|
SCRUB TOP XXL - WINE
|
Facility
|
IP
|
$16.70
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$16.70 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.37
|
| Rate for Payer: Altius Auto/Workers Compensation |
$16.03
|
| Rate for Payer: Altius Commercial |
$16.03
|
| Rate for Payer: Beech Street Commercial |
$16.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.71
|
| Rate for Payer: Cash Price |
$11.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.20
|
| Rate for Payer: Cigna of WY Commercial |
$16.37
|
| Rate for Payer: Entrust Commercial |
$15.86
|
| Rate for Payer: First Choice Health Commercial |
$15.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.02
|
| Rate for Payer: HealthUtah PPO |
$16.70
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.20
|
| Rate for Payer: Multiplan Medicare/VA |
$10.47
|
| Rate for Payer: One Health Plan of WY PPO |
$16.37
|
| Rate for Payer: PacificSource Commercial |
$15.03
|
| Rate for Payer: PHCS PPO |
$16.37
|
| Rate for Payer: Three Rivers PPO |
$12.52
|
| Rate for Payer: TriWest Veterans Administration |
$11.02
|
| Rate for Payer: United Healthcare Commercial |
$14.53
|
| Rate for Payer: United Healthcare Medicare |
$11.02
|
| Rate for Payer: WINHealth Partners Commercial |
$15.86
|
| Rate for Payer: Wise Provider Network Commercial |
$15.86
|
|
|
SCRUB TOP XXL - WINE
|
Facility
|
OP
|
$16.70
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$16.70 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.37
|
| Rate for Payer: Aetna of WY Medicare |
$11.02
|
| Rate for Payer: Altius Auto/Workers Compensation |
$16.03
|
| Rate for Payer: Altius Commercial |
$16.03
|
| Rate for Payer: Beech Street Commercial |
$16.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13.71
|
| Rate for Payer: Cash Price |
$11.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.20
|
| Rate for Payer: Cigna of WY Commercial |
$16.37
|
| Rate for Payer: Entrust Commercial |
$15.86
|
| Rate for Payer: First Choice Health Commercial |
$15.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.69
|
| Rate for Payer: HealthUtah PPO |
$16.70
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.20
|
| Rate for Payer: Multiplan Medicare/VA |
$9.20
|
| Rate for Payer: One Health Plan of WY PPO |
$16.37
|
| Rate for Payer: PacificSource Commercial |
$15.03
|
| Rate for Payer: PHCS PPO |
$16.37
|
| Rate for Payer: Three Rivers PPO |
$12.52
|
| Rate for Payer: TriWest Veterans Administration |
$9.69
|
| Rate for Payer: United Healthcare Commercial |
$14.53
|
| Rate for Payer: United Healthcare Medicare |
$9.69
|
| Rate for Payer: WINHealth Partners Commercial |
$16.37
|
| Rate for Payer: Wise Provider Network Commercial |
$15.86
|
|
|
SEALTIGHT ADULT ARM LONG
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT ARM LONG
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT ARM SHORT
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT ARM SHORT
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT ARM WIDE SHORT
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT ARM WIDE SHORT
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT FOOT/ANKLE
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT FOOT/ANKLE
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT HAND
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT HAND
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT LEG LONG
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT LEG LONG
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT LEG SHORT
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT LEG SHORT
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT LEG WIDE SHORT
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT ADULT LEG WIDE SHORT
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT PED ARM LARGE
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT PED ARM LARGE
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT PED ARM MEDIUM
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT PED ARM MEDIUM
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT PED ARM SMALL
|
Facility
|
OP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Aetna of WY Medicare |
$31.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.91
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$26.51
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$27.91
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$27.91
|
| Rate for Payer: WINHealth Partners Commercial |
$47.16
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT PED ARM SMALL
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
|
SEALTIGHT PED LEG LARGE
|
Facility
|
IP
|
$48.12
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$48.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$47.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$46.20
|
| Rate for Payer: Altius Commercial |
$46.20
|
| Rate for Payer: Beech Street Commercial |
$47.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$39.51
|
| Rate for Payer: Cash Price |
$33.69
|
| Rate for Payer: ChoiceCare Network Commercial |
$46.68
|
| Rate for Payer: Cigna of WY Commercial |
$47.16
|
| Rate for Payer: Entrust Commercial |
$45.71
|
| Rate for Payer: First Choice Health Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$45.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.76
|
| Rate for Payer: HealthUtah PPO |
$48.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$46.68
|
| Rate for Payer: Multiplan Medicare/VA |
$30.17
|
| Rate for Payer: One Health Plan of WY PPO |
$47.16
|
| Rate for Payer: PacificSource Commercial |
$43.31
|
| Rate for Payer: PHCS PPO |
$47.16
|
| Rate for Payer: Three Rivers PPO |
$36.09
|
| Rate for Payer: TriWest Veterans Administration |
$31.76
|
| Rate for Payer: United Healthcare Commercial |
$41.86
|
| Rate for Payer: United Healthcare Medicare |
$31.76
|
| Rate for Payer: WINHealth Partners Commercial |
$45.71
|
| Rate for Payer: Wise Provider Network Commercial |
$45.71
|
|
