|
SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,972.00
|
|
|
Service Code
|
HCPCS 27386 80
|
| Hospital Charge Code |
27386
|
| Min. Negotiated Rate |
$707.45 |
| Max. Negotiated Rate |
$2,972.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,912.56
|
| Rate for Payer: Aetna of WY Medicare |
$832.29
|
| Rate for Payer: Beech Street Commercial |
$2,823.40
|
| Rate for Payer: Cash Price |
$2,080.40
|
| Rate for Payer: Cash Price |
$2,080.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,882.84
|
| Rate for Payer: Cigna of WY Commercial |
$2,912.56
|
| Rate for Payer: First Choice Health Commercial |
$2,674.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,823.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$832.29
|
| Rate for Payer: HealthUtah PPO |
$2,972.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,882.84
|
| Rate for Payer: Multiplan Medicare/VA |
$707.45
|
| Rate for Payer: One Health Plan of WY PPO |
$2,912.56
|
| Rate for Payer: PacificSource Commercial |
$2,674.80
|
| Rate for Payer: PHCS PPO |
$2,823.40
|
| Rate for Payer: Three Rivers PPO |
$2,229.00
|
| Rate for Payer: TriWest Veterans Administration |
$832.29
|
| Rate for Payer: United Healthcare Commercial |
$2,585.64
|
| Rate for Payer: United Healthcare Medicare |
$832.29
|
| Rate for Payer: WINHealth Partners Commercial |
$2,526.20
|
|
|
SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,972.00
|
|
|
Service Code
|
HCPCS 27386 AS
|
| Hospital Charge Code |
27386
|
| Min. Negotiated Rate |
$707.45 |
| Max. Negotiated Rate |
$2,972.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,912.56
|
| Rate for Payer: Aetna of WY Medicare |
$832.29
|
| Rate for Payer: Beech Street Commercial |
$2,823.40
|
| Rate for Payer: Cash Price |
$2,080.40
|
| Rate for Payer: Cash Price |
$2,080.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,882.84
|
| Rate for Payer: Cigna of WY Commercial |
$2,912.56
|
| Rate for Payer: First Choice Health Commercial |
$2,674.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,823.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$832.29
|
| Rate for Payer: HealthUtah PPO |
$2,972.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,882.84
|
| Rate for Payer: Multiplan Medicare/VA |
$707.45
|
| Rate for Payer: One Health Plan of WY PPO |
$2,912.56
|
| Rate for Payer: PacificSource Commercial |
$2,674.80
|
| Rate for Payer: PHCS PPO |
$2,823.40
|
| Rate for Payer: Three Rivers PPO |
$2,229.00
|
| Rate for Payer: TriWest Veterans Administration |
$832.29
|
| Rate for Payer: United Healthcare Commercial |
$2,585.64
|
| Rate for Payer: United Healthcare Medicare |
$832.29
|
| Rate for Payer: WINHealth Partners Commercial |
$2,526.20
|
|
|
SUT RT TIGHTROPE AR-1588RT-2J
|
Facility
|
IP
|
$1,900.92
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.88 |
| Max. Negotiated Rate |
$1,900.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,862.90
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,824.88
|
| Rate for Payer: Altius Commercial |
$1,824.88
|
| Rate for Payer: Beech Street Commercial |
$1,862.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,560.66
|
| Rate for Payer: Cash Price |
$1,330.64
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,843.89
|
| Rate for Payer: Cigna of WY Commercial |
$1,862.90
|
| Rate for Payer: Entrust Commercial |
$1,805.87
|
| Rate for Payer: First Choice Health Commercial |
$1,805.87
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,805.87
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,254.61
|
| Rate for Payer: HealthUtah PPO |
$1,900.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,843.89
|
| Rate for Payer: Multiplan Medicare/VA |
$1,191.88
|
| Rate for Payer: One Health Plan of WY PPO |
$1,862.90
|
| Rate for Payer: PacificSource Commercial |
$1,710.83
|
| Rate for Payer: PHCS PPO |
$1,862.90
|
| Rate for Payer: Three Rivers PPO |
$1,425.69
|
| Rate for Payer: TriWest Veterans Administration |
$1,254.61
|
| Rate for Payer: United Healthcare Commercial |
$1,653.80
|
| Rate for Payer: United Healthcare Medicare |
$1,254.61
|
| Rate for Payer: WINHealth Partners Commercial |
$1,805.87
|
| Rate for Payer: Wise Provider Network Commercial |
$1,805.87
|
|
|
SUT RT TIGHTROPE AR-1588RT-2J
|
Facility
|
OP
|
$1,900.92
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,047.41 |
| Max. Negotiated Rate |
$1,900.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,862.90
|
| Rate for Payer: Aetna of WY Medicare |
$1,254.61
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,824.88
|
| Rate for Payer: Altius Commercial |
$1,824.88
|
| Rate for Payer: Beech Street Commercial |
$1,862.90
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,560.66
|
| Rate for Payer: Cash Price |
$1,330.64
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,843.89
|
| Rate for Payer: Cigna of WY Commercial |
$1,862.90
|
| Rate for Payer: Entrust Commercial |
$1,805.87
|
| Rate for Payer: First Choice Health Commercial |
$1,805.87
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,805.87
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,102.53
|
| Rate for Payer: HealthUtah PPO |
$1,900.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,843.89
|
| Rate for Payer: Multiplan Medicare/VA |
$1,047.41
|
| Rate for Payer: One Health Plan of WY PPO |
$1,862.90
|
| Rate for Payer: PacificSource Commercial |
$1,710.83
|
| Rate for Payer: PHCS PPO |
$1,862.90
|
| Rate for Payer: Three Rivers PPO |
$1,425.69
|
| Rate for Payer: TriWest Veterans Administration |
$1,102.53
|
| Rate for Payer: United Healthcare Commercial |
$1,653.80
|
| Rate for Payer: United Healthcare Medicare |
$1,102.53
|
| Rate for Payer: WINHealth Partners Commercial |
$1,862.90
|
| Rate for Payer: Wise Provider Network Commercial |
$1,805.87
|
|
|
SUT SILK 3-0 SH 18" 8PK
|
Facility
|
OP
|
$10.29
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$10.29 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10.08
|
| Rate for Payer: Aetna of WY Medicare |
$6.79
|
| Rate for Payer: Altius Auto/Workers Compensation |
$9.88
|
| Rate for Payer: Altius Commercial |
$9.88
|
| Rate for Payer: Beech Street Commercial |
$10.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.45
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.98
|
| Rate for Payer: Cigna of WY Commercial |
$10.08
|
| Rate for Payer: Entrust Commercial |
$9.78
|
| Rate for Payer: First Choice Health Commercial |
$9.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.97
|
| Rate for Payer: HealthUtah PPO |
$10.29
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.98
|
| Rate for Payer: Multiplan Medicare/VA |
$5.67
|
| Rate for Payer: One Health Plan of WY PPO |
$10.08
|
| Rate for Payer: PacificSource Commercial |
$9.26
|
| Rate for Payer: PHCS PPO |
$10.08
|
| Rate for Payer: Three Rivers PPO |
$7.72
|
| Rate for Payer: TriWest Veterans Administration |
$5.97
|
| Rate for Payer: United Healthcare Commercial |
$8.95
|
| Rate for Payer: United Healthcare Medicare |
$5.97
|
| Rate for Payer: WINHealth Partners Commercial |
$10.08
|
| Rate for Payer: Wise Provider Network Commercial |
$9.78
|
|
|
SUT SILK 3-0 SH 18" 8PK
|
Facility
|
IP
|
$10.29
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$10.29 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$9.88
|
| Rate for Payer: Altius Commercial |
$9.88
|
| Rate for Payer: Beech Street Commercial |
$10.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.45
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.98
|
| Rate for Payer: Cigna of WY Commercial |
$10.08
|
| Rate for Payer: Entrust Commercial |
$9.78
|
| Rate for Payer: First Choice Health Commercial |
$9.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.79
|
| Rate for Payer: HealthUtah PPO |
$10.29
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.98
|
| Rate for Payer: Multiplan Medicare/VA |
$6.45
|
| Rate for Payer: One Health Plan of WY PPO |
$10.08
|
| Rate for Payer: PacificSource Commercial |
$9.26
|
| Rate for Payer: PHCS PPO |
$10.08
|
| Rate for Payer: Three Rivers PPO |
$7.72
|
| Rate for Payer: TriWest Veterans Administration |
$6.79
|
| Rate for Payer: United Healthcare Commercial |
$8.95
|
| Rate for Payer: United Healthcare Medicare |
$6.79
|
| Rate for Payer: WINHealth Partners Commercial |
$9.78
|
| Rate for Payer: Wise Provider Network Commercial |
$9.78
|
|
|
SUT SILK BLK 0 18" FSL 678G
|
Facility
|
OP
|
$4.33
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$4.33 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.24
|
| Rate for Payer: Aetna of WY Medicare |
$2.86
|
| Rate for Payer: Altius Auto/Workers Compensation |
$4.16
|
| Rate for Payer: Altius Commercial |
$4.16
|
| Rate for Payer: Beech Street Commercial |
$4.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.55
|
| Rate for Payer: Cash Price |
$3.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.20
|
| Rate for Payer: Cigna of WY Commercial |
$4.24
|
| Rate for Payer: Entrust Commercial |
$4.11
|
| Rate for Payer: First Choice Health Commercial |
$4.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.51
|
| Rate for Payer: HealthUtah PPO |
$4.33
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.20
|
| Rate for Payer: Multiplan Medicare/VA |
$2.39
|
| Rate for Payer: One Health Plan of WY PPO |
$4.24
|
| Rate for Payer: PacificSource Commercial |
$3.90
|
| Rate for Payer: PHCS PPO |
$4.24
|
| Rate for Payer: Three Rivers PPO |
$3.25
|
| Rate for Payer: TriWest Veterans Administration |
$2.51
|
| Rate for Payer: United Healthcare Commercial |
$3.77
|
| Rate for Payer: United Healthcare Medicare |
$2.51
|
| Rate for Payer: WINHealth Partners Commercial |
$4.24
|
| Rate for Payer: Wise Provider Network Commercial |
$4.11
|
|
|
SUT SILK BLK 0 18" FSL 678G
|
Facility
|
IP
|
$4.33
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$4.33 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$4.16
|
| Rate for Payer: Altius Commercial |
$4.16
|
| Rate for Payer: Beech Street Commercial |
$4.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.55
|
| Rate for Payer: Cash Price |
$3.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.20
|
| Rate for Payer: Cigna of WY Commercial |
$4.24
|
| Rate for Payer: Entrust Commercial |
$4.11
|
| Rate for Payer: First Choice Health Commercial |
$4.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.86
|
| Rate for Payer: HealthUtah PPO |
$4.33
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.20
|
| Rate for Payer: Multiplan Medicare/VA |
$2.71
|
| Rate for Payer: One Health Plan of WY PPO |
$4.24
|
| Rate for Payer: PacificSource Commercial |
$3.90
|
| Rate for Payer: PHCS PPO |
$4.24
|
| Rate for Payer: Three Rivers PPO |
$3.25
|
| Rate for Payer: TriWest Veterans Administration |
$2.86
|
| Rate for Payer: United Healthcare Commercial |
$3.77
|
| Rate for Payer: United Healthcare Medicare |
$2.86
|
| Rate for Payer: WINHealth Partners Commercial |
$4.11
|
| Rate for Payer: Wise Provider Network Commercial |
$4.11
|
|
|
SUT STRATAFIX SYMMETRIC PDS+ CTX 1
|
Facility
|
IP
|
$87.61
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.93 |
| Max. Negotiated Rate |
$87.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$85.86
|
| Rate for Payer: Altius Auto/Workers Compensation |
$84.11
|
| Rate for Payer: Altius Commercial |
$84.11
|
| Rate for Payer: Beech Street Commercial |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.93
|
| Rate for Payer: Cash Price |
$61.33
|
| Rate for Payer: ChoiceCare Network Commercial |
$84.98
|
| Rate for Payer: Cigna of WY Commercial |
$85.86
|
| Rate for Payer: Entrust Commercial |
$83.23
|
| Rate for Payer: First Choice Health Commercial |
$83.23
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$83.23
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$57.82
|
| Rate for Payer: HealthUtah PPO |
$87.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$84.98
|
| Rate for Payer: Multiplan Medicare/VA |
$54.93
|
| Rate for Payer: One Health Plan of WY PPO |
$85.86
|
| Rate for Payer: PacificSource Commercial |
$78.85
|
| Rate for Payer: PHCS PPO |
$85.86
|
| Rate for Payer: Three Rivers PPO |
$65.71
|
| Rate for Payer: TriWest Veterans Administration |
$57.82
|
| Rate for Payer: United Healthcare Commercial |
$76.22
|
| Rate for Payer: United Healthcare Medicare |
$57.82
|
| Rate for Payer: WINHealth Partners Commercial |
$83.23
|
| Rate for Payer: Wise Provider Network Commercial |
$83.23
|
|
|
SUT STRATAFIX SYMMETRIC PDS+ CTX 1
|
Facility
|
OP
|
$87.61
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.27 |
| Max. Negotiated Rate |
$87.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$85.86
|
| Rate for Payer: Aetna of WY Medicare |
$57.82
|
| Rate for Payer: Altius Auto/Workers Compensation |
$84.11
|
| Rate for Payer: Altius Commercial |
$84.11
|
| Rate for Payer: Beech Street Commercial |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$71.93
|
| Rate for Payer: Cash Price |
$61.33
|
| Rate for Payer: ChoiceCare Network Commercial |
$84.98
|
| Rate for Payer: Cigna of WY Commercial |
$85.86
|
| Rate for Payer: Entrust Commercial |
$83.23
|
| Rate for Payer: First Choice Health Commercial |
$83.23
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$83.23
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.81
|
| Rate for Payer: HealthUtah PPO |
$87.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$84.98
|
| Rate for Payer: Multiplan Medicare/VA |
$48.27
|
| Rate for Payer: One Health Plan of WY PPO |
$85.86
|
| Rate for Payer: PacificSource Commercial |
$78.85
|
| Rate for Payer: PHCS PPO |
$85.86
|
| Rate for Payer: Three Rivers PPO |
$65.71
|
| Rate for Payer: TriWest Veterans Administration |
$50.81
|
| Rate for Payer: United Healthcare Commercial |
$76.22
|
| Rate for Payer: United Healthcare Medicare |
$50.81
|
| Rate for Payer: WINHealth Partners Commercial |
$85.86
|
| Rate for Payer: Wise Provider Network Commercial |
$83.23
|
|
|
SUT TIGERTAPE 2MM 7 AR-7237-7T
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.72 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$171.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$168.00
|
| Rate for Payer: Altius Commercial |
$168.00
|
| Rate for Payer: Beech Street Commercial |
$171.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$143.68
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$169.75
|
| Rate for Payer: Cigna of WY Commercial |
$171.50
|
| Rate for Payer: Entrust Commercial |
$166.25
|
| Rate for Payer: First Choice Health Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$115.50
|
| Rate for Payer: HealthUtah PPO |
$175.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$169.75
|
| Rate for Payer: Multiplan Medicare/VA |
$109.72
|
| Rate for Payer: One Health Plan of WY PPO |
$171.50
|
| Rate for Payer: PacificSource Commercial |
$157.50
|
| Rate for Payer: PHCS PPO |
$171.50
|
| Rate for Payer: Three Rivers PPO |
$131.25
|
| Rate for Payer: TriWest Veterans Administration |
$115.50
|
| Rate for Payer: United Healthcare Commercial |
$152.25
|
| Rate for Payer: United Healthcare Medicare |
$115.50
|
| Rate for Payer: WINHealth Partners Commercial |
$166.25
|
| Rate for Payer: Wise Provider Network Commercial |
$166.25
|
|
|
SUT TIGERTAPE 2MM 7 AR-7237-7T
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.42 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$171.50
|
| Rate for Payer: Aetna of WY Medicare |
$115.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$168.00
|
| Rate for Payer: Altius Commercial |
$168.00
|
| Rate for Payer: Beech Street Commercial |
$171.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$143.68
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$169.75
|
| Rate for Payer: Cigna of WY Commercial |
$171.50
|
| Rate for Payer: Entrust Commercial |
$166.25
|
| Rate for Payer: First Choice Health Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$166.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$101.50
|
| Rate for Payer: HealthUtah PPO |
$175.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$169.75
|
| Rate for Payer: Multiplan Medicare/VA |
$96.42
|
| Rate for Payer: One Health Plan of WY PPO |
$171.50
|
| Rate for Payer: PacificSource Commercial |
$157.50
|
| Rate for Payer: PHCS PPO |
$171.50
|
| Rate for Payer: Three Rivers PPO |
$131.25
|
| Rate for Payer: TriWest Veterans Administration |
$101.50
|
| Rate for Payer: United Healthcare Commercial |
$152.25
|
| Rate for Payer: United Healthcare Medicare |
$101.50
|
| Rate for Payer: WINHealth Partners Commercial |
$171.50
|
| Rate for Payer: Wise Provider Network Commercial |
$166.25
|
|
|
SUT UNDYED VICRYL 0 CT-2 27" J270H
|
Facility
|
IP
|
$4.46
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.37
|
| Rate for Payer: Altius Auto/Workers Compensation |
$4.28
|
| Rate for Payer: Altius Commercial |
$4.28
|
| Rate for Payer: Beech Street Commercial |
$4.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.66
|
| Rate for Payer: Cash Price |
$3.12
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.33
|
| Rate for Payer: Cigna of WY Commercial |
$4.37
|
| Rate for Payer: Entrust Commercial |
$4.24
|
| Rate for Payer: First Choice Health Commercial |
$4.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.94
|
| Rate for Payer: HealthUtah PPO |
$4.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.33
|
| Rate for Payer: Multiplan Medicare/VA |
$2.80
|
| Rate for Payer: One Health Plan of WY PPO |
$4.37
|
| Rate for Payer: PacificSource Commercial |
$4.01
|
| Rate for Payer: PHCS PPO |
$4.37
|
| Rate for Payer: Three Rivers PPO |
$3.34
|
| Rate for Payer: TriWest Veterans Administration |
$2.94
|
| Rate for Payer: United Healthcare Commercial |
$3.88
|
| Rate for Payer: United Healthcare Medicare |
$2.94
|
| Rate for Payer: WINHealth Partners Commercial |
$4.24
|
| Rate for Payer: Wise Provider Network Commercial |
$4.24
|
|
|
SUT UNDYED VICRYL 0 CT-2 27" J270H
|
Facility
|
OP
|
$4.46
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.37
|
| Rate for Payer: Aetna of WY Medicare |
$2.94
|
| Rate for Payer: Altius Auto/Workers Compensation |
$4.28
|
| Rate for Payer: Altius Commercial |
$4.28
|
| Rate for Payer: Beech Street Commercial |
$4.37
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.66
|
| Rate for Payer: Cash Price |
$3.12
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.33
|
| Rate for Payer: Cigna of WY Commercial |
$4.37
|
| Rate for Payer: Entrust Commercial |
$4.24
|
| Rate for Payer: First Choice Health Commercial |
$4.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.24
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.59
|
| Rate for Payer: HealthUtah PPO |
$4.46
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.33
|
| Rate for Payer: Multiplan Medicare/VA |
$2.46
|
| Rate for Payer: One Health Plan of WY PPO |
$4.37
|
| Rate for Payer: PacificSource Commercial |
$4.01
|
| Rate for Payer: PHCS PPO |
$4.37
|
| Rate for Payer: Three Rivers PPO |
$3.34
|
| Rate for Payer: TriWest Veterans Administration |
$2.59
|
| Rate for Payer: United Healthcare Commercial |
$3.88
|
| Rate for Payer: United Healthcare Medicare |
$2.59
|
| Rate for Payer: WINHealth Partners Commercial |
$4.37
|
| Rate for Payer: Wise Provider Network Commercial |
$4.24
|
|
|
SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE
|
Professional
|
Both
|
$2,960.00
|
|
|
Service Code
|
HCPCS 64834
|
| Hospital Charge Code |
64834
|
| Min. Negotiated Rate |
$613.07 |
| Max. Negotiated Rate |
$2,960.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,900.80
|
| Rate for Payer: Aetna of WY Medicare |
$721.26
|
| Rate for Payer: Beech Street Commercial |
$2,812.00
|
| Rate for Payer: Cash Price |
$2,072.00
|
| Rate for Payer: Cash Price |
$2,072.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,871.20
|
| Rate for Payer: Cigna of WY Commercial |
$2,900.80
|
| Rate for Payer: First Choice Health Commercial |
$2,664.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,812.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$721.26
|
| Rate for Payer: HealthUtah PPO |
$2,960.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,871.20
|
| Rate for Payer: Multiplan Medicare/VA |
$613.07
|
| Rate for Payer: One Health Plan of WY PPO |
$2,900.80
|
| Rate for Payer: PacificSource Commercial |
$2,664.00
|
| Rate for Payer: PHCS PPO |
$2,812.00
|
| Rate for Payer: Three Rivers PPO |
$2,220.00
|
| Rate for Payer: TriWest Veterans Administration |
$721.26
|
| Rate for Payer: United Healthcare Commercial |
$2,575.20
|
| Rate for Payer: United Healthcare Medicare |
$721.26
|
| Rate for Payer: WINHealth Partners Commercial |
$2,516.00
|
|
|
SUTURE ANCHOR 2.5MM AR-8825P
|
Facility
|
IP
|
$1,260.00
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$790.02 |
| Max. Negotiated Rate |
$1,260.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,234.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,209.60
|
| Rate for Payer: Altius Commercial |
$1,209.60
|
| Rate for Payer: Beech Street Commercial |
$1,234.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,034.46
|
| Rate for Payer: Cash Price |
$882.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,222.20
|
| Rate for Payer: Cigna of WY Commercial |
$1,234.80
|
| Rate for Payer: Entrust Commercial |
$1,197.00
|
| Rate for Payer: First Choice Health Commercial |
$1,197.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,197.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$831.60
|
| Rate for Payer: HealthUtah PPO |
$1,260.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,222.20
|
| Rate for Payer: Multiplan Medicare/VA |
$790.02
|
| Rate for Payer: One Health Plan of WY PPO |
$1,234.80
|
| Rate for Payer: PacificSource Commercial |
$1,134.00
|
| Rate for Payer: PHCS PPO |
$1,234.80
|
| Rate for Payer: Three Rivers PPO |
$945.00
|
| Rate for Payer: TriWest Veterans Administration |
$831.60
|
| Rate for Payer: United Healthcare Commercial |
$1,096.20
|
| Rate for Payer: United Healthcare Medicare |
$831.60
|
| Rate for Payer: WINHealth Partners Commercial |
$1,197.00
|
| Rate for Payer: Wise Provider Network Commercial |
$1,197.00
|
|
|
SUTURE ANCHOR 2.5MM AR-8825P
|
Facility
|
OP
|
$1,260.00
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$694.26 |
| Max. Negotiated Rate |
$1,260.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,234.80
|
| Rate for Payer: Aetna of WY Medicare |
$831.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$1,209.60
|
| Rate for Payer: Altius Commercial |
$1,209.60
|
| Rate for Payer: Beech Street Commercial |
$1,234.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,034.46
|
| Rate for Payer: Cash Price |
$882.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,222.20
|
| Rate for Payer: Cigna of WY Commercial |
$1,234.80
|
| Rate for Payer: Entrust Commercial |
$1,197.00
|
| Rate for Payer: First Choice Health Commercial |
$1,197.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,197.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$730.80
|
| Rate for Payer: HealthUtah PPO |
$1,260.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,222.20
|
| Rate for Payer: Multiplan Medicare/VA |
$694.26
|
| Rate for Payer: One Health Plan of WY PPO |
$1,234.80
|
| Rate for Payer: PacificSource Commercial |
$1,134.00
|
| Rate for Payer: PHCS PPO |
$1,234.80
|
| Rate for Payer: Three Rivers PPO |
$945.00
|
| Rate for Payer: TriWest Veterans Administration |
$730.80
|
| Rate for Payer: United Healthcare Commercial |
$1,096.20
|
| Rate for Payer: United Healthcare Medicare |
$730.80
|
| Rate for Payer: WINHealth Partners Commercial |
$1,234.80
|
| Rate for Payer: Wise Provider Network Commercial |
$1,197.00
|
|
|
SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
|
Professional
|
Both
|
$3,558.00
|
|
|
Service Code
|
HCPCS 64831
|
| Hospital Charge Code |
64831
|
| Min. Negotiated Rate |
$573.45 |
| Max. Negotiated Rate |
$3,558.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,486.84
|
| Rate for Payer: Aetna of WY Medicare |
$674.65
|
| Rate for Payer: Beech Street Commercial |
$3,380.10
|
| Rate for Payer: Cash Price |
$2,490.60
|
| Rate for Payer: Cash Price |
$2,490.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,451.26
|
| Rate for Payer: Cigna of WY Commercial |
$3,486.84
|
| Rate for Payer: First Choice Health Commercial |
$3,202.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,380.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$674.65
|
| Rate for Payer: HealthUtah PPO |
$3,558.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,451.26
|
| Rate for Payer: Multiplan Medicare/VA |
$573.45
|
| Rate for Payer: One Health Plan of WY PPO |
$3,486.84
|
| Rate for Payer: PacificSource Commercial |
$3,202.20
|
| Rate for Payer: PHCS PPO |
$3,380.10
|
| Rate for Payer: Three Rivers PPO |
$2,668.50
|
| Rate for Payer: TriWest Veterans Administration |
$674.65
|
| Rate for Payer: United Healthcare Commercial |
$3,095.46
|
| Rate for Payer: United Healthcare Medicare |
$674.65
|
| Rate for Payer: WINHealth Partners Commercial |
$3,024.30
|
|
|
SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$3,139.00
|
|
|
Service Code
|
HCPCS 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$517.57 |
| Max. Negotiated Rate |
$3,139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,076.22
|
| Rate for Payer: Aetna of WY Medicare |
$608.91
|
| Rate for Payer: Beech Street Commercial |
$2,982.05
|
| Rate for Payer: Cash Price |
$2,197.30
|
| Rate for Payer: Cash Price |
$2,197.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,044.83
|
| Rate for Payer: Cigna of WY Commercial |
$3,076.22
|
| Rate for Payer: First Choice Health Commercial |
$2,825.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,982.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$608.91
|
| Rate for Payer: HealthUtah PPO |
$3,139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,044.83
|
| Rate for Payer: Multiplan Medicare/VA |
$517.57
|
| Rate for Payer: One Health Plan of WY PPO |
$3,076.22
|
| Rate for Payer: PacificSource Commercial |
$2,825.10
|
| Rate for Payer: PHCS PPO |
$2,982.05
|
| Rate for Payer: Three Rivers PPO |
$2,354.25
|
| Rate for Payer: TriWest Veterans Administration |
$608.91
|
| Rate for Payer: United Healthcare Commercial |
$2,730.93
|
| Rate for Payer: United Healthcare Medicare |
$608.91
|
| Rate for Payer: WINHealth Partners Commercial |
$2,668.15
|
|
|
SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$3,139.00
|
|
|
Service Code
|
HCPCS 27380 80
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$517.57 |
| Max. Negotiated Rate |
$3,139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,076.22
|
| Rate for Payer: Aetna of WY Medicare |
$608.91
|
| Rate for Payer: Beech Street Commercial |
$2,982.05
|
| Rate for Payer: Cash Price |
$2,197.30
|
| Rate for Payer: Cash Price |
$2,197.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,044.83
|
| Rate for Payer: Cigna of WY Commercial |
$3,076.22
|
| Rate for Payer: First Choice Health Commercial |
$2,825.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,982.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$608.91
|
| Rate for Payer: HealthUtah PPO |
$3,139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,044.83
|
| Rate for Payer: Multiplan Medicare/VA |
$517.57
|
| Rate for Payer: One Health Plan of WY PPO |
$3,076.22
|
| Rate for Payer: PacificSource Commercial |
$2,825.10
|
| Rate for Payer: PHCS PPO |
$2,982.05
|
| Rate for Payer: Three Rivers PPO |
$2,354.25
|
| Rate for Payer: TriWest Veterans Administration |
$608.91
|
| Rate for Payer: United Healthcare Commercial |
$2,730.93
|
| Rate for Payer: United Healthcare Medicare |
$608.91
|
| Rate for Payer: WINHealth Partners Commercial |
$2,668.15
|
|
|
SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$3,139.00
|
|
|
Service Code
|
HCPCS 27380 AS
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$517.57 |
| Max. Negotiated Rate |
$3,139.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,076.22
|
| Rate for Payer: Aetna of WY Medicare |
$608.91
|
| Rate for Payer: Beech Street Commercial |
$2,982.05
|
| Rate for Payer: Cash Price |
$2,197.30
|
| Rate for Payer: Cash Price |
$2,197.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,044.83
|
| Rate for Payer: Cigna of WY Commercial |
$3,076.22
|
| Rate for Payer: First Choice Health Commercial |
$2,825.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,982.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$608.91
|
| Rate for Payer: HealthUtah PPO |
$3,139.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,044.83
|
| Rate for Payer: Multiplan Medicare/VA |
$517.57
|
| Rate for Payer: One Health Plan of WY PPO |
$3,076.22
|
| Rate for Payer: PacificSource Commercial |
$2,825.10
|
| Rate for Payer: PHCS PPO |
$2,982.05
|
| Rate for Payer: Three Rivers PPO |
$2,354.25
|
| Rate for Payer: TriWest Veterans Administration |
$608.91
|
| Rate for Payer: United Healthcare Commercial |
$2,730.93
|
| Rate for Payer: United Healthcare Medicare |
$608.91
|
| Rate for Payer: WINHealth Partners Commercial |
$2,668.15
|
|
|
SUTURELASSO MICRO TFCC 70° BEND
|
Facility
|
IP
|
$572.32
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$358.84 |
| Max. Negotiated Rate |
$572.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$560.87
|
| Rate for Payer: Altius Auto/Workers Compensation |
$549.43
|
| Rate for Payer: Altius Commercial |
$549.43
|
| Rate for Payer: Beech Street Commercial |
$560.87
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$469.87
|
| Rate for Payer: Cash Price |
$400.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$555.15
|
| Rate for Payer: Cigna of WY Commercial |
$560.87
|
| Rate for Payer: Entrust Commercial |
$543.70
|
| Rate for Payer: First Choice Health Commercial |
$543.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$543.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$377.73
|
| Rate for Payer: HealthUtah PPO |
$572.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$555.15
|
| Rate for Payer: Multiplan Medicare/VA |
$358.84
|
| Rate for Payer: One Health Plan of WY PPO |
$560.87
|
| Rate for Payer: PacificSource Commercial |
$515.09
|
| Rate for Payer: PHCS PPO |
$560.87
|
| Rate for Payer: Three Rivers PPO |
$429.24
|
| Rate for Payer: TriWest Veterans Administration |
$377.73
|
| Rate for Payer: United Healthcare Commercial |
$497.92
|
| Rate for Payer: United Healthcare Medicare |
$377.73
|
| Rate for Payer: WINHealth Partners Commercial |
$543.70
|
| Rate for Payer: Wise Provider Network Commercial |
$543.70
|
|
|
SUTURELASSO MICRO TFCC 70° BEND
|
Facility
|
OP
|
$572.32
|
|
| Hospital Charge Code |
27800000S1
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$315.35 |
| Max. Negotiated Rate |
$572.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$560.87
|
| Rate for Payer: Aetna of WY Medicare |
$377.73
|
| Rate for Payer: Altius Auto/Workers Compensation |
$549.43
|
| Rate for Payer: Altius Commercial |
$549.43
|
| Rate for Payer: Beech Street Commercial |
$560.87
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$469.87
|
| Rate for Payer: Cash Price |
$400.62
|
| Rate for Payer: ChoiceCare Network Commercial |
$555.15
|
| Rate for Payer: Cigna of WY Commercial |
$560.87
|
| Rate for Payer: Entrust Commercial |
$543.70
|
| Rate for Payer: First Choice Health Commercial |
$543.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$543.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$331.95
|
| Rate for Payer: HealthUtah PPO |
$572.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$555.15
|
| Rate for Payer: Multiplan Medicare/VA |
$315.35
|
| Rate for Payer: One Health Plan of WY PPO |
$560.87
|
| Rate for Payer: PacificSource Commercial |
$515.09
|
| Rate for Payer: PHCS PPO |
$560.87
|
| Rate for Payer: Three Rivers PPO |
$429.24
|
| Rate for Payer: TriWest Veterans Administration |
$331.95
|
| Rate for Payer: United Healthcare Commercial |
$497.92
|
| Rate for Payer: United Healthcare Medicare |
$331.95
|
| Rate for Payer: WINHealth Partners Commercial |
$560.87
|
| Rate for Payer: Wise Provider Network Commercial |
$543.70
|
|
|
SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$4,247.00
|
|
|
Service Code
|
HCPCS 27385 50
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$505.72 |
| Max. Negotiated Rate |
$4,247.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,162.06
|
| Rate for Payer: Aetna of WY Medicare |
$594.96
|
| Rate for Payer: Beech Street Commercial |
$4,034.65
|
| Rate for Payer: Cash Price |
$2,972.90
|
| Rate for Payer: Cash Price |
$2,972.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,119.59
|
| Rate for Payer: Cigna of WY Commercial |
$4,162.06
|
| Rate for Payer: First Choice Health Commercial |
$3,822.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,034.65
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$594.96
|
| Rate for Payer: HealthUtah PPO |
$4,247.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,119.59
|
| Rate for Payer: Multiplan Medicare/VA |
$505.72
|
| Rate for Payer: One Health Plan of WY PPO |
$4,162.06
|
| Rate for Payer: PacificSource Commercial |
$3,822.30
|
| Rate for Payer: PHCS PPO |
$4,034.65
|
| Rate for Payer: Three Rivers PPO |
$3,185.25
|
| Rate for Payer: TriWest Veterans Administration |
$594.96
|
| Rate for Payer: United Healthcare Commercial |
$3,694.89
|
| Rate for Payer: United Healthcare Medicare |
$594.96
|
| Rate for Payer: WINHealth Partners Commercial |
$3,609.95
|
|
|
SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$2,124.00
|
|
|
Service Code
|
HCPCS 27385 AS
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$505.72 |
| Max. Negotiated Rate |
$2,124.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,081.52
|
| Rate for Payer: Aetna of WY Medicare |
$594.96
|
| Rate for Payer: Beech Street Commercial |
$2,017.80
|
| Rate for Payer: Cash Price |
$1,486.80
|
| Rate for Payer: Cash Price |
$1,486.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,060.28
|
| Rate for Payer: Cigna of WY Commercial |
$2,081.52
|
| Rate for Payer: First Choice Health Commercial |
$1,911.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,017.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$594.96
|
| Rate for Payer: HealthUtah PPO |
$2,124.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,060.28
|
| Rate for Payer: Multiplan Medicare/VA |
$505.72
|
| Rate for Payer: One Health Plan of WY PPO |
$2,081.52
|
| Rate for Payer: PacificSource Commercial |
$1,911.60
|
| Rate for Payer: PHCS PPO |
$2,017.80
|
| Rate for Payer: Three Rivers PPO |
$1,593.00
|
| Rate for Payer: TriWest Veterans Administration |
$594.96
|
| Rate for Payer: United Healthcare Commercial |
$1,847.88
|
| Rate for Payer: United Healthcare Medicare |
$594.96
|
| Rate for Payer: WINHealth Partners Commercial |
$1,805.40
|
|
