|
BRACE PATELLA STAB XL RT 20175
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200149
|
|
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 RT 20175
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200149
|
|
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 XL VP40125-050
|
Facility
|
IP
|
$22.61
|
|
| Hospital Charge Code |
2200141
|
|
Hospital Revenue Code
|
272
|
| 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 XL VP40125-050
|
Facility
|
OP
|
$22.61
|
|
| Hospital Charge Code |
2200141
|
|
Hospital Revenue Code
|
272
|
| 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 XS VP40125-010
|
Facility
|
IP
|
$22.61
|
|
| Hospital Charge Code |
2200359
|
|
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 XS VP40125-010
|
Facility
|
OP
|
$22.61
|
|
| Hospital Charge Code |
2200359
|
|
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 PATELL BAND MED 79-80325
|
Facility
|
IP
|
$22.61
|
|
| Hospital Charge Code |
2200139
|
|
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 PATELL BAND MED 79-80325
|
Facility
|
OP
|
$22.61
|
|
| Hospital Charge Code |
2200139
|
|
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 PATELL STAB MED LT 20153
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200144
|
|
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 PATELL STAB MED LT 20153
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200144
|
|
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 PATELL STAB MED RT 20173
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200145
|
|
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 PATELL STAB MED RT 20173
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200145
|
|
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 PATELL STAB XXL LH 20156
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200261
|
|
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 PATELL STAB XXL LH 20156
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200261
|
|
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 PATELL STAB XXL RH 20176
|
Facility
|
OP
|
$95.55
|
|
| Hospital Charge Code |
2200262
|
|
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 PATELL STAB XXL RH 20176
|
Facility
|
IP
|
$95.55
|
|
| Hospital Charge Code |
2200262
|
|
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 TSCOPE ELBOW LEFT
|
Facility
|
OP
|
$182.52
|
|
| Hospital Charge Code |
2200250
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$182.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$178.87
|
| Rate for Payer: Aetna of WY Medicare |
$120.46
|
| Rate for Payer: Altius Commercial |
$175.22
|
| Rate for Payer: Beech Street Commercial |
$178.87
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$177.04
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$177.04
|
| Rate for Payer: Cigna of WY Commercial |
$178.87
|
| Rate for Payer: Entrust Commercial |
$173.39
|
| Rate for Payer: First Choice Health Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$182.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$177.04
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$178.87
|
| Rate for Payer: PacificSource Commercial |
$164.27
|
| Rate for Payer: PHCS PPO |
$178.87
|
| Rate for Payer: Three Rivers PPO |
$136.89
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$174.31
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$178.87
|
| Rate for Payer: Wise Provider Network Commercial |
$173.39
|
|
|
BRACE TSCOPE ELBOW LEFT
|
Facility
|
IP
|
$182.52
|
|
| Hospital Charge Code |
2200250
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.77 |
| Max. Negotiated Rate |
$182.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$178.87
|
| Rate for Payer: Aetna of WY Medicare |
$116.81
|
| Rate for Payer: Altius Commercial |
$175.22
|
| Rate for Payer: Beech Street Commercial |
$178.87
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$177.04
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$177.04
|
| Rate for Payer: Cigna of WY Commercial |
$178.87
|
| Rate for Payer: Entrust Commercial |
$173.39
|
| Rate for Payer: First Choice Health Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$111.34
|
| Rate for Payer: HealthUtah PPO |
$182.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$177.04
|
| Rate for Payer: Multiplan Medicare/VA |
$105.77
|
| Rate for Payer: One Health Plan of WY PPO |
$178.87
|
| Rate for Payer: PacificSource Commercial |
$164.27
|
| Rate for Payer: PHCS PPO |
$178.87
|
| Rate for Payer: Three Rivers PPO |
$136.89
|
| Rate for Payer: TriWest Veterans Administration |
$111.34
|
| Rate for Payer: United Healthcare Commercial |
$174.31
|
| Rate for Payer: United Healthcare Medicare |
$111.34
|
| Rate for Payer: WINHealth Partners Commercial |
$173.39
|
| Rate for Payer: Wise Provider Network Commercial |
$173.39
|
|
|
BRACE TSCOPE ELBOW RIGHT
|
Facility
|
OP
|
$182.52
|
|
| Hospital Charge Code |
2200251
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$182.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$178.87
|
| Rate for Payer: Aetna of WY Medicare |
$120.46
|
| Rate for Payer: Altius Commercial |
$175.22
|
| Rate for Payer: Beech Street Commercial |
$178.87
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$177.04
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$177.04
|
| Rate for Payer: Cigna of WY Commercial |
$178.87
|
| Rate for Payer: Entrust Commercial |
$173.39
|
| Rate for Payer: First Choice Health Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.04
|
| Rate for Payer: HealthUtah PPO |
$182.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$177.04
|
| Rate for Payer: Multiplan Medicare/VA |
$98.83
|
| Rate for Payer: One Health Plan of WY PPO |
$178.87
|
| Rate for Payer: PacificSource Commercial |
$164.27
|
| Rate for Payer: PHCS PPO |
$178.87
|
| Rate for Payer: Three Rivers PPO |
$136.89
|
| Rate for Payer: TriWest Veterans Administration |
$104.04
|
| Rate for Payer: United Healthcare Commercial |
$174.31
|
| Rate for Payer: United Healthcare Medicare |
$104.04
|
| Rate for Payer: WINHealth Partners Commercial |
$178.87
|
| Rate for Payer: Wise Provider Network Commercial |
$173.39
|
|
|
BRACE TSCOPE ELBOW RIGHT
|
Facility
|
IP
|
$182.52
|
|
| Hospital Charge Code |
2200251
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.77 |
| Max. Negotiated Rate |
$182.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$178.87
|
| Rate for Payer: Aetna of WY Medicare |
$116.81
|
| Rate for Payer: Altius Commercial |
$175.22
|
| Rate for Payer: Beech Street Commercial |
$178.87
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$177.04
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$177.04
|
| Rate for Payer: Cigna of WY Commercial |
$178.87
|
| Rate for Payer: Entrust Commercial |
$173.39
|
| Rate for Payer: First Choice Health Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$173.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$111.34
|
| Rate for Payer: HealthUtah PPO |
$182.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$177.04
|
| Rate for Payer: Multiplan Medicare/VA |
$105.77
|
| Rate for Payer: One Health Plan of WY PPO |
$178.87
|
| Rate for Payer: PacificSource Commercial |
$164.27
|
| Rate for Payer: PHCS PPO |
$178.87
|
| Rate for Payer: Three Rivers PPO |
$136.89
|
| Rate for Payer: TriWest Veterans Administration |
$111.34
|
| Rate for Payer: United Healthcare Commercial |
$174.31
|
| Rate for Payer: United Healthcare Medicare |
$111.34
|
| Rate for Payer: WINHealth Partners Commercial |
$173.39
|
| Rate for Payer: Wise Provider Network Commercial |
$173.39
|
|
|
BRACE WRIST 8" LH XL 79-87298
|
Facility
|
IP
|
$16.34
|
|
| Hospital Charge Code |
2200357
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$16.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.01
|
| Rate for Payer: Aetna of WY Medicare |
$10.46
|
| Rate for Payer: Altius Commercial |
$15.69
|
| Rate for Payer: Beech Street Commercial |
$16.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.85
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.85
|
| Rate for Payer: Cigna of WY Commercial |
$16.01
|
| Rate for Payer: Entrust Commercial |
$15.52
|
| Rate for Payer: First Choice Health Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.97
|
| Rate for Payer: HealthUtah PPO |
$16.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.85
|
| Rate for Payer: Multiplan Medicare/VA |
$9.47
|
| Rate for Payer: One Health Plan of WY PPO |
$16.01
|
| Rate for Payer: PacificSource Commercial |
$14.71
|
| Rate for Payer: PHCS PPO |
$16.01
|
| Rate for Payer: Three Rivers PPO |
$12.26
|
| Rate for Payer: TriWest Veterans Administration |
$9.97
|
| Rate for Payer: United Healthcare Commercial |
$15.60
|
| Rate for Payer: United Healthcare Medicare |
$9.97
|
| Rate for Payer: WINHealth Partners Commercial |
$15.52
|
| Rate for Payer: Wise Provider Network Commercial |
$15.52
|
|
|
BRACE WRIST 8" LH XL 79-87298
|
Facility
|
OP
|
$16.34
|
|
| Hospital Charge Code |
2200357
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$16.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.01
|
| Rate for Payer: Aetna of WY Medicare |
$10.78
|
| Rate for Payer: Altius Commercial |
$15.69
|
| Rate for Payer: Beech Street Commercial |
$16.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.85
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.85
|
| Rate for Payer: Cigna of WY Commercial |
$16.01
|
| Rate for Payer: Entrust Commercial |
$15.52
|
| Rate for Payer: First Choice Health Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.31
|
| Rate for Payer: HealthUtah PPO |
$16.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.85
|
| Rate for Payer: Multiplan Medicare/VA |
$8.85
|
| Rate for Payer: One Health Plan of WY PPO |
$16.01
|
| Rate for Payer: PacificSource Commercial |
$14.71
|
| Rate for Payer: PHCS PPO |
$16.01
|
| Rate for Payer: Three Rivers PPO |
$12.26
|
| Rate for Payer: TriWest Veterans Administration |
$9.31
|
| Rate for Payer: United Healthcare Commercial |
$15.60
|
| Rate for Payer: United Healthcare Medicare |
$9.31
|
| Rate for Payer: WINHealth Partners Commercial |
$16.01
|
| Rate for Payer: Wise Provider Network Commercial |
$15.52
|
|
|
BRACE WRIST 8" RH LG 79-87287
|
Facility
|
IP
|
$16.34
|
|
| Hospital Charge Code |
2200074
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$16.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.01
|
| Rate for Payer: Aetna of WY Medicare |
$10.46
|
| Rate for Payer: Altius Commercial |
$15.69
|
| Rate for Payer: Beech Street Commercial |
$16.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.85
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.85
|
| Rate for Payer: Cigna of WY Commercial |
$16.01
|
| Rate for Payer: Entrust Commercial |
$15.52
|
| Rate for Payer: First Choice Health Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.97
|
| Rate for Payer: HealthUtah PPO |
$16.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.85
|
| Rate for Payer: Multiplan Medicare/VA |
$9.47
|
| Rate for Payer: One Health Plan of WY PPO |
$16.01
|
| Rate for Payer: PacificSource Commercial |
$14.71
|
| Rate for Payer: PHCS PPO |
$16.01
|
| Rate for Payer: Three Rivers PPO |
$12.26
|
| Rate for Payer: TriWest Veterans Administration |
$9.97
|
| Rate for Payer: United Healthcare Commercial |
$15.60
|
| Rate for Payer: United Healthcare Medicare |
$9.97
|
| Rate for Payer: WINHealth Partners Commercial |
$15.52
|
| Rate for Payer: Wise Provider Network Commercial |
$15.52
|
|
|
BRACE WRIST 8" RH LG 79-87287
|
Facility
|
OP
|
$16.34
|
|
| Hospital Charge Code |
2200074
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$16.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.01
|
| Rate for Payer: Aetna of WY Medicare |
$10.78
|
| Rate for Payer: Altius Commercial |
$15.69
|
| Rate for Payer: Beech Street Commercial |
$16.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.85
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.85
|
| Rate for Payer: Cigna of WY Commercial |
$16.01
|
| Rate for Payer: Entrust Commercial |
$15.52
|
| Rate for Payer: First Choice Health Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.31
|
| Rate for Payer: HealthUtah PPO |
$16.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.85
|
| Rate for Payer: Multiplan Medicare/VA |
$8.85
|
| Rate for Payer: One Health Plan of WY PPO |
$16.01
|
| Rate for Payer: PacificSource Commercial |
$14.71
|
| Rate for Payer: PHCS PPO |
$16.01
|
| Rate for Payer: Three Rivers PPO |
$12.26
|
| Rate for Payer: TriWest Veterans Administration |
$9.31
|
| Rate for Payer: United Healthcare Commercial |
$15.60
|
| Rate for Payer: United Healthcare Medicare |
$9.31
|
| Rate for Payer: WINHealth Partners Commercial |
$16.01
|
| Rate for Payer: Wise Provider Network Commercial |
$15.52
|
|
|
BRACE WRIST 8" RH XL 79-87288
|
Facility
|
OP
|
$16.34
|
|
| Hospital Charge Code |
2200356
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$16.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.01
|
| Rate for Payer: Aetna of WY Medicare |
$10.78
|
| Rate for Payer: Altius Commercial |
$15.69
|
| Rate for Payer: Beech Street Commercial |
$16.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.85
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.85
|
| Rate for Payer: Cigna of WY Commercial |
$16.01
|
| Rate for Payer: Entrust Commercial |
$15.52
|
| Rate for Payer: First Choice Health Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.31
|
| Rate for Payer: HealthUtah PPO |
$16.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.85
|
| Rate for Payer: Multiplan Medicare/VA |
$8.85
|
| Rate for Payer: One Health Plan of WY PPO |
$16.01
|
| Rate for Payer: PacificSource Commercial |
$14.71
|
| Rate for Payer: PHCS PPO |
$16.01
|
| Rate for Payer: Three Rivers PPO |
$12.26
|
| Rate for Payer: TriWest Veterans Administration |
$9.31
|
| Rate for Payer: United Healthcare Commercial |
$15.60
|
| Rate for Payer: United Healthcare Medicare |
$9.31
|
| Rate for Payer: WINHealth Partners Commercial |
$16.01
|
| Rate for Payer: Wise Provider Network Commercial |
$15.52
|
|
