|
CATHETER FOLEY 2 WAY 5CC 26FR
|
Facility
|
IP
|
$21.25
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.82
|
| Rate for Payer: Altius Auto/Workers Compensation |
$20.40
|
| Rate for Payer: Altius Commercial |
$20.40
|
| Rate for Payer: Beech Street Commercial |
$20.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.45
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.61
|
| Rate for Payer: Cigna of WY Commercial |
$20.82
|
| Rate for Payer: Entrust Commercial |
$20.19
|
| Rate for Payer: First Choice Health Commercial |
$20.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$20.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.02
|
| Rate for Payer: HealthUtah PPO |
$21.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.61
|
| Rate for Payer: Multiplan Medicare/VA |
$13.32
|
| Rate for Payer: One Health Plan of WY PPO |
$20.82
|
| Rate for Payer: PacificSource Commercial |
$19.12
|
| Rate for Payer: PHCS PPO |
$20.82
|
| Rate for Payer: Three Rivers PPO |
$15.94
|
| Rate for Payer: TriWest Veterans Administration |
$14.02
|
| Rate for Payer: United Healthcare Commercial |
$18.49
|
| Rate for Payer: United Healthcare Medicare |
$14.02
|
| Rate for Payer: WINHealth Partners Commercial |
$20.19
|
| Rate for Payer: Wise Provider Network Commercial |
$20.19
|
|
|
CATHETER FOLEY 2 WAY 5CC 26FR
|
Facility
|
OP
|
$21.25
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.71 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.82
|
| Rate for Payer: Aetna of WY Medicare |
$14.02
|
| Rate for Payer: Altius Auto/Workers Compensation |
$20.40
|
| Rate for Payer: Altius Commercial |
$20.40
|
| Rate for Payer: Beech Street Commercial |
$20.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.45
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.61
|
| Rate for Payer: Cigna of WY Commercial |
$20.82
|
| Rate for Payer: Entrust Commercial |
$20.19
|
| Rate for Payer: First Choice Health Commercial |
$20.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$20.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.32
|
| Rate for Payer: HealthUtah PPO |
$21.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.61
|
| Rate for Payer: Multiplan Medicare/VA |
$11.71
|
| Rate for Payer: One Health Plan of WY PPO |
$20.82
|
| Rate for Payer: PacificSource Commercial |
$19.12
|
| Rate for Payer: PHCS PPO |
$20.82
|
| Rate for Payer: Three Rivers PPO |
$15.94
|
| Rate for Payer: TriWest Veterans Administration |
$12.32
|
| Rate for Payer: United Healthcare Commercial |
$18.49
|
| Rate for Payer: United Healthcare Medicare |
$12.32
|
| Rate for Payer: WINHealth Partners Commercial |
$20.82
|
| Rate for Payer: Wise Provider Network Commercial |
$20.19
|
|
|
CATHETER FOLEY COUDE 5CC 12FR
|
Facility
|
IP
|
$41.12
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.78 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$40.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$39.48
|
| Rate for Payer: Altius Commercial |
$39.48
|
| Rate for Payer: Beech Street Commercial |
$40.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.76
|
| Rate for Payer: Cash Price |
$28.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.89
|
| Rate for Payer: Cigna of WY Commercial |
$40.30
|
| Rate for Payer: Entrust Commercial |
$39.06
|
| Rate for Payer: First Choice Health Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.14
|
| Rate for Payer: HealthUtah PPO |
$41.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.89
|
| Rate for Payer: Multiplan Medicare/VA |
$25.78
|
| Rate for Payer: One Health Plan of WY PPO |
$40.30
|
| Rate for Payer: PacificSource Commercial |
$37.01
|
| Rate for Payer: PHCS PPO |
$40.30
|
| Rate for Payer: Three Rivers PPO |
$30.84
|
| Rate for Payer: TriWest Veterans Administration |
$27.14
|
| Rate for Payer: United Healthcare Commercial |
$35.77
|
| Rate for Payer: United Healthcare Medicare |
$27.14
|
| Rate for Payer: WINHealth Partners Commercial |
$39.06
|
| Rate for Payer: Wise Provider Network Commercial |
$39.06
|
|
|
CATHETER FOLEY COUDE 5CC 12FR
|
Facility
|
OP
|
$41.12
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.66 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$40.30
|
| Rate for Payer: Aetna of WY Medicare |
$27.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$39.48
|
| Rate for Payer: Altius Commercial |
$39.48
|
| Rate for Payer: Beech Street Commercial |
$40.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.76
|
| Rate for Payer: Cash Price |
$28.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.89
|
| Rate for Payer: Cigna of WY Commercial |
$40.30
|
| Rate for Payer: Entrust Commercial |
$39.06
|
| Rate for Payer: First Choice Health Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.85
|
| Rate for Payer: HealthUtah PPO |
$41.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.89
|
| Rate for Payer: Multiplan Medicare/VA |
$22.66
|
| Rate for Payer: One Health Plan of WY PPO |
$40.30
|
| Rate for Payer: PacificSource Commercial |
$37.01
|
| Rate for Payer: PHCS PPO |
$40.30
|
| Rate for Payer: Three Rivers PPO |
$30.84
|
| Rate for Payer: TriWest Veterans Administration |
$23.85
|
| Rate for Payer: United Healthcare Commercial |
$35.77
|
| Rate for Payer: United Healthcare Medicare |
$23.85
|
| Rate for Payer: WINHealth Partners Commercial |
$40.30
|
| Rate for Payer: Wise Provider Network Commercial |
$39.06
|
|
|
CATHETER FOLEY COUDE 5CC 14FR
|
Facility
|
IP
|
$41.12
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.78 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$40.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$39.48
|
| Rate for Payer: Altius Commercial |
$39.48
|
| Rate for Payer: Beech Street Commercial |
$40.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.76
|
| Rate for Payer: Cash Price |
$28.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.89
|
| Rate for Payer: Cigna of WY Commercial |
$40.30
|
| Rate for Payer: Entrust Commercial |
$39.06
|
| Rate for Payer: First Choice Health Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.14
|
| Rate for Payer: HealthUtah PPO |
$41.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.89
|
| Rate for Payer: Multiplan Medicare/VA |
$25.78
|
| Rate for Payer: One Health Plan of WY PPO |
$40.30
|
| Rate for Payer: PacificSource Commercial |
$37.01
|
| Rate for Payer: PHCS PPO |
$40.30
|
| Rate for Payer: Three Rivers PPO |
$30.84
|
| Rate for Payer: TriWest Veterans Administration |
$27.14
|
| Rate for Payer: United Healthcare Commercial |
$35.77
|
| Rate for Payer: United Healthcare Medicare |
$27.14
|
| Rate for Payer: WINHealth Partners Commercial |
$39.06
|
| Rate for Payer: Wise Provider Network Commercial |
$39.06
|
|
|
CATHETER FOLEY COUDE 5CC 14FR
|
Facility
|
OP
|
$41.12
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.66 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$40.30
|
| Rate for Payer: Aetna of WY Medicare |
$27.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$39.48
|
| Rate for Payer: Altius Commercial |
$39.48
|
| Rate for Payer: Beech Street Commercial |
$40.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.76
|
| Rate for Payer: Cash Price |
$28.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.89
|
| Rate for Payer: Cigna of WY Commercial |
$40.30
|
| Rate for Payer: Entrust Commercial |
$39.06
|
| Rate for Payer: First Choice Health Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.85
|
| Rate for Payer: HealthUtah PPO |
$41.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.89
|
| Rate for Payer: Multiplan Medicare/VA |
$22.66
|
| Rate for Payer: One Health Plan of WY PPO |
$40.30
|
| Rate for Payer: PacificSource Commercial |
$37.01
|
| Rate for Payer: PHCS PPO |
$40.30
|
| Rate for Payer: Three Rivers PPO |
$30.84
|
| Rate for Payer: TriWest Veterans Administration |
$23.85
|
| Rate for Payer: United Healthcare Commercial |
$35.77
|
| Rate for Payer: United Healthcare Medicare |
$23.85
|
| Rate for Payer: WINHealth Partners Commercial |
$40.30
|
| Rate for Payer: Wise Provider Network Commercial |
$39.06
|
|
|
CATHETER FOLEY COUDE 5CC 16FR
|
Facility
|
IP
|
$41.12
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.78 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$40.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$39.48
|
| Rate for Payer: Altius Commercial |
$39.48
|
| Rate for Payer: Beech Street Commercial |
$40.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.76
|
| Rate for Payer: Cash Price |
$28.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.89
|
| Rate for Payer: Cigna of WY Commercial |
$40.30
|
| Rate for Payer: Entrust Commercial |
$39.06
|
| Rate for Payer: First Choice Health Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$27.14
|
| Rate for Payer: HealthUtah PPO |
$41.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.89
|
| Rate for Payer: Multiplan Medicare/VA |
$25.78
|
| Rate for Payer: One Health Plan of WY PPO |
$40.30
|
| Rate for Payer: PacificSource Commercial |
$37.01
|
| Rate for Payer: PHCS PPO |
$40.30
|
| Rate for Payer: Three Rivers PPO |
$30.84
|
| Rate for Payer: TriWest Veterans Administration |
$27.14
|
| Rate for Payer: United Healthcare Commercial |
$35.77
|
| Rate for Payer: United Healthcare Medicare |
$27.14
|
| Rate for Payer: WINHealth Partners Commercial |
$39.06
|
| Rate for Payer: Wise Provider Network Commercial |
$39.06
|
|
|
CATHETER FOLEY COUDE 5CC 16FR
|
Facility
|
OP
|
$41.12
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.66 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$40.30
|
| Rate for Payer: Aetna of WY Medicare |
$27.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$39.48
|
| Rate for Payer: Altius Commercial |
$39.48
|
| Rate for Payer: Beech Street Commercial |
$40.30
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$33.76
|
| Rate for Payer: Cash Price |
$28.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$39.89
|
| Rate for Payer: Cigna of WY Commercial |
$40.30
|
| Rate for Payer: Entrust Commercial |
$39.06
|
| Rate for Payer: First Choice Health Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$39.06
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$23.85
|
| Rate for Payer: HealthUtah PPO |
$41.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$39.89
|
| Rate for Payer: Multiplan Medicare/VA |
$22.66
|
| Rate for Payer: One Health Plan of WY PPO |
$40.30
|
| Rate for Payer: PacificSource Commercial |
$37.01
|
| Rate for Payer: PHCS PPO |
$40.30
|
| Rate for Payer: Three Rivers PPO |
$30.84
|
| Rate for Payer: TriWest Veterans Administration |
$23.85
|
| Rate for Payer: United Healthcare Commercial |
$35.77
|
| Rate for Payer: United Healthcare Medicare |
$23.85
|
| Rate for Payer: WINHealth Partners Commercial |
$40.30
|
| Rate for Payer: Wise Provider Network Commercial |
$39.06
|
|
|
CATHETER INTRAVASCULAR 20G
|
Facility
|
OP
|
$152.88
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.24 |
| Max. Negotiated Rate |
$152.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$149.82
|
| Rate for Payer: Aetna of WY Medicare |
$100.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$146.76
|
| Rate for Payer: Altius Commercial |
$146.76
|
| Rate for Payer: Beech Street Commercial |
$149.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$125.51
|
| Rate for Payer: Cash Price |
$107.02
|
| Rate for Payer: ChoiceCare Network Commercial |
$148.29
|
| Rate for Payer: Cigna of WY Commercial |
$149.82
|
| Rate for Payer: Entrust Commercial |
$145.24
|
| Rate for Payer: First Choice Health Commercial |
$145.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$145.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$88.67
|
| Rate for Payer: HealthUtah PPO |
$152.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$148.29
|
| Rate for Payer: Multiplan Medicare/VA |
$84.24
|
| Rate for Payer: One Health Plan of WY PPO |
$149.82
|
| Rate for Payer: PacificSource Commercial |
$137.59
|
| Rate for Payer: PHCS PPO |
$149.82
|
| Rate for Payer: Three Rivers PPO |
$114.66
|
| Rate for Payer: TriWest Veterans Administration |
$88.67
|
| Rate for Payer: United Healthcare Commercial |
$133.01
|
| Rate for Payer: United Healthcare Medicare |
$88.67
|
| Rate for Payer: WINHealth Partners Commercial |
$149.82
|
| Rate for Payer: Wise Provider Network Commercial |
$145.24
|
|
|
CATHETER INTRAVASCULAR 20G
|
Facility
|
IP
|
$152.88
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$95.86 |
| Max. Negotiated Rate |
$152.88 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$149.82
|
| Rate for Payer: Altius Auto/Workers Compensation |
$146.76
|
| Rate for Payer: Altius Commercial |
$146.76
|
| Rate for Payer: Beech Street Commercial |
$149.82
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$125.51
|
| Rate for Payer: Cash Price |
$107.02
|
| Rate for Payer: ChoiceCare Network Commercial |
$148.29
|
| Rate for Payer: Cigna of WY Commercial |
$149.82
|
| Rate for Payer: Entrust Commercial |
$145.24
|
| Rate for Payer: First Choice Health Commercial |
$145.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$145.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$100.90
|
| Rate for Payer: HealthUtah PPO |
$152.88
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$148.29
|
| Rate for Payer: Multiplan Medicare/VA |
$95.86
|
| Rate for Payer: One Health Plan of WY PPO |
$149.82
|
| Rate for Payer: PacificSource Commercial |
$137.59
|
| Rate for Payer: PHCS PPO |
$149.82
|
| Rate for Payer: Three Rivers PPO |
$114.66
|
| Rate for Payer: TriWest Veterans Administration |
$100.90
|
| Rate for Payer: United Healthcare Commercial |
$133.01
|
| Rate for Payer: United Healthcare Medicare |
$100.90
|
| Rate for Payer: WINHealth Partners Commercial |
$145.24
|
| Rate for Payer: Wise Provider Network Commercial |
$145.24
|
|
|
CATHETER PACING PACEL FLOW DIR RT HEART CRV
|
Facility
|
OP
|
$455.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Aetna of WY Medicare |
$300.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$436.80
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$373.56
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$263.90
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$250.70
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$263.90
|
| Rate for Payer: United Healthcare Commercial |
$395.85
|
| Rate for Payer: United Healthcare Medicare |
$263.90
|
| Rate for Payer: WINHealth Partners Commercial |
$445.90
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
CATHETER PACING PACEL FLOW DIR RT HEART CRV
|
Facility
|
IP
|
$455.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$285.28 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$436.80
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$373.56
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$300.30
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$285.28
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$300.30
|
| Rate for Payer: United Healthcare Commercial |
$395.85
|
| Rate for Payer: United Healthcare Medicare |
$300.30
|
| Rate for Payer: WINHealth Partners Commercial |
$432.25
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
CATHETER PACING PACEL FLOW DIR STRAIGHT
|
Facility
|
IP
|
$455.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$285.28 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$436.80
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$373.56
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$300.30
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$285.28
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$300.30
|
| Rate for Payer: United Healthcare Commercial |
$395.85
|
| Rate for Payer: United Healthcare Medicare |
$300.30
|
| Rate for Payer: WINHealth Partners Commercial |
$432.25
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
CATHETER PACING PACEL FLOW DIR STRAIGHT
|
Facility
|
OP
|
$455.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$445.90
|
| Rate for Payer: Aetna of WY Medicare |
$300.30
|
| Rate for Payer: Altius Auto/Workers Compensation |
$436.80
|
| Rate for Payer: Altius Commercial |
$436.80
|
| Rate for Payer: Beech Street Commercial |
$445.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$373.56
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$441.35
|
| Rate for Payer: Cigna of WY Commercial |
$445.90
|
| Rate for Payer: Entrust Commercial |
$432.25
|
| Rate for Payer: First Choice Health Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$432.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$263.90
|
| Rate for Payer: HealthUtah PPO |
$455.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$441.35
|
| Rate for Payer: Multiplan Medicare/VA |
$250.70
|
| Rate for Payer: One Health Plan of WY PPO |
$445.90
|
| Rate for Payer: PacificSource Commercial |
$409.50
|
| Rate for Payer: PHCS PPO |
$445.90
|
| Rate for Payer: Three Rivers PPO |
$341.25
|
| Rate for Payer: TriWest Veterans Administration |
$263.90
|
| Rate for Payer: United Healthcare Commercial |
$395.85
|
| Rate for Payer: United Healthcare Medicare |
$263.90
|
| Rate for Payer: WINHealth Partners Commercial |
$445.90
|
| Rate for Payer: Wise Provider Network Commercial |
$432.25
|
|
|
CATHETER SHOCKWAVE C2+IVL I 2.5X12MM
|
Facility
|
OP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,063.95 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Aetna of WY Medicare |
$10,857.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9,541.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$9,063.95
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$9,541.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$9,541.00
|
| Rate for Payer: WINHealth Partners Commercial |
$16,121.00
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATHETER SHOCKWAVE C2+IVL I 2.5X12MM
|
Facility
|
IP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10,314.15 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10,857.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$10,314.15
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$10,857.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$10,857.00
|
| Rate for Payer: WINHealth Partners Commercial |
$15,627.50
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATHETER SHOCKWAVE C2+IVL I 3.0X12MM
|
Facility
|
IP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10,314.15 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10,857.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$10,314.15
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$10,857.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$10,857.00
|
| Rate for Payer: WINHealth Partners Commercial |
$15,627.50
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATHETER SHOCKWAVE C2+IVL I 3.0X12MM
|
Facility
|
OP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,063.95 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Aetna of WY Medicare |
$10,857.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9,541.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$9,063.95
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$9,541.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$9,541.00
|
| Rate for Payer: WINHealth Partners Commercial |
$16,121.00
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATHETER SHOCKWAVE C2+IVL I 3.5X12MM
|
Facility
|
OP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,063.95 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Aetna of WY Medicare |
$10,857.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9,541.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$9,063.95
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$9,541.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$9,541.00
|
| Rate for Payer: WINHealth Partners Commercial |
$16,121.00
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATHETER SHOCKWAVE C2+IVL I 3.5X12MM
|
Facility
|
IP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10,314.15 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10,857.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$10,314.15
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$10,857.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$10,857.00
|
| Rate for Payer: WINHealth Partners Commercial |
$15,627.50
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATHETER SHOCKWAVE C2+IVL I 4.0X12MM
|
Facility
|
OP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,063.95 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Aetna of WY Medicare |
$10,857.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9,541.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$9,063.95
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$9,541.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$9,541.00
|
| Rate for Payer: WINHealth Partners Commercial |
$16,121.00
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATHETER SHOCKWAVE C2+IVL I 4.0X12MM
|
Facility
|
IP
|
$16,450.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10,314.15 |
| Max. Negotiated Rate |
$16,450.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16,121.00
|
| Rate for Payer: Altius Auto/Workers Compensation |
$15,792.00
|
| Rate for Payer: Altius Commercial |
$15,792.00
|
| Rate for Payer: Beech Street Commercial |
$16,121.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,505.45
|
| Rate for Payer: Cash Price |
$11,515.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$15,956.50
|
| Rate for Payer: Cigna of WY Commercial |
$16,121.00
|
| Rate for Payer: Entrust Commercial |
$15,627.50
|
| Rate for Payer: First Choice Health Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15,627.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10,857.00
|
| Rate for Payer: HealthUtah PPO |
$16,450.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15,956.50
|
| Rate for Payer: Multiplan Medicare/VA |
$10,314.15
|
| Rate for Payer: One Health Plan of WY PPO |
$16,121.00
|
| Rate for Payer: PacificSource Commercial |
$14,805.00
|
| Rate for Payer: PHCS PPO |
$16,121.00
|
| Rate for Payer: Three Rivers PPO |
$12,337.50
|
| Rate for Payer: TriWest Veterans Administration |
$10,857.00
|
| Rate for Payer: United Healthcare Commercial |
$14,311.50
|
| Rate for Payer: United Healthcare Medicare |
$10,857.00
|
| Rate for Payer: WINHealth Partners Commercial |
$15,627.50
|
| Rate for Payer: Wise Provider Network Commercial |
$15,627.50
|
|
|
CATH FOGARTY OCCLUSION 3FR
|
Facility
|
OP
|
$129.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.35 |
| Max. Negotiated Rate |
$129.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$126.91
|
| Rate for Payer: Aetna of WY Medicare |
$85.47
|
| Rate for Payer: Altius Auto/Workers Compensation |
$124.32
|
| Rate for Payer: Altius Commercial |
$124.32
|
| Rate for Payer: Beech Street Commercial |
$126.91
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$106.32
|
| Rate for Payer: Cash Price |
$90.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$125.62
|
| Rate for Payer: Cigna of WY Commercial |
$126.91
|
| Rate for Payer: Entrust Commercial |
$123.02
|
| Rate for Payer: First Choice Health Commercial |
$123.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$123.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$75.11
|
| Rate for Payer: HealthUtah PPO |
$129.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$125.62
|
| Rate for Payer: Multiplan Medicare/VA |
$71.35
|
| Rate for Payer: One Health Plan of WY PPO |
$126.91
|
| Rate for Payer: PacificSource Commercial |
$116.55
|
| Rate for Payer: PHCS PPO |
$126.91
|
| Rate for Payer: Three Rivers PPO |
$97.12
|
| Rate for Payer: TriWest Veterans Administration |
$75.11
|
| Rate for Payer: United Healthcare Commercial |
$112.66
|
| Rate for Payer: United Healthcare Medicare |
$75.11
|
| Rate for Payer: WINHealth Partners Commercial |
$126.91
|
| Rate for Payer: Wise Provider Network Commercial |
$123.02
|
|
|
CATH FOGARTY OCCLUSION 3FR
|
Facility
|
IP
|
$129.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$129.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$126.91
|
| Rate for Payer: Altius Auto/Workers Compensation |
$124.32
|
| Rate for Payer: Altius Commercial |
$124.32
|
| Rate for Payer: Beech Street Commercial |
$126.91
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$106.32
|
| Rate for Payer: Cash Price |
$90.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$125.62
|
| Rate for Payer: Cigna of WY Commercial |
$126.91
|
| Rate for Payer: Entrust Commercial |
$123.02
|
| Rate for Payer: First Choice Health Commercial |
$123.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$123.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$85.47
|
| Rate for Payer: HealthUtah PPO |
$129.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$125.62
|
| Rate for Payer: Multiplan Medicare/VA |
$81.20
|
| Rate for Payer: One Health Plan of WY PPO |
$126.91
|
| Rate for Payer: PacificSource Commercial |
$116.55
|
| Rate for Payer: PHCS PPO |
$126.91
|
| Rate for Payer: Three Rivers PPO |
$97.12
|
| Rate for Payer: TriWest Veterans Administration |
$85.47
|
| Rate for Payer: United Healthcare Commercial |
$112.66
|
| Rate for Payer: United Healthcare Medicare |
$85.47
|
| Rate for Payer: WINHealth Partners Commercial |
$123.02
|
| Rate for Payer: Wise Provider Network Commercial |
$123.02
|
|
|
CATH FOGARTY OCCLUSION 4FR
|
Facility
|
OP
|
$129.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.35 |
| Max. Negotiated Rate |
$129.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$126.91
|
| Rate for Payer: Aetna of WY Medicare |
$85.47
|
| Rate for Payer: Altius Auto/Workers Compensation |
$124.32
|
| Rate for Payer: Altius Commercial |
$124.32
|
| Rate for Payer: Beech Street Commercial |
$126.91
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$106.32
|
| Rate for Payer: Cash Price |
$90.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$125.62
|
| Rate for Payer: Cigna of WY Commercial |
$126.91
|
| Rate for Payer: Entrust Commercial |
$123.02
|
| Rate for Payer: First Choice Health Commercial |
$123.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$123.02
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$75.11
|
| Rate for Payer: HealthUtah PPO |
$129.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$125.62
|
| Rate for Payer: Multiplan Medicare/VA |
$71.35
|
| Rate for Payer: One Health Plan of WY PPO |
$126.91
|
| Rate for Payer: PacificSource Commercial |
$116.55
|
| Rate for Payer: PHCS PPO |
$126.91
|
| Rate for Payer: Three Rivers PPO |
$97.12
|
| Rate for Payer: TriWest Veterans Administration |
$75.11
|
| Rate for Payer: United Healthcare Commercial |
$112.66
|
| Rate for Payer: United Healthcare Medicare |
$75.11
|
| Rate for Payer: WINHealth Partners Commercial |
$126.91
|
| Rate for Payer: Wise Provider Network Commercial |
$123.02
|
|
