|
QUETIAPINE 100 MG TABLET [7820]
|
Facility
|
IP
|
$2.12
|
|
|
Service Code
|
NDC 6068734911
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$2.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.04
|
| Rate for Payer: Altius Commercial |
$2.04
|
| Rate for Payer: Beech Street Commercial |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.74
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.06
|
| Rate for Payer: Cigna of WY Commercial |
$2.08
|
| Rate for Payer: Entrust Commercial |
$2.01
|
| Rate for Payer: First Choice Health Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.40
|
| Rate for Payer: HealthUtah PPO |
$2.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.06
|
| Rate for Payer: Multiplan Medicare/VA |
$1.33
|
| Rate for Payer: One Health Plan of WY PPO |
$2.08
|
| Rate for Payer: PacificSource Commercial |
$1.91
|
| Rate for Payer: PHCS PPO |
$2.08
|
| Rate for Payer: Three Rivers PPO |
$1.59
|
| Rate for Payer: TriWest Veterans Administration |
$1.40
|
| Rate for Payer: United Healthcare Commercial |
$1.84
|
| Rate for Payer: United Healthcare Medicare |
$1.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2.01
|
| Rate for Payer: Wise Provider Network Commercial |
$2.01
|
|
|
QUETIAPINE 100 MG TABLET [7820]
|
Facility
|
OP
|
$2.12
|
|
|
Service Code
|
NDC 6068734901
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.08
|
| Rate for Payer: Aetna of WY Medicare |
$1.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.04
|
| Rate for Payer: Altius Commercial |
$2.04
|
| Rate for Payer: Beech Street Commercial |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.74
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.06
|
| Rate for Payer: Cigna of WY Commercial |
$2.08
|
| Rate for Payer: Entrust Commercial |
$2.01
|
| Rate for Payer: First Choice Health Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.23
|
| Rate for Payer: HealthUtah PPO |
$2.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.06
|
| Rate for Payer: Multiplan Medicare/VA |
$1.17
|
| Rate for Payer: One Health Plan of WY PPO |
$2.08
|
| Rate for Payer: PacificSource Commercial |
$1.91
|
| Rate for Payer: PHCS PPO |
$2.08
|
| Rate for Payer: Three Rivers PPO |
$1.59
|
| Rate for Payer: TriWest Veterans Administration |
$1.23
|
| Rate for Payer: United Healthcare Commercial |
$1.84
|
| Rate for Payer: United Healthcare Medicare |
$1.23
|
| Rate for Payer: WINHealth Partners Commercial |
$2.08
|
| Rate for Payer: Wise Provider Network Commercial |
$2.01
|
|
|
QUETIAPINE 100 MG TABLET [7820]
|
Facility
|
IP
|
$2.12
|
|
|
Service Code
|
NDC 6068734901
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$2.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.04
|
| Rate for Payer: Altius Commercial |
$2.04
|
| Rate for Payer: Beech Street Commercial |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.74
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.06
|
| Rate for Payer: Cigna of WY Commercial |
$2.08
|
| Rate for Payer: Entrust Commercial |
$2.01
|
| Rate for Payer: First Choice Health Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.40
|
| Rate for Payer: HealthUtah PPO |
$2.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.06
|
| Rate for Payer: Multiplan Medicare/VA |
$1.33
|
| Rate for Payer: One Health Plan of WY PPO |
$2.08
|
| Rate for Payer: PacificSource Commercial |
$1.91
|
| Rate for Payer: PHCS PPO |
$2.08
|
| Rate for Payer: Three Rivers PPO |
$1.59
|
| Rate for Payer: TriWest Veterans Administration |
$1.40
|
| Rate for Payer: United Healthcare Commercial |
$1.84
|
| Rate for Payer: United Healthcare Medicare |
$1.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2.01
|
| Rate for Payer: Wise Provider Network Commercial |
$2.01
|
|
|
QUETIAPINE 25 MG TABLET [134]
|
Facility
|
IP
|
$0.20
|
|
|
Service Code
|
NDC 6586248901
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.19
|
| Rate for Payer: Altius Commercial |
$0.19
|
| Rate for Payer: Beech Street Commercial |
$0.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.19
|
| Rate for Payer: Cigna of WY Commercial |
$0.20
|
| Rate for Payer: Entrust Commercial |
$0.19
|
| Rate for Payer: First Choice Health Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.13
|
| Rate for Payer: HealthUtah PPO |
$0.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.19
|
| Rate for Payer: Multiplan Medicare/VA |
$0.13
|
| Rate for Payer: One Health Plan of WY PPO |
$0.20
|
| Rate for Payer: PacificSource Commercial |
$0.18
|
| Rate for Payer: PHCS PPO |
$0.20
|
| Rate for Payer: Three Rivers PPO |
$0.15
|
| Rate for Payer: TriWest Veterans Administration |
$0.13
|
| Rate for Payer: United Healthcare Commercial |
$0.17
|
| Rate for Payer: United Healthcare Medicare |
$0.13
|
| Rate for Payer: WINHealth Partners Commercial |
$0.19
|
| Rate for Payer: Wise Provider Network Commercial |
$0.19
|
|
|
QUETIAPINE 25 MG TABLET [134]
|
Facility
|
OP
|
$0.20
|
|
|
Service Code
|
NDC 6586248901
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.20
|
| Rate for Payer: Aetna of WY Medicare |
$0.13
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.19
|
| Rate for Payer: Altius Commercial |
$0.19
|
| Rate for Payer: Beech Street Commercial |
$0.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.19
|
| Rate for Payer: Cigna of WY Commercial |
$0.20
|
| Rate for Payer: Entrust Commercial |
$0.19
|
| Rate for Payer: First Choice Health Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.12
|
| Rate for Payer: HealthUtah PPO |
$0.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.19
|
| Rate for Payer: Multiplan Medicare/VA |
$0.11
|
| Rate for Payer: One Health Plan of WY PPO |
$0.20
|
| Rate for Payer: PacificSource Commercial |
$0.18
|
| Rate for Payer: PHCS PPO |
$0.20
|
| Rate for Payer: Three Rivers PPO |
$0.15
|
| Rate for Payer: TriWest Veterans Administration |
$0.12
|
| Rate for Payer: United Healthcare Commercial |
$0.17
|
| Rate for Payer: United Healthcare Medicare |
$0.12
|
| Rate for Payer: WINHealth Partners Commercial |
$0.20
|
| Rate for Payer: Wise Provider Network Commercial |
$0.19
|
|
|
QUETIAPINE 25 MG TABLET [134]
|
Facility
|
OP
|
$1.30
|
|
|
Service Code
|
NDC 6068732701
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.27
|
| Rate for Payer: Aetna of WY Medicare |
$0.86
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1.25
|
| Rate for Payer: Altius Commercial |
$1.25
|
| Rate for Payer: Beech Street Commercial |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.07
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.26
|
| Rate for Payer: Cigna of WY Commercial |
$1.27
|
| Rate for Payer: Entrust Commercial |
$1.24
|
| Rate for Payer: First Choice Health Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.75
|
| Rate for Payer: HealthUtah PPO |
$1.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.26
|
| Rate for Payer: Multiplan Medicare/VA |
$0.72
|
| Rate for Payer: One Health Plan of WY PPO |
$1.27
|
| Rate for Payer: PacificSource Commercial |
$1.17
|
| Rate for Payer: PHCS PPO |
$1.27
|
| Rate for Payer: Three Rivers PPO |
$0.98
|
| Rate for Payer: TriWest Veterans Administration |
$0.75
|
| Rate for Payer: United Healthcare Commercial |
$1.13
|
| Rate for Payer: United Healthcare Medicare |
$0.75
|
| Rate for Payer: WINHealth Partners Commercial |
$1.27
|
| Rate for Payer: Wise Provider Network Commercial |
$1.24
|
|
|
QUETIAPINE 25 MG TABLET [134]
|
Facility
|
IP
|
$1.30
|
|
|
Service Code
|
NDC 6068732701
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.27
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1.25
|
| Rate for Payer: Altius Commercial |
$1.25
|
| Rate for Payer: Beech Street Commercial |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.07
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.26
|
| Rate for Payer: Cigna of WY Commercial |
$1.27
|
| Rate for Payer: Entrust Commercial |
$1.24
|
| Rate for Payer: First Choice Health Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.86
|
| Rate for Payer: HealthUtah PPO |
$1.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.26
|
| Rate for Payer: Multiplan Medicare/VA |
$0.82
|
| Rate for Payer: One Health Plan of WY PPO |
$1.27
|
| Rate for Payer: PacificSource Commercial |
$1.17
|
| Rate for Payer: PHCS PPO |
$1.27
|
| Rate for Payer: Three Rivers PPO |
$0.98
|
| Rate for Payer: TriWest Veterans Administration |
$0.86
|
| Rate for Payer: United Healthcare Commercial |
$1.13
|
| Rate for Payer: United Healthcare Medicare |
$0.86
|
| Rate for Payer: WINHealth Partners Commercial |
$1.24
|
| Rate for Payer: Wise Provider Network Commercial |
$1.24
|
|
|
QUETIAPINE 25 MG TABLET [134]
|
Facility
|
OP
|
$1.30
|
|
|
Service Code
|
NDC 6068732711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.27
|
| Rate for Payer: Aetna of WY Medicare |
$0.86
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1.25
|
| Rate for Payer: Altius Commercial |
$1.25
|
| Rate for Payer: Beech Street Commercial |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.07
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.26
|
| Rate for Payer: Cigna of WY Commercial |
$1.27
|
| Rate for Payer: Entrust Commercial |
$1.24
|
| Rate for Payer: First Choice Health Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.75
|
| Rate for Payer: HealthUtah PPO |
$1.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.26
|
| Rate for Payer: Multiplan Medicare/VA |
$0.72
|
| Rate for Payer: One Health Plan of WY PPO |
$1.27
|
| Rate for Payer: PacificSource Commercial |
$1.17
|
| Rate for Payer: PHCS PPO |
$1.27
|
| Rate for Payer: Three Rivers PPO |
$0.98
|
| Rate for Payer: TriWest Veterans Administration |
$0.75
|
| Rate for Payer: United Healthcare Commercial |
$1.13
|
| Rate for Payer: United Healthcare Medicare |
$0.75
|
| Rate for Payer: WINHealth Partners Commercial |
$1.27
|
| Rate for Payer: Wise Provider Network Commercial |
$1.24
|
|
|
QUETIAPINE 25 MG TABLET [134]
|
Facility
|
IP
|
$1.30
|
|
|
Service Code
|
NDC 6068732711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.27
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1.25
|
| Rate for Payer: Altius Commercial |
$1.25
|
| Rate for Payer: Beech Street Commercial |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.07
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.26
|
| Rate for Payer: Cigna of WY Commercial |
$1.27
|
| Rate for Payer: Entrust Commercial |
$1.24
|
| Rate for Payer: First Choice Health Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.86
|
| Rate for Payer: HealthUtah PPO |
$1.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.26
|
| Rate for Payer: Multiplan Medicare/VA |
$0.82
|
| Rate for Payer: One Health Plan of WY PPO |
$1.27
|
| Rate for Payer: PacificSource Commercial |
$1.17
|
| Rate for Payer: PHCS PPO |
$1.27
|
| Rate for Payer: Three Rivers PPO |
$0.98
|
| Rate for Payer: TriWest Veterans Administration |
$0.86
|
| Rate for Payer: United Healthcare Commercial |
$1.13
|
| Rate for Payer: United Healthcare Medicare |
$0.86
|
| Rate for Payer: WINHealth Partners Commercial |
$1.24
|
| Rate for Payer: Wise Provider Network Commercial |
$1.24
|
|
|
QUICK INSERTION KIT ICM BIOTRONIK
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.72 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$171.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$168.00
|
| Rate for Payer: Altius Commercial |
$168.00
|
| Rate for Payer: Beech Street Commercial |
$171.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$143.68
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$169.75
|
| Rate for Payer: Cigna of WY Commercial |
$171.50
|
| Rate for Payer: Entrust Commercial |
$166.25
|
| Rate for Payer: First Choice Health Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$115.50
|
| Rate for Payer: HealthUtah PPO |
$175.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$169.75
|
| Rate for Payer: Multiplan Medicare/VA |
$109.72
|
| Rate for Payer: One Health Plan of WY PPO |
$171.50
|
| Rate for Payer: PacificSource Commercial |
$157.50
|
| Rate for Payer: PHCS PPO |
$171.50
|
| Rate for Payer: Three Rivers PPO |
$131.25
|
| Rate for Payer: TriWest Veterans Administration |
$115.50
|
| Rate for Payer: United Healthcare Commercial |
$152.25
|
| Rate for Payer: United Healthcare Medicare |
$115.50
|
| Rate for Payer: WINHealth Partners Commercial |
$166.25
|
| Rate for Payer: Wise Provider Network Commercial |
$166.25
|
|
|
QUICK INSERTION KIT ICM BIOTRONIK
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.42 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$171.50
|
| Rate for Payer: Aetna of WY Medicare |
$115.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$168.00
|
| Rate for Payer: Altius Commercial |
$168.00
|
| Rate for Payer: Beech Street Commercial |
$171.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$143.68
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$169.75
|
| Rate for Payer: Cigna of WY Commercial |
$171.50
|
| Rate for Payer: Entrust Commercial |
$166.25
|
| Rate for Payer: First Choice Health Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$101.50
|
| Rate for Payer: HealthUtah PPO |
$175.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$169.75
|
| Rate for Payer: Multiplan Medicare/VA |
$96.42
|
| Rate for Payer: One Health Plan of WY PPO |
$171.50
|
| Rate for Payer: PacificSource Commercial |
$157.50
|
| Rate for Payer: PHCS PPO |
$171.50
|
| Rate for Payer: Three Rivers PPO |
$131.25
|
| Rate for Payer: TriWest Veterans Administration |
$101.50
|
| Rate for Payer: United Healthcare Commercial |
$152.25
|
| Rate for Payer: United Healthcare Medicare |
$101.50
|
| Rate for Payer: WINHealth Partners Commercial |
$171.50
|
| Rate for Payer: Wise Provider Network Commercial |
$166.25
|
|
|
QUICK PRESS MONITOR SET
|
Facility
|
IP
|
$463.75
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$290.77 |
| Max. Negotiated Rate |
$463.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$454.48
|
| Rate for Payer: Altius Auto/Workers Compensation |
$445.20
|
| Rate for Payer: Altius Commercial |
$445.20
|
| Rate for Payer: Beech Street Commercial |
$454.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$380.74
|
| Rate for Payer: Cash Price |
$324.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$449.84
|
| Rate for Payer: Cigna of WY Commercial |
$454.48
|
| Rate for Payer: Entrust Commercial |
$440.56
|
| Rate for Payer: First Choice Health Commercial |
$440.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$440.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$306.08
|
| Rate for Payer: HealthUtah PPO |
$463.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$449.84
|
| Rate for Payer: Multiplan Medicare/VA |
$290.77
|
| Rate for Payer: One Health Plan of WY PPO |
$454.48
|
| Rate for Payer: PacificSource Commercial |
$417.38
|
| Rate for Payer: PHCS PPO |
$454.48
|
| Rate for Payer: Three Rivers PPO |
$347.81
|
| Rate for Payer: TriWest Veterans Administration |
$306.08
|
| Rate for Payer: United Healthcare Commercial |
$403.46
|
| Rate for Payer: United Healthcare Medicare |
$306.08
|
| Rate for Payer: WINHealth Partners Commercial |
$440.56
|
| Rate for Payer: Wise Provider Network Commercial |
$440.56
|
|
|
QUICK PRESS MONITOR SET
|
Facility
|
OP
|
$463.75
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$463.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$454.48
|
| Rate for Payer: Aetna of WY Medicare |
$306.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$445.20
|
| Rate for Payer: Altius Commercial |
$445.20
|
| Rate for Payer: Beech Street Commercial |
$454.48
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$380.74
|
| Rate for Payer: Cash Price |
$324.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$449.84
|
| Rate for Payer: Cigna of WY Commercial |
$454.48
|
| Rate for Payer: Entrust Commercial |
$440.56
|
| Rate for Payer: First Choice Health Commercial |
$440.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$440.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$268.98
|
| Rate for Payer: HealthUtah PPO |
$463.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$449.84
|
| Rate for Payer: Multiplan Medicare/VA |
$255.53
|
| Rate for Payer: One Health Plan of WY PPO |
$454.48
|
| Rate for Payer: PacificSource Commercial |
$417.38
|
| Rate for Payer: PHCS PPO |
$454.48
|
| Rate for Payer: Three Rivers PPO |
$347.81
|
| Rate for Payer: TriWest Veterans Administration |
$268.98
|
| Rate for Payer: United Healthcare Commercial |
$403.46
|
| Rate for Payer: United Healthcare Medicare |
$268.98
|
| Rate for Payer: WINHealth Partners Commercial |
$454.48
|
| Rate for Payer: Wise Provider Network Commercial |
$440.56
|
|
|
R1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$4,816.00
|
|
|
Service Code
|
HCPCS 49561 AS
|
| Hospital Charge Code |
49561
|
| Min. Negotiated Rate |
$3,612.00 |
| Max. Negotiated Rate |
$4,816.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,719.68
|
| Rate for Payer: Beech Street Commercial |
$4,575.20
|
| Rate for Payer: Cash Price |
$3,371.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,671.52
|
| Rate for Payer: Cigna of WY Commercial |
$4,719.68
|
| Rate for Payer: First Choice Health Commercial |
$4,334.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,575.20
|
| Rate for Payer: HealthUtah PPO |
$4,816.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,671.52
|
| Rate for Payer: One Health Plan of WY PPO |
$4,719.68
|
| Rate for Payer: PacificSource Commercial |
$4,334.40
|
| Rate for Payer: PHCS PPO |
$4,575.20
|
| Rate for Payer: Three Rivers PPO |
$3,612.00
|
| Rate for Payer: United Healthcare Commercial |
$4,189.92
|
| Rate for Payer: WINHealth Partners Commercial |
$4,093.60
|
|
|
R1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$4,816.00
|
|
|
Service Code
|
HCPCS 49561
|
| Hospital Charge Code |
49561
|
| Min. Negotiated Rate |
$3,612.00 |
| Max. Negotiated Rate |
$4,816.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,719.68
|
| Rate for Payer: Beech Street Commercial |
$4,575.20
|
| Rate for Payer: Cash Price |
$3,371.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,671.52
|
| Rate for Payer: Cigna of WY Commercial |
$4,719.68
|
| Rate for Payer: First Choice Health Commercial |
$4,334.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,575.20
|
| Rate for Payer: HealthUtah PPO |
$4,816.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,671.52
|
| Rate for Payer: One Health Plan of WY PPO |
$4,719.68
|
| Rate for Payer: PacificSource Commercial |
$4,334.40
|
| Rate for Payer: PHCS PPO |
$4,575.20
|
| Rate for Payer: Three Rivers PPO |
$3,612.00
|
| Rate for Payer: United Healthcare Commercial |
$4,189.92
|
| Rate for Payer: WINHealth Partners Commercial |
$4,093.60
|
|
|
R1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$4,816.00
|
|
|
Service Code
|
HCPCS 49561 80
|
| Hospital Charge Code |
49561
|
| Min. Negotiated Rate |
$3,612.00 |
| Max. Negotiated Rate |
$4,816.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,719.68
|
| Rate for Payer: Beech Street Commercial |
$4,575.20
|
| Rate for Payer: Cash Price |
$3,371.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,671.52
|
| Rate for Payer: Cigna of WY Commercial |
$4,719.68
|
| Rate for Payer: First Choice Health Commercial |
$4,334.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,575.20
|
| Rate for Payer: HealthUtah PPO |
$4,816.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,671.52
|
| Rate for Payer: One Health Plan of WY PPO |
$4,719.68
|
| Rate for Payer: PacificSource Commercial |
$4,334.40
|
| Rate for Payer: PHCS PPO |
$4,575.20
|
| Rate for Payer: Three Rivers PPO |
$3,612.00
|
| Rate for Payer: United Healthcare Commercial |
$4,189.92
|
| Rate for Payer: WINHealth Partners Commercial |
$4,093.60
|
|
|
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION [152305]
|
Facility
|
OP
|
$695.50
|
|
|
Service Code
|
HCPCS 90375
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$383.22 |
| Max. Negotiated Rate |
$695.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$681.59
|
| Rate for Payer: Aetna of WY Medicare |
$459.03
|
| Rate for Payer: Altius Auto/Workers Compensation |
$667.68
|
| Rate for Payer: Altius Commercial |
$667.68
|
| Rate for Payer: Beech Street Commercial |
$681.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$571.01
|
| Rate for Payer: Cash Price |
$486.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$674.64
|
| Rate for Payer: Cigna of WY Commercial |
$681.59
|
| Rate for Payer: Entrust Commercial |
$660.72
|
| Rate for Payer: First Choice Health Commercial |
$660.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$660.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$403.39
|
| Rate for Payer: HealthUtah PPO |
$695.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$674.64
|
| Rate for Payer: Multiplan Medicare/VA |
$383.22
|
| Rate for Payer: One Health Plan of WY PPO |
$681.59
|
| Rate for Payer: PacificSource Commercial |
$625.95
|
| Rate for Payer: PHCS PPO |
$681.59
|
| Rate for Payer: Three Rivers PPO |
$521.62
|
| Rate for Payer: TriWest Veterans Administration |
$403.39
|
| Rate for Payer: United Healthcare Commercial |
$605.08
|
| Rate for Payer: United Healthcare Medicare |
$403.39
|
| Rate for Payer: WINHealth Partners Commercial |
$681.59
|
| Rate for Payer: Wise Provider Network Commercial |
$660.72
|
|
|
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION [152305]
|
Facility
|
IP
|
$695.50
|
|
|
Service Code
|
HCPCS 90375
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$436.08 |
| Max. Negotiated Rate |
$695.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$681.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$667.68
|
| Rate for Payer: Altius Commercial |
$667.68
|
| Rate for Payer: Beech Street Commercial |
$681.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$571.01
|
| Rate for Payer: Cash Price |
$486.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$674.64
|
| Rate for Payer: Cigna of WY Commercial |
$681.59
|
| Rate for Payer: Entrust Commercial |
$660.72
|
| Rate for Payer: First Choice Health Commercial |
$660.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$660.72
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$459.03
|
| Rate for Payer: HealthUtah PPO |
$695.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$674.64
|
| Rate for Payer: Multiplan Medicare/VA |
$436.08
|
| Rate for Payer: One Health Plan of WY PPO |
$681.59
|
| Rate for Payer: PacificSource Commercial |
$625.95
|
| Rate for Payer: PHCS PPO |
$681.59
|
| Rate for Payer: Three Rivers PPO |
$521.62
|
| Rate for Payer: TriWest Veterans Administration |
$459.03
|
| Rate for Payer: United Healthcare Commercial |
$605.08
|
| Rate for Payer: United Healthcare Medicare |
$459.03
|
| Rate for Payer: WINHealth Partners Commercial |
$660.72
|
| Rate for Payer: Wise Provider Network Commercial |
$660.72
|
|
|
RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 90375
|
| Hospital Charge Code |
90375
|
| Min. Negotiated Rate |
$242.80 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$749.70
|
| Rate for Payer: Aetna of WY Medicare |
$285.65
|
| Rate for Payer: Beech Street Commercial |
$726.75
|
| Rate for Payer: Cash Price |
$535.50
|
| Rate for Payer: Cash Price |
$535.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$742.05
|
| Rate for Payer: Cigna of WY Commercial |
$749.70
|
| Rate for Payer: First Choice Health Commercial |
$688.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$726.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$285.65
|
| Rate for Payer: HealthUtah PPO |
$765.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$742.05
|
| Rate for Payer: Multiplan Medicare/VA |
$242.80
|
| Rate for Payer: One Health Plan of WY PPO |
$749.70
|
| Rate for Payer: PacificSource Commercial |
$688.50
|
| Rate for Payer: PHCS PPO |
$726.75
|
| Rate for Payer: Three Rivers PPO |
$573.75
|
| Rate for Payer: TriWest Veterans Administration |
$285.65
|
| Rate for Payer: United Healthcare Commercial |
$665.55
|
| Rate for Payer: United Healthcare Medicare |
$285.65
|
| Rate for Payer: WINHealth Partners Commercial |
$726.75
|
|
|
RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION [53009]
|
Facility
|
IP
|
$466.16
|
|
|
Service Code
|
HCPCS 90675
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$292.28 |
| Max. Negotiated Rate |
$466.16 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$456.84
|
| Rate for Payer: Altius Auto/Workers Compensation |
$447.51
|
| Rate for Payer: Altius Commercial |
$447.51
|
| Rate for Payer: Beech Street Commercial |
$456.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$382.72
|
| Rate for Payer: Cash Price |
$326.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$452.18
|
| Rate for Payer: Cigna of WY Commercial |
$456.84
|
| Rate for Payer: Entrust Commercial |
$442.85
|
| Rate for Payer: First Choice Health Commercial |
$442.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$442.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$307.67
|
| Rate for Payer: HealthUtah PPO |
$466.16
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$452.18
|
| Rate for Payer: Multiplan Medicare/VA |
$292.28
|
| Rate for Payer: One Health Plan of WY PPO |
$456.84
|
| Rate for Payer: PacificSource Commercial |
$419.54
|
| Rate for Payer: PHCS PPO |
$456.84
|
| Rate for Payer: Three Rivers PPO |
$349.62
|
| Rate for Payer: TriWest Veterans Administration |
$307.67
|
| Rate for Payer: United Healthcare Commercial |
$405.56
|
| Rate for Payer: United Healthcare Medicare |
$307.67
|
| Rate for Payer: WINHealth Partners Commercial |
$442.85
|
| Rate for Payer: Wise Provider Network Commercial |
$442.85
|
|
|
RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION [53009]
|
Facility
|
OP
|
$466.16
|
|
|
Service Code
|
HCPCS 90675
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$256.85 |
| Max. Negotiated Rate |
$466.16 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$456.84
|
| Rate for Payer: Aetna of WY Medicare |
$307.67
|
| Rate for Payer: Altius Auto/Workers Compensation |
$447.51
|
| Rate for Payer: Altius Commercial |
$447.51
|
| Rate for Payer: Beech Street Commercial |
$456.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$382.72
|
| Rate for Payer: Cash Price |
$326.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$452.18
|
| Rate for Payer: Cigna of WY Commercial |
$456.84
|
| Rate for Payer: Entrust Commercial |
$442.85
|
| Rate for Payer: First Choice Health Commercial |
$442.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$442.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$270.37
|
| Rate for Payer: HealthUtah PPO |
$466.16
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$452.18
|
| Rate for Payer: Multiplan Medicare/VA |
$256.85
|
| Rate for Payer: One Health Plan of WY PPO |
$456.84
|
| Rate for Payer: PacificSource Commercial |
$419.54
|
| Rate for Payer: PHCS PPO |
$456.84
|
| Rate for Payer: Three Rivers PPO |
$349.62
|
| Rate for Payer: TriWest Veterans Administration |
$270.37
|
| Rate for Payer: United Healthcare Commercial |
$405.56
|
| Rate for Payer: United Healthcare Medicare |
$270.37
|
| Rate for Payer: WINHealth Partners Commercial |
$456.84
|
| Rate for Payer: Wise Provider Network Commercial |
$442.85
|
|
|
RABIES VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$615.00
|
|
|
Service Code
|
HCPCS 90675
|
| Hospital Charge Code |
90675
|
| Min. Negotiated Rate |
$274.35 |
| Max. Negotiated Rate |
$615.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$602.70
|
| Rate for Payer: Aetna of WY Medicare |
$322.76
|
| Rate for Payer: Beech Street Commercial |
$584.25
|
| Rate for Payer: Cash Price |
$430.50
|
| Rate for Payer: Cash Price |
$430.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$596.55
|
| Rate for Payer: Cigna of WY Commercial |
$602.70
|
| Rate for Payer: First Choice Health Commercial |
$553.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$584.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$322.76
|
| Rate for Payer: HealthUtah PPO |
$615.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$596.55
|
| Rate for Payer: Multiplan Medicare/VA |
$274.35
|
| Rate for Payer: One Health Plan of WY PPO |
$602.70
|
| Rate for Payer: PacificSource Commercial |
$553.50
|
| Rate for Payer: PHCS PPO |
$584.25
|
| Rate for Payer: Three Rivers PPO |
$461.25
|
| Rate for Payer: TriWest Veterans Administration |
$322.76
|
| Rate for Payer: United Healthcare Commercial |
$535.05
|
| Rate for Payer: United Healthcare Medicare |
$322.76
|
| Rate for Payer: WINHealth Partners Commercial |
$615.00
|
|
|
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION [35924]
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
NDC 0487278401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.84
|
| Rate for Payer: Altius Auto/Workers Compensation |
$7.68
|
| Rate for Payer: Altius Commercial |
$7.68
|
| Rate for Payer: Beech Street Commercial |
$7.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.57
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.76
|
| Rate for Payer: Cigna of WY Commercial |
$7.84
|
| Rate for Payer: Entrust Commercial |
$7.60
|
| Rate for Payer: First Choice Health Commercial |
$7.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.28
|
| Rate for Payer: HealthUtah PPO |
$8.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.76
|
| Rate for Payer: Multiplan Medicare/VA |
$5.02
|
| Rate for Payer: One Health Plan of WY PPO |
$7.84
|
| Rate for Payer: PacificSource Commercial |
$7.20
|
| Rate for Payer: PHCS PPO |
$7.84
|
| Rate for Payer: Three Rivers PPO |
$6.00
|
| Rate for Payer: TriWest Veterans Administration |
$5.28
|
| Rate for Payer: United Healthcare Commercial |
$6.96
|
| Rate for Payer: United Healthcare Medicare |
$5.28
|
| Rate for Payer: WINHealth Partners Commercial |
$7.60
|
| Rate for Payer: Wise Provider Network Commercial |
$7.60
|
|
|
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION [35924]
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
NDC 0487278401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.84
|
| Rate for Payer: Aetna of WY Medicare |
$5.28
|
| Rate for Payer: Altius Auto/Workers Compensation |
$7.68
|
| Rate for Payer: Altius Commercial |
$7.68
|
| Rate for Payer: Beech Street Commercial |
$7.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.57
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.76
|
| Rate for Payer: Cigna of WY Commercial |
$7.84
|
| Rate for Payer: Entrust Commercial |
$7.60
|
| Rate for Payer: First Choice Health Commercial |
$7.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.64
|
| Rate for Payer: HealthUtah PPO |
$8.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.76
|
| Rate for Payer: Multiplan Medicare/VA |
$4.41
|
| Rate for Payer: One Health Plan of WY PPO |
$7.84
|
| Rate for Payer: PacificSource Commercial |
$7.20
|
| Rate for Payer: PHCS PPO |
$7.84
|
| Rate for Payer: Three Rivers PPO |
$6.00
|
| Rate for Payer: TriWest Veterans Administration |
$4.64
|
| Rate for Payer: United Healthcare Commercial |
$6.96
|
| Rate for Payer: United Healthcare Medicare |
$4.64
|
| Rate for Payer: WINHealth Partners Commercial |
$7.84
|
| Rate for Payer: Wise Provider Network Commercial |
$7.60
|
|
|
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION [35924]
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
NDC 0487590199
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.84
|
| Rate for Payer: Aetna of WY Medicare |
$5.28
|
| Rate for Payer: Altius Auto/Workers Compensation |
$7.68
|
| Rate for Payer: Altius Commercial |
$7.68
|
| Rate for Payer: Beech Street Commercial |
$7.84
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.57
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.76
|
| Rate for Payer: Cigna of WY Commercial |
$7.84
|
| Rate for Payer: Entrust Commercial |
$7.60
|
| Rate for Payer: First Choice Health Commercial |
$7.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.64
|
| Rate for Payer: HealthUtah PPO |
$8.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.76
|
| Rate for Payer: Multiplan Medicare/VA |
$4.41
|
| Rate for Payer: One Health Plan of WY PPO |
$7.84
|
| Rate for Payer: PacificSource Commercial |
$7.20
|
| Rate for Payer: PHCS PPO |
$7.84
|
| Rate for Payer: Three Rivers PPO |
$6.00
|
| Rate for Payer: TriWest Veterans Administration |
$4.64
|
| Rate for Payer: United Healthcare Commercial |
$6.96
|
| Rate for Payer: United Healthcare Medicare |
$4.64
|
| Rate for Payer: WINHealth Partners Commercial |
$7.84
|
| Rate for Payer: Wise Provider Network Commercial |
$7.60
|
|
