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Hospital Charge Code 27200000S1
Hospital Revenue Code 272
Min. Negotiated Rate $304.40
Max. Negotiated Rate $485.48
Rate for Payer: Aetna of WY Commercial/Medical Rental $475.77
Rate for Payer: Altius Auto/Workers Compensation $466.06
Rate for Payer: Altius Commercial $466.06
Rate for Payer: Beech Street Commercial $475.77
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $398.58
Rate for Payer: Cash Price $339.84
Rate for Payer: ChoiceCare Network Commercial $470.92
Rate for Payer: Cigna of WY Commercial $475.77
Rate for Payer: Entrust Commercial $461.21
Rate for Payer: First Choice Health Commercial $461.21
Rate for Payer: Government Employees Health Association (GEHA) Commercial $461.21
Rate for Payer: Government Employees Health Association (GEHA) Medicare $320.42
Rate for Payer: HealthUtah PPO $485.48
Rate for Payer: Idaho Integrated Healthcare Commercial $470.92
Rate for Payer: Multiplan Medicare/VA $304.40
Rate for Payer: One Health Plan of WY PPO $475.77
Rate for Payer: PacificSource Commercial $436.93
Rate for Payer: PHCS PPO $475.77
Rate for Payer: Three Rivers PPO $364.11
Rate for Payer: TriWest Veterans Administration $320.42
Rate for Payer: United Healthcare Commercial $422.37
Rate for Payer: United Healthcare Medicare $320.42
Rate for Payer: WINHealth Partners Commercial $461.21
Rate for Payer: Wise Provider Network Commercial $461.21
Hospital Charge Code 27200000S1
Hospital Revenue Code 272
Min. Negotiated Rate $267.50
Max. Negotiated Rate $485.48
Rate for Payer: Aetna of WY Commercial/Medical Rental $475.77
Rate for Payer: Aetna of WY Medicare $320.42
Rate for Payer: Altius Auto/Workers Compensation $466.06
Rate for Payer: Altius Commercial $466.06
Rate for Payer: Beech Street Commercial $475.77
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $398.58
Rate for Payer: Cash Price $339.84
Rate for Payer: ChoiceCare Network Commercial $470.92
Rate for Payer: Cigna of WY Commercial $475.77
Rate for Payer: Entrust Commercial $461.21
Rate for Payer: First Choice Health Commercial $461.21
Rate for Payer: Government Employees Health Association (GEHA) Commercial $461.21
Rate for Payer: Government Employees Health Association (GEHA) Medicare $281.58
Rate for Payer: HealthUtah PPO $485.48
Rate for Payer: Idaho Integrated Healthcare Commercial $470.92
Rate for Payer: Multiplan Medicare/VA $267.50
Rate for Payer: One Health Plan of WY PPO $475.77
Rate for Payer: PacificSource Commercial $436.93
Rate for Payer: PHCS PPO $475.77
Rate for Payer: Three Rivers PPO $364.11
Rate for Payer: TriWest Veterans Administration $281.58
Rate for Payer: United Healthcare Commercial $422.37
Rate for Payer: United Healthcare Medicare $281.58
Rate for Payer: WINHealth Partners Commercial $475.77
Rate for Payer: Wise Provider Network Commercial $461.21
Hospital Charge Code 27200000S1
Hospital Revenue Code 272
Min. Negotiated Rate $9.69
Max. Negotiated Rate $15.46
Rate for Payer: Aetna of WY Commercial/Medical Rental $15.15
Rate for Payer: Altius Auto/Workers Compensation $14.84
Rate for Payer: Altius Commercial $14.84
Rate for Payer: Beech Street Commercial $15.15
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $12.69
Rate for Payer: Cash Price $10.82
Rate for Payer: ChoiceCare Network Commercial $15.00
Rate for Payer: Cigna of WY Commercial $15.15
Rate for Payer: Entrust Commercial $14.69
Rate for Payer: First Choice Health Commercial $14.69
Rate for Payer: Government Employees Health Association (GEHA) Commercial $14.69
Rate for Payer: Government Employees Health Association (GEHA) Medicare $10.20
Rate for Payer: HealthUtah PPO $15.46
Rate for Payer: Idaho Integrated Healthcare Commercial $15.00
Rate for Payer: Multiplan Medicare/VA $9.69
Rate for Payer: One Health Plan of WY PPO $15.15
Rate for Payer: PacificSource Commercial $13.91
Rate for Payer: PHCS PPO $15.15
Rate for Payer: Three Rivers PPO $11.60
Rate for Payer: TriWest Veterans Administration $10.20
Rate for Payer: United Healthcare Commercial $13.45
Rate for Payer: United Healthcare Medicare $10.20
Rate for Payer: WINHealth Partners Commercial $14.69
Rate for Payer: Wise Provider Network Commercial $14.69
Hospital Charge Code 27200000S1
Hospital Revenue Code 272
Min. Negotiated Rate $8.52
Max. Negotiated Rate $15.46
Rate for Payer: Aetna of WY Commercial/Medical Rental $15.15
Rate for Payer: Aetna of WY Medicare $10.20
Rate for Payer: Altius Auto/Workers Compensation $14.84
Rate for Payer: Altius Commercial $14.84
Rate for Payer: Beech Street Commercial $15.15
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $12.69
Rate for Payer: Cash Price $10.82
Rate for Payer: ChoiceCare Network Commercial $15.00
Rate for Payer: Cigna of WY Commercial $15.15
Rate for Payer: Entrust Commercial $14.69
Rate for Payer: First Choice Health Commercial $14.69
Rate for Payer: Government Employees Health Association (GEHA) Commercial $14.69
Rate for Payer: Government Employees Health Association (GEHA) Medicare $8.97
Rate for Payer: HealthUtah PPO $15.46
Rate for Payer: Idaho Integrated Healthcare Commercial $15.00
Rate for Payer: Multiplan Medicare/VA $8.52
Rate for Payer: One Health Plan of WY PPO $15.15
Rate for Payer: PacificSource Commercial $13.91
Rate for Payer: PHCS PPO $15.15
Rate for Payer: Three Rivers PPO $11.60
Rate for Payer: TriWest Veterans Administration $8.97
Rate for Payer: United Healthcare Commercial $13.45
Rate for Payer: United Healthcare Medicare $8.97
Rate for Payer: WINHealth Partners Commercial $15.15
Rate for Payer: Wise Provider Network Commercial $14.69
Service Code NDC 0904686861
Hospital Revenue Code 250
Min. Negotiated Rate $0.31
Max. Negotiated Rate $0.49
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.48
Rate for Payer: Altius Auto/Workers Compensation $0.47
Rate for Payer: Altius Commercial $0.47
Rate for Payer: Beech Street Commercial $0.48
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.40
Rate for Payer: Cash Price $0.35
Rate for Payer: ChoiceCare Network Commercial $0.48
Rate for Payer: Cigna of WY Commercial $0.48
Rate for Payer: Entrust Commercial $0.47
Rate for Payer: First Choice Health Commercial $0.47
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.47
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.32
Rate for Payer: HealthUtah PPO $0.49
Rate for Payer: Idaho Integrated Healthcare Commercial $0.48
Rate for Payer: Multiplan Medicare/VA $0.31
Rate for Payer: One Health Plan of WY PPO $0.48
Rate for Payer: PacificSource Commercial $0.44
Rate for Payer: PHCS PPO $0.48
Rate for Payer: Three Rivers PPO $0.37
Rate for Payer: TriWest Veterans Administration $0.32
Rate for Payer: United Healthcare Commercial $0.43
Rate for Payer: United Healthcare Medicare $0.32
Rate for Payer: WINHealth Partners Commercial $0.47
Rate for Payer: Wise Provider Network Commercial $0.47
Service Code NDC 0904686861
Hospital Revenue Code 250
Min. Negotiated Rate $0.27
Max. Negotiated Rate $0.49
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.48
Rate for Payer: Aetna of WY Medicare $0.32
Rate for Payer: Altius Auto/Workers Compensation $0.47
Rate for Payer: Altius Commercial $0.47
Rate for Payer: Beech Street Commercial $0.48
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.40
Rate for Payer: Cash Price $0.35
Rate for Payer: ChoiceCare Network Commercial $0.48
Rate for Payer: Cigna of WY Commercial $0.48
Rate for Payer: Entrust Commercial $0.47
Rate for Payer: First Choice Health Commercial $0.47
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.47
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.28
Rate for Payer: HealthUtah PPO $0.49
Rate for Payer: Idaho Integrated Healthcare Commercial $0.48
Rate for Payer: Multiplan Medicare/VA $0.27
Rate for Payer: One Health Plan of WY PPO $0.48
Rate for Payer: PacificSource Commercial $0.44
Rate for Payer: PHCS PPO $0.48
Rate for Payer: Three Rivers PPO $0.37
Rate for Payer: TriWest Veterans Administration $0.28
Rate for Payer: United Healthcare Commercial $0.43
Rate for Payer: United Healthcare Medicare $0.28
Rate for Payer: WINHealth Partners Commercial $0.48
Rate for Payer: Wise Provider Network Commercial $0.47
Service Code NDC 5011156002
Hospital Revenue Code 250
Min. Negotiated Rate $0.15
Max. Negotiated Rate $0.24
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.24
Rate for Payer: Altius Auto/Workers Compensation $0.23
Rate for Payer: Altius Commercial $0.23
Rate for Payer: Beech Street Commercial $0.24
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.20
Rate for Payer: Cash Price $0.17
Rate for Payer: ChoiceCare Network Commercial $0.23
Rate for Payer: Cigna of WY Commercial $0.24
Rate for Payer: Entrust Commercial $0.23
Rate for Payer: First Choice Health Commercial $0.23
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.23
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.16
Rate for Payer: HealthUtah PPO $0.24
Rate for Payer: Idaho Integrated Healthcare Commercial $0.23
Rate for Payer: Multiplan Medicare/VA $0.15
Rate for Payer: One Health Plan of WY PPO $0.24
Rate for Payer: PacificSource Commercial $0.22
Rate for Payer: PHCS PPO $0.24
Rate for Payer: Three Rivers PPO $0.18
Rate for Payer: TriWest Veterans Administration $0.16
Rate for Payer: United Healthcare Commercial $0.21
Rate for Payer: United Healthcare Medicare $0.16
Rate for Payer: WINHealth Partners Commercial $0.23
Rate for Payer: Wise Provider Network Commercial $0.23
Service Code NDC 5011156002
Hospital Revenue Code 250
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.24
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.24
Rate for Payer: Aetna of WY Medicare $0.16
Rate for Payer: Altius Auto/Workers Compensation $0.23
Rate for Payer: Altius Commercial $0.23
Rate for Payer: Beech Street Commercial $0.24
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.20
Rate for Payer: Cash Price $0.17
Rate for Payer: ChoiceCare Network Commercial $0.23
Rate for Payer: Cigna of WY Commercial $0.24
Rate for Payer: Entrust Commercial $0.23
Rate for Payer: First Choice Health Commercial $0.23
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.23
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.14
Rate for Payer: HealthUtah PPO $0.24
Rate for Payer: Idaho Integrated Healthcare Commercial $0.23
Rate for Payer: Multiplan Medicare/VA $0.13
Rate for Payer: One Health Plan of WY PPO $0.24
Rate for Payer: PacificSource Commercial $0.22
Rate for Payer: PHCS PPO $0.24
Rate for Payer: Three Rivers PPO $0.18
Rate for Payer: TriWest Veterans Administration $0.14
Rate for Payer: United Healthcare Commercial $0.21
Rate for Payer: United Healthcare Medicare $0.14
Rate for Payer: WINHealth Partners Commercial $0.24
Rate for Payer: Wise Provider Network Commercial $0.23
Service Code NDC 6068744301
Hospital Revenue Code 250
Min. Negotiated Rate $0.33
Max. Negotiated Rate $0.52
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.51
Rate for Payer: Altius Auto/Workers Compensation $0.50
Rate for Payer: Altius Commercial $0.50
Rate for Payer: Beech Street Commercial $0.51
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.43
Rate for Payer: Cash Price $0.36
Rate for Payer: ChoiceCare Network Commercial $0.50
Rate for Payer: Cigna of WY Commercial $0.51
Rate for Payer: Entrust Commercial $0.49
Rate for Payer: First Choice Health Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.34
Rate for Payer: HealthUtah PPO $0.52
Rate for Payer: Idaho Integrated Healthcare Commercial $0.50
Rate for Payer: Multiplan Medicare/VA $0.33
Rate for Payer: One Health Plan of WY PPO $0.51
Rate for Payer: PacificSource Commercial $0.47
Rate for Payer: PHCS PPO $0.51
Rate for Payer: Three Rivers PPO $0.39
Rate for Payer: TriWest Veterans Administration $0.34
Rate for Payer: United Healthcare Commercial $0.45
Rate for Payer: United Healthcare Medicare $0.34
Rate for Payer: WINHealth Partners Commercial $0.49
Rate for Payer: Wise Provider Network Commercial $0.49
Service Code NDC 6068744301
Hospital Revenue Code 250
Min. Negotiated Rate $0.29
Max. Negotiated Rate $0.52
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.51
Rate for Payer: Aetna of WY Medicare $0.34
Rate for Payer: Altius Auto/Workers Compensation $0.50
Rate for Payer: Altius Commercial $0.50
Rate for Payer: Beech Street Commercial $0.51
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.43
Rate for Payer: Cash Price $0.36
Rate for Payer: ChoiceCare Network Commercial $0.50
Rate for Payer: Cigna of WY Commercial $0.51
Rate for Payer: Entrust Commercial $0.49
Rate for Payer: First Choice Health Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.30
Rate for Payer: HealthUtah PPO $0.52
Rate for Payer: Idaho Integrated Healthcare Commercial $0.50
Rate for Payer: Multiplan Medicare/VA $0.29
Rate for Payer: One Health Plan of WY PPO $0.51
Rate for Payer: PacificSource Commercial $0.47
Rate for Payer: PHCS PPO $0.51
Rate for Payer: Three Rivers PPO $0.39
Rate for Payer: TriWest Veterans Administration $0.30
Rate for Payer: United Healthcare Commercial $0.45
Rate for Payer: United Healthcare Medicare $0.30
Rate for Payer: WINHealth Partners Commercial $0.51
Rate for Payer: Wise Provider Network Commercial $0.49
Service Code NDC 6068744311
Hospital Revenue Code 250
Min. Negotiated Rate $0.33
Max. Negotiated Rate $0.52
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.51
Rate for Payer: Altius Auto/Workers Compensation $0.50
Rate for Payer: Altius Commercial $0.50
Rate for Payer: Beech Street Commercial $0.51
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.43
Rate for Payer: Cash Price $0.36
Rate for Payer: ChoiceCare Network Commercial $0.50
Rate for Payer: Cigna of WY Commercial $0.51
Rate for Payer: Entrust Commercial $0.49
Rate for Payer: First Choice Health Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.34
Rate for Payer: HealthUtah PPO $0.52
Rate for Payer: Idaho Integrated Healthcare Commercial $0.50
Rate for Payer: Multiplan Medicare/VA $0.33
Rate for Payer: One Health Plan of WY PPO $0.51
Rate for Payer: PacificSource Commercial $0.47
Rate for Payer: PHCS PPO $0.51
Rate for Payer: Three Rivers PPO $0.39
Rate for Payer: TriWest Veterans Administration $0.34
Rate for Payer: United Healthcare Commercial $0.45
Rate for Payer: United Healthcare Medicare $0.34
Rate for Payer: WINHealth Partners Commercial $0.49
Rate for Payer: Wise Provider Network Commercial $0.49
Service Code NDC 6068744311
Hospital Revenue Code 250
Min. Negotiated Rate $0.29
Max. Negotiated Rate $0.52
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.51
Rate for Payer: Aetna of WY Medicare $0.34
Rate for Payer: Altius Auto/Workers Compensation $0.50
Rate for Payer: Altius Commercial $0.50
Rate for Payer: Beech Street Commercial $0.51
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.43
Rate for Payer: Cash Price $0.36
Rate for Payer: ChoiceCare Network Commercial $0.50
Rate for Payer: Cigna of WY Commercial $0.51
Rate for Payer: Entrust Commercial $0.49
Rate for Payer: First Choice Health Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.49
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.30
Rate for Payer: HealthUtah PPO $0.52
Rate for Payer: Idaho Integrated Healthcare Commercial $0.50
Rate for Payer: Multiplan Medicare/VA $0.29
Rate for Payer: One Health Plan of WY PPO $0.51
Rate for Payer: PacificSource Commercial $0.47
Rate for Payer: PHCS PPO $0.51
Rate for Payer: Three Rivers PPO $0.39
Rate for Payer: TriWest Veterans Administration $0.30
Rate for Payer: United Healthcare Commercial $0.45
Rate for Payer: United Healthcare Medicare $0.30
Rate for Payer: WINHealth Partners Commercial $0.51
Rate for Payer: Wise Provider Network Commercial $0.49
Service Code HCPCS 24605
Hospital Charge Code 24605
Min. Negotiated Rate $401.83
Max. Negotiated Rate $1,687.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,653.26
Rate for Payer: Aetna of WY Medicare $472.74
Rate for Payer: Beech Street Commercial $1,602.65
Rate for Payer: Cash Price $1,180.90
Rate for Payer: Cash Price $1,180.90
Rate for Payer: ChoiceCare Network Commercial $1,636.39
Rate for Payer: Cigna of WY Commercial $1,653.26
Rate for Payer: First Choice Health Commercial $1,518.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,602.65
Rate for Payer: Government Employees Health Association (GEHA) Medicare $472.74
Rate for Payer: HealthUtah PPO $1,687.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,636.39
Rate for Payer: Multiplan Medicare/VA $401.83
Rate for Payer: One Health Plan of WY PPO $1,653.26
Rate for Payer: PacificSource Commercial $1,518.30
Rate for Payer: PHCS PPO $1,602.65
Rate for Payer: Three Rivers PPO $1,265.25
Rate for Payer: TriWest Veterans Administration $472.74
Rate for Payer: United Healthcare Commercial $1,467.69
Rate for Payer: United Healthcare Medicare $472.74
Rate for Payer: WINHealth Partners Commercial $1,433.95
Service Code HCPCS 24600
Hospital Charge Code 24600
Min. Negotiated Rate $290.09
Max. Negotiated Rate $1,737.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,702.26
Rate for Payer: Aetna of WY Medicare $341.28
Rate for Payer: Beech Street Commercial $1,650.15
Rate for Payer: Cash Price $1,215.90
Rate for Payer: Cash Price $1,215.90
Rate for Payer: ChoiceCare Network Commercial $1,684.89
Rate for Payer: Cigna of WY Commercial $1,702.26
Rate for Payer: First Choice Health Commercial $1,563.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,650.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $341.28
Rate for Payer: HealthUtah PPO $1,737.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,684.89
Rate for Payer: Multiplan Medicare/VA $290.09
Rate for Payer: One Health Plan of WY PPO $1,702.26
Rate for Payer: PacificSource Commercial $1,563.30
Rate for Payer: PHCS PPO $1,650.15
Rate for Payer: Three Rivers PPO $1,302.75
Rate for Payer: TriWest Veterans Administration $341.28
Rate for Payer: United Healthcare Commercial $1,511.19
Rate for Payer: United Healthcare Medicare $341.28
Rate for Payer: WINHealth Partners Commercial $1,476.45
Service Code HCPCS J3301
Hospital Charge Code J3301
Min. Negotiated Rate $0.92
Max. Negotiated Rate $7.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $6.86
Rate for Payer: Aetna of WY Medicare $1.08
Rate for Payer: Beech Street Commercial $6.65
Rate for Payer: Cash Price $4.90
Rate for Payer: Cash Price $4.90
Rate for Payer: ChoiceCare Network Commercial $6.79
Rate for Payer: Cigna of WY Commercial $6.86
Rate for Payer: First Choice Health Commercial $6.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $6.65
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.08
Rate for Payer: HealthUtah PPO $7.00
Rate for Payer: Idaho Integrated Healthcare Commercial $6.79
Rate for Payer: Multiplan Medicare/VA $0.92
Rate for Payer: One Health Plan of WY PPO $6.86
Rate for Payer: PacificSource Commercial $6.30
Rate for Payer: PHCS PPO $6.65
Rate for Payer: Three Rivers PPO $5.25
Rate for Payer: TriWest Veterans Administration $1.08
Rate for Payer: United Healthcare Commercial $6.09
Rate for Payer: United Healthcare Medicare $1.08
Rate for Payer: WINHealth Partners Commercial $6.65
Service Code NDC 3334232715
Hospital Revenue Code 250
Min. Negotiated Rate $0.38
Max. Negotiated Rate $0.61
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.60
Rate for Payer: Altius Auto/Workers Compensation $0.59
Rate for Payer: Altius Commercial $0.59
Rate for Payer: Beech Street Commercial $0.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.50
Rate for Payer: Cash Price $0.43
Rate for Payer: ChoiceCare Network Commercial $0.59
Rate for Payer: Cigna of WY Commercial $0.60
Rate for Payer: Entrust Commercial $0.58
Rate for Payer: First Choice Health Commercial $0.58
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.58
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.40
Rate for Payer: HealthUtah PPO $0.61
Rate for Payer: Idaho Integrated Healthcare Commercial $0.59
Rate for Payer: Multiplan Medicare/VA $0.38
Rate for Payer: One Health Plan of WY PPO $0.60
Rate for Payer: PacificSource Commercial $0.55
Rate for Payer: PHCS PPO $0.60
Rate for Payer: Three Rivers PPO $0.46
Rate for Payer: TriWest Veterans Administration $0.40
Rate for Payer: United Healthcare Commercial $0.53
Rate for Payer: United Healthcare Medicare $0.40
Rate for Payer: WINHealth Partners Commercial $0.58
Rate for Payer: Wise Provider Network Commercial $0.58
Service Code NDC 3334232715
Hospital Revenue Code 250
Min. Negotiated Rate $0.34
Max. Negotiated Rate $0.61
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.60
Rate for Payer: Aetna of WY Medicare $0.40
Rate for Payer: Altius Auto/Workers Compensation $0.59
Rate for Payer: Altius Commercial $0.59
Rate for Payer: Beech Street Commercial $0.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.50
Rate for Payer: Cash Price $0.43
Rate for Payer: ChoiceCare Network Commercial $0.59
Rate for Payer: Cigna of WY Commercial $0.60
Rate for Payer: Entrust Commercial $0.58
Rate for Payer: First Choice Health Commercial $0.58
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.58
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.35
Rate for Payer: HealthUtah PPO $0.61
Rate for Payer: Idaho Integrated Healthcare Commercial $0.59
Rate for Payer: Multiplan Medicare/VA $0.34
Rate for Payer: One Health Plan of WY PPO $0.60
Rate for Payer: PacificSource Commercial $0.55
Rate for Payer: PHCS PPO $0.60
Rate for Payer: Three Rivers PPO $0.46
Rate for Payer: TriWest Veterans Administration $0.35
Rate for Payer: United Healthcare Commercial $0.53
Rate for Payer: United Healthcare Medicare $0.35
Rate for Payer: WINHealth Partners Commercial $0.60
Rate for Payer: Wise Provider Network Commercial $0.58
Service Code NDC 4580206335
Hospital Revenue Code 250
Min. Negotiated Rate $0.60
Max. Negotiated Rate $0.96
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.94
Rate for Payer: Altius Auto/Workers Compensation $0.92
Rate for Payer: Altius Commercial $0.92
Rate for Payer: Beech Street Commercial $0.94
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.79
Rate for Payer: Cash Price $0.67
Rate for Payer: ChoiceCare Network Commercial $0.93
Rate for Payer: Cigna of WY Commercial $0.94
Rate for Payer: Entrust Commercial $0.91
Rate for Payer: First Choice Health Commercial $0.91
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.91
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.63
Rate for Payer: HealthUtah PPO $0.96
Rate for Payer: Idaho Integrated Healthcare Commercial $0.93
Rate for Payer: Multiplan Medicare/VA $0.60
Rate for Payer: One Health Plan of WY PPO $0.94
Rate for Payer: PacificSource Commercial $0.86
Rate for Payer: PHCS PPO $0.94
Rate for Payer: Three Rivers PPO $0.72
Rate for Payer: TriWest Veterans Administration $0.63
Rate for Payer: United Healthcare Commercial $0.84
Rate for Payer: United Healthcare Medicare $0.63
Rate for Payer: WINHealth Partners Commercial $0.91
Rate for Payer: Wise Provider Network Commercial $0.91
Service Code NDC 4580206335
Hospital Revenue Code 250
Min. Negotiated Rate $0.53
Max. Negotiated Rate $0.96
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.94
Rate for Payer: Aetna of WY Medicare $0.63
Rate for Payer: Altius Auto/Workers Compensation $0.92
Rate for Payer: Altius Commercial $0.92
Rate for Payer: Beech Street Commercial $0.94
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.79
Rate for Payer: Cash Price $0.67
Rate for Payer: ChoiceCare Network Commercial $0.93
Rate for Payer: Cigna of WY Commercial $0.94
Rate for Payer: Entrust Commercial $0.91
Rate for Payer: First Choice Health Commercial $0.91
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.91
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.56
Rate for Payer: HealthUtah PPO $0.96
Rate for Payer: Idaho Integrated Healthcare Commercial $0.93
Rate for Payer: Multiplan Medicare/VA $0.53
Rate for Payer: One Health Plan of WY PPO $0.94
Rate for Payer: PacificSource Commercial $0.86
Rate for Payer: PHCS PPO $0.94
Rate for Payer: Three Rivers PPO $0.72
Rate for Payer: TriWest Veterans Administration $0.56
Rate for Payer: United Healthcare Commercial $0.84
Rate for Payer: United Healthcare Medicare $0.56
Rate for Payer: WINHealth Partners Commercial $0.94
Rate for Payer: Wise Provider Network Commercial $0.91
Service Code NDC 5167212822
Hospital Revenue Code 250
Min. Negotiated Rate $0.53
Max. Negotiated Rate $0.84
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.82
Rate for Payer: Altius Auto/Workers Compensation $0.81
Rate for Payer: Altius Commercial $0.81
Rate for Payer: Beech Street Commercial $0.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.69
Rate for Payer: Cash Price $0.59
Rate for Payer: ChoiceCare Network Commercial $0.81
Rate for Payer: Cigna of WY Commercial $0.82
Rate for Payer: Entrust Commercial $0.80
Rate for Payer: First Choice Health Commercial $0.80
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.55
Rate for Payer: HealthUtah PPO $0.84
Rate for Payer: Idaho Integrated Healthcare Commercial $0.81
Rate for Payer: Multiplan Medicare/VA $0.53
Rate for Payer: One Health Plan of WY PPO $0.82
Rate for Payer: PacificSource Commercial $0.76
Rate for Payer: PHCS PPO $0.82
Rate for Payer: Three Rivers PPO $0.63
Rate for Payer: TriWest Veterans Administration $0.55
Rate for Payer: United Healthcare Commercial $0.73
Rate for Payer: United Healthcare Medicare $0.55
Rate for Payer: WINHealth Partners Commercial $0.80
Rate for Payer: Wise Provider Network Commercial $0.80
Service Code NDC 5167212822
Hospital Revenue Code 250
Min. Negotiated Rate $0.46
Max. Negotiated Rate $0.84
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.82
Rate for Payer: Aetna of WY Medicare $0.55
Rate for Payer: Altius Auto/Workers Compensation $0.81
Rate for Payer: Altius Commercial $0.81
Rate for Payer: Beech Street Commercial $0.82
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.69
Rate for Payer: Cash Price $0.59
Rate for Payer: ChoiceCare Network Commercial $0.81
Rate for Payer: Cigna of WY Commercial $0.82
Rate for Payer: Entrust Commercial $0.80
Rate for Payer: First Choice Health Commercial $0.80
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.49
Rate for Payer: HealthUtah PPO $0.84
Rate for Payer: Idaho Integrated Healthcare Commercial $0.81
Rate for Payer: Multiplan Medicare/VA $0.46
Rate for Payer: One Health Plan of WY PPO $0.82
Rate for Payer: PacificSource Commercial $0.76
Rate for Payer: PHCS PPO $0.82
Rate for Payer: Three Rivers PPO $0.63
Rate for Payer: TriWest Veterans Administration $0.49
Rate for Payer: United Healthcare Commercial $0.73
Rate for Payer: United Healthcare Medicare $0.49
Rate for Payer: WINHealth Partners Commercial $0.82
Rate for Payer: Wise Provider Network Commercial $0.80
Service Code NDC 6787725130
Hospital Revenue Code 250
Min. Negotiated Rate $0.51
Max. Negotiated Rate $0.81
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.79
Rate for Payer: Altius Auto/Workers Compensation $0.78
Rate for Payer: Altius Commercial $0.78
Rate for Payer: Beech Street Commercial $0.79
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.67
Rate for Payer: Cash Price $0.57
Rate for Payer: ChoiceCare Network Commercial $0.79
Rate for Payer: Cigna of WY Commercial $0.79
Rate for Payer: Entrust Commercial $0.77
Rate for Payer: First Choice Health Commercial $0.77
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.77
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.53
Rate for Payer: HealthUtah PPO $0.81
Rate for Payer: Idaho Integrated Healthcare Commercial $0.79
Rate for Payer: Multiplan Medicare/VA $0.51
Rate for Payer: One Health Plan of WY PPO $0.79
Rate for Payer: PacificSource Commercial $0.73
Rate for Payer: PHCS PPO $0.79
Rate for Payer: Three Rivers PPO $0.61
Rate for Payer: TriWest Veterans Administration $0.53
Rate for Payer: United Healthcare Commercial $0.70
Rate for Payer: United Healthcare Medicare $0.53
Rate for Payer: WINHealth Partners Commercial $0.77
Rate for Payer: Wise Provider Network Commercial $0.77
Service Code NDC 6787725130
Hospital Revenue Code 250
Min. Negotiated Rate $0.45
Max. Negotiated Rate $0.81
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.79
Rate for Payer: Aetna of WY Medicare $0.53
Rate for Payer: Altius Auto/Workers Compensation $0.78
Rate for Payer: Altius Commercial $0.78
Rate for Payer: Beech Street Commercial $0.79
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.67
Rate for Payer: Cash Price $0.57
Rate for Payer: ChoiceCare Network Commercial $0.79
Rate for Payer: Cigna of WY Commercial $0.79
Rate for Payer: Entrust Commercial $0.77
Rate for Payer: First Choice Health Commercial $0.77
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.77
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.47
Rate for Payer: HealthUtah PPO $0.81
Rate for Payer: Idaho Integrated Healthcare Commercial $0.79
Rate for Payer: Multiplan Medicare/VA $0.45
Rate for Payer: One Health Plan of WY PPO $0.79
Rate for Payer: PacificSource Commercial $0.73
Rate for Payer: PHCS PPO $0.79
Rate for Payer: Three Rivers PPO $0.61
Rate for Payer: TriWest Veterans Administration $0.47
Rate for Payer: United Healthcare Commercial $0.70
Rate for Payer: United Healthcare Medicare $0.47
Rate for Payer: WINHealth Partners Commercial $0.79
Rate for Payer: Wise Provider Network Commercial $0.77
Service Code NDC 2192206304
Hospital Revenue Code 250
Min. Negotiated Rate $0.37
Max. Negotiated Rate $0.59
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.58
Rate for Payer: Altius Auto/Workers Compensation $0.57
Rate for Payer: Altius Commercial $0.57
Rate for Payer: Beech Street Commercial $0.58
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.48
Rate for Payer: Cash Price $0.41
Rate for Payer: ChoiceCare Network Commercial $0.57
Rate for Payer: Cigna of WY Commercial $0.58
Rate for Payer: Entrust Commercial $0.56
Rate for Payer: First Choice Health Commercial $0.56
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.56
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.39
Rate for Payer: HealthUtah PPO $0.59
Rate for Payer: Idaho Integrated Healthcare Commercial $0.57
Rate for Payer: Multiplan Medicare/VA $0.37
Rate for Payer: One Health Plan of WY PPO $0.58
Rate for Payer: PacificSource Commercial $0.53
Rate for Payer: PHCS PPO $0.58
Rate for Payer: Three Rivers PPO $0.44
Rate for Payer: TriWest Veterans Administration $0.39
Rate for Payer: United Healthcare Commercial $0.51
Rate for Payer: United Healthcare Medicare $0.39
Rate for Payer: WINHealth Partners Commercial $0.56
Rate for Payer: Wise Provider Network Commercial $0.56
Service Code NDC 2192206304
Hospital Revenue Code 250
Min. Negotiated Rate $0.33
Max. Negotiated Rate $0.59
Rate for Payer: Aetna of WY Commercial/Medical Rental $0.58
Rate for Payer: Aetna of WY Medicare $0.39
Rate for Payer: Altius Auto/Workers Compensation $0.57
Rate for Payer: Altius Commercial $0.57
Rate for Payer: Beech Street Commercial $0.58
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $0.48
Rate for Payer: Cash Price $0.41
Rate for Payer: ChoiceCare Network Commercial $0.57
Rate for Payer: Cigna of WY Commercial $0.58
Rate for Payer: Entrust Commercial $0.56
Rate for Payer: First Choice Health Commercial $0.56
Rate for Payer: Government Employees Health Association (GEHA) Commercial $0.56
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.34
Rate for Payer: HealthUtah PPO $0.59
Rate for Payer: Idaho Integrated Healthcare Commercial $0.57
Rate for Payer: Multiplan Medicare/VA $0.33
Rate for Payer: One Health Plan of WY PPO $0.58
Rate for Payer: PacificSource Commercial $0.53
Rate for Payer: PHCS PPO $0.58
Rate for Payer: Three Rivers PPO $0.44
Rate for Payer: TriWest Veterans Administration $0.34
Rate for Payer: United Healthcare Commercial $0.51
Rate for Payer: United Healthcare Medicare $0.34
Rate for Payer: WINHealth Partners Commercial $0.58
Rate for Payer: Wise Provider Network Commercial $0.56