|
BP CUFF DISP INFANT
|
Facility
|
IP
|
$4.68
|
|
| Hospital Charge Code |
4400314
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.59
|
| Rate for Payer: Aetna of WY Medicare |
$3.00
|
| Rate for Payer: Altius Commercial |
$4.49
|
| Rate for Payer: Beech Street Commercial |
$4.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.54
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.54
|
| Rate for Payer: Cigna of WY Commercial |
$4.59
|
| Rate for Payer: Entrust Commercial |
$4.45
|
| Rate for Payer: First Choice Health Commercial |
$4.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.85
|
| Rate for Payer: HealthUtah PPO |
$4.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.54
|
| Rate for Payer: Multiplan Medicare/VA |
$2.71
|
| Rate for Payer: One Health Plan of WY PPO |
$4.59
|
| Rate for Payer: PacificSource Commercial |
$4.21
|
| Rate for Payer: PHCS PPO |
$4.59
|
| Rate for Payer: Three Rivers PPO |
$3.51
|
| Rate for Payer: TriWest Veterans Administration |
$2.85
|
| Rate for Payer: United Healthcare Commercial |
$4.47
|
| Rate for Payer: United Healthcare Medicare |
$2.85
|
| Rate for Payer: WINHealth Partners Commercial |
$4.45
|
| Rate for Payer: Wise Provider Network Commercial |
$4.45
|
|
|
BP CUFF DISP INFANT
|
Facility
|
OP
|
$4.68
|
|
| Hospital Charge Code |
4400314
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.59
|
| Rate for Payer: Aetna of WY Medicare |
$3.09
|
| Rate for Payer: Altius Commercial |
$4.49
|
| Rate for Payer: Beech Street Commercial |
$4.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.54
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.54
|
| Rate for Payer: Cigna of WY Commercial |
$4.59
|
| Rate for Payer: Entrust Commercial |
$4.45
|
| Rate for Payer: First Choice Health Commercial |
$4.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.67
|
| Rate for Payer: HealthUtah PPO |
$4.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.54
|
| Rate for Payer: Multiplan Medicare/VA |
$2.53
|
| Rate for Payer: One Health Plan of WY PPO |
$4.59
|
| Rate for Payer: PacificSource Commercial |
$4.21
|
| Rate for Payer: PHCS PPO |
$4.59
|
| Rate for Payer: Three Rivers PPO |
$3.51
|
| Rate for Payer: TriWest Veterans Administration |
$2.67
|
| Rate for Payer: United Healthcare Commercial |
$4.47
|
| Rate for Payer: United Healthcare Medicare |
$2.67
|
| Rate for Payer: WINHealth Partners Commercial |
$4.59
|
| Rate for Payer: Wise Provider Network Commercial |
$4.45
|
|
|
BP CUFF DISP LG ADULT
|
Facility
|
OP
|
$6.29
|
|
| Hospital Charge Code |
4400318
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$6.29 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.16
|
| Rate for Payer: Aetna of WY Medicare |
$4.15
|
| Rate for Payer: Altius Commercial |
$6.04
|
| Rate for Payer: Beech Street Commercial |
$6.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$4.41
|
| Rate for Payer: ChoiceCare Network Commercial |
$6.10
|
| Rate for Payer: Cigna of WY Commercial |
$6.16
|
| Rate for Payer: Entrust Commercial |
$5.98
|
| Rate for Payer: First Choice Health Commercial |
$5.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.59
|
| Rate for Payer: HealthUtah PPO |
$6.29
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6.10
|
| Rate for Payer: Multiplan Medicare/VA |
$3.41
|
| Rate for Payer: One Health Plan of WY PPO |
$6.16
|
| Rate for Payer: PacificSource Commercial |
$5.66
|
| Rate for Payer: PHCS PPO |
$6.16
|
| Rate for Payer: Three Rivers PPO |
$4.72
|
| Rate for Payer: TriWest Veterans Administration |
$3.59
|
| Rate for Payer: United Healthcare Commercial |
$6.01
|
| Rate for Payer: United Healthcare Medicare |
$3.59
|
| Rate for Payer: WINHealth Partners Commercial |
$6.16
|
| Rate for Payer: Wise Provider Network Commercial |
$5.98
|
|
|
BP CUFF DISP LG ADULT
|
Facility
|
IP
|
$6.29
|
|
| Hospital Charge Code |
4400318
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$6.29 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.16
|
| Rate for Payer: Aetna of WY Medicare |
$4.03
|
| Rate for Payer: Altius Commercial |
$6.04
|
| Rate for Payer: Beech Street Commercial |
$6.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$4.41
|
| Rate for Payer: ChoiceCare Network Commercial |
$6.10
|
| Rate for Payer: Cigna of WY Commercial |
$6.16
|
| Rate for Payer: Entrust Commercial |
$5.98
|
| Rate for Payer: First Choice Health Commercial |
$5.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.84
|
| Rate for Payer: HealthUtah PPO |
$6.29
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6.10
|
| Rate for Payer: Multiplan Medicare/VA |
$3.65
|
| Rate for Payer: One Health Plan of WY PPO |
$6.16
|
| Rate for Payer: PacificSource Commercial |
$5.66
|
| Rate for Payer: PHCS PPO |
$6.16
|
| Rate for Payer: Three Rivers PPO |
$4.72
|
| Rate for Payer: TriWest Veterans Administration |
$3.84
|
| Rate for Payer: United Healthcare Commercial |
$6.01
|
| Rate for Payer: United Healthcare Medicare |
$3.84
|
| Rate for Payer: WINHealth Partners Commercial |
$5.98
|
| Rate for Payer: Wise Provider Network Commercial |
$5.98
|
|
|
BP CUFF DISP SM ADULT
|
Facility
|
IP
|
$5.05
|
|
| Hospital Charge Code |
4400316
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$5.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.95
|
| Rate for Payer: Aetna of WY Medicare |
$3.23
|
| Rate for Payer: Altius Commercial |
$4.85
|
| Rate for Payer: Beech Street Commercial |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.90
|
| Rate for Payer: Cash Price |
$3.53
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.90
|
| Rate for Payer: Cigna of WY Commercial |
$4.95
|
| Rate for Payer: Entrust Commercial |
$4.80
|
| Rate for Payer: First Choice Health Commercial |
$4.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.08
|
| Rate for Payer: HealthUtah PPO |
$5.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.90
|
| Rate for Payer: Multiplan Medicare/VA |
$2.93
|
| Rate for Payer: One Health Plan of WY PPO |
$4.95
|
| Rate for Payer: PacificSource Commercial |
$4.54
|
| Rate for Payer: PHCS PPO |
$4.95
|
| Rate for Payer: Three Rivers PPO |
$3.79
|
| Rate for Payer: TriWest Veterans Administration |
$3.08
|
| Rate for Payer: United Healthcare Commercial |
$4.82
|
| Rate for Payer: United Healthcare Medicare |
$3.08
|
| Rate for Payer: WINHealth Partners Commercial |
$4.80
|
| Rate for Payer: Wise Provider Network Commercial |
$4.80
|
|
|
BP CUFF DISP SM ADULT
|
Facility
|
OP
|
$5.05
|
|
| Hospital Charge Code |
4400316
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$5.05 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.95
|
| Rate for Payer: Aetna of WY Medicare |
$3.33
|
| Rate for Payer: Altius Commercial |
$4.85
|
| Rate for Payer: Beech Street Commercial |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.90
|
| Rate for Payer: Cash Price |
$3.53
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.90
|
| Rate for Payer: Cigna of WY Commercial |
$4.95
|
| Rate for Payer: Entrust Commercial |
$4.80
|
| Rate for Payer: First Choice Health Commercial |
$4.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.88
|
| Rate for Payer: HealthUtah PPO |
$5.05
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.90
|
| Rate for Payer: Multiplan Medicare/VA |
$2.73
|
| Rate for Payer: One Health Plan of WY PPO |
$4.95
|
| Rate for Payer: PacificSource Commercial |
$4.54
|
| Rate for Payer: PHCS PPO |
$4.95
|
| Rate for Payer: Three Rivers PPO |
$3.79
|
| Rate for Payer: TriWest Veterans Administration |
$2.88
|
| Rate for Payer: United Healthcare Commercial |
$4.82
|
| Rate for Payer: United Healthcare Medicare |
$2.88
|
| Rate for Payer: WINHealth Partners Commercial |
$4.95
|
| Rate for Payer: Wise Provider Network Commercial |
$4.80
|
|
|
BP CUFF DISP THIGH
|
Facility
|
IP
|
$38.59
|
|
| Hospital Charge Code |
4400319
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.36 |
| Max. Negotiated Rate |
$38.59 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$37.82
|
| Rate for Payer: Aetna of WY Medicare |
$24.70
|
| Rate for Payer: Altius Commercial |
$37.05
|
| Rate for Payer: Beech Street Commercial |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$37.43
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: ChoiceCare Network Commercial |
$37.43
|
| Rate for Payer: Cigna of WY Commercial |
$37.82
|
| Rate for Payer: Entrust Commercial |
$36.66
|
| Rate for Payer: First Choice Health Commercial |
$36.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$36.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.54
|
| Rate for Payer: HealthUtah PPO |
$38.59
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$37.43
|
| Rate for Payer: Multiplan Medicare/VA |
$22.36
|
| Rate for Payer: One Health Plan of WY PPO |
$37.82
|
| Rate for Payer: PacificSource Commercial |
$34.73
|
| Rate for Payer: PHCS PPO |
$37.82
|
| Rate for Payer: Three Rivers PPO |
$28.94
|
| Rate for Payer: TriWest Veterans Administration |
$23.54
|
| Rate for Payer: United Healthcare Commercial |
$36.85
|
| Rate for Payer: United Healthcare Medicare |
$23.54
|
| Rate for Payer: WINHealth Partners Commercial |
$36.66
|
| Rate for Payer: Wise Provider Network Commercial |
$36.66
|
|
|
BP CUFF DISP THIGH
|
Facility
|
OP
|
$38.59
|
|
| Hospital Charge Code |
4400319
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$38.59 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$37.82
|
| Rate for Payer: Aetna of WY Medicare |
$25.47
|
| Rate for Payer: Altius Commercial |
$37.05
|
| Rate for Payer: Beech Street Commercial |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$37.43
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: ChoiceCare Network Commercial |
$37.43
|
| Rate for Payer: Cigna of WY Commercial |
$37.82
|
| Rate for Payer: Entrust Commercial |
$36.66
|
| Rate for Payer: First Choice Health Commercial |
$36.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$36.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$22.00
|
| Rate for Payer: HealthUtah PPO |
$38.59
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$37.43
|
| Rate for Payer: Multiplan Medicare/VA |
$20.90
|
| Rate for Payer: One Health Plan of WY PPO |
$37.82
|
| Rate for Payer: PacificSource Commercial |
$34.73
|
| Rate for Payer: PHCS PPO |
$37.82
|
| Rate for Payer: Three Rivers PPO |
$28.94
|
| Rate for Payer: TriWest Veterans Administration |
$22.00
|
| Rate for Payer: United Healthcare Commercial |
$36.85
|
| Rate for Payer: United Healthcare Medicare |
$22.00
|
| Rate for Payer: WINHealth Partners Commercial |
$37.82
|
| Rate for Payer: Wise Provider Network Commercial |
$36.66
|
|
|
BP CUFF NEONATAL #1 BAYONET
|
Facility
|
IP
|
$4.12
|
|
| Hospital Charge Code |
2400214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$4.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.04
|
| Rate for Payer: Aetna of WY Medicare |
$2.64
|
| Rate for Payer: Altius Commercial |
$3.96
|
| Rate for Payer: Beech Street Commercial |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.00
|
| Rate for Payer: Cash Price |
$2.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.00
|
| Rate for Payer: Cigna of WY Commercial |
$4.04
|
| Rate for Payer: Entrust Commercial |
$3.91
|
| Rate for Payer: First Choice Health Commercial |
$3.91
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.91
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.51
|
| Rate for Payer: HealthUtah PPO |
$4.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.00
|
| Rate for Payer: Multiplan Medicare/VA |
$2.39
|
| Rate for Payer: One Health Plan of WY PPO |
$4.04
|
| Rate for Payer: PacificSource Commercial |
$3.71
|
| Rate for Payer: PHCS PPO |
$4.04
|
| Rate for Payer: Three Rivers PPO |
$3.09
|
| Rate for Payer: TriWest Veterans Administration |
$2.51
|
| Rate for Payer: United Healthcare Commercial |
$3.93
|
| Rate for Payer: United Healthcare Medicare |
$2.51
|
| Rate for Payer: WINHealth Partners Commercial |
$3.91
|
| Rate for Payer: Wise Provider Network Commercial |
$3.91
|
|
|
BP CUFF NEONATAL #1 BAYONET
|
Facility
|
OP
|
$4.12
|
|
| Hospital Charge Code |
2400214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$4.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.04
|
| Rate for Payer: Aetna of WY Medicare |
$2.72
|
| Rate for Payer: Altius Commercial |
$3.96
|
| Rate for Payer: Beech Street Commercial |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.00
|
| Rate for Payer: Cash Price |
$2.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.00
|
| Rate for Payer: Cigna of WY Commercial |
$4.04
|
| Rate for Payer: Entrust Commercial |
$3.91
|
| Rate for Payer: First Choice Health Commercial |
$3.91
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.91
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.35
|
| Rate for Payer: HealthUtah PPO |
$4.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.00
|
| Rate for Payer: Multiplan Medicare/VA |
$2.23
|
| Rate for Payer: One Health Plan of WY PPO |
$4.04
|
| Rate for Payer: PacificSource Commercial |
$3.71
|
| Rate for Payer: PHCS PPO |
$4.04
|
| Rate for Payer: Three Rivers PPO |
$3.09
|
| Rate for Payer: TriWest Veterans Administration |
$2.35
|
| Rate for Payer: United Healthcare Commercial |
$3.93
|
| Rate for Payer: United Healthcare Medicare |
$2.35
|
| Rate for Payer: WINHealth Partners Commercial |
$4.04
|
| Rate for Payer: Wise Provider Network Commercial |
$3.91
|
|
|
BP CUFF NEONATAL #2 BAYONET
|
Facility
|
IP
|
$2.31
|
|
| Hospital Charge Code |
2400215
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.34 |
| Max. Negotiated Rate |
$2.31 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.26
|
| Rate for Payer: Aetna of WY Medicare |
$1.48
|
| Rate for Payer: Altius Commercial |
$2.22
|
| Rate for Payer: Beech Street Commercial |
$2.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.24
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.24
|
| Rate for Payer: Cigna of WY Commercial |
$2.26
|
| Rate for Payer: Entrust Commercial |
$2.19
|
| Rate for Payer: First Choice Health Commercial |
$2.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.41
|
| Rate for Payer: HealthUtah PPO |
$2.31
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.24
|
| Rate for Payer: Multiplan Medicare/VA |
$1.34
|
| Rate for Payer: One Health Plan of WY PPO |
$2.26
|
| Rate for Payer: PacificSource Commercial |
$2.08
|
| Rate for Payer: PHCS PPO |
$2.26
|
| Rate for Payer: Three Rivers PPO |
$1.73
|
| Rate for Payer: TriWest Veterans Administration |
$1.41
|
| Rate for Payer: United Healthcare Commercial |
$2.21
|
| Rate for Payer: United Healthcare Medicare |
$1.41
|
| Rate for Payer: WINHealth Partners Commercial |
$2.19
|
| Rate for Payer: Wise Provider Network Commercial |
$2.19
|
|
|
BP CUFF NEONATAL #2 BAYONET
|
Facility
|
OP
|
$2.31
|
|
| Hospital Charge Code |
2400215
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$2.31 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.26
|
| Rate for Payer: Aetna of WY Medicare |
$1.52
|
| Rate for Payer: Altius Commercial |
$2.22
|
| Rate for Payer: Beech Street Commercial |
$2.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.24
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.24
|
| Rate for Payer: Cigna of WY Commercial |
$2.26
|
| Rate for Payer: Entrust Commercial |
$2.19
|
| Rate for Payer: First Choice Health Commercial |
$2.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.32
|
| Rate for Payer: HealthUtah PPO |
$2.31
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.24
|
| Rate for Payer: Multiplan Medicare/VA |
$1.25
|
| Rate for Payer: One Health Plan of WY PPO |
$2.26
|
| Rate for Payer: PacificSource Commercial |
$2.08
|
| Rate for Payer: PHCS PPO |
$2.26
|
| Rate for Payer: Three Rivers PPO |
$1.73
|
| Rate for Payer: TriWest Veterans Administration |
$1.32
|
| Rate for Payer: United Healthcare Commercial |
$2.21
|
| Rate for Payer: United Healthcare Medicare |
$1.32
|
| Rate for Payer: WINHealth Partners Commercial |
$2.26
|
| Rate for Payer: Wise Provider Network Commercial |
$2.19
|
|
|
BP CUFF NEONATAL #3 BAYONET
|
Facility
|
IP
|
$2.38
|
|
| Hospital Charge Code |
2400025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.33
|
| Rate for Payer: Aetna of WY Medicare |
$1.52
|
| Rate for Payer: Altius Commercial |
$2.28
|
| Rate for Payer: Beech Street Commercial |
$2.33
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.31
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.31
|
| Rate for Payer: Cigna of WY Commercial |
$2.33
|
| Rate for Payer: Entrust Commercial |
$2.26
|
| Rate for Payer: First Choice Health Commercial |
$2.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.45
|
| Rate for Payer: HealthUtah PPO |
$2.38
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.31
|
| Rate for Payer: Multiplan Medicare/VA |
$1.38
|
| Rate for Payer: One Health Plan of WY PPO |
$2.33
|
| Rate for Payer: PacificSource Commercial |
$2.14
|
| Rate for Payer: PHCS PPO |
$2.33
|
| Rate for Payer: Three Rivers PPO |
$1.78
|
| Rate for Payer: TriWest Veterans Administration |
$1.45
|
| Rate for Payer: United Healthcare Commercial |
$2.27
|
| Rate for Payer: United Healthcare Medicare |
$1.45
|
| Rate for Payer: WINHealth Partners Commercial |
$2.26
|
| Rate for Payer: Wise Provider Network Commercial |
$2.26
|
|
|
BP CUFF NEONATAL #3 BAYONET
|
Facility
|
OP
|
$2.38
|
|
| Hospital Charge Code |
2400025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.33
|
| Rate for Payer: Aetna of WY Medicare |
$1.57
|
| Rate for Payer: Altius Commercial |
$2.28
|
| Rate for Payer: Beech Street Commercial |
$2.33
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.31
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.31
|
| Rate for Payer: Cigna of WY Commercial |
$2.33
|
| Rate for Payer: Entrust Commercial |
$2.26
|
| Rate for Payer: First Choice Health Commercial |
$2.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.26
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.36
|
| Rate for Payer: HealthUtah PPO |
$2.38
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.31
|
| Rate for Payer: Multiplan Medicare/VA |
$1.29
|
| Rate for Payer: One Health Plan of WY PPO |
$2.33
|
| Rate for Payer: PacificSource Commercial |
$2.14
|
| Rate for Payer: PHCS PPO |
$2.33
|
| Rate for Payer: Three Rivers PPO |
$1.78
|
| Rate for Payer: TriWest Veterans Administration |
$1.36
|
| Rate for Payer: United Healthcare Commercial |
$2.27
|
| Rate for Payer: United Healthcare Medicare |
$1.36
|
| Rate for Payer: WINHealth Partners Commercial |
$2.33
|
| Rate for Payer: Wise Provider Network Commercial |
$2.26
|
|
|
BP CUFF NEONATAL #4 BAYONET
|
Facility
|
OP
|
$2.45
|
|
| Hospital Charge Code |
2400023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.40
|
| Rate for Payer: Aetna of WY Medicare |
$1.62
|
| Rate for Payer: Altius Commercial |
$2.35
|
| Rate for Payer: Beech Street Commercial |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.38
|
| Rate for Payer: Cash Price |
$1.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.38
|
| Rate for Payer: Cigna of WY Commercial |
$2.40
|
| Rate for Payer: Entrust Commercial |
$2.33
|
| Rate for Payer: First Choice Health Commercial |
$2.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.40
|
| Rate for Payer: HealthUtah PPO |
$2.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.38
|
| Rate for Payer: Multiplan Medicare/VA |
$1.33
|
| Rate for Payer: One Health Plan of WY PPO |
$2.40
|
| Rate for Payer: PacificSource Commercial |
$2.20
|
| Rate for Payer: PHCS PPO |
$2.40
|
| Rate for Payer: Three Rivers PPO |
$1.84
|
| Rate for Payer: TriWest Veterans Administration |
$1.40
|
| Rate for Payer: United Healthcare Commercial |
$2.34
|
| Rate for Payer: United Healthcare Medicare |
$1.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2.40
|
| Rate for Payer: Wise Provider Network Commercial |
$2.33
|
|
|
BP CUFF NEONATAL #4 BAYONET
|
Facility
|
IP
|
$2.45
|
|
| Hospital Charge Code |
2400023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.40
|
| Rate for Payer: Aetna of WY Medicare |
$1.57
|
| Rate for Payer: Altius Commercial |
$2.35
|
| Rate for Payer: Beech Street Commercial |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.38
|
| Rate for Payer: Cash Price |
$1.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.38
|
| Rate for Payer: Cigna of WY Commercial |
$2.40
|
| Rate for Payer: Entrust Commercial |
$2.33
|
| Rate for Payer: First Choice Health Commercial |
$2.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.49
|
| Rate for Payer: HealthUtah PPO |
$2.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.38
|
| Rate for Payer: Multiplan Medicare/VA |
$1.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2.40
|
| Rate for Payer: PacificSource Commercial |
$2.20
|
| Rate for Payer: PHCS PPO |
$2.40
|
| Rate for Payer: Three Rivers PPO |
$1.84
|
| Rate for Payer: TriWest Veterans Administration |
$1.49
|
| Rate for Payer: United Healthcare Commercial |
$2.34
|
| Rate for Payer: United Healthcare Medicare |
$1.49
|
| Rate for Payer: WINHealth Partners Commercial |
$2.33
|
| Rate for Payer: Wise Provider Network Commercial |
$2.33
|
|
|
BP CUFF NEONATAL #5 BAYONET
|
Facility
|
IP
|
$2.62
|
|
| Hospital Charge Code |
2400213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$2.62 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.57
|
| Rate for Payer: Aetna of WY Medicare |
$1.68
|
| Rate for Payer: Altius Commercial |
$2.52
|
| Rate for Payer: Beech Street Commercial |
$2.57
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.54
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.54
|
| Rate for Payer: Cigna of WY Commercial |
$2.57
|
| Rate for Payer: Entrust Commercial |
$2.49
|
| Rate for Payer: First Choice Health Commercial |
$2.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.60
|
| Rate for Payer: HealthUtah PPO |
$2.62
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.54
|
| Rate for Payer: Multiplan Medicare/VA |
$1.52
|
| Rate for Payer: One Health Plan of WY PPO |
$2.57
|
| Rate for Payer: PacificSource Commercial |
$2.36
|
| Rate for Payer: PHCS PPO |
$2.57
|
| Rate for Payer: Three Rivers PPO |
$1.96
|
| Rate for Payer: TriWest Veterans Administration |
$1.60
|
| Rate for Payer: United Healthcare Commercial |
$2.50
|
| Rate for Payer: United Healthcare Medicare |
$1.60
|
| Rate for Payer: WINHealth Partners Commercial |
$2.49
|
| Rate for Payer: Wise Provider Network Commercial |
$2.49
|
|
|
BP CUFF NEONATAL #5 BAYONET
|
Facility
|
OP
|
$2.62
|
|
| Hospital Charge Code |
2400213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$2.62 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.57
|
| Rate for Payer: Aetna of WY Medicare |
$1.73
|
| Rate for Payer: Altius Commercial |
$2.52
|
| Rate for Payer: Beech Street Commercial |
$2.57
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.54
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.54
|
| Rate for Payer: Cigna of WY Commercial |
$2.57
|
| Rate for Payer: Entrust Commercial |
$2.49
|
| Rate for Payer: First Choice Health Commercial |
$2.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.49
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.49
|
| Rate for Payer: HealthUtah PPO |
$2.62
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.54
|
| Rate for Payer: Multiplan Medicare/VA |
$1.42
|
| Rate for Payer: One Health Plan of WY PPO |
$2.57
|
| Rate for Payer: PacificSource Commercial |
$2.36
|
| Rate for Payer: PHCS PPO |
$2.57
|
| Rate for Payer: Three Rivers PPO |
$1.96
|
| Rate for Payer: TriWest Veterans Administration |
$1.49
|
| Rate for Payer: United Healthcare Commercial |
$2.50
|
| Rate for Payer: United Healthcare Medicare |
$1.49
|
| Rate for Payer: WINHealth Partners Commercial |
$2.57
|
| Rate for Payer: Wise Provider Network Commercial |
$2.49
|
|
|
BRA 3XL RECONSTRUCTION B2 BEIG
|
Facility
|
OP
|
$137.20
|
|
| Hospital Charge Code |
2650909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.29 |
| Max. Negotiated Rate |
$137.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$134.46
|
| Rate for Payer: Aetna of WY Medicare |
$90.55
|
| Rate for Payer: Altius Commercial |
$131.71
|
| Rate for Payer: Beech Street Commercial |
$134.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$133.08
|
| Rate for Payer: Cash Price |
$96.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$133.08
|
| Rate for Payer: Cigna of WY Commercial |
$134.46
|
| Rate for Payer: Entrust Commercial |
$130.34
|
| Rate for Payer: First Choice Health Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.20
|
| Rate for Payer: HealthUtah PPO |
$137.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$133.08
|
| Rate for Payer: Multiplan Medicare/VA |
$74.29
|
| Rate for Payer: One Health Plan of WY PPO |
$134.46
|
| Rate for Payer: PacificSource Commercial |
$123.48
|
| Rate for Payer: PHCS PPO |
$134.46
|
| Rate for Payer: Three Rivers PPO |
$102.90
|
| Rate for Payer: TriWest Veterans Administration |
$78.20
|
| Rate for Payer: United Healthcare Commercial |
$131.03
|
| Rate for Payer: United Healthcare Medicare |
$78.20
|
| Rate for Payer: WINHealth Partners Commercial |
$134.46
|
| Rate for Payer: Wise Provider Network Commercial |
$130.34
|
|
|
BRA 3XL RECONSTRUCTION B2 BEIG
|
Facility
|
IP
|
$137.20
|
|
| Hospital Charge Code |
2650909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.51 |
| Max. Negotiated Rate |
$137.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$134.46
|
| Rate for Payer: Aetna of WY Medicare |
$87.81
|
| Rate for Payer: Altius Commercial |
$131.71
|
| Rate for Payer: Beech Street Commercial |
$134.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$133.08
|
| Rate for Payer: Cash Price |
$96.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$133.08
|
| Rate for Payer: Cigna of WY Commercial |
$134.46
|
| Rate for Payer: Entrust Commercial |
$130.34
|
| Rate for Payer: First Choice Health Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.69
|
| Rate for Payer: HealthUtah PPO |
$137.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$133.08
|
| Rate for Payer: Multiplan Medicare/VA |
$79.51
|
| Rate for Payer: One Health Plan of WY PPO |
$134.46
|
| Rate for Payer: PacificSource Commercial |
$123.48
|
| Rate for Payer: PHCS PPO |
$134.46
|
| Rate for Payer: Three Rivers PPO |
$102.90
|
| Rate for Payer: TriWest Veterans Administration |
$83.69
|
| Rate for Payer: United Healthcare Commercial |
$131.03
|
| Rate for Payer: United Healthcare Medicare |
$83.69
|
| Rate for Payer: WINHealth Partners Commercial |
$130.34
|
| Rate for Payer: Wise Provider Network Commercial |
$130.34
|
|
|
BRA 3XL RECONSTRUCTION B2 BLAC
|
Facility
|
IP
|
$137.20
|
|
| Hospital Charge Code |
2650908
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.51 |
| Max. Negotiated Rate |
$137.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$134.46
|
| Rate for Payer: Aetna of WY Medicare |
$87.81
|
| Rate for Payer: Altius Commercial |
$131.71
|
| Rate for Payer: Beech Street Commercial |
$134.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$133.08
|
| Rate for Payer: Cash Price |
$96.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$133.08
|
| Rate for Payer: Cigna of WY Commercial |
$134.46
|
| Rate for Payer: Entrust Commercial |
$130.34
|
| Rate for Payer: First Choice Health Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$83.69
|
| Rate for Payer: HealthUtah PPO |
$137.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$133.08
|
| Rate for Payer: Multiplan Medicare/VA |
$79.51
|
| Rate for Payer: One Health Plan of WY PPO |
$134.46
|
| Rate for Payer: PacificSource Commercial |
$123.48
|
| Rate for Payer: PHCS PPO |
$134.46
|
| Rate for Payer: Three Rivers PPO |
$102.90
|
| Rate for Payer: TriWest Veterans Administration |
$83.69
|
| Rate for Payer: United Healthcare Commercial |
$131.03
|
| Rate for Payer: United Healthcare Medicare |
$83.69
|
| Rate for Payer: WINHealth Partners Commercial |
$130.34
|
| Rate for Payer: Wise Provider Network Commercial |
$130.34
|
|
|
BRA 3XL RECONSTRUCTION B2 BLAC
|
Facility
|
OP
|
$137.20
|
|
| Hospital Charge Code |
2650908
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.29 |
| Max. Negotiated Rate |
$137.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$134.46
|
| Rate for Payer: Aetna of WY Medicare |
$90.55
|
| Rate for Payer: Altius Commercial |
$131.71
|
| Rate for Payer: Beech Street Commercial |
$134.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$133.08
|
| Rate for Payer: Cash Price |
$96.04
|
| Rate for Payer: ChoiceCare Network Commercial |
$133.08
|
| Rate for Payer: Cigna of WY Commercial |
$134.46
|
| Rate for Payer: Entrust Commercial |
$130.34
|
| Rate for Payer: First Choice Health Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$130.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.20
|
| Rate for Payer: HealthUtah PPO |
$137.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$133.08
|
| Rate for Payer: Multiplan Medicare/VA |
$74.29
|
| Rate for Payer: One Health Plan of WY PPO |
$134.46
|
| Rate for Payer: PacificSource Commercial |
$123.48
|
| Rate for Payer: PHCS PPO |
$134.46
|
| Rate for Payer: Three Rivers PPO |
$102.90
|
| Rate for Payer: TriWest Veterans Administration |
$78.20
|
| Rate for Payer: United Healthcare Commercial |
$131.03
|
| Rate for Payer: United Healthcare Medicare |
$78.20
|
| Rate for Payer: WINHealth Partners Commercial |
$134.46
|
| Rate for Payer: Wise Provider Network Commercial |
$130.34
|
|
|
BRACE 10" WRIST MED LH 10453
|
Facility
|
OP
|
$21.18
|
|
| Hospital Charge Code |
2200064
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.47 |
| Max. Negotiated Rate |
$21.18 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.76
|
| Rate for Payer: Aetna of WY Medicare |
$13.98
|
| Rate for Payer: Altius Commercial |
$20.33
|
| Rate for Payer: Beech Street Commercial |
$20.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.54
|
| Rate for Payer: Cash Price |
$14.82
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.54
|
| Rate for Payer: Cigna of WY Commercial |
$20.76
|
| Rate for Payer: Entrust Commercial |
$20.12
|
| Rate for Payer: First Choice Health Commercial |
$20.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$20.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.07
|
| Rate for Payer: HealthUtah PPO |
$21.18
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.54
|
| Rate for Payer: Multiplan Medicare/VA |
$11.47
|
| Rate for Payer: One Health Plan of WY PPO |
$20.76
|
| Rate for Payer: PacificSource Commercial |
$19.06
|
| Rate for Payer: PHCS PPO |
$20.76
|
| Rate for Payer: Three Rivers PPO |
$15.88
|
| Rate for Payer: TriWest Veterans Administration |
$12.07
|
| Rate for Payer: United Healthcare Commercial |
$20.23
|
| Rate for Payer: United Healthcare Medicare |
$12.07
|
| Rate for Payer: WINHealth Partners Commercial |
$20.76
|
| Rate for Payer: Wise Provider Network Commercial |
$20.12
|
|
|
BRACE 10" WRIST MED LH 10453
|
Facility
|
IP
|
$21.18
|
|
| Hospital Charge Code |
2200064
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.27 |
| Max. Negotiated Rate |
$21.18 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.76
|
| Rate for Payer: Aetna of WY Medicare |
$13.56
|
| Rate for Payer: Altius Commercial |
$20.33
|
| Rate for Payer: Beech Street Commercial |
$20.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.54
|
| Rate for Payer: Cash Price |
$14.82
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.54
|
| Rate for Payer: Cigna of WY Commercial |
$20.76
|
| Rate for Payer: Entrust Commercial |
$20.12
|
| Rate for Payer: First Choice Health Commercial |
$20.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$20.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.92
|
| Rate for Payer: HealthUtah PPO |
$21.18
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.54
|
| Rate for Payer: Multiplan Medicare/VA |
$12.27
|
| Rate for Payer: One Health Plan of WY PPO |
$20.76
|
| Rate for Payer: PacificSource Commercial |
$19.06
|
| Rate for Payer: PHCS PPO |
$20.76
|
| Rate for Payer: Three Rivers PPO |
$15.88
|
| Rate for Payer: TriWest Veterans Administration |
$12.92
|
| Rate for Payer: United Healthcare Commercial |
$20.23
|
| Rate for Payer: United Healthcare Medicare |
$12.92
|
| Rate for Payer: WINHealth Partners Commercial |
$20.12
|
| Rate for Payer: Wise Provider Network Commercial |
$20.12
|
|
|
BRACE 8" WRIST L UNIV SZ BREG
|
Facility
|
IP
|
$17.32
|
|
| Hospital Charge Code |
2200437
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$17.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.97
|
| Rate for Payer: Aetna of WY Medicare |
$11.08
|
| Rate for Payer: Altius Commercial |
$16.63
|
| Rate for Payer: Beech Street Commercial |
$16.97
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.80
|
| Rate for Payer: Cash Price |
$12.13
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.80
|
| Rate for Payer: Cigna of WY Commercial |
$16.97
|
| Rate for Payer: Entrust Commercial |
$16.45
|
| Rate for Payer: First Choice Health Commercial |
$16.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.57
|
| Rate for Payer: HealthUtah PPO |
$17.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.80
|
| Rate for Payer: Multiplan Medicare/VA |
$10.04
|
| Rate for Payer: One Health Plan of WY PPO |
$16.97
|
| Rate for Payer: PacificSource Commercial |
$15.59
|
| Rate for Payer: PHCS PPO |
$16.97
|
| Rate for Payer: Three Rivers PPO |
$12.99
|
| Rate for Payer: TriWest Veterans Administration |
$10.57
|
| Rate for Payer: United Healthcare Commercial |
$16.54
|
| Rate for Payer: United Healthcare Medicare |
$10.57
|
| Rate for Payer: WINHealth Partners Commercial |
$16.45
|
| Rate for Payer: Wise Provider Network Commercial |
$16.45
|
|
