|
CATH UMBILICAL 3.5F 8888160333
|
Facility
|
OP
|
$36.72
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.23 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.99
|
| Rate for Payer: Aetna of WY Medicare |
$24.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$35.25
|
| Rate for Payer: Altius Commercial |
$35.25
|
| Rate for Payer: Beech Street Commercial |
$35.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$30.15
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.62
|
| Rate for Payer: Cigna of WY Commercial |
$35.99
|
| Rate for Payer: Entrust Commercial |
$34.88
|
| Rate for Payer: First Choice Health Commercial |
$34.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$34.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.30
|
| Rate for Payer: HealthUtah PPO |
$36.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.62
|
| Rate for Payer: Multiplan Medicare/VA |
$20.23
|
| Rate for Payer: One Health Plan of WY PPO |
$35.99
|
| Rate for Payer: PacificSource Commercial |
$33.05
|
| Rate for Payer: PHCS PPO |
$35.99
|
| Rate for Payer: Three Rivers PPO |
$27.54
|
| Rate for Payer: TriWest Veterans Administration |
$21.30
|
| Rate for Payer: United Healthcare Commercial |
$31.95
|
| Rate for Payer: United Healthcare Medicare |
$21.30
|
| Rate for Payer: WINHealth Partners Commercial |
$35.99
|
| Rate for Payer: Wise Provider Network Commercial |
$34.88
|
|
|
CATH UMBILICAL 3.5F 8888160333
|
Facility
|
IP
|
$36.72
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.02 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$35.99
|
| Rate for Payer: Altius Auto/Workers Compensation |
$35.25
|
| Rate for Payer: Altius Commercial |
$35.25
|
| Rate for Payer: Beech Street Commercial |
$35.99
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$30.15
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.62
|
| Rate for Payer: Cigna of WY Commercial |
$35.99
|
| Rate for Payer: Entrust Commercial |
$34.88
|
| Rate for Payer: First Choice Health Commercial |
$34.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$34.88
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.24
|
| Rate for Payer: HealthUtah PPO |
$36.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.62
|
| Rate for Payer: Multiplan Medicare/VA |
$23.02
|
| Rate for Payer: One Health Plan of WY PPO |
$35.99
|
| Rate for Payer: PacificSource Commercial |
$33.05
|
| Rate for Payer: PHCS PPO |
$35.99
|
| Rate for Payer: Three Rivers PPO |
$27.54
|
| Rate for Payer: TriWest Veterans Administration |
$24.24
|
| Rate for Payer: United Healthcare Commercial |
$31.95
|
| Rate for Payer: United Healthcare Medicare |
$24.24
|
| Rate for Payer: WINHealth Partners Commercial |
$34.88
|
| Rate for Payer: Wise Provider Network Commercial |
$34.88
|
|
|
CATH UMBILICAL 5F 8888160341
|
Facility
|
OP
|
$37.06
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.42 |
| Max. Negotiated Rate |
$37.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$36.32
|
| Rate for Payer: Aetna of WY Medicare |
$24.46
|
| Rate for Payer: Altius Auto/Workers Compensation |
$35.58
|
| Rate for Payer: Altius Commercial |
$35.58
|
| Rate for Payer: Beech Street Commercial |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$30.43
|
| Rate for Payer: Cash Price |
$25.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.95
|
| Rate for Payer: Cigna of WY Commercial |
$36.32
|
| Rate for Payer: Entrust Commercial |
$35.21
|
| Rate for Payer: First Choice Health Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.49
|
| Rate for Payer: HealthUtah PPO |
$37.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.95
|
| Rate for Payer: Multiplan Medicare/VA |
$20.42
|
| Rate for Payer: One Health Plan of WY PPO |
$36.32
|
| Rate for Payer: PacificSource Commercial |
$33.35
|
| Rate for Payer: PHCS PPO |
$36.32
|
| Rate for Payer: Three Rivers PPO |
$27.80
|
| Rate for Payer: TriWest Veterans Administration |
$21.49
|
| Rate for Payer: United Healthcare Commercial |
$32.24
|
| Rate for Payer: United Healthcare Medicare |
$21.49
|
| Rate for Payer: WINHealth Partners Commercial |
$36.32
|
| Rate for Payer: Wise Provider Network Commercial |
$35.21
|
|
|
CATH UMBILICAL 5F 8888160341
|
Facility
|
IP
|
$37.06
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.24 |
| Max. Negotiated Rate |
$37.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$36.32
|
| Rate for Payer: Altius Auto/Workers Compensation |
$35.58
|
| Rate for Payer: Altius Commercial |
$35.58
|
| Rate for Payer: Beech Street Commercial |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$30.43
|
| Rate for Payer: Cash Price |
$25.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.95
|
| Rate for Payer: Cigna of WY Commercial |
$36.32
|
| Rate for Payer: Entrust Commercial |
$35.21
|
| Rate for Payer: First Choice Health Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.46
|
| Rate for Payer: HealthUtah PPO |
$37.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.95
|
| Rate for Payer: Multiplan Medicare/VA |
$23.24
|
| Rate for Payer: One Health Plan of WY PPO |
$36.32
|
| Rate for Payer: PacificSource Commercial |
$33.35
|
| Rate for Payer: PHCS PPO |
$36.32
|
| Rate for Payer: Three Rivers PPO |
$27.80
|
| Rate for Payer: TriWest Veterans Administration |
$24.46
|
| Rate for Payer: United Healthcare Commercial |
$32.24
|
| Rate for Payer: United Healthcare Medicare |
$24.46
|
| Rate for Payer: WINHealth Partners Commercial |
$35.21
|
| Rate for Payer: Wise Provider Network Commercial |
$35.21
|
|
|
CATH URETERAL OPEN TIP 5F 70CM
|
Facility
|
OP
|
$51.09
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.15 |
| Max. Negotiated Rate |
$51.09 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$50.07
|
| Rate for Payer: Aetna of WY Medicare |
$33.72
|
| Rate for Payer: Altius Auto/Workers Compensation |
$49.05
|
| Rate for Payer: Altius Commercial |
$49.05
|
| Rate for Payer: Beech Street Commercial |
$50.07
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$41.94
|
| Rate for Payer: Cash Price |
$35.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.56
|
| Rate for Payer: Cigna of WY Commercial |
$50.07
|
| Rate for Payer: Entrust Commercial |
$48.54
|
| Rate for Payer: First Choice Health Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.63
|
| Rate for Payer: HealthUtah PPO |
$51.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.56
|
| Rate for Payer: Multiplan Medicare/VA |
$28.15
|
| Rate for Payer: One Health Plan of WY PPO |
$50.07
|
| Rate for Payer: PacificSource Commercial |
$45.98
|
| Rate for Payer: PHCS PPO |
$50.07
|
| Rate for Payer: Three Rivers PPO |
$38.32
|
| Rate for Payer: TriWest Veterans Administration |
$29.63
|
| Rate for Payer: United Healthcare Commercial |
$44.45
|
| Rate for Payer: United Healthcare Medicare |
$29.63
|
| Rate for Payer: WINHealth Partners Commercial |
$50.07
|
| Rate for Payer: Wise Provider Network Commercial |
$48.54
|
|
|
CATH URETERAL OPEN TIP 5F 70CM
|
Facility
|
IP
|
$51.09
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.03 |
| Max. Negotiated Rate |
$51.09 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$50.07
|
| Rate for Payer: Altius Auto/Workers Compensation |
$49.05
|
| Rate for Payer: Altius Commercial |
$49.05
|
| Rate for Payer: Beech Street Commercial |
$50.07
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$41.94
|
| Rate for Payer: Cash Price |
$35.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.56
|
| Rate for Payer: Cigna of WY Commercial |
$50.07
|
| Rate for Payer: Entrust Commercial |
$48.54
|
| Rate for Payer: First Choice Health Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$33.72
|
| Rate for Payer: HealthUtah PPO |
$51.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.56
|
| Rate for Payer: Multiplan Medicare/VA |
$32.03
|
| Rate for Payer: One Health Plan of WY PPO |
$50.07
|
| Rate for Payer: PacificSource Commercial |
$45.98
|
| Rate for Payer: PHCS PPO |
$50.07
|
| Rate for Payer: Three Rivers PPO |
$38.32
|
| Rate for Payer: TriWest Veterans Administration |
$33.72
|
| Rate for Payer: United Healthcare Commercial |
$44.45
|
| Rate for Payer: United Healthcare Medicare |
$33.72
|
| Rate for Payer: WINHealth Partners Commercial |
$48.54
|
| Rate for Payer: Wise Provider Network Commercial |
$48.54
|
|
|
CATH WORD BARTHOLINS CYST
|
Facility
|
OP
|
$202.21
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$111.42 |
| Max. Negotiated Rate |
$202.21 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$198.17
|
| Rate for Payer: Aetna of WY Medicare |
$133.46
|
| Rate for Payer: Altius Auto/Workers Compensation |
$194.12
|
| Rate for Payer: Altius Commercial |
$194.12
|
| Rate for Payer: Beech Street Commercial |
$198.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$166.01
|
| Rate for Payer: Cash Price |
$141.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$196.14
|
| Rate for Payer: Cigna of WY Commercial |
$198.17
|
| Rate for Payer: Entrust Commercial |
$192.10
|
| Rate for Payer: First Choice Health Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$117.28
|
| Rate for Payer: HealthUtah PPO |
$202.21
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$196.14
|
| Rate for Payer: Multiplan Medicare/VA |
$111.42
|
| Rate for Payer: One Health Plan of WY PPO |
$198.17
|
| Rate for Payer: PacificSource Commercial |
$181.99
|
| Rate for Payer: PHCS PPO |
$198.17
|
| Rate for Payer: Three Rivers PPO |
$151.66
|
| Rate for Payer: TriWest Veterans Administration |
$117.28
|
| Rate for Payer: United Healthcare Commercial |
$175.92
|
| Rate for Payer: United Healthcare Medicare |
$117.28
|
| Rate for Payer: WINHealth Partners Commercial |
$198.17
|
| Rate for Payer: Wise Provider Network Commercial |
$192.10
|
|
|
CATH WORD BARTHOLINS CYST
|
Facility
|
IP
|
$202.21
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.79 |
| Max. Negotiated Rate |
$202.21 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$198.17
|
| Rate for Payer: Altius Auto/Workers Compensation |
$194.12
|
| Rate for Payer: Altius Commercial |
$194.12
|
| Rate for Payer: Beech Street Commercial |
$198.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$166.01
|
| Rate for Payer: Cash Price |
$141.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$196.14
|
| Rate for Payer: Cigna of WY Commercial |
$198.17
|
| Rate for Payer: Entrust Commercial |
$192.10
|
| Rate for Payer: First Choice Health Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$133.46
|
| Rate for Payer: HealthUtah PPO |
$202.21
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$196.14
|
| Rate for Payer: Multiplan Medicare/VA |
$126.79
|
| Rate for Payer: One Health Plan of WY PPO |
$198.17
|
| Rate for Payer: PacificSource Commercial |
$181.99
|
| Rate for Payer: PHCS PPO |
$198.17
|
| Rate for Payer: Three Rivers PPO |
$151.66
|
| Rate for Payer: TriWest Veterans Administration |
$133.46
|
| Rate for Payer: United Healthcare Commercial |
$175.92
|
| Rate for Payer: United Healthcare Medicare |
$133.46
|
| Rate for Payer: WINHealth Partners Commercial |
$192.10
|
| Rate for Payer: Wise Provider Network Commercial |
$192.10
|
|
|
CAUT DISP BIPOLAR DUAL PLUG
|
Facility
|
IP
|
$5.30
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.19
|
| Rate for Payer: Altius Auto/Workers Compensation |
$5.09
|
| Rate for Payer: Altius Commercial |
$5.09
|
| Rate for Payer: Beech Street Commercial |
$5.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.35
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.14
|
| Rate for Payer: Cigna of WY Commercial |
$5.19
|
| Rate for Payer: Entrust Commercial |
$5.04
|
| Rate for Payer: First Choice Health Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.50
|
| Rate for Payer: HealthUtah PPO |
$5.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.14
|
| Rate for Payer: Multiplan Medicare/VA |
$3.32
|
| Rate for Payer: One Health Plan of WY PPO |
$5.19
|
| Rate for Payer: PacificSource Commercial |
$4.77
|
| Rate for Payer: PHCS PPO |
$5.19
|
| Rate for Payer: Three Rivers PPO |
$3.98
|
| Rate for Payer: TriWest Veterans Administration |
$3.50
|
| Rate for Payer: United Healthcare Commercial |
$4.61
|
| Rate for Payer: United Healthcare Medicare |
$3.50
|
| Rate for Payer: WINHealth Partners Commercial |
$5.04
|
| Rate for Payer: Wise Provider Network Commercial |
$5.04
|
|
|
CAUT DISP BIPOLAR DUAL PLUG
|
Facility
|
OP
|
$5.30
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.19
|
| Rate for Payer: Aetna of WY Medicare |
$3.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$5.09
|
| Rate for Payer: Altius Commercial |
$5.09
|
| Rate for Payer: Beech Street Commercial |
$5.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.35
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.14
|
| Rate for Payer: Cigna of WY Commercial |
$5.19
|
| Rate for Payer: Entrust Commercial |
$5.04
|
| Rate for Payer: First Choice Health Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.07
|
| Rate for Payer: HealthUtah PPO |
$5.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.14
|
| Rate for Payer: Multiplan Medicare/VA |
$2.92
|
| Rate for Payer: One Health Plan of WY PPO |
$5.19
|
| Rate for Payer: PacificSource Commercial |
$4.77
|
| Rate for Payer: PHCS PPO |
$5.19
|
| Rate for Payer: Three Rivers PPO |
$3.98
|
| Rate for Payer: TriWest Veterans Administration |
$3.07
|
| Rate for Payer: United Healthcare Commercial |
$4.61
|
| Rate for Payer: United Healthcare Medicare |
$3.07
|
| Rate for Payer: WINHealth Partners Commercial |
$5.19
|
| Rate for Payer: Wise Provider Network Commercial |
$5.04
|
|
|
CAUTERY 4" EXTENSION E1450-4
|
Facility
|
OP
|
$12.36
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$12.36 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.11
|
| Rate for Payer: Aetna of WY Medicare |
$8.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.87
|
| Rate for Payer: Altius Commercial |
$11.87
|
| Rate for Payer: Beech Street Commercial |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.15
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.99
|
| Rate for Payer: Cigna of WY Commercial |
$12.11
|
| Rate for Payer: Entrust Commercial |
$11.74
|
| Rate for Payer: First Choice Health Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.17
|
| Rate for Payer: HealthUtah PPO |
$12.36
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.99
|
| Rate for Payer: Multiplan Medicare/VA |
$6.81
|
| Rate for Payer: One Health Plan of WY PPO |
$12.11
|
| Rate for Payer: PacificSource Commercial |
$11.12
|
| Rate for Payer: PHCS PPO |
$12.11
|
| Rate for Payer: Three Rivers PPO |
$9.27
|
| Rate for Payer: TriWest Veterans Administration |
$7.17
|
| Rate for Payer: United Healthcare Commercial |
$10.75
|
| Rate for Payer: United Healthcare Medicare |
$7.17
|
| Rate for Payer: WINHealth Partners Commercial |
$12.11
|
| Rate for Payer: Wise Provider Network Commercial |
$11.74
|
|
|
CAUTERY 4" EXTENSION E1450-4
|
Facility
|
IP
|
$12.36
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$12.36 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.11
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.87
|
| Rate for Payer: Altius Commercial |
$11.87
|
| Rate for Payer: Beech Street Commercial |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.15
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.99
|
| Rate for Payer: Cigna of WY Commercial |
$12.11
|
| Rate for Payer: Entrust Commercial |
$11.74
|
| Rate for Payer: First Choice Health Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.16
|
| Rate for Payer: HealthUtah PPO |
$12.36
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.99
|
| Rate for Payer: Multiplan Medicare/VA |
$7.75
|
| Rate for Payer: One Health Plan of WY PPO |
$12.11
|
| Rate for Payer: PacificSource Commercial |
$11.12
|
| Rate for Payer: PHCS PPO |
$12.11
|
| Rate for Payer: Three Rivers PPO |
$9.27
|
| Rate for Payer: TriWest Veterans Administration |
$8.16
|
| Rate for Payer: United Healthcare Commercial |
$10.75
|
| Rate for Payer: United Healthcare Medicare |
$8.16
|
| Rate for Payer: WINHealth Partners Commercial |
$11.74
|
| Rate for Payer: Wise Provider Network Commercial |
$11.74
|
|
|
CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT
|
Professional
|
Both
|
$708.00
|
|
|
Service Code
|
HCPCS 57511
|
| Hospital Charge Code |
57511
|
| Min. Negotiated Rate |
$122.02 |
| Max. Negotiated Rate |
$708.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$693.84
|
| Rate for Payer: Aetna of WY Medicare |
$143.55
|
| Rate for Payer: Beech Street Commercial |
$672.60
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$686.76
|
| Rate for Payer: Cigna of WY Commercial |
$693.84
|
| Rate for Payer: First Choice Health Commercial |
$637.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$672.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$143.55
|
| Rate for Payer: HealthUtah PPO |
$708.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$686.76
|
| Rate for Payer: Multiplan Medicare/VA |
$122.02
|
| Rate for Payer: One Health Plan of WY PPO |
$693.84
|
| Rate for Payer: PacificSource Commercial |
$637.20
|
| Rate for Payer: PHCS PPO |
$672.60
|
| Rate for Payer: Three Rivers PPO |
$531.00
|
| Rate for Payer: TriWest Veterans Administration |
$143.55
|
| Rate for Payer: United Healthcare Commercial |
$615.96
|
| Rate for Payer: United Healthcare Medicare |
$143.55
|
| Rate for Payer: WINHealth Partners Commercial |
$601.80
|
|
|
CAUTERY CERVIX ELECTRO/THERMAL
|
Professional
|
Both
|
$2,008.00
|
|
|
Service Code
|
HCPCS 57510
|
| Hospital Charge Code |
57510
|
| Min. Negotiated Rate |
$92.58 |
| Max. Negotiated Rate |
$2,008.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,967.84
|
| Rate for Payer: Aetna of WY Medicare |
$108.92
|
| Rate for Payer: Beech Street Commercial |
$1,907.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,947.76
|
| Rate for Payer: Cigna of WY Commercial |
$1,967.84
|
| Rate for Payer: First Choice Health Commercial |
$1,807.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,907.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$108.92
|
| Rate for Payer: HealthUtah PPO |
$2,008.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,947.76
|
| Rate for Payer: Multiplan Medicare/VA |
$92.58
|
| Rate for Payer: One Health Plan of WY PPO |
$1,967.84
|
| Rate for Payer: PacificSource Commercial |
$1,807.20
|
| Rate for Payer: PHCS PPO |
$1,907.60
|
| Rate for Payer: Three Rivers PPO |
$1,506.00
|
| Rate for Payer: TriWest Veterans Administration |
$108.92
|
| Rate for Payer: United Healthcare Commercial |
$1,746.96
|
| Rate for Payer: United Healthcare Medicare |
$108.92
|
| Rate for Payer: WINHealth Partners Commercial |
$1,706.80
|
|
|
CAUTERY EXTENSION TIP 6IN
|
Facility
|
OP
|
$11.23
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.19 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.01
|
| Rate for Payer: Aetna of WY Medicare |
$7.41
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.78
|
| Rate for Payer: Altius Commercial |
$10.78
|
| Rate for Payer: Beech Street Commercial |
$11.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.22
|
| Rate for Payer: Cash Price |
$7.86
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.89
|
| Rate for Payer: Cigna of WY Commercial |
$11.01
|
| Rate for Payer: Entrust Commercial |
$10.67
|
| Rate for Payer: First Choice Health Commercial |
$10.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.51
|
| Rate for Payer: HealthUtah PPO |
$11.23
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.89
|
| Rate for Payer: Multiplan Medicare/VA |
$6.19
|
| Rate for Payer: One Health Plan of WY PPO |
$11.01
|
| Rate for Payer: PacificSource Commercial |
$10.11
|
| Rate for Payer: PHCS PPO |
$11.01
|
| Rate for Payer: Three Rivers PPO |
$8.42
|
| Rate for Payer: TriWest Veterans Administration |
$6.51
|
| Rate for Payer: United Healthcare Commercial |
$9.77
|
| Rate for Payer: United Healthcare Medicare |
$6.51
|
| Rate for Payer: WINHealth Partners Commercial |
$11.01
|
| Rate for Payer: Wise Provider Network Commercial |
$10.67
|
|
|
CAUTERY EXTENSION TIP 6IN
|
Facility
|
IP
|
$11.23
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.78
|
| Rate for Payer: Altius Commercial |
$10.78
|
| Rate for Payer: Beech Street Commercial |
$11.01
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.22
|
| Rate for Payer: Cash Price |
$7.86
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.89
|
| Rate for Payer: Cigna of WY Commercial |
$11.01
|
| Rate for Payer: Entrust Commercial |
$10.67
|
| Rate for Payer: First Choice Health Commercial |
$10.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.41
|
| Rate for Payer: HealthUtah PPO |
$11.23
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.89
|
| Rate for Payer: Multiplan Medicare/VA |
$7.04
|
| Rate for Payer: One Health Plan of WY PPO |
$11.01
|
| Rate for Payer: PacificSource Commercial |
$10.11
|
| Rate for Payer: PHCS PPO |
$11.01
|
| Rate for Payer: Three Rivers PPO |
$8.42
|
| Rate for Payer: TriWest Veterans Administration |
$7.41
|
| Rate for Payer: United Healthcare Commercial |
$9.77
|
| Rate for Payer: United Healthcare Medicare |
$7.41
|
| Rate for Payer: WINHealth Partners Commercial |
$10.67
|
| Rate for Payer: Wise Provider Network Commercial |
$10.67
|
|
|
CAUTERY HIGH TEMP PEN AA21
|
Facility
|
OP
|
$20.70
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.29
|
| Rate for Payer: Aetna of WY Medicare |
$13.66
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.87
|
| Rate for Payer: Altius Commercial |
$19.87
|
| Rate for Payer: Beech Street Commercial |
$20.29
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.99
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.08
|
| Rate for Payer: Cigna of WY Commercial |
$20.29
|
| Rate for Payer: Entrust Commercial |
$19.66
|
| Rate for Payer: First Choice Health Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.01
|
| Rate for Payer: HealthUtah PPO |
$20.70
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.08
|
| Rate for Payer: Multiplan Medicare/VA |
$11.41
|
| Rate for Payer: One Health Plan of WY PPO |
$20.29
|
| Rate for Payer: PacificSource Commercial |
$18.63
|
| Rate for Payer: PHCS PPO |
$20.29
|
| Rate for Payer: Three Rivers PPO |
$15.52
|
| Rate for Payer: TriWest Veterans Administration |
$12.01
|
| Rate for Payer: United Healthcare Commercial |
$18.01
|
| Rate for Payer: United Healthcare Medicare |
$12.01
|
| Rate for Payer: WINHealth Partners Commercial |
$20.29
|
| Rate for Payer: Wise Provider Network Commercial |
$19.66
|
|
|
CAUTERY HIGH TEMP PEN AA21
|
Facility
|
IP
|
$20.70
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.98 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.29
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.87
|
| Rate for Payer: Altius Commercial |
$19.87
|
| Rate for Payer: Beech Street Commercial |
$20.29
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.99
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.08
|
| Rate for Payer: Cigna of WY Commercial |
$20.29
|
| Rate for Payer: Entrust Commercial |
$19.66
|
| Rate for Payer: First Choice Health Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.66
|
| Rate for Payer: HealthUtah PPO |
$20.70
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.08
|
| Rate for Payer: Multiplan Medicare/VA |
$12.98
|
| Rate for Payer: One Health Plan of WY PPO |
$20.29
|
| Rate for Payer: PacificSource Commercial |
$18.63
|
| Rate for Payer: PHCS PPO |
$20.29
|
| Rate for Payer: Three Rivers PPO |
$15.52
|
| Rate for Payer: TriWest Veterans Administration |
$13.66
|
| Rate for Payer: United Healthcare Commercial |
$18.01
|
| Rate for Payer: United Healthcare Medicare |
$13.66
|
| Rate for Payer: WINHealth Partners Commercial |
$19.66
|
| Rate for Payer: Wise Provider Network Commercial |
$19.66
|
|
|
CAUTERY INSULTED BLADE 2.75"
|
Facility
|
OP
|
$11.07
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10.85
|
| Rate for Payer: Aetna of WY Medicare |
$7.31
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.63
|
| Rate for Payer: Altius Commercial |
$10.63
|
| Rate for Payer: Beech Street Commercial |
$10.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.09
|
| Rate for Payer: Cash Price |
$7.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.74
|
| Rate for Payer: Cigna of WY Commercial |
$10.85
|
| Rate for Payer: Entrust Commercial |
$10.52
|
| Rate for Payer: First Choice Health Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.42
|
| Rate for Payer: HealthUtah PPO |
$11.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.74
|
| Rate for Payer: Multiplan Medicare/VA |
$6.10
|
| Rate for Payer: One Health Plan of WY PPO |
$10.85
|
| Rate for Payer: PacificSource Commercial |
$9.96
|
| Rate for Payer: PHCS PPO |
$10.85
|
| Rate for Payer: Three Rivers PPO |
$8.30
|
| Rate for Payer: TriWest Veterans Administration |
$6.42
|
| Rate for Payer: United Healthcare Commercial |
$9.63
|
| Rate for Payer: United Healthcare Medicare |
$6.42
|
| Rate for Payer: WINHealth Partners Commercial |
$10.85
|
| Rate for Payer: Wise Provider Network Commercial |
$10.52
|
|
|
CAUTERY INSULTED BLADE 2.75"
|
Facility
|
IP
|
$11.07
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10.85
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.63
|
| Rate for Payer: Altius Commercial |
$10.63
|
| Rate for Payer: Beech Street Commercial |
$10.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.09
|
| Rate for Payer: Cash Price |
$7.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.74
|
| Rate for Payer: Cigna of WY Commercial |
$10.85
|
| Rate for Payer: Entrust Commercial |
$10.52
|
| Rate for Payer: First Choice Health Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.31
|
| Rate for Payer: HealthUtah PPO |
$11.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.74
|
| Rate for Payer: Multiplan Medicare/VA |
$6.94
|
| Rate for Payer: One Health Plan of WY PPO |
$10.85
|
| Rate for Payer: PacificSource Commercial |
$9.96
|
| Rate for Payer: PHCS PPO |
$10.85
|
| Rate for Payer: Three Rivers PPO |
$8.30
|
| Rate for Payer: TriWest Veterans Administration |
$7.31
|
| Rate for Payer: United Healthcare Commercial |
$9.63
|
| Rate for Payer: United Healthcare Medicare |
$7.31
|
| Rate for Payer: WINHealth Partners Commercial |
$10.52
|
| Rate for Payer: Wise Provider Network Commercial |
$10.52
|
|
|
CAUTERY INSULTED BLADE 6.0"
|
Facility
|
IP
|
$11.39
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$11.39 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.16
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.93
|
| Rate for Payer: Altius Commercial |
$10.93
|
| Rate for Payer: Beech Street Commercial |
$11.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.35
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.05
|
| Rate for Payer: Cigna of WY Commercial |
$11.16
|
| Rate for Payer: Entrust Commercial |
$10.82
|
| Rate for Payer: First Choice Health Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.52
|
| Rate for Payer: HealthUtah PPO |
$11.39
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.05
|
| Rate for Payer: Multiplan Medicare/VA |
$7.14
|
| Rate for Payer: One Health Plan of WY PPO |
$11.16
|
| Rate for Payer: PacificSource Commercial |
$10.25
|
| Rate for Payer: PHCS PPO |
$11.16
|
| Rate for Payer: Three Rivers PPO |
$8.54
|
| Rate for Payer: TriWest Veterans Administration |
$7.52
|
| Rate for Payer: United Healthcare Commercial |
$9.91
|
| Rate for Payer: United Healthcare Medicare |
$7.52
|
| Rate for Payer: WINHealth Partners Commercial |
$10.82
|
| Rate for Payer: Wise Provider Network Commercial |
$10.82
|
|
|
CAUTERY INSULTED BLADE 6.0"
|
Facility
|
OP
|
$11.39
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$11.39 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.16
|
| Rate for Payer: Aetna of WY Medicare |
$7.52
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.93
|
| Rate for Payer: Altius Commercial |
$10.93
|
| Rate for Payer: Beech Street Commercial |
$11.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.35
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.05
|
| Rate for Payer: Cigna of WY Commercial |
$11.16
|
| Rate for Payer: Entrust Commercial |
$10.82
|
| Rate for Payer: First Choice Health Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.61
|
| Rate for Payer: HealthUtah PPO |
$11.39
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.05
|
| Rate for Payer: Multiplan Medicare/VA |
$6.28
|
| Rate for Payer: One Health Plan of WY PPO |
$11.16
|
| Rate for Payer: PacificSource Commercial |
$10.25
|
| Rate for Payer: PHCS PPO |
$11.16
|
| Rate for Payer: Three Rivers PPO |
$8.54
|
| Rate for Payer: TriWest Veterans Administration |
$6.61
|
| Rate for Payer: United Healthcare Commercial |
$9.91
|
| Rate for Payer: United Healthcare Medicare |
$6.61
|
| Rate for Payer: WINHealth Partners Commercial |
$11.16
|
| Rate for Payer: Wise Provider Network Commercial |
$10.82
|
|
|
CAUTERY INSULTED NEEDLE 2.75"
|
Facility
|
OP
|
$11.42
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$11.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.19
|
| Rate for Payer: Aetna of WY Medicare |
$7.54
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.96
|
| Rate for Payer: Altius Commercial |
$10.96
|
| Rate for Payer: Beech Street Commercial |
$11.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.38
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.08
|
| Rate for Payer: Cigna of WY Commercial |
$11.19
|
| Rate for Payer: Entrust Commercial |
$10.85
|
| Rate for Payer: First Choice Health Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.62
|
| Rate for Payer: HealthUtah PPO |
$11.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.08
|
| Rate for Payer: Multiplan Medicare/VA |
$6.29
|
| Rate for Payer: One Health Plan of WY PPO |
$11.19
|
| Rate for Payer: PacificSource Commercial |
$10.28
|
| Rate for Payer: PHCS PPO |
$11.19
|
| Rate for Payer: Three Rivers PPO |
$8.56
|
| Rate for Payer: TriWest Veterans Administration |
$6.62
|
| Rate for Payer: United Healthcare Commercial |
$9.94
|
| Rate for Payer: United Healthcare Medicare |
$6.62
|
| Rate for Payer: WINHealth Partners Commercial |
$11.19
|
| Rate for Payer: Wise Provider Network Commercial |
$10.85
|
|
|
CAUTERY INSULTED NEEDLE 2.75"
|
Facility
|
IP
|
$11.42
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$11.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.19
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.96
|
| Rate for Payer: Altius Commercial |
$10.96
|
| Rate for Payer: Beech Street Commercial |
$11.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.38
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.08
|
| Rate for Payer: Cigna of WY Commercial |
$11.19
|
| Rate for Payer: Entrust Commercial |
$10.85
|
| Rate for Payer: First Choice Health Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.54
|
| Rate for Payer: HealthUtah PPO |
$11.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.08
|
| Rate for Payer: Multiplan Medicare/VA |
$7.16
|
| Rate for Payer: One Health Plan of WY PPO |
$11.19
|
| Rate for Payer: PacificSource Commercial |
$10.28
|
| Rate for Payer: PHCS PPO |
$11.19
|
| Rate for Payer: Three Rivers PPO |
$8.56
|
| Rate for Payer: TriWest Veterans Administration |
$7.54
|
| Rate for Payer: United Healthcare Commercial |
$9.94
|
| Rate for Payer: United Healthcare Medicare |
$7.54
|
| Rate for Payer: WINHealth Partners Commercial |
$10.85
|
| Rate for Payer: Wise Provider Network Commercial |
$10.85
|
|
|
CAUT GROUNDING PAD SPLIT CORD
|
Facility
|
IP
|
$7.78
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$7.78 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.62
|
| Rate for Payer: Altius Auto/Workers Compensation |
$7.47
|
| Rate for Payer: Altius Commercial |
$7.47
|
| Rate for Payer: Beech Street Commercial |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.39
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.55
|
| Rate for Payer: Cigna of WY Commercial |
$7.62
|
| Rate for Payer: Entrust Commercial |
$7.39
|
| Rate for Payer: First Choice Health Commercial |
$7.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.13
|
| Rate for Payer: HealthUtah PPO |
$7.78
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.55
|
| Rate for Payer: Multiplan Medicare/VA |
$4.88
|
| Rate for Payer: One Health Plan of WY PPO |
$7.62
|
| Rate for Payer: PacificSource Commercial |
$7.00
|
| Rate for Payer: PHCS PPO |
$7.62
|
| Rate for Payer: Three Rivers PPO |
$5.84
|
| Rate for Payer: TriWest Veterans Administration |
$5.13
|
| Rate for Payer: United Healthcare Commercial |
$6.77
|
| Rate for Payer: United Healthcare Medicare |
$5.13
|
| Rate for Payer: WINHealth Partners Commercial |
$7.39
|
| Rate for Payer: Wise Provider Network Commercial |
$7.39
|
|
