01
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$11.59
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$11.59
|
| Rate for Payer: WINHealth Partners Commercial |
$19.59
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHAR AIRWAY 20FR
|
Facility
|
IP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.19
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$12.53
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$13.19
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$13.19
|
| Rate for Payer: WINHealth Partners Commercial |
$18.99
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHAR AIRWAY 24FR
|
Facility
|
OP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.01 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Aetna of WY Medicare |
$13.19
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.59
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$11.01
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$11.59
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$11.59
|
| Rate for Payer: WINHealth Partners Commercial |
$19.59
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHAR AIRWAY 24FR
|
Facility
|
IP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.19
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$12.53
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$13.19
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$13.19
|
| Rate for Payer: WINHealth Partners Commercial |
$18.99
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHAR AIRWAY 26FR
|
Facility
|
OP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.01 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Aetna of WY Medicare |
$13.19
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.59
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$11.01
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$11.59
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$11.59
|
| Rate for Payer: WINHealth Partners Commercial |
$19.59
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHAR AIRWAY 26FR
|
Facility
|
IP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.19
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$12.53
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$13.19
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$13.19
|
| Rate for Payer: WINHealth Partners Commercial |
$18.99
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHAR AIRWAY 28FR
|
Facility
|
OP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.01 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Aetna of WY Medicare |
$13.19
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.59
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$11.01
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$11.59
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$11.59
|
| Rate for Payer: WINHealth Partners Commercial |
$19.59
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHAR AIRWAY 28FR
|
Facility
|
IP
|
$19.99
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.19
|
| Rate for Payer: Altius Commercial |
$19.19
|
| Rate for Payer: Beech Street Commercial |
$19.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.39
|
| Rate for Payer: Cigna of WY Commercial |
$19.59
|
| Rate for Payer: Entrust Commercial |
$18.99
|
| Rate for Payer: First Choice Health Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$18.99
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.19
|
| Rate for Payer: HealthUtah PPO |
$19.99
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.39
|
| Rate for Payer: Multiplan Medicare/VA |
$12.53
|
| Rate for Payer: One Health Plan of WY PPO |
$19.59
|
| Rate for Payer: PacificSource Commercial |
$17.99
|
| Rate for Payer: PHCS PPO |
$19.59
|
| Rate for Payer: Three Rivers PPO |
$14.99
|
| Rate for Payer: TriWest Veterans Administration |
$13.19
|
| Rate for Payer: United Healthcare Commercial |
$17.39
|
| Rate for Payer: United Healthcare Medicare |
$13.19
|
| Rate for Payer: WINHealth Partners Commercial |
$18.99
|
| Rate for Payer: Wise Provider Network Commercial |
$18.99
|
|
|
NASOPHARYNGOSCOPY W/ENDOSCOPE SPX
|
Professional
|
Both
|
$503.00
|
|
|
Service Code
|
HCPCS 92511
|
| Hospital Charge Code |
92511
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$503.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$492.94
|
| Rate for Payer: Aetna of WY Medicare |
$36.66
|
| Rate for Payer: Beech Street Commercial |
$477.85
|
| Rate for Payer: Cash Price |
$352.10
|
| Rate for Payer: Cash Price |
$352.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$487.91
|
| Rate for Payer: Cigna of WY Commercial |
$492.94
|
| Rate for Payer: First Choice Health Commercial |
$452.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$477.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$36.66
|
| Rate for Payer: HealthUtah PPO |
$503.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$487.91
|
| Rate for Payer: Multiplan Medicare/VA |
$31.16
|
| Rate for Payer: One Health Plan of WY PPO |
$492.94
|
| Rate for Payer: PacificSource Commercial |
$452.70
|
| Rate for Payer: PHCS PPO |
$477.85
|
| Rate for Payer: Three Rivers PPO |
$377.25
|
| Rate for Payer: TriWest Veterans Administration |
$36.66
|
| Rate for Payer: United Healthcare Commercial |
$437.61
|
| Rate for Payer: United Healthcare Medicare |
$36.66
|
| Rate for Payer: WINHealth Partners Commercial |
$477.85
|
|
|
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION [37309]
|
Facility
|
IP
|
$562.29
|
|
|
Service Code
|
HCPCS J2323
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$352.56 |
| Max. Negotiated Rate |
$562.29 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$551.04
|
| Rate for Payer: Altius Auto/Workers Compensation |
$539.80
|
| Rate for Payer: Altius Commercial |
$539.80
|
| Rate for Payer: Beech Street Commercial |
$551.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$461.64
|
| Rate for Payer: Cash Price |
$393.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$545.42
|
| Rate for Payer: Cigna of WY Commercial |
$551.04
|
| Rate for Payer: Entrust Commercial |
$534.18
|
| Rate for Payer: First Choice Health Commercial |
$534.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$534.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$371.11
|
| Rate for Payer: HealthUtah PPO |
$562.29
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$545.42
|
| Rate for Payer: Multiplan Medicare/VA |
$352.56
|
| Rate for Payer: One Health Plan of WY PPO |
$551.04
|
| Rate for Payer: PacificSource Commercial |
$506.06
|
| Rate for Payer: PHCS PPO |
$551.04
|
| Rate for Payer: Three Rivers PPO |
$421.72
|
| Rate for Payer: TriWest Veterans Administration |
$371.11
|
| Rate for Payer: United Healthcare Commercial |
$489.19
|
| Rate for Payer: United Healthcare Medicare |
$371.11
|
| Rate for Payer: WINHealth Partners Commercial |
$534.18
|
| Rate for Payer: Wise Provider Network Commercial |
$534.18
|
|
|
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION [37309]
|
Facility
|
OP
|
$562.29
|
|
|
Service Code
|
HCPCS J2323
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$309.82 |
| Max. Negotiated Rate |
$562.29 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$551.04
|
| Rate for Payer: Aetna of WY Medicare |
$371.11
|
| Rate for Payer: Altius Auto/Workers Compensation |
$539.80
|
| Rate for Payer: Altius Commercial |
$539.80
|
| Rate for Payer: Beech Street Commercial |
$551.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$461.64
|
| Rate for Payer: Cash Price |
$393.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$545.42
|
| Rate for Payer: Cigna of WY Commercial |
$551.04
|
| Rate for Payer: Entrust Commercial |
$534.18
|
| Rate for Payer: First Choice Health Commercial |
$534.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$534.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$326.13
|
| Rate for Payer: HealthUtah PPO |
$562.29
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$545.42
|
| Rate for Payer: Multiplan Medicare/VA |
$309.82
|
| Rate for Payer: One Health Plan of WY PPO |
$551.04
|
| Rate for Payer: PacificSource Commercial |
$506.06
|
| Rate for Payer: PHCS PPO |
$551.04
|
| Rate for Payer: Three Rivers PPO |
$421.72
|
| Rate for Payer: TriWest Veterans Administration |
$326.13
|
| Rate for Payer: United Healthcare Commercial |
$489.19
|
| Rate for Payer: United Healthcare Medicare |
$326.13
|
| Rate for Payer: WINHealth Partners Commercial |
$551.04
|
| Rate for Payer: Wise Provider Network Commercial |
$534.18
|
|
|
NC EMERGE MONORAIL 2.0 X 12MM
|
Facility
|
OP
|
$378.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$208.28 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$370.44
|
| Rate for Payer: Aetna of WY Medicare |
$249.48
|
| Rate for Payer: Altius Auto/Workers Compensation |
$362.88
|
| Rate for Payer: Altius Commercial |
$362.88
|
| Rate for Payer: Beech Street Commercial |
$370.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$310.34
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$366.66
|
| Rate for Payer: Cigna of WY Commercial |
$370.44
|
| Rate for Payer: Entrust Commercial |
$359.10
|
| Rate for Payer: First Choice Health Commercial |
$359.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$359.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$219.24
|
| Rate for Payer: HealthUtah PPO |
$378.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$366.66
|
| Rate for Payer: Multiplan Medicare/VA |
$208.28
|
| Rate for Payer: One Health Plan of WY PPO |
$370.44
|
| Rate for Payer: PacificSource Commercial |
$340.20
|
| Rate for Payer: PHCS PPO |
$370.44
|
| Rate for Payer: Three Rivers PPO |
$283.50
|
| Rate for Payer: TriWest Veterans Administration |
$219.24
|
| Rate for Payer: United Healthcare Commercial |
$328.86
|
| Rate for Payer: United Healthcare Medicare |
$219.24
|
| Rate for Payer: WINHealth Partners Commercial |
$370.44
|
| Rate for Payer: Wise Provider Network Commercial |
$359.10
|
|
