|
RHINECTOMY TOTAL
|
Professional
|
Both
|
$2,836.00
|
|
|
Service Code
|
HCPCS 30160
|
| Hospital Charge Code |
30160
|
| Min. Negotiated Rate |
$675.19 |
| Max. Negotiated Rate |
$2,836.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,779.28
|
| Rate for Payer: Aetna of WY Medicare |
$794.34
|
| Rate for Payer: Beech Street Commercial |
$2,694.20
|
| Rate for Payer: Cash Price |
$1,985.20
|
| Rate for Payer: Cash Price |
$1,985.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,750.92
|
| Rate for Payer: Cigna of WY Commercial |
$2,779.28
|
| Rate for Payer: First Choice Health Commercial |
$2,552.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,694.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$794.34
|
| Rate for Payer: HealthUtah PPO |
$2,836.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,750.92
|
| Rate for Payer: Multiplan Medicare/VA |
$675.19
|
| Rate for Payer: One Health Plan of WY PPO |
$2,779.28
|
| Rate for Payer: PacificSource Commercial |
$2,552.40
|
| Rate for Payer: PHCS PPO |
$2,694.20
|
| Rate for Payer: Three Rivers PPO |
$2,127.00
|
| Rate for Payer: TriWest Veterans Administration |
$794.34
|
| Rate for Payer: United Healthcare Commercial |
$2,467.32
|
| Rate for Payer: United Healthcare Medicare |
$794.34
|
| Rate for Payer: WINHealth Partners Commercial |
$2,410.60
|
|
|
RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR
|
Professional
|
Both
|
$5,171.00
|
|
|
Service Code
|
HCPCS 30420
|
| Hospital Charge Code |
30420
|
| Min. Negotiated Rate |
$1,200.91 |
| Max. Negotiated Rate |
$5,171.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5,067.58
|
| Rate for Payer: Aetna of WY Medicare |
$1,412.83
|
| Rate for Payer: Beech Street Commercial |
$4,912.45
|
| Rate for Payer: Cash Price |
$3,619.70
|
| Rate for Payer: Cash Price |
$3,619.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$5,015.87
|
| Rate for Payer: Cigna of WY Commercial |
$5,067.58
|
| Rate for Payer: First Choice Health Commercial |
$4,653.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,912.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,412.83
|
| Rate for Payer: HealthUtah PPO |
$5,171.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5,015.87
|
| Rate for Payer: Multiplan Medicare/VA |
$1,200.91
|
| Rate for Payer: One Health Plan of WY PPO |
$5,067.58
|
| Rate for Payer: PacificSource Commercial |
$4,653.90
|
| Rate for Payer: PHCS PPO |
$4,912.45
|
| Rate for Payer: Three Rivers PPO |
$3,878.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,412.83
|
| Rate for Payer: United Healthcare Commercial |
$4,498.77
|
| Rate for Payer: United Healthcare Medicare |
$1,412.83
|
| Rate for Payer: WINHealth Partners Commercial |
$4,395.35
|
|
|
RHINOPLASTY SECONDARY INTERMEDIATE REVISION
|
Professional
|
Both
|
$4,641.00
|
|
|
Service Code
|
HCPCS 30435
|
| Hospital Charge Code |
30435
|
| Min. Negotiated Rate |
$1,105.76 |
| Max. Negotiated Rate |
$4,641.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,548.18
|
| Rate for Payer: Aetna of WY Medicare |
$1,300.90
|
| Rate for Payer: Beech Street Commercial |
$4,408.95
|
| Rate for Payer: Cash Price |
$3,248.70
|
| Rate for Payer: Cash Price |
$3,248.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,501.77
|
| Rate for Payer: Cigna of WY Commercial |
$4,548.18
|
| Rate for Payer: First Choice Health Commercial |
$4,176.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,408.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,300.90
|
| Rate for Payer: HealthUtah PPO |
$4,641.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,501.77
|
| Rate for Payer: Multiplan Medicare/VA |
$1,105.76
|
| Rate for Payer: One Health Plan of WY PPO |
$4,548.18
|
| Rate for Payer: PacificSource Commercial |
$4,176.90
|
| Rate for Payer: PHCS PPO |
$4,408.95
|
| Rate for Payer: Three Rivers PPO |
$3,480.75
|
| Rate for Payer: TriWest Veterans Administration |
$1,300.90
|
| Rate for Payer: United Healthcare Commercial |
$4,037.67
|
| Rate for Payer: United Healthcare Medicare |
$1,300.90
|
| Rate for Payer: WINHealth Partners Commercial |
$3,944.85
|
|
|
RHINO ROCKET SLIMLINE MEDIUM
|
Facility
|
OP
|
$51.46
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$51.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$50.43
|
| Rate for Payer: Aetna of WY Medicare |
$33.96
|
| Rate for Payer: Altius Auto/Workers Compensation |
$49.40
|
| Rate for Payer: Altius Commercial |
$49.40
|
| Rate for Payer: Beech Street Commercial |
$50.43
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$42.25
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.92
|
| Rate for Payer: Cigna of WY Commercial |
$50.43
|
| Rate for Payer: Entrust Commercial |
$48.89
|
| Rate for Payer: First Choice Health Commercial |
$48.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.85
|
| Rate for Payer: HealthUtah PPO |
$51.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.92
|
| Rate for Payer: Multiplan Medicare/VA |
$28.35
|
| Rate for Payer: One Health Plan of WY PPO |
$50.43
|
| Rate for Payer: PacificSource Commercial |
$46.31
|
| Rate for Payer: PHCS PPO |
$50.43
|
| Rate for Payer: Three Rivers PPO |
$38.60
|
| Rate for Payer: TriWest Veterans Administration |
$29.85
|
| Rate for Payer: United Healthcare Commercial |
$44.77
|
| Rate for Payer: United Healthcare Medicare |
$29.85
|
| Rate for Payer: WINHealth Partners Commercial |
$50.43
|
| Rate for Payer: Wise Provider Network Commercial |
$48.89
|
|
|
RHINO ROCKET SLIMLINE MEDIUM
|
Facility
|
IP
|
$51.46
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.27 |
| Max. Negotiated Rate |
$51.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$50.43
|
| Rate for Payer: Altius Auto/Workers Compensation |
$49.40
|
| Rate for Payer: Altius Commercial |
$49.40
|
| Rate for Payer: Beech Street Commercial |
$50.43
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$42.25
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.92
|
| Rate for Payer: Cigna of WY Commercial |
$50.43
|
| Rate for Payer: Entrust Commercial |
$48.89
|
| Rate for Payer: First Choice Health Commercial |
$48.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$33.96
|
| Rate for Payer: HealthUtah PPO |
$51.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.92
|
| Rate for Payer: Multiplan Medicare/VA |
$32.27
|
| Rate for Payer: One Health Plan of WY PPO |
$50.43
|
| Rate for Payer: PacificSource Commercial |
$46.31
|
| Rate for Payer: PHCS PPO |
$50.43
|
| Rate for Payer: Three Rivers PPO |
$38.60
|
| Rate for Payer: TriWest Veterans Administration |
$33.96
|
| Rate for Payer: United Healthcare Commercial |
$44.77
|
| Rate for Payer: United Healthcare Medicare |
$33.96
|
| Rate for Payer: WINHealth Partners Commercial |
$48.89
|
| Rate for Payer: Wise Provider Network Commercial |
$48.89
|
|
|
RHINP DFRM W/COLUM LNGTH TIP ONLY
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 30460
|
| Hospital Charge Code |
30460
|
| Min. Negotiated Rate |
$680.62 |
| Max. Negotiated Rate |
$2,857.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,799.86
|
| Rate for Payer: Aetna of WY Medicare |
$800.73
|
| Rate for Payer: Beech Street Commercial |
$2,714.15
|
| Rate for Payer: Cash Price |
$1,999.90
|
| Rate for Payer: Cash Price |
$1,999.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,771.29
|
| Rate for Payer: Cigna of WY Commercial |
$2,799.86
|
| Rate for Payer: First Choice Health Commercial |
$2,571.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,714.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$800.73
|
| Rate for Payer: HealthUtah PPO |
$2,857.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,771.29
|
| Rate for Payer: Multiplan Medicare/VA |
$680.62
|
| Rate for Payer: One Health Plan of WY PPO |
$2,799.86
|
| Rate for Payer: PacificSource Commercial |
$2,571.30
|
| Rate for Payer: PHCS PPO |
$2,714.15
|
| Rate for Payer: Three Rivers PPO |
$2,142.75
|
| Rate for Payer: TriWest Veterans Administration |
$800.73
|
| Rate for Payer: United Healthcare Commercial |
$2,485.59
|
| Rate for Payer: United Healthcare Medicare |
$800.73
|
| Rate for Payer: WINHealth Partners Commercial |
$2,428.45
|
|
|
RHINP PRIM COMPLETE XTRNL PARTS
|
Professional
|
Both
|
$4,899.00
|
|
|
Service Code
|
HCPCS 30410
|
| Hospital Charge Code |
30410
|
| Min. Negotiated Rate |
$1,166.85 |
| Max. Negotiated Rate |
$4,899.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,801.02
|
| Rate for Payer: Aetna of WY Medicare |
$1,372.77
|
| Rate for Payer: Beech Street Commercial |
$4,654.05
|
| Rate for Payer: Cash Price |
$3,429.30
|
| Rate for Payer: Cash Price |
$3,429.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,752.03
|
| Rate for Payer: Cigna of WY Commercial |
$4,801.02
|
| Rate for Payer: First Choice Health Commercial |
$4,409.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,654.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,372.77
|
| Rate for Payer: HealthUtah PPO |
$4,899.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,752.03
|
| Rate for Payer: Multiplan Medicare/VA |
$1,166.85
|
| Rate for Payer: One Health Plan of WY PPO |
$4,801.02
|
| Rate for Payer: PacificSource Commercial |
$4,409.10
|
| Rate for Payer: PHCS PPO |
$4,654.05
|
| Rate for Payer: Three Rivers PPO |
$3,674.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,372.77
|
| Rate for Payer: United Healthcare Commercial |
$4,262.13
|
| Rate for Payer: United Healthcare Medicare |
$1,372.77
|
| Rate for Payer: WINHealth Partners Commercial |
$4,164.15
|
|
|
RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI
|
Professional
|
Both
|
$4,267.00
|
|
|
Service Code
|
HCPCS 30400
|
| Hospital Charge Code |
30400
|
| Min. Negotiated Rate |
$1,016.32 |
| Max. Negotiated Rate |
$4,267.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,181.66
|
| Rate for Payer: Aetna of WY Medicare |
$1,195.67
|
| Rate for Payer: Beech Street Commercial |
$4,053.65
|
| Rate for Payer: Cash Price |
$2,986.90
|
| Rate for Payer: Cash Price |
$2,986.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,138.99
|
| Rate for Payer: Cigna of WY Commercial |
$4,181.66
|
| Rate for Payer: First Choice Health Commercial |
$3,840.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,053.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,195.67
|
| Rate for Payer: HealthUtah PPO |
$4,267.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,138.99
|
| Rate for Payer: Multiplan Medicare/VA |
$1,016.32
|
| Rate for Payer: One Health Plan of WY PPO |
$4,181.66
|
| Rate for Payer: PacificSource Commercial |
$3,840.30
|
| Rate for Payer: PHCS PPO |
$4,053.65
|
| Rate for Payer: Three Rivers PPO |
$3,200.25
|
| Rate for Payer: TriWest Veterans Administration |
$1,195.67
|
| Rate for Payer: United Healthcare Commercial |
$3,712.29
|
| Rate for Payer: United Healthcare Medicare |
$1,195.67
|
| Rate for Payer: WINHealth Partners Commercial |
$3,626.95
|
|
|
RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE [31807]
|
Facility
|
IP
|
$163.88
|
|
|
Service Code
|
HCPCS J2791
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$102.75 |
| Max. Negotiated Rate |
$163.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$157.32
|
| Rate for Payer: Altius Commercial |
$157.32
|
| Rate for Payer: Beech Street Commercial |
$160.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.55
|
| Rate for Payer: Cash Price |
$114.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$158.96
|
| Rate for Payer: Cigna of WY Commercial |
$160.60
|
| Rate for Payer: Entrust Commercial |
$155.69
|
| Rate for Payer: First Choice Health Commercial |
$155.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$108.16
|
| Rate for Payer: HealthUtah PPO |
$163.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$158.96
|
| Rate for Payer: Multiplan Medicare/VA |
$102.75
|
| Rate for Payer: One Health Plan of WY PPO |
$160.60
|
| Rate for Payer: PacificSource Commercial |
$147.49
|
| Rate for Payer: PHCS PPO |
$160.60
|
| Rate for Payer: Three Rivers PPO |
$122.91
|
| Rate for Payer: TriWest Veterans Administration |
$108.16
|
| Rate for Payer: United Healthcare Commercial |
$142.58
|
| Rate for Payer: United Healthcare Medicare |
$108.16
|
| Rate for Payer: WINHealth Partners Commercial |
$155.69
|
| Rate for Payer: Wise Provider Network Commercial |
$155.69
|
|
|
RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE [31807]
|
Facility
|
OP
|
$163.88
|
|
|
Service Code
|
HCPCS J2791
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$90.30 |
| Max. Negotiated Rate |
$163.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$160.60
|
| Rate for Payer: Aetna of WY Medicare |
$108.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$157.32
|
| Rate for Payer: Altius Commercial |
$157.32
|
| Rate for Payer: Beech Street Commercial |
$160.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.55
|
| Rate for Payer: Cash Price |
$114.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$158.96
|
| Rate for Payer: Cigna of WY Commercial |
$160.60
|
| Rate for Payer: Entrust Commercial |
$155.69
|
| Rate for Payer: First Choice Health Commercial |
$155.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$155.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$95.05
|
| Rate for Payer: HealthUtah PPO |
$163.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$158.96
|
| Rate for Payer: Multiplan Medicare/VA |
$90.30
|
| Rate for Payer: One Health Plan of WY PPO |
$160.60
|
| Rate for Payer: PacificSource Commercial |
$147.49
|
| Rate for Payer: PHCS PPO |
$160.60
|
| Rate for Payer: Three Rivers PPO |
$122.91
|
| Rate for Payer: TriWest Veterans Administration |
$95.05
|
| Rate for Payer: United Healthcare Commercial |
$142.58
|
| Rate for Payer: United Healthcare Medicare |
$95.05
|
| Rate for Payer: WINHealth Partners Commercial |
$160.60
|
| Rate for Payer: Wise Provider Network Commercial |
$155.69
|
|
|
RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE [25652]
|
Facility
|
IP
|
$159.95
|
|
|
Service Code
|
HCPCS J2790
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$100.29 |
| Max. Negotiated Rate |
$159.95 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$156.75
|
| Rate for Payer: Altius Auto/Workers Compensation |
$153.55
|
| Rate for Payer: Altius Commercial |
$153.55
|
| Rate for Payer: Beech Street Commercial |
$156.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$131.32
|
| Rate for Payer: Cash Price |
$111.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$155.15
|
| Rate for Payer: Cigna of WY Commercial |
$156.75
|
| Rate for Payer: Entrust Commercial |
$151.95
|
| Rate for Payer: First Choice Health Commercial |
$151.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$151.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$105.57
|
| Rate for Payer: HealthUtah PPO |
$159.95
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$155.15
|
| Rate for Payer: Multiplan Medicare/VA |
$100.29
|
| Rate for Payer: One Health Plan of WY PPO |
$156.75
|
| Rate for Payer: PacificSource Commercial |
$143.96
|
| Rate for Payer: PHCS PPO |
$156.75
|
| Rate for Payer: Three Rivers PPO |
$119.96
|
| Rate for Payer: TriWest Veterans Administration |
$105.57
|
| Rate for Payer: United Healthcare Commercial |
$139.16
|
| Rate for Payer: United Healthcare Medicare |
$105.57
|
| Rate for Payer: WINHealth Partners Commercial |
$151.95
|
| Rate for Payer: Wise Provider Network Commercial |
$151.95
|
|
|
RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE [25652]
|
Facility
|
OP
|
$159.95
|
|
|
Service Code
|
HCPCS J2790
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$88.13 |
| Max. Negotiated Rate |
$159.95 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$156.75
|
| Rate for Payer: Aetna of WY Medicare |
$105.57
|
| Rate for Payer: Altius Auto/Workers Compensation |
$153.55
|
| Rate for Payer: Altius Commercial |
$153.55
|
| Rate for Payer: Beech Street Commercial |
$156.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$131.32
|
| Rate for Payer: Cash Price |
$111.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$155.15
|
| Rate for Payer: Cigna of WY Commercial |
$156.75
|
| Rate for Payer: Entrust Commercial |
$151.95
|
| Rate for Payer: First Choice Health Commercial |
$151.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$151.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$92.77
|
| Rate for Payer: HealthUtah PPO |
$159.95
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$155.15
|
| Rate for Payer: Multiplan Medicare/VA |
$88.13
|
| Rate for Payer: One Health Plan of WY PPO |
$156.75
|
| Rate for Payer: PacificSource Commercial |
$143.96
|
| Rate for Payer: PHCS PPO |
$156.75
|
| Rate for Payer: Three Rivers PPO |
$119.96
|
| Rate for Payer: TriWest Veterans Administration |
$92.77
|
| Rate for Payer: United Healthcare Commercial |
$139.16
|
| Rate for Payer: United Healthcare Medicare |
$92.77
|
| Rate for Payer: WINHealth Partners Commercial |
$156.75
|
| Rate for Payer: Wise Provider Network Commercial |
$151.95
|
|
|
RHO(D) IMMUNE GLOBULIN 250 UNIT (50 MCG) INTRAMUSCULAR SYRINGE [10721]
|
Facility
|
IP
|
$74.68
|
|
|
Service Code
|
HCPCS J2788
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.82 |
| Max. Negotiated Rate |
$74.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$73.19
|
| Rate for Payer: Altius Auto/Workers Compensation |
$71.69
|
| Rate for Payer: Altius Commercial |
$71.69
|
| Rate for Payer: Beech Street Commercial |
$73.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$61.31
|
| Rate for Payer: Cash Price |
$52.28
|
| Rate for Payer: ChoiceCare Network Commercial |
$72.44
|
| Rate for Payer: Cigna of WY Commercial |
$73.19
|
| Rate for Payer: Entrust Commercial |
$70.95
|
| Rate for Payer: First Choice Health Commercial |
$70.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$70.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$49.29
|
| Rate for Payer: HealthUtah PPO |
$74.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$72.44
|
| Rate for Payer: Multiplan Medicare/VA |
$46.82
|
| Rate for Payer: One Health Plan of WY PPO |
$73.19
|
| Rate for Payer: PacificSource Commercial |
$67.21
|
| Rate for Payer: PHCS PPO |
$73.19
|
| Rate for Payer: Three Rivers PPO |
$56.01
|
| Rate for Payer: TriWest Veterans Administration |
$49.29
|
| Rate for Payer: United Healthcare Commercial |
$64.97
|
| Rate for Payer: United Healthcare Medicare |
$49.29
|
| Rate for Payer: WINHealth Partners Commercial |
$70.95
|
| Rate for Payer: Wise Provider Network Commercial |
$70.95
|
|
|
RHO(D) IMMUNE GLOBULIN 250 UNIT (50 MCG) INTRAMUSCULAR SYRINGE [10721]
|
Facility
|
OP
|
$74.68
|
|
|
Service Code
|
HCPCS J2788
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.15 |
| Max. Negotiated Rate |
$74.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$73.19
|
| Rate for Payer: Aetna of WY Medicare |
$49.29
|
| Rate for Payer: Altius Auto/Workers Compensation |
$71.69
|
| Rate for Payer: Altius Commercial |
$71.69
|
| Rate for Payer: Beech Street Commercial |
$73.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$61.31
|
| Rate for Payer: Cash Price |
$52.28
|
| Rate for Payer: ChoiceCare Network Commercial |
$72.44
|
| Rate for Payer: Cigna of WY Commercial |
$73.19
|
| Rate for Payer: Entrust Commercial |
$70.95
|
| Rate for Payer: First Choice Health Commercial |
$70.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$70.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.31
|
| Rate for Payer: HealthUtah PPO |
$74.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$72.44
|
| Rate for Payer: Multiplan Medicare/VA |
$41.15
|
| Rate for Payer: One Health Plan of WY PPO |
$73.19
|
| Rate for Payer: PacificSource Commercial |
$67.21
|
| Rate for Payer: PHCS PPO |
$73.19
|
| Rate for Payer: Three Rivers PPO |
$56.01
|
| Rate for Payer: TriWest Veterans Administration |
$43.31
|
| Rate for Payer: United Healthcare Commercial |
$64.97
|
| Rate for Payer: United Healthcare Medicare |
$43.31
|
| Rate for Payer: WINHealth Partners Commercial |
$73.19
|
| Rate for Payer: Wise Provider Network Commercial |
$70.95
|
|
|
RHO D IMMUNE GLOBULIN 50 MCG
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS J2788
|
| Hospital Charge Code |
J2788
|
| Min. Negotiated Rate |
$18.60 |
| Max. Negotiated Rate |
$131.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$128.38
|
| Rate for Payer: Aetna of WY Medicare |
$21.88
|
| Rate for Payer: Beech Street Commercial |
$124.45
|
| Rate for Payer: Cash Price |
$91.70
|
| Rate for Payer: Cash Price |
$91.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$127.07
|
| Rate for Payer: Cigna of WY Commercial |
$128.38
|
| Rate for Payer: First Choice Health Commercial |
$117.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$124.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.88
|
| Rate for Payer: HealthUtah PPO |
$131.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$127.07
|
| Rate for Payer: Multiplan Medicare/VA |
$18.60
|
| Rate for Payer: One Health Plan of WY PPO |
$128.38
|
| Rate for Payer: PacificSource Commercial |
$117.90
|
| Rate for Payer: PHCS PPO |
$124.45
|
| Rate for Payer: Three Rivers PPO |
$98.25
|
| Rate for Payer: TriWest Veterans Administration |
$21.88
|
| Rate for Payer: United Healthcare Commercial |
$113.97
|
| Rate for Payer: United Healthcare Medicare |
$21.88
|
| Rate for Payer: WINHealth Partners Commercial |
$124.45
|
|
|
RHO D IMMUNE GLOBULIN INJ
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
J2790
|
| Min. Negotiated Rate |
$67.98 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$244.02
|
| Rate for Payer: Aetna of WY Medicare |
$79.98
|
| Rate for Payer: Beech Street Commercial |
$236.55
|
| Rate for Payer: Cash Price |
$174.30
|
| Rate for Payer: Cash Price |
$174.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$241.53
|
| Rate for Payer: Cigna of WY Commercial |
$244.02
|
| Rate for Payer: First Choice Health Commercial |
$224.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$236.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$79.98
|
| Rate for Payer: HealthUtah PPO |
$249.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$241.53
|
| Rate for Payer: Multiplan Medicare/VA |
$67.98
|
| Rate for Payer: One Health Plan of WY PPO |
$244.02
|
| Rate for Payer: PacificSource Commercial |
$224.10
|
| Rate for Payer: PHCS PPO |
$236.55
|
| Rate for Payer: Three Rivers PPO |
$186.75
|
| Rate for Payer: TriWest Veterans Administration |
$79.98
|
| Rate for Payer: United Healthcare Commercial |
$216.63
|
| Rate for Payer: United Healthcare Medicare |
$79.98
|
| Rate for Payer: WINHealth Partners Commercial |
$236.55
|
|
|
RHYTHMLINK PROBE 2.5 BALLTIP
|
Facility
|
OP
|
$145.32
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.07 |
| Max. Negotiated Rate |
$145.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$142.41
|
| Rate for Payer: Aetna of WY Medicare |
$95.91
|
| Rate for Payer: Altius Auto/Workers Compensation |
$139.51
|
| Rate for Payer: Altius Commercial |
$139.51
|
| Rate for Payer: Beech Street Commercial |
$142.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$119.31
|
| Rate for Payer: Cash Price |
$101.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$140.96
|
| Rate for Payer: Cigna of WY Commercial |
$142.41
|
| Rate for Payer: Entrust Commercial |
$138.05
|
| Rate for Payer: First Choice Health Commercial |
$138.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$138.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$84.29
|
| Rate for Payer: HealthUtah PPO |
$145.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$140.96
|
| Rate for Payer: Multiplan Medicare/VA |
$80.07
|
| Rate for Payer: One Health Plan of WY PPO |
$142.41
|
| Rate for Payer: PacificSource Commercial |
$130.79
|
| Rate for Payer: PHCS PPO |
$142.41
|
| Rate for Payer: Three Rivers PPO |
$108.99
|
| Rate for Payer: TriWest Veterans Administration |
$84.29
|
| Rate for Payer: United Healthcare Commercial |
$126.43
|
| Rate for Payer: United Healthcare Medicare |
$84.29
|
| Rate for Payer: WINHealth Partners Commercial |
$142.41
|
| Rate for Payer: Wise Provider Network Commercial |
$138.05
|
|
|
RHYTHMLINK PROBE 2.5 BALLTIP
|
Facility
|
IP
|
$145.32
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.12 |
| Max. Negotiated Rate |
$145.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$142.41
|
| Rate for Payer: Altius Auto/Workers Compensation |
$139.51
|
| Rate for Payer: Altius Commercial |
$139.51
|
| Rate for Payer: Beech Street Commercial |
$142.41
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$119.31
|
| Rate for Payer: Cash Price |
$101.72
|
| Rate for Payer: ChoiceCare Network Commercial |
$140.96
|
| Rate for Payer: Cigna of WY Commercial |
$142.41
|
| Rate for Payer: Entrust Commercial |
$138.05
|
| Rate for Payer: First Choice Health Commercial |
$138.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$138.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$95.91
|
| Rate for Payer: HealthUtah PPO |
$145.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$140.96
|
| Rate for Payer: Multiplan Medicare/VA |
$91.12
|
| Rate for Payer: One Health Plan of WY PPO |
$142.41
|
| Rate for Payer: PacificSource Commercial |
$130.79
|
| Rate for Payer: PHCS PPO |
$142.41
|
| Rate for Payer: Three Rivers PPO |
$108.99
|
| Rate for Payer: TriWest Veterans Administration |
$95.91
|
| Rate for Payer: United Healthcare Commercial |
$126.43
|
| Rate for Payer: United Healthcare Medicare |
$95.91
|
| Rate for Payer: WINHealth Partners Commercial |
$138.05
|
| Rate for Payer: Wise Provider Network Commercial |
$138.05
|
|
|
RIB BELT MEN UNIVERSAL
|
Facility
|
IP
|
$15.51
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$14.89
|
| Rate for Payer: Altius Commercial |
$14.89
|
| Rate for Payer: Beech Street Commercial |
$15.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12.73
|
| Rate for Payer: Cash Price |
$10.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.04
|
| Rate for Payer: Cigna of WY Commercial |
$15.20
|
| Rate for Payer: Entrust Commercial |
$14.73
|
| Rate for Payer: First Choice Health Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.24
|
| Rate for Payer: HealthUtah PPO |
$15.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.04
|
| Rate for Payer: Multiplan Medicare/VA |
$9.72
|
| Rate for Payer: One Health Plan of WY PPO |
$15.20
|
| Rate for Payer: PacificSource Commercial |
$13.96
|
| Rate for Payer: PHCS PPO |
$15.20
|
| Rate for Payer: Three Rivers PPO |
$11.63
|
| Rate for Payer: TriWest Veterans Administration |
$10.24
|
| Rate for Payer: United Healthcare Commercial |
$13.49
|
| Rate for Payer: United Healthcare Medicare |
$10.24
|
| Rate for Payer: WINHealth Partners Commercial |
$14.73
|
| Rate for Payer: Wise Provider Network Commercial |
$14.73
|
|
|
RIB BELT MEN UNIVERSAL
|
Facility
|
OP
|
$15.51
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.55 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.20
|
| Rate for Payer: Aetna of WY Medicare |
$10.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$14.89
|
| Rate for Payer: Altius Commercial |
$14.89
|
| Rate for Payer: Beech Street Commercial |
$15.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12.73
|
| Rate for Payer: Cash Price |
$10.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.04
|
| Rate for Payer: Cigna of WY Commercial |
$15.20
|
| Rate for Payer: Entrust Commercial |
$14.73
|
| Rate for Payer: First Choice Health Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.00
|
| Rate for Payer: HealthUtah PPO |
$15.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.04
|
| Rate for Payer: Multiplan Medicare/VA |
$8.55
|
| Rate for Payer: One Health Plan of WY PPO |
$15.20
|
| Rate for Payer: PacificSource Commercial |
$13.96
|
| Rate for Payer: PHCS PPO |
$15.20
|
| Rate for Payer: Three Rivers PPO |
$11.63
|
| Rate for Payer: TriWest Veterans Administration |
$9.00
|
| Rate for Payer: United Healthcare Commercial |
$13.49
|
| Rate for Payer: United Healthcare Medicare |
$9.00
|
| Rate for Payer: WINHealth Partners Commercial |
$15.20
|
| Rate for Payer: Wise Provider Network Commercial |
$14.73
|
|
|
RIB BELT WOMEN UNIVERSAL
|
Facility
|
IP
|
$15.51
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.20
|
| Rate for Payer: Altius Auto/Workers Compensation |
$14.89
|
| Rate for Payer: Altius Commercial |
$14.89
|
| Rate for Payer: Beech Street Commercial |
$15.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12.73
|
| Rate for Payer: Cash Price |
$10.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.04
|
| Rate for Payer: Cigna of WY Commercial |
$15.20
|
| Rate for Payer: Entrust Commercial |
$14.73
|
| Rate for Payer: First Choice Health Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.24
|
| Rate for Payer: HealthUtah PPO |
$15.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.04
|
| Rate for Payer: Multiplan Medicare/VA |
$9.72
|
| Rate for Payer: One Health Plan of WY PPO |
$15.20
|
| Rate for Payer: PacificSource Commercial |
$13.96
|
| Rate for Payer: PHCS PPO |
$15.20
|
| Rate for Payer: Three Rivers PPO |
$11.63
|
| Rate for Payer: TriWest Veterans Administration |
$10.24
|
| Rate for Payer: United Healthcare Commercial |
$13.49
|
| Rate for Payer: United Healthcare Medicare |
$10.24
|
| Rate for Payer: WINHealth Partners Commercial |
$14.73
|
| Rate for Payer: Wise Provider Network Commercial |
$14.73
|
|
|
RIB BELT WOMEN UNIVERSAL
|
Facility
|
OP
|
$15.51
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.55 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.20
|
| Rate for Payer: Aetna of WY Medicare |
$10.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$14.89
|
| Rate for Payer: Altius Commercial |
$14.89
|
| Rate for Payer: Beech Street Commercial |
$15.20
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12.73
|
| Rate for Payer: Cash Price |
$10.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.04
|
| Rate for Payer: Cigna of WY Commercial |
$15.20
|
| Rate for Payer: Entrust Commercial |
$14.73
|
| Rate for Payer: First Choice Health Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.73
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.00
|
| Rate for Payer: HealthUtah PPO |
$15.51
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.04
|
| Rate for Payer: Multiplan Medicare/VA |
$8.55
|
| Rate for Payer: One Health Plan of WY PPO |
$15.20
|
| Rate for Payer: PacificSource Commercial |
$13.96
|
| Rate for Payer: PHCS PPO |
$15.20
|
| Rate for Payer: Three Rivers PPO |
$11.63
|
| Rate for Payer: TriWest Veterans Administration |
$9.00
|
| Rate for Payer: United Healthcare Commercial |
$13.49
|
| Rate for Payer: United Healthcare Medicare |
$9.00
|
| Rate for Payer: WINHealth Partners Commercial |
$15.20
|
| Rate for Payer: Wise Provider Network Commercial |
$14.73
|
|
|
RICHARD WOLF TIPCONTROL RF PROBE 35CM
|
Facility
|
OP
|
$2,047.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,128.17 |
| Max. Negotiated Rate |
$2,047.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,006.55
|
| Rate for Payer: Aetna of WY Medicare |
$1,351.35
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,965.60
|
| Rate for Payer: Altius Commercial |
$1,965.60
|
| Rate for Payer: Beech Street Commercial |
$2,006.55
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,681.00
|
| Rate for Payer: Cash Price |
$1,433.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,986.08
|
| Rate for Payer: Cigna of WY Commercial |
$2,006.55
|
| Rate for Payer: Entrust Commercial |
$1,945.12
|
| Rate for Payer: First Choice Health Commercial |
$1,945.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,945.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,187.55
|
| Rate for Payer: HealthUtah PPO |
$2,047.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,986.08
|
| Rate for Payer: Multiplan Medicare/VA |
$1,128.17
|
| Rate for Payer: One Health Plan of WY PPO |
$2,006.55
|
| Rate for Payer: PacificSource Commercial |
$1,842.75
|
| Rate for Payer: PHCS PPO |
$2,006.55
|
| Rate for Payer: Three Rivers PPO |
$1,535.62
|
| Rate for Payer: TriWest Veterans Administration |
$1,187.55
|
| Rate for Payer: United Healthcare Commercial |
$1,781.32
|
| Rate for Payer: United Healthcare Medicare |
$1,187.55
|
| Rate for Payer: WINHealth Partners Commercial |
$2,006.55
|
| Rate for Payer: Wise Provider Network Commercial |
$1,945.12
|
|
|
RICHARD WOLF TIPCONTROL RF PROBE 35CM
|
Facility
|
IP
|
$2,047.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,283.78 |
| Max. Negotiated Rate |
$2,047.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,006.55
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,965.60
|
| Rate for Payer: Altius Commercial |
$1,965.60
|
| Rate for Payer: Beech Street Commercial |
$2,006.55
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,681.00
|
| Rate for Payer: Cash Price |
$1,433.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,986.08
|
| Rate for Payer: Cigna of WY Commercial |
$2,006.55
|
| Rate for Payer: Entrust Commercial |
$1,945.12
|
| Rate for Payer: First Choice Health Commercial |
$1,945.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,945.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,351.35
|
| Rate for Payer: HealthUtah PPO |
$2,047.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,986.08
|
| Rate for Payer: Multiplan Medicare/VA |
$1,283.78
|
| Rate for Payer: One Health Plan of WY PPO |
$2,006.55
|
| Rate for Payer: PacificSource Commercial |
$1,842.75
|
| Rate for Payer: PHCS PPO |
$2,006.55
|
| Rate for Payer: Three Rivers PPO |
$1,535.62
|
| Rate for Payer: TriWest Veterans Administration |
$1,351.35
|
| Rate for Payer: United Healthcare Commercial |
$1,781.32
|
| Rate for Payer: United Healthcare Medicare |
$1,351.35
|
| Rate for Payer: WINHealth Partners Commercial |
$1,945.12
|
| Rate for Payer: Wise Provider Network Commercial |
$1,945.12
|
|
|
RIFAMPIN 150 MG CAPSULE [10952]
|
Facility
|
OP
|
$11.94
|
|
|
Service Code
|
NDC 6068757511
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.70
|
| Rate for Payer: Aetna of WY Medicare |
$7.88
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.46
|
| Rate for Payer: Altius Commercial |
$11.46
|
| Rate for Payer: Beech Street Commercial |
$11.70
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.80
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.58
|
| Rate for Payer: Cigna of WY Commercial |
$11.70
|
| Rate for Payer: Entrust Commercial |
$11.34
|
| Rate for Payer: First Choice Health Commercial |
$11.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.93
|
| Rate for Payer: HealthUtah PPO |
$11.94
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.58
|
| Rate for Payer: Multiplan Medicare/VA |
$6.58
|
| Rate for Payer: One Health Plan of WY PPO |
$11.70
|
| Rate for Payer: PacificSource Commercial |
$10.75
|
| Rate for Payer: PHCS PPO |
$11.70
|
| Rate for Payer: Three Rivers PPO |
$8.96
|
| Rate for Payer: TriWest Veterans Administration |
$6.93
|
| Rate for Payer: United Healthcare Commercial |
$10.39
|
| Rate for Payer: United Healthcare Medicare |
$6.93
|
| Rate for Payer: WINHealth Partners Commercial |
$11.70
|
| Rate for Payer: Wise Provider Network Commercial |
$11.34
|
|
