|
BRACE ANK VISCO FIGURE 8 RT XL
|
Facility
|
OP
|
$138.46
|
|
| Hospital Charge Code |
2200409
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.69
|
| Rate for Payer: Aetna of WY Medicare |
$91.38
|
| Rate for Payer: Altius Commercial |
$132.92
|
| Rate for Payer: Beech Street Commercial |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.31
|
| Rate for Payer: Cash Price |
$96.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.31
|
| Rate for Payer: Cigna of WY Commercial |
$135.69
|
| Rate for Payer: Entrust Commercial |
$131.54
|
| Rate for Payer: First Choice Health Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.92
|
| Rate for Payer: HealthUtah PPO |
$138.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.31
|
| Rate for Payer: Multiplan Medicare/VA |
$74.98
|
| Rate for Payer: One Health Plan of WY PPO |
$135.69
|
| Rate for Payer: PacificSource Commercial |
$124.61
|
| Rate for Payer: PHCS PPO |
$135.69
|
| Rate for Payer: Three Rivers PPO |
$103.84
|
| Rate for Payer: TriWest Veterans Administration |
$78.92
|
| Rate for Payer: United Healthcare Commercial |
$132.23
|
| Rate for Payer: United Healthcare Medicare |
$78.92
|
| Rate for Payer: WINHealth Partners Commercial |
$135.69
|
| Rate for Payer: Wise Provider Network Commercial |
$131.54
|
|
|
BRACE ANK VISCO FIGURE 8 RT XS
|
Facility
|
IP
|
$138.46
|
|
| Hospital Charge Code |
2200421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.24 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.69
|
| Rate for Payer: Aetna of WY Medicare |
$88.61
|
| Rate for Payer: Altius Commercial |
$132.92
|
| Rate for Payer: Beech Street Commercial |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.31
|
| Rate for Payer: Cash Price |
$96.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.31
|
| Rate for Payer: Cigna of WY Commercial |
$135.69
|
| Rate for Payer: Entrust Commercial |
$131.54
|
| Rate for Payer: First Choice Health Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$84.46
|
| Rate for Payer: HealthUtah PPO |
$138.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.31
|
| Rate for Payer: Multiplan Medicare/VA |
$80.24
|
| Rate for Payer: One Health Plan of WY PPO |
$135.69
|
| Rate for Payer: PacificSource Commercial |
$124.61
|
| Rate for Payer: PHCS PPO |
$135.69
|
| Rate for Payer: Three Rivers PPO |
$103.84
|
| Rate for Payer: TriWest Veterans Administration |
$84.46
|
| Rate for Payer: United Healthcare Commercial |
$132.23
|
| Rate for Payer: United Healthcare Medicare |
$84.46
|
| Rate for Payer: WINHealth Partners Commercial |
$131.54
|
| Rate for Payer: Wise Provider Network Commercial |
$131.54
|
|
|
BRACE ANK VISCO FIGURE 8 RT XS
|
Facility
|
OP
|
$138.46
|
|
| Hospital Charge Code |
2200421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.69
|
| Rate for Payer: Aetna of WY Medicare |
$91.38
|
| Rate for Payer: Altius Commercial |
$132.92
|
| Rate for Payer: Beech Street Commercial |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.31
|
| Rate for Payer: Cash Price |
$96.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.31
|
| Rate for Payer: Cigna of WY Commercial |
$135.69
|
| Rate for Payer: Entrust Commercial |
$131.54
|
| Rate for Payer: First Choice Health Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.92
|
| Rate for Payer: HealthUtah PPO |
$138.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.31
|
| Rate for Payer: Multiplan Medicare/VA |
$74.98
|
| Rate for Payer: One Health Plan of WY PPO |
$135.69
|
| Rate for Payer: PacificSource Commercial |
$124.61
|
| Rate for Payer: PHCS PPO |
$135.69
|
| Rate for Payer: Three Rivers PPO |
$103.84
|
| Rate for Payer: TriWest Veterans Administration |
$78.92
|
| Rate for Payer: United Healthcare Commercial |
$132.23
|
| Rate for Payer: United Healthcare Medicare |
$78.92
|
| Rate for Payer: WINHealth Partners Commercial |
$135.69
|
| Rate for Payer: Wise Provider Network Commercial |
$131.54
|
|
|
BRACE ANK VISCO FIGURE8 RT XXL
|
Facility
|
OP
|
$138.46
|
|
| Hospital Charge Code |
2200410
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.69
|
| Rate for Payer: Aetna of WY Medicare |
$91.38
|
| Rate for Payer: Altius Commercial |
$132.92
|
| Rate for Payer: Beech Street Commercial |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.31
|
| Rate for Payer: Cash Price |
$96.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.31
|
| Rate for Payer: Cigna of WY Commercial |
$135.69
|
| Rate for Payer: Entrust Commercial |
$131.54
|
| Rate for Payer: First Choice Health Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$78.92
|
| Rate for Payer: HealthUtah PPO |
$138.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.31
|
| Rate for Payer: Multiplan Medicare/VA |
$74.98
|
| Rate for Payer: One Health Plan of WY PPO |
$135.69
|
| Rate for Payer: PacificSource Commercial |
$124.61
|
| Rate for Payer: PHCS PPO |
$135.69
|
| Rate for Payer: Three Rivers PPO |
$103.84
|
| Rate for Payer: TriWest Veterans Administration |
$78.92
|
| Rate for Payer: United Healthcare Commercial |
$132.23
|
| Rate for Payer: United Healthcare Medicare |
$78.92
|
| Rate for Payer: WINHealth Partners Commercial |
$135.69
|
| Rate for Payer: Wise Provider Network Commercial |
$131.54
|
|
|
BRACE ANK VISCO FIGURE8 RT XXL
|
Facility
|
IP
|
$138.46
|
|
| Hospital Charge Code |
2200410
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$80.24 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$135.69
|
| Rate for Payer: Aetna of WY Medicare |
$88.61
|
| Rate for Payer: Altius Commercial |
$132.92
|
| Rate for Payer: Beech Street Commercial |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$134.31
|
| Rate for Payer: Cash Price |
$96.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$134.31
|
| Rate for Payer: Cigna of WY Commercial |
$135.69
|
| Rate for Payer: Entrust Commercial |
$131.54
|
| Rate for Payer: First Choice Health Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$131.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$84.46
|
| Rate for Payer: HealthUtah PPO |
$138.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$134.31
|
| Rate for Payer: Multiplan Medicare/VA |
$80.24
|
| Rate for Payer: One Health Plan of WY PPO |
$135.69
|
| Rate for Payer: PacificSource Commercial |
$124.61
|
| Rate for Payer: PHCS PPO |
$135.69
|
| Rate for Payer: Three Rivers PPO |
$103.84
|
| Rate for Payer: TriWest Veterans Administration |
$84.46
|
| Rate for Payer: United Healthcare Commercial |
$132.23
|
| Rate for Payer: United Healthcare Medicare |
$84.46
|
| Rate for Payer: WINHealth Partners Commercial |
$131.54
|
| Rate for Payer: Wise Provider Network Commercial |
$131.54
|
|
|
BRACE BREG KNEE XXL 21706
|
Facility
|
OP
|
$110.95
|
|
| Hospital Charge Code |
2200223
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.08 |
| Max. Negotiated Rate |
$110.95 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$108.73
|
| Rate for Payer: Aetna of WY Medicare |
$73.23
|
| Rate for Payer: Altius Commercial |
$106.51
|
| Rate for Payer: Beech Street Commercial |
$108.73
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$107.62
|
| Rate for Payer: Cash Price |
$77.66
|
| Rate for Payer: ChoiceCare Network Commercial |
$107.62
|
| Rate for Payer: Cigna of WY Commercial |
$108.73
|
| Rate for Payer: Entrust Commercial |
$105.40
|
| Rate for Payer: First Choice Health Commercial |
$105.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$105.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$63.24
|
| Rate for Payer: HealthUtah PPO |
$110.95
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$107.62
|
| Rate for Payer: Multiplan Medicare/VA |
$60.08
|
| Rate for Payer: One Health Plan of WY PPO |
$108.73
|
| Rate for Payer: PacificSource Commercial |
$99.86
|
| Rate for Payer: PHCS PPO |
$108.73
|
| Rate for Payer: Three Rivers PPO |
$83.21
|
| Rate for Payer: TriWest Veterans Administration |
$63.24
|
| Rate for Payer: United Healthcare Commercial |
$105.96
|
| Rate for Payer: United Healthcare Medicare |
$63.24
|
| Rate for Payer: WINHealth Partners Commercial |
$108.73
|
| Rate for Payer: Wise Provider Network Commercial |
$105.40
|
|
|
BRACE BREG KNEE XXL 21706
|
Facility
|
IP
|
$110.95
|
|
| Hospital Charge Code |
2200223
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$64.30 |
| Max. Negotiated Rate |
$110.95 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$108.73
|
| Rate for Payer: Aetna of WY Medicare |
$71.01
|
| Rate for Payer: Altius Commercial |
$106.51
|
| Rate for Payer: Beech Street Commercial |
$108.73
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$107.62
|
| Rate for Payer: Cash Price |
$77.66
|
| Rate for Payer: ChoiceCare Network Commercial |
$107.62
|
| Rate for Payer: Cigna of WY Commercial |
$108.73
|
| Rate for Payer: Entrust Commercial |
$105.40
|
| Rate for Payer: First Choice Health Commercial |
$105.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$105.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$67.68
|
| Rate for Payer: HealthUtah PPO |
$110.95
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$107.62
|
| Rate for Payer: Multiplan Medicare/VA |
$64.30
|
| Rate for Payer: One Health Plan of WY PPO |
$108.73
|
| Rate for Payer: PacificSource Commercial |
$99.86
|
| Rate for Payer: PHCS PPO |
$108.73
|
| Rate for Payer: Three Rivers PPO |
$83.21
|
| Rate for Payer: TriWest Veterans Administration |
$67.68
|
| Rate for Payer: United Healthcare Commercial |
$105.96
|
| Rate for Payer: United Healthcare Medicare |
$67.68
|
| Rate for Payer: WINHealth Partners Commercial |
$105.40
|
| Rate for Payer: Wise Provider Network Commercial |
$105.40
|
|
|
BRACE BREG PTO LG L
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200205
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO LG L
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200205
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO LG LEFT
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200224
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO LG LEFT
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200224
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO LG. R
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200212
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO LG. R
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200212
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO MED. L
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200204
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO MED. L
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200204
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO MED. R
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO MED. R
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO SM L
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200203
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO SM L
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200203
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO SM R
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200210
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO SM R
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200210
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO XSM L
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200209
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO XSM L
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200209
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO XSM R
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
2200208
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.35 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$112.56
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$97.21
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$92.35
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$97.21
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
| Rate for Payer: WINHealth Partners Commercial |
$167.14
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
|
BRACE BREG PTO XSM R
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
2200208
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$167.14
|
| Rate for Payer: Aetna of WY Medicare |
$109.15
|
| Rate for Payer: Altius Commercial |
$163.73
|
| Rate for Payer: Beech Street Commercial |
$167.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$165.43
|
| Rate for Payer: Cash Price |
$119.39
|
| Rate for Payer: ChoiceCare Network Commercial |
$165.43
|
| Rate for Payer: Cigna of WY Commercial |
$167.14
|
| Rate for Payer: Entrust Commercial |
$162.02
|
| Rate for Payer: First Choice Health Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$162.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$170.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$165.43
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$167.14
|
| Rate for Payer: PacificSource Commercial |
$153.50
|
| Rate for Payer: PHCS PPO |
$167.14
|
| Rate for Payer: Three Rivers PPO |
$127.91
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$162.88
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$162.02
|
| Rate for Payer: Wise Provider Network Commercial |
$162.02
|
|
