|
BRACE 8" WRIST L UNIV SZ BREG
|
Facility
|
OP
|
$17.32
|
|
| Hospital Charge Code |
2200437
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$17.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.97
|
| Rate for Payer: Aetna of WY Medicare |
$11.43
|
| 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 |
$9.87
|
| Rate for Payer: HealthUtah PPO |
$17.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.80
|
| Rate for Payer: Multiplan Medicare/VA |
$9.38
|
| 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 |
$9.87
|
| Rate for Payer: United Healthcare Commercial |
$16.54
|
| Rate for Payer: United Healthcare Medicare |
$9.87
|
| Rate for Payer: WINHealth Partners Commercial |
$16.97
|
| Rate for Payer: Wise Provider Network Commercial |
$16.45
|
|
|
BRACE 8" WRIST R UNIV SZ BREG
|
Facility
|
IP
|
$17.32
|
|
| Hospital Charge Code |
2200436
|
|
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
|
|
|
BRACE 8" WRIST R UNIV SZ BREG
|
Facility
|
OP
|
$17.32
|
|
| Hospital Charge Code |
2200436
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$17.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.97
|
| Rate for Payer: Aetna of WY Medicare |
$11.43
|
| 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 |
$9.87
|
| Rate for Payer: HealthUtah PPO |
$17.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.80
|
| Rate for Payer: Multiplan Medicare/VA |
$9.38
|
| 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 |
$9.87
|
| Rate for Payer: United Healthcare Commercial |
$16.54
|
| Rate for Payer: United Healthcare Medicare |
$9.87
|
| Rate for Payer: WINHealth Partners Commercial |
$16.97
|
| Rate for Payer: Wise Provider Network Commercial |
$16.45
|
|
|
BRACE AFO DROP FOOT LARGE LT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200450
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT LARGE LT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200450
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT LARGE RT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200454
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT LARGE RT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200454
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT MEDIUM LT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT MEDIUM LT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT MEDIUM RT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200453
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT MEDIUM RT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200453
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT SMALL LT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT SMALL LT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT SMALL RT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200452
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT SMALL RT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200452
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT XLARGE LT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200451
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT XLARGE LT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200451
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT XLARGE RT
|
Facility
|
IP
|
$68.50
|
|
| Hospital Charge Code |
2200455
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$43.84
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$41.78
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$39.70
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$41.78
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$41.78
|
| Rate for Payer: WINHealth Partners Commercial |
$65.08
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE AFO DROP FOOT XLARGE RT
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
2200455
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.09 |
| Max. Negotiated Rate |
$68.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$67.13
|
| Rate for Payer: Aetna of WY Medicare |
$45.21
|
| Rate for Payer: Altius Commercial |
$65.76
|
| Rate for Payer: Beech Street Commercial |
$67.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$66.44
|
| Rate for Payer: Cash Price |
$47.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$66.44
|
| Rate for Payer: Cigna of WY Commercial |
$67.13
|
| Rate for Payer: Entrust Commercial |
$65.08
|
| Rate for Payer: First Choice Health Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$65.08
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.04
|
| Rate for Payer: HealthUtah PPO |
$68.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$66.44
|
| Rate for Payer: Multiplan Medicare/VA |
$37.09
|
| Rate for Payer: One Health Plan of WY PPO |
$67.13
|
| Rate for Payer: PacificSource Commercial |
$61.65
|
| Rate for Payer: PHCS PPO |
$67.13
|
| Rate for Payer: Three Rivers PPO |
$51.38
|
| Rate for Payer: TriWest Veterans Administration |
$39.04
|
| Rate for Payer: United Healthcare Commercial |
$65.42
|
| Rate for Payer: United Healthcare Medicare |
$39.04
|
| Rate for Payer: WINHealth Partners Commercial |
$67.13
|
| Rate for Payer: Wise Provider Network Commercial |
$65.08
|
|
|
BRACE ANKLE LARGE SA702507
|
Facility
|
IP
|
$48.34
|
|
| Hospital Charge Code |
2200399
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$48.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.37
|
| Rate for Payer: Aetna of WY Medicare |
$30.94
|
| Rate for Payer: Altius Commercial |
$46.41
|
| Rate for Payer: Beech Street Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.89
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.89
|
| Rate for Payer: Cigna of WY Commercial |
$47.37
|
| Rate for Payer: Entrust Commercial |
$45.92
|
| Rate for Payer: First Choice Health Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.49
|
| Rate for Payer: HealthUtah PPO |
$48.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.89
|
| Rate for Payer: Multiplan Medicare/VA |
$28.01
|
| Rate for Payer: One Health Plan of WY PPO |
$47.37
|
| Rate for Payer: PacificSource Commercial |
$43.51
|
| Rate for Payer: PHCS PPO |
$47.37
|
| Rate for Payer: Three Rivers PPO |
$36.26
|
| Rate for Payer: TriWest Veterans Administration |
$29.49
|
| Rate for Payer: United Healthcare Commercial |
$46.16
|
| Rate for Payer: United Healthcare Medicare |
$29.49
|
| Rate for Payer: WINHealth Partners Commercial |
$45.92
|
| Rate for Payer: Wise Provider Network Commercial |
$45.92
|
|
|
BRACE ANKLE LARGE SA702507
|
Facility
|
OP
|
$48.34
|
|
| Hospital Charge Code |
2200399
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.18 |
| Max. Negotiated Rate |
$48.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.37
|
| Rate for Payer: Aetna of WY Medicare |
$31.90
|
| Rate for Payer: Altius Commercial |
$46.41
|
| Rate for Payer: Beech Street Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.89
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.89
|
| Rate for Payer: Cigna of WY Commercial |
$47.37
|
| Rate for Payer: Entrust Commercial |
$45.92
|
| Rate for Payer: First Choice Health Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.55
|
| Rate for Payer: HealthUtah PPO |
$48.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.89
|
| Rate for Payer: Multiplan Medicare/VA |
$26.18
|
| Rate for Payer: One Health Plan of WY PPO |
$47.37
|
| Rate for Payer: PacificSource Commercial |
$43.51
|
| Rate for Payer: PHCS PPO |
$47.37
|
| Rate for Payer: Three Rivers PPO |
$36.26
|
| Rate for Payer: TriWest Veterans Administration |
$27.55
|
| Rate for Payer: United Healthcare Commercial |
$46.16
|
| Rate for Payer: United Healthcare Medicare |
$27.55
|
| Rate for Payer: WINHealth Partners Commercial |
$47.37
|
| Rate for Payer: Wise Provider Network Commercial |
$45.92
|
|
|
BRACE ANKLE MEDIUM SA702505
|
Facility
|
IP
|
$48.34
|
|
| Hospital Charge Code |
2200398
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$48.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.37
|
| Rate for Payer: Aetna of WY Medicare |
$30.94
|
| Rate for Payer: Altius Commercial |
$46.41
|
| Rate for Payer: Beech Street Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.89
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.89
|
| Rate for Payer: Cigna of WY Commercial |
$47.37
|
| Rate for Payer: Entrust Commercial |
$45.92
|
| Rate for Payer: First Choice Health Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.49
|
| Rate for Payer: HealthUtah PPO |
$48.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.89
|
| Rate for Payer: Multiplan Medicare/VA |
$28.01
|
| Rate for Payer: One Health Plan of WY PPO |
$47.37
|
| Rate for Payer: PacificSource Commercial |
$43.51
|
| Rate for Payer: PHCS PPO |
$47.37
|
| Rate for Payer: Three Rivers PPO |
$36.26
|
| Rate for Payer: TriWest Veterans Administration |
$29.49
|
| Rate for Payer: United Healthcare Commercial |
$46.16
|
| Rate for Payer: United Healthcare Medicare |
$29.49
|
| Rate for Payer: WINHealth Partners Commercial |
$45.92
|
| Rate for Payer: Wise Provider Network Commercial |
$45.92
|
|
|
BRACE ANKLE MEDIUM SA702505
|
Facility
|
OP
|
$48.34
|
|
| Hospital Charge Code |
2200398
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.18 |
| Max. Negotiated Rate |
$48.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.37
|
| Rate for Payer: Aetna of WY Medicare |
$31.90
|
| Rate for Payer: Altius Commercial |
$46.41
|
| Rate for Payer: Beech Street Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.89
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.89
|
| Rate for Payer: Cigna of WY Commercial |
$47.37
|
| Rate for Payer: Entrust Commercial |
$45.92
|
| Rate for Payer: First Choice Health Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.55
|
| Rate for Payer: HealthUtah PPO |
$48.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.89
|
| Rate for Payer: Multiplan Medicare/VA |
$26.18
|
| Rate for Payer: One Health Plan of WY PPO |
$47.37
|
| Rate for Payer: PacificSource Commercial |
$43.51
|
| Rate for Payer: PHCS PPO |
$47.37
|
| Rate for Payer: Three Rivers PPO |
$36.26
|
| Rate for Payer: TriWest Veterans Administration |
$27.55
|
| Rate for Payer: United Healthcare Commercial |
$46.16
|
| Rate for Payer: United Healthcare Medicare |
$27.55
|
| Rate for Payer: WINHealth Partners Commercial |
$47.37
|
| Rate for Payer: Wise Provider Network Commercial |
$45.92
|
|
|
BRACE ANKLE SMALL SA702503
|
Facility
|
IP
|
$48.34
|
|
| Hospital Charge Code |
2200397
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$48.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.37
|
| Rate for Payer: Aetna of WY Medicare |
$30.94
|
| Rate for Payer: Altius Commercial |
$46.41
|
| Rate for Payer: Beech Street Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.89
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.89
|
| Rate for Payer: Cigna of WY Commercial |
$47.37
|
| Rate for Payer: Entrust Commercial |
$45.92
|
| Rate for Payer: First Choice Health Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.49
|
| Rate for Payer: HealthUtah PPO |
$48.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.89
|
| Rate for Payer: Multiplan Medicare/VA |
$28.01
|
| Rate for Payer: One Health Plan of WY PPO |
$47.37
|
| Rate for Payer: PacificSource Commercial |
$43.51
|
| Rate for Payer: PHCS PPO |
$47.37
|
| Rate for Payer: Three Rivers PPO |
$36.26
|
| Rate for Payer: TriWest Veterans Administration |
$29.49
|
| Rate for Payer: United Healthcare Commercial |
$46.16
|
| Rate for Payer: United Healthcare Medicare |
$29.49
|
| Rate for Payer: WINHealth Partners Commercial |
$45.92
|
| Rate for Payer: Wise Provider Network Commercial |
$45.92
|
|
|
BRACE ANKLE SMALL SA702503
|
Facility
|
OP
|
$48.34
|
|
| Hospital Charge Code |
2200397
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.18 |
| Max. Negotiated Rate |
$48.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.37
|
| Rate for Payer: Aetna of WY Medicare |
$31.90
|
| Rate for Payer: Altius Commercial |
$46.41
|
| Rate for Payer: Beech Street Commercial |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$46.89
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.89
|
| Rate for Payer: Cigna of WY Commercial |
$47.37
|
| Rate for Payer: Entrust Commercial |
$45.92
|
| Rate for Payer: First Choice Health Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.92
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.55
|
| Rate for Payer: HealthUtah PPO |
$48.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.89
|
| Rate for Payer: Multiplan Medicare/VA |
$26.18
|
| Rate for Payer: One Health Plan of WY PPO |
$47.37
|
| Rate for Payer: PacificSource Commercial |
$43.51
|
| Rate for Payer: PHCS PPO |
$47.37
|
| Rate for Payer: Three Rivers PPO |
$36.26
|
| Rate for Payer: TriWest Veterans Administration |
$27.55
|
| Rate for Payer: United Healthcare Commercial |
$46.16
|
| Rate for Payer: United Healthcare Medicare |
$27.55
|
| Rate for Payer: WINHealth Partners Commercial |
$47.37
|
| Rate for Payer: Wise Provider Network Commercial |
$45.92
|
|
