|
TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC
|
Professional
|
Both
|
$3,302.00
|
|
|
Service Code
|
HCPCS 27690 AS
|
| Hospital Charge Code |
27690
|
| Min. Negotiated Rate |
$528.69 |
| Max. Negotiated Rate |
$3,302.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,235.96
|
| Rate for Payer: Aetna of WY Medicare |
$621.99
|
| Rate for Payer: Beech Street Commercial |
$3,136.90
|
| Rate for Payer: Cash Price |
$2,311.40
|
| Rate for Payer: Cash Price |
$2,311.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,202.94
|
| Rate for Payer: Cigna of WY Commercial |
$3,235.96
|
| Rate for Payer: First Choice Health Commercial |
$2,971.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,136.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$621.99
|
| Rate for Payer: HealthUtah PPO |
$3,302.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,202.94
|
| Rate for Payer: Multiplan Medicare/VA |
$528.69
|
| Rate for Payer: One Health Plan of WY PPO |
$3,235.96
|
| Rate for Payer: PacificSource Commercial |
$2,971.80
|
| Rate for Payer: PHCS PPO |
$3,136.90
|
| Rate for Payer: Three Rivers PPO |
$2,476.50
|
| Rate for Payer: TriWest Veterans Administration |
$621.99
|
| Rate for Payer: United Healthcare Commercial |
$2,872.74
|
| Rate for Payer: United Healthcare Medicare |
$621.99
|
| Rate for Payer: WINHealth Partners Commercial |
$2,806.70
|
|
|
TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 26480 80
|
| Hospital Charge Code |
26480
|
| Min. Negotiated Rate |
$654.99 |
| Max. Negotiated Rate |
$3,299.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,233.02
|
| Rate for Payer: Aetna of WY Medicare |
$770.58
|
| Rate for Payer: Beech Street Commercial |
$3,134.05
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,200.03
|
| Rate for Payer: Cigna of WY Commercial |
$3,233.02
|
| Rate for Payer: First Choice Health Commercial |
$2,969.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,134.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$770.58
|
| Rate for Payer: HealthUtah PPO |
$3,299.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,200.03
|
| Rate for Payer: Multiplan Medicare/VA |
$654.99
|
| Rate for Payer: One Health Plan of WY PPO |
$3,233.02
|
| Rate for Payer: PacificSource Commercial |
$2,969.10
|
| Rate for Payer: PHCS PPO |
$3,134.05
|
| Rate for Payer: Three Rivers PPO |
$2,474.25
|
| Rate for Payer: TriWest Veterans Administration |
$770.58
|
| Rate for Payer: United Healthcare Commercial |
$2,870.13
|
| Rate for Payer: United Healthcare Medicare |
$770.58
|
| Rate for Payer: WINHealth Partners Commercial |
$2,804.15
|
|
|
TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 26480 AS
|
| Hospital Charge Code |
26480
|
| Min. Negotiated Rate |
$654.99 |
| Max. Negotiated Rate |
$3,299.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,233.02
|
| Rate for Payer: Aetna of WY Medicare |
$770.58
|
| Rate for Payer: Beech Street Commercial |
$3,134.05
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,200.03
|
| Rate for Payer: Cigna of WY Commercial |
$3,233.02
|
| Rate for Payer: First Choice Health Commercial |
$2,969.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,134.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$770.58
|
| Rate for Payer: HealthUtah PPO |
$3,299.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,200.03
|
| Rate for Payer: Multiplan Medicare/VA |
$654.99
|
| Rate for Payer: One Health Plan of WY PPO |
$3,233.02
|
| Rate for Payer: PacificSource Commercial |
$2,969.10
|
| Rate for Payer: PHCS PPO |
$3,134.05
|
| Rate for Payer: Three Rivers PPO |
$2,474.25
|
| Rate for Payer: TriWest Veterans Administration |
$770.58
|
| Rate for Payer: United Healthcare Commercial |
$2,870.13
|
| Rate for Payer: United Healthcare Medicare |
$770.58
|
| Rate for Payer: WINHealth Partners Commercial |
$2,804.15
|
|
|
TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 26480
|
| Hospital Charge Code |
26480
|
| Min. Negotiated Rate |
$654.99 |
| Max. Negotiated Rate |
$3,299.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,233.02
|
| Rate for Payer: Aetna of WY Medicare |
$770.58
|
| Rate for Payer: Beech Street Commercial |
$3,134.05
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: Cash Price |
$2,309.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,200.03
|
| Rate for Payer: Cigna of WY Commercial |
$3,233.02
|
| Rate for Payer: First Choice Health Commercial |
$2,969.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,134.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$770.58
|
| Rate for Payer: HealthUtah PPO |
$3,299.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,200.03
|
| Rate for Payer: Multiplan Medicare/VA |
$654.99
|
| Rate for Payer: One Health Plan of WY PPO |
$3,233.02
|
| Rate for Payer: PacificSource Commercial |
$2,969.10
|
| Rate for Payer: PHCS PPO |
$3,134.05
|
| Rate for Payer: Three Rivers PPO |
$2,474.25
|
| Rate for Payer: TriWest Veterans Administration |
$770.58
|
| Rate for Payer: United Healthcare Commercial |
$2,870.13
|
| Rate for Payer: United Healthcare Medicare |
$770.58
|
| Rate for Payer: WINHealth Partners Commercial |
$2,804.15
|
|
|
TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE
|
Professional
|
Both
|
$2,890.00
|
|
|
Service Code
|
HCPCS 52601
|
| Hospital Charge Code |
52601
|
| Min. Negotiated Rate |
$593.10 |
| Max. Negotiated Rate |
$2,890.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,832.20
|
| Rate for Payer: Aetna of WY Medicare |
$697.77
|
| Rate for Payer: Beech Street Commercial |
$2,745.50
|
| Rate for Payer: Cash Price |
$2,023.00
|
| Rate for Payer: Cash Price |
$2,023.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,803.30
|
| Rate for Payer: Cigna of WY Commercial |
$2,832.20
|
| Rate for Payer: First Choice Health Commercial |
$2,601.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,745.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$697.77
|
| Rate for Payer: HealthUtah PPO |
$2,890.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,803.30
|
| Rate for Payer: Multiplan Medicare/VA |
$593.10
|
| Rate for Payer: One Health Plan of WY PPO |
$2,832.20
|
| Rate for Payer: PacificSource Commercial |
$2,601.00
|
| Rate for Payer: PHCS PPO |
$2,745.50
|
| Rate for Payer: Three Rivers PPO |
$2,167.50
|
| Rate for Payer: TriWest Veterans Administration |
$697.77
|
| Rate for Payer: United Healthcare Commercial |
$2,514.30
|
| Rate for Payer: United Healthcare Medicare |
$697.77
|
| Rate for Payer: WINHealth Partners Commercial |
$2,456.50
|
|
|
TTE W OR WO FOL WCON,DOPPLER
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS C8929 26
|
| Hospital Charge Code |
C8929
|
| Min. Negotiated Rate |
$314.25 |
| Max. Negotiated Rate |
$419.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$410.62
|
| Rate for Payer: Beech Street Commercial |
$398.05
|
| Rate for Payer: Cash Price |
$293.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$406.43
|
| Rate for Payer: Cigna of WY Commercial |
$410.62
|
| Rate for Payer: First Choice Health Commercial |
$377.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$398.05
|
| Rate for Payer: HealthUtah PPO |
$419.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$406.43
|
| Rate for Payer: One Health Plan of WY PPO |
$410.62
|
| Rate for Payer: PacificSource Commercial |
$377.10
|
| Rate for Payer: PHCS PPO |
$398.05
|
| Rate for Payer: Three Rivers PPO |
$314.25
|
| Rate for Payer: United Healthcare Commercial |
$364.53
|
| Rate for Payer: WINHealth Partners Commercial |
$398.05
|
|
|
T-TUBE DEAVER MODEL
|
Facility
|
OP
|
$23.61
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$23.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.14
|
| Rate for Payer: Aetna of WY Medicare |
$15.58
|
| Rate for Payer: Altius Auto/Workers Compensation |
$22.67
|
| Rate for Payer: Altius Commercial |
$22.67
|
| Rate for Payer: Beech Street Commercial |
$23.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$19.38
|
| Rate for Payer: Cash Price |
$16.53
|
| Rate for Payer: ChoiceCare Network Commercial |
$22.90
|
| Rate for Payer: Cigna of WY Commercial |
$23.14
|
| Rate for Payer: Entrust Commercial |
$22.43
|
| Rate for Payer: First Choice Health Commercial |
$22.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$22.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.69
|
| Rate for Payer: HealthUtah PPO |
$23.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$22.90
|
| Rate for Payer: Multiplan Medicare/VA |
$13.01
|
| Rate for Payer: One Health Plan of WY PPO |
$23.14
|
| Rate for Payer: PacificSource Commercial |
$21.25
|
| Rate for Payer: PHCS PPO |
$23.14
|
| Rate for Payer: Three Rivers PPO |
$17.71
|
| Rate for Payer: TriWest Veterans Administration |
$13.69
|
| Rate for Payer: United Healthcare Commercial |
$20.54
|
| Rate for Payer: United Healthcare Medicare |
$13.69
|
| Rate for Payer: WINHealth Partners Commercial |
$23.14
|
| Rate for Payer: Wise Provider Network Commercial |
$22.43
|
|
|
T-TUBE DEAVER MODEL
|
Facility
|
IP
|
$23.61
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$23.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$23.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$22.67
|
| Rate for Payer: Altius Commercial |
$22.67
|
| Rate for Payer: Beech Street Commercial |
$23.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$19.38
|
| Rate for Payer: Cash Price |
$16.53
|
| Rate for Payer: ChoiceCare Network Commercial |
$22.90
|
| Rate for Payer: Cigna of WY Commercial |
$23.14
|
| Rate for Payer: Entrust Commercial |
$22.43
|
| Rate for Payer: First Choice Health Commercial |
$22.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$22.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$15.58
|
| Rate for Payer: HealthUtah PPO |
$23.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$22.90
|
| Rate for Payer: Multiplan Medicare/VA |
$14.80
|
| Rate for Payer: One Health Plan of WY PPO |
$23.14
|
| Rate for Payer: PacificSource Commercial |
$21.25
|
| Rate for Payer: PHCS PPO |
$23.14
|
| Rate for Payer: Three Rivers PPO |
$17.71
|
| Rate for Payer: TriWest Veterans Administration |
$15.58
|
| Rate for Payer: United Healthcare Commercial |
$20.54
|
| Rate for Payer: United Healthcare Medicare |
$15.58
|
| Rate for Payer: WINHealth Partners Commercial |
$22.43
|
| Rate for Payer: Wise Provider Network Commercial |
$22.43
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [1073]
|
Facility
|
IP
|
$182.90
|
|
|
Service Code
|
NDC 4202310401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$114.68 |
| Max. Negotiated Rate |
$182.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$179.24
|
| Rate for Payer: Altius Auto/Workers Compensation |
$175.58
|
| Rate for Payer: Altius Commercial |
$175.58
|
| Rate for Payer: Beech Street Commercial |
$179.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$150.16
|
| Rate for Payer: Cash Price |
$128.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$177.41
|
| Rate for Payer: Cigna of WY Commercial |
$179.24
|
| Rate for Payer: Entrust Commercial |
$173.76
|
| Rate for Payer: First Choice Health Commercial |
$173.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$173.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$120.71
|
| Rate for Payer: HealthUtah PPO |
$182.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$177.41
|
| Rate for Payer: Multiplan Medicare/VA |
$114.68
|
| Rate for Payer: One Health Plan of WY PPO |
$179.24
|
| Rate for Payer: PacificSource Commercial |
$164.61
|
| Rate for Payer: PHCS PPO |
$179.24
|
| Rate for Payer: Three Rivers PPO |
$137.18
|
| Rate for Payer: TriWest Veterans Administration |
$120.71
|
| Rate for Payer: United Healthcare Commercial |
$159.12
|
| Rate for Payer: United Healthcare Medicare |
$120.71
|
| Rate for Payer: WINHealth Partners Commercial |
$173.76
|
| Rate for Payer: Wise Provider Network Commercial |
$173.76
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [1073]
|
Facility
|
OP
|
$182.90
|
|
|
Service Code
|
NDC 4202310401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$100.78 |
| Max. Negotiated Rate |
$182.90 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$179.24
|
| Rate for Payer: Aetna of WY Medicare |
$120.71
|
| Rate for Payer: Altius Auto/Workers Compensation |
$175.58
|
| Rate for Payer: Altius Commercial |
$175.58
|
| Rate for Payer: Beech Street Commercial |
$179.24
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$150.16
|
| Rate for Payer: Cash Price |
$128.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$177.41
|
| Rate for Payer: Cigna of WY Commercial |
$179.24
|
| Rate for Payer: Entrust Commercial |
$173.76
|
| Rate for Payer: First Choice Health Commercial |
$173.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$173.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$106.08
|
| Rate for Payer: HealthUtah PPO |
$182.90
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$177.41
|
| Rate for Payer: Multiplan Medicare/VA |
$100.78
|
| Rate for Payer: One Health Plan of WY PPO |
$179.24
|
| Rate for Payer: PacificSource Commercial |
$164.61
|
| Rate for Payer: PHCS PPO |
$179.24
|
| Rate for Payer: Three Rivers PPO |
$137.18
|
| Rate for Payer: TriWest Veterans Administration |
$106.08
|
| Rate for Payer: United Healthcare Commercial |
$159.12
|
| Rate for Payer: United Healthcare Medicare |
$106.08
|
| Rate for Payer: WINHealth Partners Commercial |
$179.24
|
| Rate for Payer: Wise Provider Network Commercial |
$173.76
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [1073]
|
Facility
|
IP
|
$180.34
|
|
|
Service Code
|
NDC 4928175221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$113.07 |
| Max. Negotiated Rate |
$180.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$176.73
|
| Rate for Payer: Altius Auto/Workers Compensation |
$173.13
|
| Rate for Payer: Altius Commercial |
$173.13
|
| Rate for Payer: Beech Street Commercial |
$176.73
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$148.06
|
| Rate for Payer: Cash Price |
$126.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$174.93
|
| Rate for Payer: Cigna of WY Commercial |
$176.73
|
| Rate for Payer: Entrust Commercial |
$171.32
|
| Rate for Payer: First Choice Health Commercial |
$171.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$171.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$119.02
|
| Rate for Payer: HealthUtah PPO |
$180.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$174.93
|
| Rate for Payer: Multiplan Medicare/VA |
$113.07
|
| Rate for Payer: One Health Plan of WY PPO |
$176.73
|
| Rate for Payer: PacificSource Commercial |
$162.31
|
| Rate for Payer: PHCS PPO |
$176.73
|
| Rate for Payer: Three Rivers PPO |
$135.26
|
| Rate for Payer: TriWest Veterans Administration |
$119.02
|
| Rate for Payer: United Healthcare Commercial |
$156.90
|
| Rate for Payer: United Healthcare Medicare |
$119.02
|
| Rate for Payer: WINHealth Partners Commercial |
$171.32
|
| Rate for Payer: Wise Provider Network Commercial |
$171.32
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [1073]
|
Facility
|
OP
|
$180.34
|
|
|
Service Code
|
NDC 4928175221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$99.37 |
| Max. Negotiated Rate |
$180.34 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$176.73
|
| Rate for Payer: Aetna of WY Medicare |
$119.02
|
| Rate for Payer: Altius Auto/Workers Compensation |
$173.13
|
| Rate for Payer: Altius Commercial |
$173.13
|
| Rate for Payer: Beech Street Commercial |
$176.73
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$148.06
|
| Rate for Payer: Cash Price |
$126.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$174.93
|
| Rate for Payer: Cigna of WY Commercial |
$176.73
|
| Rate for Payer: Entrust Commercial |
$171.32
|
| Rate for Payer: First Choice Health Commercial |
$171.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$171.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$104.60
|
| Rate for Payer: HealthUtah PPO |
$180.34
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$174.93
|
| Rate for Payer: Multiplan Medicare/VA |
$99.37
|
| Rate for Payer: One Health Plan of WY PPO |
$176.73
|
| Rate for Payer: PacificSource Commercial |
$162.31
|
| Rate for Payer: PHCS PPO |
$176.73
|
| Rate for Payer: Three Rivers PPO |
$135.26
|
| Rate for Payer: TriWest Veterans Administration |
$104.60
|
| Rate for Payer: United Healthcare Commercial |
$156.90
|
| Rate for Payer: United Healthcare Medicare |
$104.60
|
| Rate for Payer: WINHealth Partners Commercial |
$176.73
|
| Rate for Payer: Wise Provider Network Commercial |
$171.32
|
|
|
TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$1,575.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
32551
|
| Min. Negotiated Rate |
$123.90 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,543.50
|
| Rate for Payer: Aetna of WY Medicare |
$145.77
|
| Rate for Payer: Beech Street Commercial |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,102.50
|
| Rate for Payer: Cash Price |
$1,102.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,527.75
|
| Rate for Payer: Cigna of WY Commercial |
$1,543.50
|
| Rate for Payer: First Choice Health Commercial |
$1,417.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,496.25
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.77
|
| Rate for Payer: HealthUtah PPO |
$1,575.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,527.75
|
| Rate for Payer: Multiplan Medicare/VA |
$123.90
|
| Rate for Payer: One Health Plan of WY PPO |
$1,543.50
|
| Rate for Payer: PacificSource Commercial |
$1,417.50
|
| Rate for Payer: PHCS PPO |
$1,496.25
|
| Rate for Payer: Three Rivers PPO |
$1,181.25
|
| Rate for Payer: TriWest Veterans Administration |
$145.77
|
| Rate for Payer: United Healthcare Commercial |
$1,370.25
|
| Rate for Payer: United Healthcare Medicare |
$145.77
|
| Rate for Payer: WINHealth Partners Commercial |
$1,338.75
|
|
|
TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$3,150.00
|
|
|
Service Code
|
HCPCS 32551 50
|
| Hospital Charge Code |
32551
|
| Min. Negotiated Rate |
$123.90 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,087.00
|
| Rate for Payer: Aetna of WY Medicare |
$145.77
|
| Rate for Payer: Beech Street Commercial |
$2,992.50
|
| Rate for Payer: Cash Price |
$2,205.00
|
| Rate for Payer: Cash Price |
$2,205.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,055.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,087.00
|
| Rate for Payer: First Choice Health Commercial |
$2,835.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,992.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$145.77
|
| Rate for Payer: HealthUtah PPO |
$3,150.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,055.50
|
| Rate for Payer: Multiplan Medicare/VA |
$123.90
|
| Rate for Payer: One Health Plan of WY PPO |
$3,087.00
|
| Rate for Payer: PacificSource Commercial |
$2,835.00
|
| Rate for Payer: PHCS PPO |
$2,992.50
|
| Rate for Payer: Three Rivers PPO |
$2,362.50
|
| Rate for Payer: TriWest Veterans Administration |
$145.77
|
| Rate for Payer: United Healthcare Commercial |
$2,740.50
|
| Rate for Payer: United Healthcare Medicare |
$145.77
|
| Rate for Payer: WINHealth Partners Commercial |
$2,677.50
|
|
|
TUBING HP ROTATING ADAPTER 10"
|
Facility
|
IP
|
$8.40
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.23
|
| Rate for Payer: Altius Auto/Workers Compensation |
$8.06
|
| Rate for Payer: Altius Commercial |
$8.06
|
| Rate for Payer: Beech Street Commercial |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.90
|
| Rate for Payer: Cash Price |
$5.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.15
|
| Rate for Payer: Cigna of WY Commercial |
$8.23
|
| Rate for Payer: Entrust Commercial |
$7.98
|
| Rate for Payer: First Choice Health Commercial |
$7.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.54
|
| Rate for Payer: HealthUtah PPO |
$8.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.15
|
| Rate for Payer: Multiplan Medicare/VA |
$5.27
|
| Rate for Payer: One Health Plan of WY PPO |
$8.23
|
| Rate for Payer: PacificSource Commercial |
$7.56
|
| Rate for Payer: PHCS PPO |
$8.23
|
| Rate for Payer: Three Rivers PPO |
$6.30
|
| Rate for Payer: TriWest Veterans Administration |
$5.54
|
| Rate for Payer: United Healthcare Commercial |
$7.31
|
| Rate for Payer: United Healthcare Medicare |
$5.54
|
| Rate for Payer: WINHealth Partners Commercial |
$7.98
|
| Rate for Payer: Wise Provider Network Commercial |
$7.98
|
|
|
TUBING HP ROTATING ADAPTER 10"
|
Facility
|
OP
|
$8.40
|
|
| Hospital Charge Code |
27000000S1
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.23
|
| Rate for Payer: Aetna of WY Medicare |
$5.54
|
| Rate for Payer: Altius Auto/Workers Compensation |
$8.06
|
| Rate for Payer: Altius Commercial |
$8.06
|
| Rate for Payer: Beech Street Commercial |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.90
|
| Rate for Payer: Cash Price |
$5.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.15
|
| Rate for Payer: Cigna of WY Commercial |
$8.23
|
| Rate for Payer: Entrust Commercial |
$7.98
|
| Rate for Payer: First Choice Health Commercial |
$7.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.98
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.87
|
| Rate for Payer: HealthUtah PPO |
$8.40
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.15
|
| Rate for Payer: Multiplan Medicare/VA |
$4.63
|
| Rate for Payer: One Health Plan of WY PPO |
$8.23
|
| Rate for Payer: PacificSource Commercial |
$7.56
|
| Rate for Payer: PHCS PPO |
$8.23
|
| Rate for Payer: Three Rivers PPO |
$6.30
|
| Rate for Payer: TriWest Veterans Administration |
$4.87
|
| Rate for Payer: United Healthcare Commercial |
$7.31
|
| Rate for Payer: United Healthcare Medicare |
$4.87
|
| Rate for Payer: WINHealth Partners Commercial |
$8.23
|
| Rate for Payer: Wise Provider Network Commercial |
$7.98
|
|
|
TUBING INSUFFLATOR FILTER SUC CONNECTOR
|
Facility
|
OP
|
$23.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$23.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.54
|
| Rate for Payer: Aetna of WY Medicare |
$15.18
|
| Rate for Payer: Altius Auto/Workers Compensation |
$22.08
|
| Rate for Payer: Altius Commercial |
$22.08
|
| Rate for Payer: Beech Street Commercial |
$22.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$18.88
|
| Rate for Payer: Cash Price |
$16.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$22.31
|
| Rate for Payer: Cigna of WY Commercial |
$22.54
|
| Rate for Payer: Entrust Commercial |
$21.85
|
| Rate for Payer: First Choice Health Commercial |
$21.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.34
|
| Rate for Payer: HealthUtah PPO |
$23.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$22.31
|
| Rate for Payer: Multiplan Medicare/VA |
$12.67
|
| Rate for Payer: One Health Plan of WY PPO |
$22.54
|
| Rate for Payer: PacificSource Commercial |
$20.70
|
| Rate for Payer: PHCS PPO |
$22.54
|
| Rate for Payer: Three Rivers PPO |
$17.25
|
| Rate for Payer: TriWest Veterans Administration |
$13.34
|
| Rate for Payer: United Healthcare Commercial |
$20.01
|
| Rate for Payer: United Healthcare Medicare |
$13.34
|
| Rate for Payer: WINHealth Partners Commercial |
$22.54
|
| Rate for Payer: Wise Provider Network Commercial |
$21.85
|
|
|
TUBING INSUFFLATOR FILTER SUC CONNECTOR
|
Facility
|
IP
|
$23.00
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.42 |
| Max. Negotiated Rate |
$23.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$22.54
|
| Rate for Payer: Altius Auto/Workers Compensation |
$22.08
|
| Rate for Payer: Altius Commercial |
$22.08
|
| Rate for Payer: Beech Street Commercial |
$22.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$18.88
|
| Rate for Payer: Cash Price |
$16.10
|
| Rate for Payer: ChoiceCare Network Commercial |
$22.31
|
| Rate for Payer: Cigna of WY Commercial |
$22.54
|
| Rate for Payer: Entrust Commercial |
$21.85
|
| Rate for Payer: First Choice Health Commercial |
$21.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$21.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$15.18
|
| Rate for Payer: HealthUtah PPO |
$23.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$22.31
|
| Rate for Payer: Multiplan Medicare/VA |
$14.42
|
| Rate for Payer: One Health Plan of WY PPO |
$22.54
|
| Rate for Payer: PacificSource Commercial |
$20.70
|
| Rate for Payer: PHCS PPO |
$22.54
|
| Rate for Payer: Three Rivers PPO |
$17.25
|
| Rate for Payer: TriWest Veterans Administration |
$15.18
|
| Rate for Payer: United Healthcare Commercial |
$20.01
|
| Rate for Payer: United Healthcare Medicare |
$15.18
|
| Rate for Payer: WINHealth Partners Commercial |
$21.85
|
| Rate for Payer: Wise Provider Network Commercial |
$21.85
|
|
|
TUBING IRRIGATION WITH CO2
|
Facility
|
IP
|
$64.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.27 |
| Max. Negotiated Rate |
$64.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$62.94
|
| Rate for Payer: Altius Auto/Workers Compensation |
$61.65
|
| Rate for Payer: Altius Commercial |
$61.65
|
| Rate for Payer: Beech Street Commercial |
$62.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.72
|
| Rate for Payer: Cash Price |
$44.96
|
| Rate for Payer: ChoiceCare Network Commercial |
$62.29
|
| Rate for Payer: Cigna of WY Commercial |
$62.94
|
| Rate for Payer: Entrust Commercial |
$61.01
|
| Rate for Payer: First Choice Health Commercial |
$61.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$61.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$42.39
|
| Rate for Payer: HealthUtah PPO |
$64.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$62.29
|
| Rate for Payer: Multiplan Medicare/VA |
$40.27
|
| Rate for Payer: One Health Plan of WY PPO |
$62.94
|
| Rate for Payer: PacificSource Commercial |
$57.80
|
| Rate for Payer: PHCS PPO |
$62.94
|
| Rate for Payer: Three Rivers PPO |
$48.16
|
| Rate for Payer: TriWest Veterans Administration |
$42.39
|
| Rate for Payer: United Healthcare Commercial |
$55.87
|
| Rate for Payer: United Healthcare Medicare |
$42.39
|
| Rate for Payer: WINHealth Partners Commercial |
$61.01
|
| Rate for Payer: Wise Provider Network Commercial |
$61.01
|
|
|
TUBING IRRIGATION WITH CO2
|
Facility
|
OP
|
$64.22
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.39 |
| Max. Negotiated Rate |
$64.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$62.94
|
| Rate for Payer: Aetna of WY Medicare |
$42.39
|
| Rate for Payer: Altius Auto/Workers Compensation |
$61.65
|
| Rate for Payer: Altius Commercial |
$61.65
|
| Rate for Payer: Beech Street Commercial |
$62.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$52.72
|
| Rate for Payer: Cash Price |
$44.96
|
| Rate for Payer: ChoiceCare Network Commercial |
$62.29
|
| Rate for Payer: Cigna of WY Commercial |
$62.94
|
| Rate for Payer: Entrust Commercial |
$61.01
|
| Rate for Payer: First Choice Health Commercial |
$61.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$61.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$37.25
|
| Rate for Payer: HealthUtah PPO |
$64.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$62.29
|
| Rate for Payer: Multiplan Medicare/VA |
$35.39
|
| Rate for Payer: One Health Plan of WY PPO |
$62.94
|
| Rate for Payer: PacificSource Commercial |
$57.80
|
| Rate for Payer: PHCS PPO |
$62.94
|
| Rate for Payer: Three Rivers PPO |
$48.16
|
| Rate for Payer: TriWest Veterans Administration |
$37.25
|
| Rate for Payer: United Healthcare Commercial |
$55.87
|
| Rate for Payer: United Healthcare Medicare |
$37.25
|
| Rate for Payer: WINHealth Partners Commercial |
$62.94
|
| Rate for Payer: Wise Provider Network Commercial |
$61.01
|
|
|
TUBING SMALL JOINT 9350
|
Facility
|
OP
|
$149.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$82.23 |
| Max. Negotiated Rate |
$149.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$146.26
|
| Rate for Payer: Aetna of WY Medicare |
$98.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$143.27
|
| Rate for Payer: Altius Commercial |
$143.27
|
| Rate for Payer: Beech Street Commercial |
$146.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$122.53
|
| Rate for Payer: Cash Price |
$104.47
|
| Rate for Payer: ChoiceCare Network Commercial |
$144.76
|
| Rate for Payer: Cigna of WY Commercial |
$146.26
|
| Rate for Payer: Entrust Commercial |
$141.78
|
| Rate for Payer: First Choice Health Commercial |
$141.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$141.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$86.56
|
| Rate for Payer: HealthUtah PPO |
$149.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$144.76
|
| Rate for Payer: Multiplan Medicare/VA |
$82.23
|
| Rate for Payer: One Health Plan of WY PPO |
$146.26
|
| Rate for Payer: PacificSource Commercial |
$134.32
|
| Rate for Payer: PHCS PPO |
$146.26
|
| Rate for Payer: Three Rivers PPO |
$111.93
|
| Rate for Payer: TriWest Veterans Administration |
$86.56
|
| Rate for Payer: United Healthcare Commercial |
$129.84
|
| Rate for Payer: United Healthcare Medicare |
$86.56
|
| Rate for Payer: WINHealth Partners Commercial |
$146.26
|
| Rate for Payer: Wise Provider Network Commercial |
$141.78
|
|
|
TUBING SMALL JOINT 9350
|
Facility
|
IP
|
$149.24
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.57 |
| Max. Negotiated Rate |
$149.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$146.26
|
| Rate for Payer: Altius Auto/Workers Compensation |
$143.27
|
| Rate for Payer: Altius Commercial |
$143.27
|
| Rate for Payer: Beech Street Commercial |
$146.26
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$122.53
|
| Rate for Payer: Cash Price |
$104.47
|
| Rate for Payer: ChoiceCare Network Commercial |
$144.76
|
| Rate for Payer: Cigna of WY Commercial |
$146.26
|
| Rate for Payer: Entrust Commercial |
$141.78
|
| Rate for Payer: First Choice Health Commercial |
$141.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$141.78
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$98.50
|
| Rate for Payer: HealthUtah PPO |
$149.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$144.76
|
| Rate for Payer: Multiplan Medicare/VA |
$93.57
|
| Rate for Payer: One Health Plan of WY PPO |
$146.26
|
| Rate for Payer: PacificSource Commercial |
$134.32
|
| Rate for Payer: PHCS PPO |
$146.26
|
| Rate for Payer: Three Rivers PPO |
$111.93
|
| Rate for Payer: TriWest Veterans Administration |
$98.50
|
| Rate for Payer: United Healthcare Commercial |
$129.84
|
| Rate for Payer: United Healthcare Medicare |
$98.50
|
| Rate for Payer: WINHealth Partners Commercial |
$141.78
|
| Rate for Payer: Wise Provider Network Commercial |
$141.78
|
|
|
TUBING SMOKE EVAC OLYMPUS DISP
|
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
|
|
|
TUBING SMOKE EVAC OLYMPUS DISP
|
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
|
|
|
TUBING STRAIGHTSHOT TO XPS
|
Facility
|
IP
|
$109.42
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.61 |
| Max. Negotiated Rate |
$109.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$107.23
|
| Rate for Payer: Altius Auto/Workers Compensation |
$105.04
|
| Rate for Payer: Altius Commercial |
$105.04
|
| Rate for Payer: Beech Street Commercial |
$107.23
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$89.83
|
| Rate for Payer: Cash Price |
$76.59
|
| Rate for Payer: ChoiceCare Network Commercial |
$106.14
|
| Rate for Payer: Cigna of WY Commercial |
$107.23
|
| Rate for Payer: Entrust Commercial |
$103.95
|
| Rate for Payer: First Choice Health Commercial |
$103.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$103.95
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$72.22
|
| Rate for Payer: HealthUtah PPO |
$109.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$106.14
|
| Rate for Payer: Multiplan Medicare/VA |
$68.61
|
| Rate for Payer: One Health Plan of WY PPO |
$107.23
|
| Rate for Payer: PacificSource Commercial |
$98.48
|
| Rate for Payer: PHCS PPO |
$107.23
|
| Rate for Payer: Three Rivers PPO |
$82.06
|
| Rate for Payer: TriWest Veterans Administration |
$72.22
|
| Rate for Payer: United Healthcare Commercial |
$95.20
|
| Rate for Payer: United Healthcare Medicare |
$72.22
|
| Rate for Payer: WINHealth Partners Commercial |
$103.95
|
| Rate for Payer: Wise Provider Network Commercial |
$103.95
|
|
