|
TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 22858
|
| Hospital Charge Code |
22858
|
| Min. Negotiated Rate |
$402.10 |
| Max. Negotiated Rate |
$2,032.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,991.36
|
| Rate for Payer: Aetna of WY Medicare |
$473.06
|
| Rate for Payer: Beech Street Commercial |
$1,930.40
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,971.04
|
| Rate for Payer: Cigna of WY Commercial |
$1,991.36
|
| Rate for Payer: First Choice Health Commercial |
$1,828.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,930.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$473.06
|
| Rate for Payer: HealthUtah PPO |
$2,032.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,971.04
|
| Rate for Payer: Multiplan Medicare/VA |
$402.10
|
| Rate for Payer: One Health Plan of WY PPO |
$1,991.36
|
| Rate for Payer: PacificSource Commercial |
$1,828.80
|
| Rate for Payer: PHCS PPO |
$1,930.40
|
| Rate for Payer: Three Rivers PPO |
$1,524.00
|
| Rate for Payer: TriWest Veterans Administration |
$473.06
|
| Rate for Payer: United Healthcare Commercial |
$1,767.84
|
| Rate for Payer: United Healthcare Medicare |
$473.06
|
| Rate for Payer: WINHealth Partners Commercial |
$1,727.20
|
|
|
TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$6,594.00
|
|
|
Service Code
|
HCPCS 22856
|
| Hospital Charge Code |
22856
|
| Min. Negotiated Rate |
$4,945.50 |
| Max. Negotiated Rate |
$6,594.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,462.12
|
| Rate for Payer: Beech Street Commercial |
$6,264.30
|
| Rate for Payer: Cash Price |
$4,615.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,396.18
|
| Rate for Payer: Cigna of WY Commercial |
$6,462.12
|
| Rate for Payer: First Choice Health Commercial |
$5,934.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,264.30
|
| Rate for Payer: HealthUtah PPO |
$6,594.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,396.18
|
| Rate for Payer: One Health Plan of WY PPO |
$6,462.12
|
| Rate for Payer: PacificSource Commercial |
$5,934.60
|
| Rate for Payer: PHCS PPO |
$6,264.30
|
| Rate for Payer: Three Rivers PPO |
$4,945.50
|
| Rate for Payer: United Healthcare Commercial |
$5,736.78
|
| Rate for Payer: WINHealth Partners Commercial |
$5,604.90
|
|
|
TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$6,594.00
|
|
|
Service Code
|
HCPCS 22856 AS
|
| Hospital Charge Code |
22856
|
| Min. Negotiated Rate |
$4,945.50 |
| Max. Negotiated Rate |
$6,594.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6,462.12
|
| Rate for Payer: Beech Street Commercial |
$6,264.30
|
| Rate for Payer: Cash Price |
$4,615.80
|
| Rate for Payer: ChoiceCare Network Commercial |
$6,396.18
|
| Rate for Payer: Cigna of WY Commercial |
$6,462.12
|
| Rate for Payer: First Choice Health Commercial |
$5,934.60
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$6,264.30
|
| Rate for Payer: HealthUtah PPO |
$6,594.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6,396.18
|
| Rate for Payer: One Health Plan of WY PPO |
$6,462.12
|
| Rate for Payer: PacificSource Commercial |
$5,934.60
|
| Rate for Payer: PHCS PPO |
$6,264.30
|
| Rate for Payer: Three Rivers PPO |
$4,945.50
|
| Rate for Payer: United Healthcare Commercial |
$5,736.78
|
| Rate for Payer: WINHealth Partners Commercial |
$5,604.90
|
|
|
TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$3,633.00
|
|
|
Service Code
|
HCPCS 60220 80
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$577.57 |
| Max. Negotiated Rate |
$3,633.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,560.34
|
| Rate for Payer: Aetna of WY Medicare |
$679.49
|
| Rate for Payer: Beech Street Commercial |
$3,451.35
|
| Rate for Payer: Cash Price |
$2,543.10
|
| Rate for Payer: Cash Price |
$2,543.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,524.01
|
| Rate for Payer: Cigna of WY Commercial |
$3,560.34
|
| Rate for Payer: First Choice Health Commercial |
$3,269.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,451.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$679.49
|
| Rate for Payer: HealthUtah PPO |
$3,633.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,524.01
|
| Rate for Payer: Multiplan Medicare/VA |
$577.57
|
| Rate for Payer: One Health Plan of WY PPO |
$3,560.34
|
| Rate for Payer: PacificSource Commercial |
$3,269.70
|
| Rate for Payer: PHCS PPO |
$3,451.35
|
| Rate for Payer: Three Rivers PPO |
$2,724.75
|
| Rate for Payer: TriWest Veterans Administration |
$679.49
|
| Rate for Payer: United Healthcare Commercial |
$3,160.71
|
| Rate for Payer: United Healthcare Medicare |
$679.49
|
| Rate for Payer: WINHealth Partners Commercial |
$3,088.05
|
|
|
TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$3,633.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$577.57 |
| Max. Negotiated Rate |
$3,633.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,560.34
|
| Rate for Payer: Aetna of WY Medicare |
$679.49
|
| Rate for Payer: Beech Street Commercial |
$3,451.35
|
| Rate for Payer: Cash Price |
$2,543.10
|
| Rate for Payer: Cash Price |
$2,543.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,524.01
|
| Rate for Payer: Cigna of WY Commercial |
$3,560.34
|
| Rate for Payer: First Choice Health Commercial |
$3,269.70
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,451.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$679.49
|
| Rate for Payer: HealthUtah PPO |
$3,633.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,524.01
|
| Rate for Payer: Multiplan Medicare/VA |
$577.57
|
| Rate for Payer: One Health Plan of WY PPO |
$3,560.34
|
| Rate for Payer: PacificSource Commercial |
$3,269.70
|
| Rate for Payer: PHCS PPO |
$3,451.35
|
| Rate for Payer: Three Rivers PPO |
$2,724.75
|
| Rate for Payer: TriWest Veterans Administration |
$679.49
|
| Rate for Payer: United Healthcare Commercial |
$3,160.71
|
| Rate for Payer: United Healthcare Medicare |
$679.49
|
| Rate for Payer: WINHealth Partners Commercial |
$3,088.05
|
|
|
TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$4,798.00
|
|
|
Service Code
|
HCPCS 60225
|
| Hospital Charge Code |
60225
|
| Min. Negotiated Rate |
$765.92 |
| Max. Negotiated Rate |
$4,798.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4,702.04
|
| Rate for Payer: Aetna of WY Medicare |
$901.08
|
| Rate for Payer: Beech Street Commercial |
$4,558.10
|
| Rate for Payer: Cash Price |
$3,358.60
|
| Rate for Payer: Cash Price |
$3,358.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$4,654.06
|
| Rate for Payer: Cigna of WY Commercial |
$4,702.04
|
| Rate for Payer: First Choice Health Commercial |
$4,318.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4,558.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$901.08
|
| Rate for Payer: HealthUtah PPO |
$4,798.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4,654.06
|
| Rate for Payer: Multiplan Medicare/VA |
$765.92
|
| Rate for Payer: One Health Plan of WY PPO |
$4,702.04
|
| Rate for Payer: PacificSource Commercial |
$4,318.20
|
| Rate for Payer: PHCS PPO |
$4,558.10
|
| Rate for Payer: Three Rivers PPO |
$3,598.50
|
| Rate for Payer: TriWest Veterans Administration |
$901.08
|
| Rate for Payer: United Healthcare Commercial |
$4,174.26
|
| Rate for Payer: United Healthcare Medicare |
$901.08
|
| Rate for Payer: WINHealth Partners Commercial |
$4,078.30
|
|
|
TOURN DUAL CUFF/DUAL BLADD18IN
|
Facility
|
OP
|
$32.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.76 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$31.60
|
| Rate for Payer: Aetna of WY Medicare |
$21.28
|
| Rate for Payer: Altius Auto/Workers Compensation |
$30.95
|
| Rate for Payer: Altius Commercial |
$30.95
|
| Rate for Payer: Beech Street Commercial |
$31.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$26.47
|
| Rate for Payer: Cash Price |
$22.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$31.27
|
| Rate for Payer: Cigna of WY Commercial |
$31.60
|
| Rate for Payer: Entrust Commercial |
$30.63
|
| Rate for Payer: First Choice Health Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.70
|
| Rate for Payer: HealthUtah PPO |
$32.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$31.27
|
| Rate for Payer: Multiplan Medicare/VA |
$17.76
|
| Rate for Payer: One Health Plan of WY PPO |
$31.60
|
| Rate for Payer: PacificSource Commercial |
$29.02
|
| Rate for Payer: PHCS PPO |
$31.60
|
| Rate for Payer: Three Rivers PPO |
$24.18
|
| Rate for Payer: TriWest Veterans Administration |
$18.70
|
| Rate for Payer: United Healthcare Commercial |
$28.05
|
| Rate for Payer: United Healthcare Medicare |
$18.70
|
| Rate for Payer: WINHealth Partners Commercial |
$31.60
|
| Rate for Payer: Wise Provider Network Commercial |
$30.63
|
|
|
TOURN DUAL CUFF/DUAL BLADD18IN
|
Facility
|
IP
|
$32.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$31.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$30.95
|
| Rate for Payer: Altius Commercial |
$30.95
|
| Rate for Payer: Beech Street Commercial |
$31.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$26.47
|
| Rate for Payer: Cash Price |
$22.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$31.27
|
| Rate for Payer: Cigna of WY Commercial |
$31.60
|
| Rate for Payer: Entrust Commercial |
$30.63
|
| Rate for Payer: First Choice Health Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.28
|
| Rate for Payer: HealthUtah PPO |
$32.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$31.27
|
| Rate for Payer: Multiplan Medicare/VA |
$20.21
|
| Rate for Payer: One Health Plan of WY PPO |
$31.60
|
| Rate for Payer: PacificSource Commercial |
$29.02
|
| Rate for Payer: PHCS PPO |
$31.60
|
| Rate for Payer: Three Rivers PPO |
$24.18
|
| Rate for Payer: TriWest Veterans Administration |
$21.28
|
| Rate for Payer: United Healthcare Commercial |
$28.05
|
| Rate for Payer: United Healthcare Medicare |
$21.28
|
| Rate for Payer: WINHealth Partners Commercial |
$30.63
|
| Rate for Payer: Wise Provider Network Commercial |
$30.63
|
|
|
TOURNIQUET CUFF DISP 12IN
|
Facility
|
IP
|
$32.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$31.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$30.95
|
| Rate for Payer: Altius Commercial |
$30.95
|
| Rate for Payer: Beech Street Commercial |
$31.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$26.47
|
| Rate for Payer: Cash Price |
$22.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$31.27
|
| Rate for Payer: Cigna of WY Commercial |
$31.60
|
| Rate for Payer: Entrust Commercial |
$30.63
|
| Rate for Payer: First Choice Health Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.28
|
| Rate for Payer: HealthUtah PPO |
$32.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$31.27
|
| Rate for Payer: Multiplan Medicare/VA |
$20.21
|
| Rate for Payer: One Health Plan of WY PPO |
$31.60
|
| Rate for Payer: PacificSource Commercial |
$29.02
|
| Rate for Payer: PHCS PPO |
$31.60
|
| Rate for Payer: Three Rivers PPO |
$24.18
|
| Rate for Payer: TriWest Veterans Administration |
$21.28
|
| Rate for Payer: United Healthcare Commercial |
$28.05
|
| Rate for Payer: United Healthcare Medicare |
$21.28
|
| Rate for Payer: WINHealth Partners Commercial |
$30.63
|
| Rate for Payer: Wise Provider Network Commercial |
$30.63
|
|
|
TOURNIQUET CUFF DISP 12IN
|
Facility
|
OP
|
$32.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.76 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$31.60
|
| Rate for Payer: Aetna of WY Medicare |
$21.28
|
| Rate for Payer: Altius Auto/Workers Compensation |
$30.95
|
| Rate for Payer: Altius Commercial |
$30.95
|
| Rate for Payer: Beech Street Commercial |
$31.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$26.47
|
| Rate for Payer: Cash Price |
$22.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$31.27
|
| Rate for Payer: Cigna of WY Commercial |
$31.60
|
| Rate for Payer: Entrust Commercial |
$30.63
|
| Rate for Payer: First Choice Health Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$30.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.70
|
| Rate for Payer: HealthUtah PPO |
$32.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$31.27
|
| Rate for Payer: Multiplan Medicare/VA |
$17.76
|
| Rate for Payer: One Health Plan of WY PPO |
$31.60
|
| Rate for Payer: PacificSource Commercial |
$29.02
|
| Rate for Payer: PHCS PPO |
$31.60
|
| Rate for Payer: Three Rivers PPO |
$24.18
|
| Rate for Payer: TriWest Veterans Administration |
$18.70
|
| Rate for Payer: United Healthcare Commercial |
$28.05
|
| Rate for Payer: United Healthcare Medicare |
$18.70
|
| Rate for Payer: WINHealth Partners Commercial |
$31.60
|
| Rate for Payer: Wise Provider Network Commercial |
$30.63
|
|
|
TOURNIQUET CUFF DISP 18IN
|
Facility
|
OP
|
$45.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.07 |
| Max. Negotiated Rate |
$45.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.59
|
| Rate for Payer: Aetna of WY Medicare |
$30.03
|
| Rate for Payer: Altius Auto/Workers Compensation |
$43.68
|
| Rate for Payer: Altius Commercial |
$43.68
|
| Rate for Payer: Beech Street Commercial |
$44.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$37.36
|
| Rate for Payer: Cash Price |
$31.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.14
|
| Rate for Payer: Cigna of WY Commercial |
$44.59
|
| Rate for Payer: Entrust Commercial |
$43.22
|
| Rate for Payer: First Choice Health Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.39
|
| Rate for Payer: HealthUtah PPO |
$45.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.14
|
| Rate for Payer: Multiplan Medicare/VA |
$25.07
|
| Rate for Payer: One Health Plan of WY PPO |
$44.59
|
| Rate for Payer: PacificSource Commercial |
$40.95
|
| Rate for Payer: PHCS PPO |
$44.59
|
| Rate for Payer: Three Rivers PPO |
$34.12
|
| Rate for Payer: TriWest Veterans Administration |
$26.39
|
| Rate for Payer: United Healthcare Commercial |
$39.58
|
| Rate for Payer: United Healthcare Medicare |
$26.39
|
| Rate for Payer: WINHealth Partners Commercial |
$44.59
|
| Rate for Payer: Wise Provider Network Commercial |
$43.22
|
|
|
TOURNIQUET CUFF DISP 18IN
|
Facility
|
IP
|
$45.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$45.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$43.68
|
| Rate for Payer: Altius Commercial |
$43.68
|
| Rate for Payer: Beech Street Commercial |
$44.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$37.36
|
| Rate for Payer: Cash Price |
$31.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.14
|
| Rate for Payer: Cigna of WY Commercial |
$44.59
|
| Rate for Payer: Entrust Commercial |
$43.22
|
| Rate for Payer: First Choice Health Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$30.03
|
| Rate for Payer: HealthUtah PPO |
$45.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.14
|
| Rate for Payer: Multiplan Medicare/VA |
$28.53
|
| Rate for Payer: One Health Plan of WY PPO |
$44.59
|
| Rate for Payer: PacificSource Commercial |
$40.95
|
| Rate for Payer: PHCS PPO |
$44.59
|
| Rate for Payer: Three Rivers PPO |
$34.12
|
| Rate for Payer: TriWest Veterans Administration |
$30.03
|
| Rate for Payer: United Healthcare Commercial |
$39.58
|
| Rate for Payer: United Healthcare Medicare |
$30.03
|
| Rate for Payer: WINHealth Partners Commercial |
$43.22
|
| Rate for Payer: Wise Provider Network Commercial |
$43.22
|
|
|
TOURNIQUET CUFF DISP 24IN
|
Facility
|
OP
|
$33.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$33.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.56
|
| Rate for Payer: Aetna of WY Medicare |
$21.93
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.89
|
| Rate for Payer: Altius Commercial |
$31.89
|
| Rate for Payer: Beech Street Commercial |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$32.22
|
| Rate for Payer: Cigna of WY Commercial |
$32.56
|
| Rate for Payer: Entrust Commercial |
$31.56
|
| Rate for Payer: First Choice Health Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$19.27
|
| Rate for Payer: HealthUtah PPO |
$33.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$32.22
|
| Rate for Payer: Multiplan Medicare/VA |
$18.30
|
| Rate for Payer: One Health Plan of WY PPO |
$32.56
|
| Rate for Payer: PacificSource Commercial |
$29.90
|
| Rate for Payer: PHCS PPO |
$32.56
|
| Rate for Payer: Three Rivers PPO |
$24.92
|
| Rate for Payer: TriWest Veterans Administration |
$19.27
|
| Rate for Payer: United Healthcare Commercial |
$28.90
|
| Rate for Payer: United Healthcare Medicare |
$19.27
|
| Rate for Payer: WINHealth Partners Commercial |
$32.56
|
| Rate for Payer: Wise Provider Network Commercial |
$31.56
|
|
|
TOURNIQUET CUFF DISP 24IN
|
Facility
|
IP
|
$33.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.83 |
| Max. Negotiated Rate |
$33.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.56
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.89
|
| Rate for Payer: Altius Commercial |
$31.89
|
| Rate for Payer: Beech Street Commercial |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$32.22
|
| Rate for Payer: Cigna of WY Commercial |
$32.56
|
| Rate for Payer: Entrust Commercial |
$31.56
|
| Rate for Payer: First Choice Health Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.93
|
| Rate for Payer: HealthUtah PPO |
$33.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$32.22
|
| Rate for Payer: Multiplan Medicare/VA |
$20.83
|
| Rate for Payer: One Health Plan of WY PPO |
$32.56
|
| Rate for Payer: PacificSource Commercial |
$29.90
|
| Rate for Payer: PHCS PPO |
$32.56
|
| Rate for Payer: Three Rivers PPO |
$24.92
|
| Rate for Payer: TriWest Veterans Administration |
$21.93
|
| Rate for Payer: United Healthcare Commercial |
$28.90
|
| Rate for Payer: United Healthcare Medicare |
$21.93
|
| Rate for Payer: WINHealth Partners Commercial |
$31.56
|
| Rate for Payer: Wise Provider Network Commercial |
$31.56
|
|
|
TOURNIQUET CUFF DISP 30IN
|
Facility
|
OP
|
$33.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$33.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.56
|
| Rate for Payer: Aetna of WY Medicare |
$21.93
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.89
|
| Rate for Payer: Altius Commercial |
$31.89
|
| Rate for Payer: Beech Street Commercial |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$32.22
|
| Rate for Payer: Cigna of WY Commercial |
$32.56
|
| Rate for Payer: Entrust Commercial |
$31.56
|
| Rate for Payer: First Choice Health Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$19.27
|
| Rate for Payer: HealthUtah PPO |
$33.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$32.22
|
| Rate for Payer: Multiplan Medicare/VA |
$18.30
|
| Rate for Payer: One Health Plan of WY PPO |
$32.56
|
| Rate for Payer: PacificSource Commercial |
$29.90
|
| Rate for Payer: PHCS PPO |
$32.56
|
| Rate for Payer: Three Rivers PPO |
$24.92
|
| Rate for Payer: TriWest Veterans Administration |
$19.27
|
| Rate for Payer: United Healthcare Commercial |
$28.90
|
| Rate for Payer: United Healthcare Medicare |
$19.27
|
| Rate for Payer: WINHealth Partners Commercial |
$32.56
|
| Rate for Payer: Wise Provider Network Commercial |
$31.56
|
|
|
TOURNIQUET CUFF DISP 30IN
|
Facility
|
IP
|
$33.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.83 |
| Max. Negotiated Rate |
$33.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.56
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.89
|
| Rate for Payer: Altius Commercial |
$31.89
|
| Rate for Payer: Beech Street Commercial |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$32.22
|
| Rate for Payer: Cigna of WY Commercial |
$32.56
|
| Rate for Payer: Entrust Commercial |
$31.56
|
| Rate for Payer: First Choice Health Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.93
|
| Rate for Payer: HealthUtah PPO |
$33.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$32.22
|
| Rate for Payer: Multiplan Medicare/VA |
$20.83
|
| Rate for Payer: One Health Plan of WY PPO |
$32.56
|
| Rate for Payer: PacificSource Commercial |
$29.90
|
| Rate for Payer: PHCS PPO |
$32.56
|
| Rate for Payer: Three Rivers PPO |
$24.92
|
| Rate for Payer: TriWest Veterans Administration |
$21.93
|
| Rate for Payer: United Healthcare Commercial |
$28.90
|
| Rate for Payer: United Healthcare Medicare |
$21.93
|
| Rate for Payer: WINHealth Partners Commercial |
$31.56
|
| Rate for Payer: Wise Provider Network Commercial |
$31.56
|
|
|
TOURNIQUET CUFF DISP 34IN
|
Facility
|
OP
|
$33.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$33.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.56
|
| Rate for Payer: Aetna of WY Medicare |
$21.93
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.89
|
| Rate for Payer: Altius Commercial |
$31.89
|
| Rate for Payer: Beech Street Commercial |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$32.22
|
| Rate for Payer: Cigna of WY Commercial |
$32.56
|
| Rate for Payer: Entrust Commercial |
$31.56
|
| Rate for Payer: First Choice Health Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$19.27
|
| Rate for Payer: HealthUtah PPO |
$33.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$32.22
|
| Rate for Payer: Multiplan Medicare/VA |
$18.30
|
| Rate for Payer: One Health Plan of WY PPO |
$32.56
|
| Rate for Payer: PacificSource Commercial |
$29.90
|
| Rate for Payer: PHCS PPO |
$32.56
|
| Rate for Payer: Three Rivers PPO |
$24.92
|
| Rate for Payer: TriWest Veterans Administration |
$19.27
|
| Rate for Payer: United Healthcare Commercial |
$28.90
|
| Rate for Payer: United Healthcare Medicare |
$19.27
|
| Rate for Payer: WINHealth Partners Commercial |
$32.56
|
| Rate for Payer: Wise Provider Network Commercial |
$31.56
|
|
|
TOURNIQUET CUFF DISP 34IN
|
Facility
|
IP
|
$33.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.83 |
| Max. Negotiated Rate |
$33.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.56
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.89
|
| Rate for Payer: Altius Commercial |
$31.89
|
| Rate for Payer: Beech Street Commercial |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$32.22
|
| Rate for Payer: Cigna of WY Commercial |
$32.56
|
| Rate for Payer: Entrust Commercial |
$31.56
|
| Rate for Payer: First Choice Health Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.56
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.93
|
| Rate for Payer: HealthUtah PPO |
$33.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$32.22
|
| Rate for Payer: Multiplan Medicare/VA |
$20.83
|
| Rate for Payer: One Health Plan of WY PPO |
$32.56
|
| Rate for Payer: PacificSource Commercial |
$29.90
|
| Rate for Payer: PHCS PPO |
$32.56
|
| Rate for Payer: Three Rivers PPO |
$24.92
|
| Rate for Payer: TriWest Veterans Administration |
$21.93
|
| Rate for Payer: United Healthcare Commercial |
$28.90
|
| Rate for Payer: United Healthcare Medicare |
$21.93
|
| Rate for Payer: WINHealth Partners Commercial |
$31.56
|
| Rate for Payer: Wise Provider Network Commercial |
$31.56
|
|
|
TOURNIQUET CUFF DISP 42IN
|
Facility
|
OP
|
$32.73
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$32.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.08
|
| Rate for Payer: Aetna of WY Medicare |
$21.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.42
|
| Rate for Payer: Altius Commercial |
$31.42
|
| Rate for Payer: Beech Street Commercial |
$32.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$26.87
|
| Rate for Payer: Cash Price |
$22.91
|
| Rate for Payer: ChoiceCare Network Commercial |
$31.75
|
| Rate for Payer: Cigna of WY Commercial |
$32.08
|
| Rate for Payer: Entrust Commercial |
$31.09
|
| Rate for Payer: First Choice Health Commercial |
$31.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.98
|
| Rate for Payer: HealthUtah PPO |
$32.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$31.75
|
| Rate for Payer: Multiplan Medicare/VA |
$18.03
|
| Rate for Payer: One Health Plan of WY PPO |
$32.08
|
| Rate for Payer: PacificSource Commercial |
$29.46
|
| Rate for Payer: PHCS PPO |
$32.08
|
| Rate for Payer: Three Rivers PPO |
$24.55
|
| Rate for Payer: TriWest Veterans Administration |
$18.98
|
| Rate for Payer: United Healthcare Commercial |
$28.48
|
| Rate for Payer: United Healthcare Medicare |
$18.98
|
| Rate for Payer: WINHealth Partners Commercial |
$32.08
|
| Rate for Payer: Wise Provider Network Commercial |
$31.09
|
|
|
TOURNIQUET CUFF DISP 42IN
|
Facility
|
IP
|
$32.73
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$32.73 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$32.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$31.42
|
| Rate for Payer: Altius Commercial |
$31.42
|
| Rate for Payer: Beech Street Commercial |
$32.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$26.87
|
| Rate for Payer: Cash Price |
$22.91
|
| Rate for Payer: ChoiceCare Network Commercial |
$31.75
|
| Rate for Payer: Cigna of WY Commercial |
$32.08
|
| Rate for Payer: Entrust Commercial |
$31.09
|
| Rate for Payer: First Choice Health Commercial |
$31.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$31.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.60
|
| Rate for Payer: HealthUtah PPO |
$32.73
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$31.75
|
| Rate for Payer: Multiplan Medicare/VA |
$20.52
|
| Rate for Payer: One Health Plan of WY PPO |
$32.08
|
| Rate for Payer: PacificSource Commercial |
$29.46
|
| Rate for Payer: PHCS PPO |
$32.08
|
| Rate for Payer: Three Rivers PPO |
$24.55
|
| Rate for Payer: TriWest Veterans Administration |
$21.60
|
| Rate for Payer: United Healthcare Commercial |
$28.48
|
| Rate for Payer: United Healthcare Medicare |
$21.60
|
| Rate for Payer: WINHealth Partners Commercial |
$31.09
|
| Rate for Payer: Wise Provider Network Commercial |
$31.09
|
|
|
TOURNIQUET CUFF DISP 8"
|
Facility
|
OP
|
$45.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.07 |
| Max. Negotiated Rate |
$45.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.59
|
| Rate for Payer: Aetna of WY Medicare |
$30.03
|
| Rate for Payer: Altius Auto/Workers Compensation |
$43.68
|
| Rate for Payer: Altius Commercial |
$43.68
|
| Rate for Payer: Beech Street Commercial |
$44.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$37.36
|
| Rate for Payer: Cash Price |
$31.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.14
|
| Rate for Payer: Cigna of WY Commercial |
$44.59
|
| Rate for Payer: Entrust Commercial |
$43.22
|
| Rate for Payer: First Choice Health Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.39
|
| Rate for Payer: HealthUtah PPO |
$45.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.14
|
| Rate for Payer: Multiplan Medicare/VA |
$25.07
|
| Rate for Payer: One Health Plan of WY PPO |
$44.59
|
| Rate for Payer: PacificSource Commercial |
$40.95
|
| Rate for Payer: PHCS PPO |
$44.59
|
| Rate for Payer: Three Rivers PPO |
$34.12
|
| Rate for Payer: TriWest Veterans Administration |
$26.39
|
| Rate for Payer: United Healthcare Commercial |
$39.58
|
| Rate for Payer: United Healthcare Medicare |
$26.39
|
| Rate for Payer: WINHealth Partners Commercial |
$44.59
|
| Rate for Payer: Wise Provider Network Commercial |
$43.22
|
|
|
TOURNIQUET CUFF DISP 8"
|
Facility
|
IP
|
$45.50
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$45.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$44.59
|
| Rate for Payer: Altius Auto/Workers Compensation |
$43.68
|
| Rate for Payer: Altius Commercial |
$43.68
|
| Rate for Payer: Beech Street Commercial |
$44.59
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$37.36
|
| Rate for Payer: Cash Price |
$31.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$44.14
|
| Rate for Payer: Cigna of WY Commercial |
$44.59
|
| Rate for Payer: Entrust Commercial |
$43.22
|
| Rate for Payer: First Choice Health Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$43.22
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$30.03
|
| Rate for Payer: HealthUtah PPO |
$45.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$44.14
|
| Rate for Payer: Multiplan Medicare/VA |
$28.53
|
| Rate for Payer: One Health Plan of WY PPO |
$44.59
|
| Rate for Payer: PacificSource Commercial |
$40.95
|
| Rate for Payer: PHCS PPO |
$44.59
|
| Rate for Payer: Three Rivers PPO |
$34.12
|
| Rate for Payer: TriWest Veterans Administration |
$30.03
|
| Rate for Payer: United Healthcare Commercial |
$39.58
|
| Rate for Payer: United Healthcare Medicare |
$30.03
|
| Rate for Payer: WINHealth Partners Commercial |
$43.22
|
| Rate for Payer: Wise Provider Network Commercial |
$43.22
|
|
|
TOURNIQUET EXTENSIONS ST
|
Facility
|
OP
|
$25.10
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$25.10 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.60
|
| Rate for Payer: Aetna of WY Medicare |
$16.57
|
| Rate for Payer: Altius Auto/Workers Compensation |
$24.10
|
| Rate for Payer: Altius Commercial |
$24.10
|
| Rate for Payer: Beech Street Commercial |
$24.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.61
|
| Rate for Payer: Cash Price |
$17.57
|
| Rate for Payer: ChoiceCare Network Commercial |
$24.35
|
| Rate for Payer: Cigna of WY Commercial |
$24.60
|
| Rate for Payer: Entrust Commercial |
$23.84
|
| Rate for Payer: First Choice Health Commercial |
$23.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$14.56
|
| Rate for Payer: HealthUtah PPO |
$25.10
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$24.35
|
| Rate for Payer: Multiplan Medicare/VA |
$13.83
|
| Rate for Payer: One Health Plan of WY PPO |
$24.60
|
| Rate for Payer: PacificSource Commercial |
$22.59
|
| Rate for Payer: PHCS PPO |
$24.60
|
| Rate for Payer: Three Rivers PPO |
$18.82
|
| Rate for Payer: TriWest Veterans Administration |
$14.56
|
| Rate for Payer: United Healthcare Commercial |
$21.84
|
| Rate for Payer: United Healthcare Medicare |
$14.56
|
| Rate for Payer: WINHealth Partners Commercial |
$24.60
|
| Rate for Payer: Wise Provider Network Commercial |
$23.84
|
|
|
TOURNIQUET EXTENSIONS ST
|
Facility
|
IP
|
$25.10
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$25.10 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$24.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$24.10
|
| Rate for Payer: Altius Commercial |
$24.10
|
| Rate for Payer: Beech Street Commercial |
$24.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.61
|
| Rate for Payer: Cash Price |
$17.57
|
| Rate for Payer: ChoiceCare Network Commercial |
$24.35
|
| Rate for Payer: Cigna of WY Commercial |
$24.60
|
| Rate for Payer: Entrust Commercial |
$23.84
|
| Rate for Payer: First Choice Health Commercial |
$23.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$23.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.57
|
| Rate for Payer: HealthUtah PPO |
$25.10
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$24.35
|
| Rate for Payer: Multiplan Medicare/VA |
$15.74
|
| Rate for Payer: One Health Plan of WY PPO |
$24.60
|
| Rate for Payer: PacificSource Commercial |
$22.59
|
| Rate for Payer: PHCS PPO |
$24.60
|
| Rate for Payer: Three Rivers PPO |
$18.82
|
| Rate for Payer: TriWest Veterans Administration |
$16.57
|
| Rate for Payer: United Healthcare Commercial |
$21.84
|
| Rate for Payer: United Healthcare Medicare |
$16.57
|
| Rate for Payer: WINHealth Partners Commercial |
$23.84
|
| Rate for Payer: Wise Provider Network Commercial |
$23.84
|
|
|
TOURNIQUET FINGER/TOE XL
|
Facility
|
IP
|
$11.84
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$11.37
|
| Rate for Payer: Altius Commercial |
$11.37
|
| Rate for Payer: Beech Street Commercial |
$11.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.72
|
| Rate for Payer: Cash Price |
$8.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.48
|
| Rate for Payer: Cigna of WY Commercial |
$11.60
|
| Rate for Payer: Entrust Commercial |
$11.25
|
| Rate for Payer: First Choice Health Commercial |
$11.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.81
|
| Rate for Payer: HealthUtah PPO |
$11.84
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.48
|
| Rate for Payer: Multiplan Medicare/VA |
$7.42
|
| Rate for Payer: One Health Plan of WY PPO |
$11.60
|
| Rate for Payer: PacificSource Commercial |
$10.66
|
| Rate for Payer: PHCS PPO |
$11.60
|
| Rate for Payer: Three Rivers PPO |
$8.88
|
| Rate for Payer: TriWest Veterans Administration |
$7.81
|
| Rate for Payer: United Healthcare Commercial |
$10.30
|
| Rate for Payer: United Healthcare Medicare |
$7.81
|
| Rate for Payer: WINHealth Partners Commercial |
$11.25
|
| Rate for Payer: Wise Provider Network Commercial |
$11.25
|
|
