|
BRACE KNEE TRIPANEL IMMOB 16"
|
Facility
|
OP
|
$88.73
|
|
| Hospital Charge Code |
2200131
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.05 |
| Max. Negotiated Rate |
$88.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.96
|
| Rate for Payer: Aetna of WY Medicare |
$58.56
|
| Rate for Payer: Altius Commercial |
$85.18
|
| Rate for Payer: Beech Street Commercial |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$86.07
|
| Rate for Payer: Cigna of WY Commercial |
$86.96
|
| Rate for Payer: Entrust Commercial |
$84.29
|
| Rate for Payer: First Choice Health Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.58
|
| Rate for Payer: HealthUtah PPO |
$88.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$86.07
|
| Rate for Payer: Multiplan Medicare/VA |
$48.05
|
| Rate for Payer: One Health Plan of WY PPO |
$86.96
|
| Rate for Payer: PacificSource Commercial |
$79.86
|
| Rate for Payer: PHCS PPO |
$86.96
|
| Rate for Payer: Three Rivers PPO |
$66.55
|
| Rate for Payer: TriWest Veterans Administration |
$50.58
|
| Rate for Payer: United Healthcare Commercial |
$84.74
|
| Rate for Payer: United Healthcare Medicare |
$50.58
|
| Rate for Payer: WINHealth Partners Commercial |
$86.96
|
| Rate for Payer: Wise Provider Network Commercial |
$84.29
|
|
|
BRACE KNEE TRIPANEL IMMOB 20"
|
Facility
|
IP
|
$88.73
|
|
| Hospital Charge Code |
2200252
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.42 |
| Max. Negotiated Rate |
$88.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.96
|
| Rate for Payer: Aetna of WY Medicare |
$56.79
|
| Rate for Payer: Altius Commercial |
$85.18
|
| Rate for Payer: Beech Street Commercial |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$86.07
|
| Rate for Payer: Cigna of WY Commercial |
$86.96
|
| Rate for Payer: Entrust Commercial |
$84.29
|
| Rate for Payer: First Choice Health Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.13
|
| Rate for Payer: HealthUtah PPO |
$88.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$86.07
|
| Rate for Payer: Multiplan Medicare/VA |
$51.42
|
| Rate for Payer: One Health Plan of WY PPO |
$86.96
|
| Rate for Payer: PacificSource Commercial |
$79.86
|
| Rate for Payer: PHCS PPO |
$86.96
|
| Rate for Payer: Three Rivers PPO |
$66.55
|
| Rate for Payer: TriWest Veterans Administration |
$54.13
|
| Rate for Payer: United Healthcare Commercial |
$84.74
|
| Rate for Payer: United Healthcare Medicare |
$54.13
|
| Rate for Payer: WINHealth Partners Commercial |
$84.29
|
| Rate for Payer: Wise Provider Network Commercial |
$84.29
|
|
|
BRACE KNEE TRIPANEL IMMOB 20"
|
Facility
|
OP
|
$88.73
|
|
| Hospital Charge Code |
2200252
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.05 |
| Max. Negotiated Rate |
$88.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.96
|
| Rate for Payer: Aetna of WY Medicare |
$58.56
|
| Rate for Payer: Altius Commercial |
$85.18
|
| Rate for Payer: Beech Street Commercial |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$86.07
|
| Rate for Payer: Cigna of WY Commercial |
$86.96
|
| Rate for Payer: Entrust Commercial |
$84.29
|
| Rate for Payer: First Choice Health Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.58
|
| Rate for Payer: HealthUtah PPO |
$88.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$86.07
|
| Rate for Payer: Multiplan Medicare/VA |
$48.05
|
| Rate for Payer: One Health Plan of WY PPO |
$86.96
|
| Rate for Payer: PacificSource Commercial |
$79.86
|
| Rate for Payer: PHCS PPO |
$86.96
|
| Rate for Payer: Three Rivers PPO |
$66.55
|
| Rate for Payer: TriWest Veterans Administration |
$50.58
|
| Rate for Payer: United Healthcare Commercial |
$84.74
|
| Rate for Payer: United Healthcare Medicare |
$50.58
|
| Rate for Payer: WINHealth Partners Commercial |
$86.96
|
| Rate for Payer: Wise Provider Network Commercial |
$84.29
|
|
|
BRACE KNEE TRIPANEL IMMOB 22"
|
Facility
|
OP
|
$88.73
|
|
| Hospital Charge Code |
2200253
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.05 |
| Max. Negotiated Rate |
$88.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.96
|
| Rate for Payer: Aetna of WY Medicare |
$58.56
|
| Rate for Payer: Altius Commercial |
$85.18
|
| Rate for Payer: Beech Street Commercial |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$86.07
|
| Rate for Payer: Cigna of WY Commercial |
$86.96
|
| Rate for Payer: Entrust Commercial |
$84.29
|
| Rate for Payer: First Choice Health Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.58
|
| Rate for Payer: HealthUtah PPO |
$88.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$86.07
|
| Rate for Payer: Multiplan Medicare/VA |
$48.05
|
| Rate for Payer: One Health Plan of WY PPO |
$86.96
|
| Rate for Payer: PacificSource Commercial |
$79.86
|
| Rate for Payer: PHCS PPO |
$86.96
|
| Rate for Payer: Three Rivers PPO |
$66.55
|
| Rate for Payer: TriWest Veterans Administration |
$50.58
|
| Rate for Payer: United Healthcare Commercial |
$84.74
|
| Rate for Payer: United Healthcare Medicare |
$50.58
|
| Rate for Payer: WINHealth Partners Commercial |
$86.96
|
| Rate for Payer: Wise Provider Network Commercial |
$84.29
|
|
|
BRACE KNEE TRIPANEL IMMOB 22"
|
Facility
|
IP
|
$88.73
|
|
| Hospital Charge Code |
2200253
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.42 |
| Max. Negotiated Rate |
$88.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.96
|
| Rate for Payer: Aetna of WY Medicare |
$56.79
|
| Rate for Payer: Altius Commercial |
$85.18
|
| Rate for Payer: Beech Street Commercial |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$86.07
|
| Rate for Payer: Cigna of WY Commercial |
$86.96
|
| Rate for Payer: Entrust Commercial |
$84.29
|
| Rate for Payer: First Choice Health Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.13
|
| Rate for Payer: HealthUtah PPO |
$88.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$86.07
|
| Rate for Payer: Multiplan Medicare/VA |
$51.42
|
| Rate for Payer: One Health Plan of WY PPO |
$86.96
|
| Rate for Payer: PacificSource Commercial |
$79.86
|
| Rate for Payer: PHCS PPO |
$86.96
|
| Rate for Payer: Three Rivers PPO |
$66.55
|
| Rate for Payer: TriWest Veterans Administration |
$54.13
|
| Rate for Payer: United Healthcare Commercial |
$84.74
|
| Rate for Payer: United Healthcare Medicare |
$54.13
|
| Rate for Payer: WINHealth Partners Commercial |
$84.29
|
| Rate for Payer: Wise Provider Network Commercial |
$84.29
|
|
|
BRACE KNEE TRIPANEL IMMOB 24"
|
Facility
|
IP
|
$88.73
|
|
| Hospital Charge Code |
2200134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.42 |
| Max. Negotiated Rate |
$88.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.96
|
| Rate for Payer: Aetna of WY Medicare |
$56.79
|
| Rate for Payer: Altius Commercial |
$85.18
|
| Rate for Payer: Beech Street Commercial |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$86.07
|
| Rate for Payer: Cigna of WY Commercial |
$86.96
|
| Rate for Payer: Entrust Commercial |
$84.29
|
| Rate for Payer: First Choice Health Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.13
|
| Rate for Payer: HealthUtah PPO |
$88.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$86.07
|
| Rate for Payer: Multiplan Medicare/VA |
$51.42
|
| Rate for Payer: One Health Plan of WY PPO |
$86.96
|
| Rate for Payer: PacificSource Commercial |
$79.86
|
| Rate for Payer: PHCS PPO |
$86.96
|
| Rate for Payer: Three Rivers PPO |
$66.55
|
| Rate for Payer: TriWest Veterans Administration |
$54.13
|
| Rate for Payer: United Healthcare Commercial |
$84.74
|
| Rate for Payer: United Healthcare Medicare |
$54.13
|
| Rate for Payer: WINHealth Partners Commercial |
$84.29
|
| Rate for Payer: Wise Provider Network Commercial |
$84.29
|
|
|
BRACE KNEE TRIPANEL IMMOB 24"
|
Facility
|
OP
|
$88.73
|
|
| Hospital Charge Code |
2200134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.05 |
| Max. Negotiated Rate |
$88.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.96
|
| Rate for Payer: Aetna of WY Medicare |
$58.56
|
| Rate for Payer: Altius Commercial |
$85.18
|
| Rate for Payer: Beech Street Commercial |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$86.07
|
| Rate for Payer: Cigna of WY Commercial |
$86.96
|
| Rate for Payer: Entrust Commercial |
$84.29
|
| Rate for Payer: First Choice Health Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$84.29
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.58
|
| Rate for Payer: HealthUtah PPO |
$88.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$86.07
|
| Rate for Payer: Multiplan Medicare/VA |
$48.05
|
| Rate for Payer: One Health Plan of WY PPO |
$86.96
|
| Rate for Payer: PacificSource Commercial |
$79.86
|
| Rate for Payer: PHCS PPO |
$86.96
|
| Rate for Payer: Three Rivers PPO |
$66.55
|
| Rate for Payer: TriWest Veterans Administration |
$50.58
|
| Rate for Payer: United Healthcare Commercial |
$84.74
|
| Rate for Payer: United Healthcare Medicare |
$50.58
|
| Rate for Payer: WINHealth Partners Commercial |
$86.96
|
| Rate for Payer: Wise Provider Network Commercial |
$84.29
|
|
|
BRACE KNEE T-SCOPE BREG 08814
|
Facility
|
OP
|
$228.23
|
|
| Hospital Charge Code |
2200156
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$123.59 |
| Max. Negotiated Rate |
$228.23 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$223.67
|
| Rate for Payer: Aetna of WY Medicare |
$150.63
|
| Rate for Payer: Altius Commercial |
$219.10
|
| Rate for Payer: Beech Street Commercial |
$223.67
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$221.38
|
| Rate for Payer: Cash Price |
$159.76
|
| Rate for Payer: ChoiceCare Network Commercial |
$221.38
|
| Rate for Payer: Cigna of WY Commercial |
$223.67
|
| Rate for Payer: Entrust Commercial |
$216.82
|
| Rate for Payer: First Choice Health Commercial |
$216.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$130.09
|
| Rate for Payer: HealthUtah PPO |
$228.23
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$221.38
|
| Rate for Payer: Multiplan Medicare/VA |
$123.59
|
| Rate for Payer: One Health Plan of WY PPO |
$223.67
|
| Rate for Payer: PacificSource Commercial |
$205.41
|
| Rate for Payer: PHCS PPO |
$223.67
|
| Rate for Payer: Three Rivers PPO |
$171.17
|
| Rate for Payer: TriWest Veterans Administration |
$130.09
|
| Rate for Payer: United Healthcare Commercial |
$217.96
|
| Rate for Payer: United Healthcare Medicare |
$130.09
|
| Rate for Payer: WINHealth Partners Commercial |
$223.67
|
| Rate for Payer: Wise Provider Network Commercial |
$216.82
|
|
|
BRACE KNEE T-SCOPE BREG 08814
|
Facility
|
IP
|
$228.23
|
|
| Hospital Charge Code |
2200156
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$132.26 |
| Max. Negotiated Rate |
$228.23 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$223.67
|
| Rate for Payer: Aetna of WY Medicare |
$146.07
|
| Rate for Payer: Altius Commercial |
$219.10
|
| Rate for Payer: Beech Street Commercial |
$223.67
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$221.38
|
| Rate for Payer: Cash Price |
$159.76
|
| Rate for Payer: ChoiceCare Network Commercial |
$221.38
|
| Rate for Payer: Cigna of WY Commercial |
$223.67
|
| Rate for Payer: Entrust Commercial |
$216.82
|
| Rate for Payer: First Choice Health Commercial |
$216.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$139.22
|
| Rate for Payer: HealthUtah PPO |
$228.23
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$221.38
|
| Rate for Payer: Multiplan Medicare/VA |
$132.26
|
| Rate for Payer: One Health Plan of WY PPO |
$223.67
|
| Rate for Payer: PacificSource Commercial |
$205.41
|
| Rate for Payer: PHCS PPO |
$223.67
|
| Rate for Payer: Three Rivers PPO |
$171.17
|
| Rate for Payer: TriWest Veterans Administration |
$139.22
|
| Rate for Payer: United Healthcare Commercial |
$217.96
|
| Rate for Payer: United Healthcare Medicare |
$139.22
|
| Rate for Payer: WINHealth Partners Commercial |
$216.82
|
| Rate for Payer: Wise Provider Network Commercial |
$216.82
|
|
|
BRACE KNEE T-SCOPE PEDIATRIC
|
Facility
|
OP
|
$361.72
|
|
| Hospital Charge Code |
2200441
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$195.87 |
| Max. Negotiated Rate |
$361.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$354.49
|
| Rate for Payer: Aetna of WY Medicare |
$238.74
|
| Rate for Payer: Altius Commercial |
$347.25
|
| Rate for Payer: Beech Street Commercial |
$354.49
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$350.87
|
| Rate for Payer: Cash Price |
$253.21
|
| Rate for Payer: ChoiceCare Network Commercial |
$350.87
|
| Rate for Payer: Cigna of WY Commercial |
$354.49
|
| Rate for Payer: Entrust Commercial |
$343.63
|
| Rate for Payer: First Choice Health Commercial |
$343.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$343.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$206.18
|
| Rate for Payer: HealthUtah PPO |
$361.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$350.87
|
| Rate for Payer: Multiplan Medicare/VA |
$195.87
|
| Rate for Payer: One Health Plan of WY PPO |
$354.49
|
| Rate for Payer: PacificSource Commercial |
$325.55
|
| Rate for Payer: PHCS PPO |
$354.49
|
| Rate for Payer: Three Rivers PPO |
$271.29
|
| Rate for Payer: TriWest Veterans Administration |
$206.18
|
| Rate for Payer: United Healthcare Commercial |
$345.44
|
| Rate for Payer: United Healthcare Medicare |
$206.18
|
| Rate for Payer: WINHealth Partners Commercial |
$354.49
|
| Rate for Payer: Wise Provider Network Commercial |
$343.63
|
|
|
BRACE KNEE T-SCOPE PEDIATRIC
|
Facility
|
IP
|
$361.72
|
|
| Hospital Charge Code |
2200441
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$209.62 |
| Max. Negotiated Rate |
$361.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$354.49
|
| Rate for Payer: Aetna of WY Medicare |
$231.50
|
| Rate for Payer: Altius Commercial |
$347.25
|
| Rate for Payer: Beech Street Commercial |
$354.49
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$350.87
|
| Rate for Payer: Cash Price |
$253.21
|
| Rate for Payer: ChoiceCare Network Commercial |
$350.87
|
| Rate for Payer: Cigna of WY Commercial |
$354.49
|
| Rate for Payer: Entrust Commercial |
$343.63
|
| Rate for Payer: First Choice Health Commercial |
$343.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$343.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$220.65
|
| Rate for Payer: HealthUtah PPO |
$361.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$350.87
|
| Rate for Payer: Multiplan Medicare/VA |
$209.62
|
| Rate for Payer: One Health Plan of WY PPO |
$354.49
|
| Rate for Payer: PacificSource Commercial |
$325.55
|
| Rate for Payer: PHCS PPO |
$354.49
|
| Rate for Payer: Three Rivers PPO |
$271.29
|
| Rate for Payer: TriWest Veterans Administration |
$220.65
|
| Rate for Payer: United Healthcare Commercial |
$345.44
|
| Rate for Payer: United Healthcare Medicare |
$220.65
|
| Rate for Payer: WINHealth Partners Commercial |
$343.63
|
| Rate for Payer: Wise Provider Network Commercial |
$343.63
|
|
|
BRACE PATELLA LG VP40125-040
|
Facility
|
OP
|
$22.61
|
|
| Hospital Charge Code |
2200138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$22.61 |
| Rate for Payer: United Healthcare Commercial |
$21.59
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.16
|
| Rate for Payer: Aetna of WY Medicare |
$14.92
|
| Rate for Payer: Altius Commercial |
$21.71
|
| Rate for Payer: Beech Street Commercial |
$22.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$21.93
|
| Rate for Payer: Cash Price |
$15.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$21.93
|
| Rate for Payer: Cigna of WY Commercial |
$22.16
|
| Rate for Payer: Entrust Commercial |
$21.48
|
| Rate for Payer: First Choice Health Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.89
|
| Rate for Payer: HealthUtah PPO |
$22.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$21.93
|
| Rate for Payer: Multiplan Medicare/VA |
$12.24
|
| Rate for Payer: One Health Plan of WY PPO |
$22.16
|
| Rate for Payer: PacificSource Commercial |
$20.35
|
| Rate for Payer: PHCS PPO |
$22.16
|
| Rate for Payer: Three Rivers PPO |
$16.96
|
| Rate for Payer: TriWest Veterans Administration |
$12.89
|
| Rate for Payer: United Healthcare Medicare |
$12.89
|
| Rate for Payer: WINHealth Partners Commercial |
$22.16
|
| Rate for Payer: Wise Provider Network Commercial |
$21.48
|
|
|
BRACE PATELLA LG VP40125-040
|
Facility
|
IP
|
$22.61
|
|
| Hospital Charge Code |
2200138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$22.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.16
|
| Rate for Payer: Aetna of WY Medicare |
$14.47
|
| Rate for Payer: Altius Commercial |
$21.71
|
| Rate for Payer: Beech Street Commercial |
$22.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$21.93
|
| Rate for Payer: Cash Price |
$15.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$21.93
|
| Rate for Payer: Cigna of WY Commercial |
$22.16
|
| Rate for Payer: Entrust Commercial |
$21.48
|
| Rate for Payer: First Choice Health Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.79
|
| Rate for Payer: HealthUtah PPO |
$22.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$21.93
|
| Rate for Payer: Multiplan Medicare/VA |
$13.10
|
| Rate for Payer: One Health Plan of WY PPO |
$22.16
|
| Rate for Payer: PacificSource Commercial |
$20.35
|
| Rate for Payer: PHCS PPO |
$22.16
|
| Rate for Payer: Three Rivers PPO |
$16.96
|
| Rate for Payer: TriWest Veterans Administration |
$13.79
|
| Rate for Payer: United Healthcare Commercial |
$21.59
|
| Rate for Payer: United Healthcare Medicare |
$13.79
|
| Rate for Payer: WINHealth Partners Commercial |
$21.48
|
| Rate for Payer: Wise Provider Network Commercial |
$21.48
|
|
|
BRACE PATELLA SM VP40125-020
|
Facility
|
IP
|
$22.61
|
|
| Hospital Charge Code |
2200140
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$22.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.16
|
| Rate for Payer: Aetna of WY Medicare |
$14.47
|
| Rate for Payer: Altius Commercial |
$21.71
|
| Rate for Payer: Beech Street Commercial |
$22.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$21.93
|
| Rate for Payer: Cash Price |
$15.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$21.93
|
| Rate for Payer: Cigna of WY Commercial |
$22.16
|
| Rate for Payer: Entrust Commercial |
$21.48
|
| Rate for Payer: First Choice Health Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.79
|
| Rate for Payer: HealthUtah PPO |
$22.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$21.93
|
| Rate for Payer: Multiplan Medicare/VA |
$13.10
|
| Rate for Payer: One Health Plan of WY PPO |
$22.16
|
| Rate for Payer: PacificSource Commercial |
$20.35
|
| Rate for Payer: PHCS PPO |
$22.16
|
| Rate for Payer: Three Rivers PPO |
$16.96
|
| Rate for Payer: TriWest Veterans Administration |
$13.79
|
| Rate for Payer: United Healthcare Commercial |
$21.59
|
| Rate for Payer: United Healthcare Medicare |
$13.79
|
| Rate for Payer: WINHealth Partners Commercial |
$21.48
|
| Rate for Payer: Wise Provider Network Commercial |
$21.48
|
|
|
BRACE PATELLA SM VP40125-020
|
Facility
|
OP
|
$22.61
|
|
| Hospital Charge Code |
2200140
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$22.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.16
|
| Rate for Payer: Aetna of WY Medicare |
$14.92
|
| Rate for Payer: Altius Commercial |
$21.71
|
| Rate for Payer: Beech Street Commercial |
$22.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$21.93
|
| Rate for Payer: Cash Price |
$15.83
|
| Rate for Payer: ChoiceCare Network Commercial |
$21.93
|
| Rate for Payer: Cigna of WY Commercial |
$22.16
|
| Rate for Payer: Entrust Commercial |
$21.48
|
| Rate for Payer: First Choice Health Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.89
|
| Rate for Payer: HealthUtah PPO |
$22.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$21.93
|
| Rate for Payer: Multiplan Medicare/VA |
$12.24
|
| Rate for Payer: One Health Plan of WY PPO |
$22.16
|
| Rate for Payer: PacificSource Commercial |
$20.35
|
| Rate for Payer: PHCS PPO |
$22.16
|
| Rate for Payer: Three Rivers PPO |
$16.96
|
| Rate for Payer: TriWest Veterans Administration |
$12.89
|
| Rate for Payer: United Healthcare Commercial |
$21.59
|
| Rate for Payer: United Healthcare Medicare |
$12.89
|
| Rate for Payer: WINHealth Partners Commercial |
$22.16
|
| Rate for Payer: Wise Provider Network Commercial |
$21.48
|
|
|
BRACE PATELLA STAB LG LT 20154
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.74 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$63.06
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.46
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$51.74
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$54.46
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$54.46
|
| Rate for Payer: WINHealth Partners Commercial |
$93.64
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB LG LT 20154
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$61.15
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.29
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$55.37
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$58.29
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$58.29
|
| Rate for Payer: WINHealth Partners Commercial |
$90.77
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB LG RT 20174
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$61.15
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.29
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$55.37
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$58.29
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$58.29
|
| Rate for Payer: WINHealth Partners Commercial |
$90.77
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB LG RT 20174
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.74 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$63.06
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.46
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$51.74
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$54.46
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$54.46
|
| Rate for Payer: WINHealth Partners Commercial |
$93.64
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB SM LT 20152
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.74 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$63.06
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.46
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$51.74
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$54.46
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$54.46
|
| Rate for Payer: WINHealth Partners Commercial |
$93.64
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB SM LT 20152
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$61.15
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.29
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$55.37
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$58.29
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$58.29
|
| Rate for Payer: WINHealth Partners Commercial |
$90.77
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB SM RT 20172
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$61.15
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.29
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$55.37
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$58.29
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$58.29
|
| Rate for Payer: WINHealth Partners Commercial |
$90.77
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB SM RT 20172
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.74 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$63.06
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.46
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$51.74
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$54.46
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$54.46
|
| Rate for Payer: WINHealth Partners Commercial |
$93.64
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB XL LT 20155
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$61.15
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.29
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$55.37
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$58.29
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$58.29
|
| Rate for Payer: WINHealth Partners Commercial |
$90.77
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
|
BRACE PATELLA STAB XL LT 20155
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.74 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$93.64
|
| Rate for Payer: Aetna of WY Medicare |
$63.06
|
| Rate for Payer: Altius Commercial |
$91.73
|
| Rate for Payer: Beech Street Commercial |
$93.64
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$92.68
|
| Rate for Payer: Cash Price |
$66.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$92.68
|
| Rate for Payer: Cigna of WY Commercial |
$93.64
|
| Rate for Payer: Entrust Commercial |
$90.77
|
| Rate for Payer: First Choice Health Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$90.77
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$54.46
|
| Rate for Payer: HealthUtah PPO |
$95.55
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$92.68
|
| Rate for Payer: Multiplan Medicare/VA |
$51.74
|
| Rate for Payer: One Health Plan of WY PPO |
$93.64
|
| Rate for Payer: PacificSource Commercial |
$86.00
|
| Rate for Payer: PHCS PPO |
$93.64
|
| Rate for Payer: Three Rivers PPO |
$71.66
|
| Rate for Payer: TriWest Veterans Administration |
$54.46
|
| Rate for Payer: United Healthcare Commercial |
$91.25
|
| Rate for Payer: United Healthcare Medicare |
$54.46
|
| Rate for Payer: WINHealth Partners Commercial |
$93.64
|
| Rate for Payer: Wise Provider Network Commercial |
$90.77
|
|
