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Service Code NDC 0832121101
Hospital Revenue Code 250
Min. Negotiated Rate $0.93
Max. Negotiated Rate $1.48
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.45
Rate for Payer: Altius Auto/Workers Compensation $1.42
Rate for Payer: Altius Commercial $1.42
Rate for Payer: Beech Street Commercial $1.45
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.22
Rate for Payer: Cash Price $1.04
Rate for Payer: ChoiceCare Network Commercial $1.44
Rate for Payer: Cigna of WY Commercial $1.45
Rate for Payer: Entrust Commercial $1.41
Rate for Payer: First Choice Health Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.98
Rate for Payer: HealthUtah PPO $1.48
Rate for Payer: Idaho Integrated Healthcare Commercial $1.44
Rate for Payer: Multiplan Medicare/VA $0.93
Rate for Payer: One Health Plan of WY PPO $1.45
Rate for Payer: PacificSource Commercial $1.33
Rate for Payer: PHCS PPO $1.45
Rate for Payer: Three Rivers PPO $1.11
Rate for Payer: TriWest Veterans Administration $0.98
Rate for Payer: United Healthcare Commercial $1.29
Rate for Payer: United Healthcare Medicare $0.98
Rate for Payer: WINHealth Partners Commercial $1.41
Rate for Payer: Wise Provider Network Commercial $1.41
Service Code NDC 0832121101
Hospital Revenue Code 250
Min. Negotiated Rate $0.82
Max. Negotiated Rate $1.48
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.45
Rate for Payer: Aetna of WY Medicare $0.98
Rate for Payer: Altius Auto/Workers Compensation $1.42
Rate for Payer: Altius Commercial $1.42
Rate for Payer: Beech Street Commercial $1.45
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.22
Rate for Payer: Cash Price $1.04
Rate for Payer: ChoiceCare Network Commercial $1.44
Rate for Payer: Cigna of WY Commercial $1.45
Rate for Payer: Entrust Commercial $1.41
Rate for Payer: First Choice Health Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.86
Rate for Payer: HealthUtah PPO $1.48
Rate for Payer: Idaho Integrated Healthcare Commercial $1.44
Rate for Payer: Multiplan Medicare/VA $0.82
Rate for Payer: One Health Plan of WY PPO $1.45
Rate for Payer: PacificSource Commercial $1.33
Rate for Payer: PHCS PPO $1.45
Rate for Payer: Three Rivers PPO $1.11
Rate for Payer: TriWest Veterans Administration $0.86
Rate for Payer: United Healthcare Commercial $1.29
Rate for Payer: United Healthcare Medicare $0.86
Rate for Payer: WINHealth Partners Commercial $1.45
Rate for Payer: Wise Provider Network Commercial $1.41
Service Code NDC 0832121189
Hospital Revenue Code 250
Min. Negotiated Rate $0.93
Max. Negotiated Rate $1.48
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.45
Rate for Payer: Altius Auto/Workers Compensation $1.42
Rate for Payer: Altius Commercial $1.42
Rate for Payer: Beech Street Commercial $1.45
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.22
Rate for Payer: Cash Price $1.04
Rate for Payer: ChoiceCare Network Commercial $1.44
Rate for Payer: Cigna of WY Commercial $1.45
Rate for Payer: Entrust Commercial $1.41
Rate for Payer: First Choice Health Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.98
Rate for Payer: HealthUtah PPO $1.48
Rate for Payer: Idaho Integrated Healthcare Commercial $1.44
Rate for Payer: Multiplan Medicare/VA $0.93
Rate for Payer: One Health Plan of WY PPO $1.45
Rate for Payer: PacificSource Commercial $1.33
Rate for Payer: PHCS PPO $1.45
Rate for Payer: Three Rivers PPO $1.11
Rate for Payer: TriWest Veterans Administration $0.98
Rate for Payer: United Healthcare Commercial $1.29
Rate for Payer: United Healthcare Medicare $0.98
Rate for Payer: WINHealth Partners Commercial $1.41
Rate for Payer: Wise Provider Network Commercial $1.41
Service Code NDC 0832121189
Hospital Revenue Code 250
Min. Negotiated Rate $0.82
Max. Negotiated Rate $1.48
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.45
Rate for Payer: Aetna of WY Medicare $0.98
Rate for Payer: Altius Auto/Workers Compensation $1.42
Rate for Payer: Altius Commercial $1.42
Rate for Payer: Beech Street Commercial $1.45
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.22
Rate for Payer: Cash Price $1.04
Rate for Payer: ChoiceCare Network Commercial $1.44
Rate for Payer: Cigna of WY Commercial $1.45
Rate for Payer: Entrust Commercial $1.41
Rate for Payer: First Choice Health Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.41
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.86
Rate for Payer: HealthUtah PPO $1.48
Rate for Payer: Idaho Integrated Healthcare Commercial $1.44
Rate for Payer: Multiplan Medicare/VA $0.82
Rate for Payer: One Health Plan of WY PPO $1.45
Rate for Payer: PacificSource Commercial $1.33
Rate for Payer: PHCS PPO $1.45
Rate for Payer: Three Rivers PPO $1.11
Rate for Payer: TriWest Veterans Administration $0.86
Rate for Payer: United Healthcare Commercial $1.29
Rate for Payer: United Healthcare Medicare $0.86
Rate for Payer: WINHealth Partners Commercial $1.45
Rate for Payer: Wise Provider Network Commercial $1.41
Service Code NDC 0832121389
Hospital Revenue Code 250
Min. Negotiated Rate $0.98
Max. Negotiated Rate $1.56
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.53
Rate for Payer: Altius Auto/Workers Compensation $1.50
Rate for Payer: Altius Commercial $1.50
Rate for Payer: Beech Street Commercial $1.53
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.28
Rate for Payer: Cash Price $1.09
Rate for Payer: ChoiceCare Network Commercial $1.51
Rate for Payer: Cigna of WY Commercial $1.53
Rate for Payer: Entrust Commercial $1.48
Rate for Payer: First Choice Health Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.03
Rate for Payer: HealthUtah PPO $1.56
Rate for Payer: Idaho Integrated Healthcare Commercial $1.51
Rate for Payer: Multiplan Medicare/VA $0.98
Rate for Payer: One Health Plan of WY PPO $1.53
Rate for Payer: PacificSource Commercial $1.40
Rate for Payer: PHCS PPO $1.53
Rate for Payer: Three Rivers PPO $1.17
Rate for Payer: TriWest Veterans Administration $1.03
Rate for Payer: United Healthcare Commercial $1.36
Rate for Payer: United Healthcare Medicare $1.03
Rate for Payer: WINHealth Partners Commercial $1.48
Rate for Payer: Wise Provider Network Commercial $1.48
Service Code NDC 0832121389
Hospital Revenue Code 250
Min. Negotiated Rate $0.86
Max. Negotiated Rate $1.56
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.53
Rate for Payer: Aetna of WY Medicare $1.03
Rate for Payer: Altius Auto/Workers Compensation $1.50
Rate for Payer: Altius Commercial $1.50
Rate for Payer: Beech Street Commercial $1.53
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.28
Rate for Payer: Cash Price $1.09
Rate for Payer: ChoiceCare Network Commercial $1.51
Rate for Payer: Cigna of WY Commercial $1.53
Rate for Payer: Entrust Commercial $1.48
Rate for Payer: First Choice Health Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.90
Rate for Payer: HealthUtah PPO $1.56
Rate for Payer: Idaho Integrated Healthcare Commercial $1.51
Rate for Payer: Multiplan Medicare/VA $0.86
Rate for Payer: One Health Plan of WY PPO $1.53
Rate for Payer: PacificSource Commercial $1.40
Rate for Payer: PHCS PPO $1.53
Rate for Payer: Three Rivers PPO $1.17
Rate for Payer: TriWest Veterans Administration $0.90
Rate for Payer: United Healthcare Commercial $1.36
Rate for Payer: United Healthcare Medicare $0.90
Rate for Payer: WINHealth Partners Commercial $1.53
Rate for Payer: Wise Provider Network Commercial $1.48
Service Code NDC 0832121301
Hospital Revenue Code 250
Min. Negotiated Rate $0.98
Max. Negotiated Rate $1.56
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.53
Rate for Payer: Altius Auto/Workers Compensation $1.50
Rate for Payer: Altius Commercial $1.50
Rate for Payer: Beech Street Commercial $1.53
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.28
Rate for Payer: Cash Price $1.09
Rate for Payer: ChoiceCare Network Commercial $1.51
Rate for Payer: Cigna of WY Commercial $1.53
Rate for Payer: Entrust Commercial $1.48
Rate for Payer: First Choice Health Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.03
Rate for Payer: HealthUtah PPO $1.56
Rate for Payer: Idaho Integrated Healthcare Commercial $1.51
Rate for Payer: Multiplan Medicare/VA $0.98
Rate for Payer: One Health Plan of WY PPO $1.53
Rate for Payer: PacificSource Commercial $1.40
Rate for Payer: PHCS PPO $1.53
Rate for Payer: Three Rivers PPO $1.17
Rate for Payer: TriWest Veterans Administration $1.03
Rate for Payer: United Healthcare Commercial $1.36
Rate for Payer: United Healthcare Medicare $1.03
Rate for Payer: WINHealth Partners Commercial $1.48
Rate for Payer: Wise Provider Network Commercial $1.48
Service Code NDC 0832121301
Hospital Revenue Code 250
Min. Negotiated Rate $0.86
Max. Negotiated Rate $1.56
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.53
Rate for Payer: Aetna of WY Medicare $1.03
Rate for Payer: Altius Auto/Workers Compensation $1.50
Rate for Payer: Altius Commercial $1.50
Rate for Payer: Beech Street Commercial $1.53
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.28
Rate for Payer: Cash Price $1.09
Rate for Payer: ChoiceCare Network Commercial $1.51
Rate for Payer: Cigna of WY Commercial $1.53
Rate for Payer: Entrust Commercial $1.48
Rate for Payer: First Choice Health Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.48
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.90
Rate for Payer: HealthUtah PPO $1.56
Rate for Payer: Idaho Integrated Healthcare Commercial $1.51
Rate for Payer: Multiplan Medicare/VA $0.86
Rate for Payer: One Health Plan of WY PPO $1.53
Rate for Payer: PacificSource Commercial $1.40
Rate for Payer: PHCS PPO $1.53
Rate for Payer: Three Rivers PPO $1.17
Rate for Payer: TriWest Veterans Administration $0.90
Rate for Payer: United Healthcare Commercial $1.36
Rate for Payer: United Healthcare Medicare $0.90
Rate for Payer: WINHealth Partners Commercial $1.53
Rate for Payer: Wise Provider Network Commercial $1.48
Service Code NDC 0832121401
Hospital Revenue Code 250
Min. Negotiated Rate $1.00
Max. Negotiated Rate $1.59
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.56
Rate for Payer: Altius Auto/Workers Compensation $1.53
Rate for Payer: Altius Commercial $1.53
Rate for Payer: Beech Street Commercial $1.56
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.31
Rate for Payer: Cash Price $1.11
Rate for Payer: ChoiceCare Network Commercial $1.54
Rate for Payer: Cigna of WY Commercial $1.56
Rate for Payer: Entrust Commercial $1.51
Rate for Payer: First Choice Health Commercial $1.51
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.51
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.05
Rate for Payer: HealthUtah PPO $1.59
Rate for Payer: Idaho Integrated Healthcare Commercial $1.54
Rate for Payer: Multiplan Medicare/VA $1.00
Rate for Payer: One Health Plan of WY PPO $1.56
Rate for Payer: PacificSource Commercial $1.43
Rate for Payer: PHCS PPO $1.56
Rate for Payer: Three Rivers PPO $1.19
Rate for Payer: TriWest Veterans Administration $1.05
Rate for Payer: United Healthcare Commercial $1.38
Rate for Payer: United Healthcare Medicare $1.05
Rate for Payer: WINHealth Partners Commercial $1.51
Rate for Payer: Wise Provider Network Commercial $1.51
Service Code NDC 0832121401
Hospital Revenue Code 250
Min. Negotiated Rate $0.88
Max. Negotiated Rate $1.59
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.56
Rate for Payer: Aetna of WY Medicare $1.05
Rate for Payer: Altius Auto/Workers Compensation $1.53
Rate for Payer: Altius Commercial $1.53
Rate for Payer: Beech Street Commercial $1.56
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.31
Rate for Payer: Cash Price $1.11
Rate for Payer: ChoiceCare Network Commercial $1.54
Rate for Payer: Cigna of WY Commercial $1.56
Rate for Payer: Entrust Commercial $1.51
Rate for Payer: First Choice Health Commercial $1.51
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.51
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.92
Rate for Payer: HealthUtah PPO $1.59
Rate for Payer: Idaho Integrated Healthcare Commercial $1.54
Rate for Payer: Multiplan Medicare/VA $0.88
Rate for Payer: One Health Plan of WY PPO $1.56
Rate for Payer: PacificSource Commercial $1.43
Rate for Payer: PHCS PPO $1.56
Rate for Payer: Three Rivers PPO $1.19
Rate for Payer: TriWest Veterans Administration $0.92
Rate for Payer: United Healthcare Commercial $1.38
Rate for Payer: United Healthcare Medicare $0.92
Rate for Payer: WINHealth Partners Commercial $1.56
Rate for Payer: Wise Provider Network Commercial $1.51
Service Code NDC 0832121489
Hospital Revenue Code 250
Min. Negotiated Rate $1.00
Max. Negotiated Rate $1.60
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.57
Rate for Payer: Altius Auto/Workers Compensation $1.54
Rate for Payer: Altius Commercial $1.54
Rate for Payer: Beech Street Commercial $1.57
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.31
Rate for Payer: Cash Price $1.12
Rate for Payer: ChoiceCare Network Commercial $1.55
Rate for Payer: Cigna of WY Commercial $1.57
Rate for Payer: Entrust Commercial $1.52
Rate for Payer: First Choice Health Commercial $1.52
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.52
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.06
Rate for Payer: HealthUtah PPO $1.60
Rate for Payer: Idaho Integrated Healthcare Commercial $1.55
Rate for Payer: Multiplan Medicare/VA $1.00
Rate for Payer: One Health Plan of WY PPO $1.57
Rate for Payer: PacificSource Commercial $1.44
Rate for Payer: PHCS PPO $1.57
Rate for Payer: Three Rivers PPO $1.20
Rate for Payer: TriWest Veterans Administration $1.06
Rate for Payer: United Healthcare Commercial $1.39
Rate for Payer: United Healthcare Medicare $1.06
Rate for Payer: WINHealth Partners Commercial $1.52
Rate for Payer: Wise Provider Network Commercial $1.52
Service Code NDC 0832121489
Hospital Revenue Code 250
Min. Negotiated Rate $0.88
Max. Negotiated Rate $1.60
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.57
Rate for Payer: Aetna of WY Medicare $1.06
Rate for Payer: Altius Auto/Workers Compensation $1.54
Rate for Payer: Altius Commercial $1.54
Rate for Payer: Beech Street Commercial $1.57
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.31
Rate for Payer: Cash Price $1.12
Rate for Payer: ChoiceCare Network Commercial $1.55
Rate for Payer: Cigna of WY Commercial $1.57
Rate for Payer: Entrust Commercial $1.52
Rate for Payer: First Choice Health Commercial $1.52
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.52
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.93
Rate for Payer: HealthUtah PPO $1.60
Rate for Payer: Idaho Integrated Healthcare Commercial $1.55
Rate for Payer: Multiplan Medicare/VA $0.88
Rate for Payer: One Health Plan of WY PPO $1.57
Rate for Payer: PacificSource Commercial $1.44
Rate for Payer: PHCS PPO $1.57
Rate for Payer: Three Rivers PPO $1.20
Rate for Payer: TriWest Veterans Administration $0.93
Rate for Payer: United Healthcare Commercial $1.39
Rate for Payer: United Healthcare Medicare $0.93
Rate for Payer: WINHealth Partners Commercial $1.57
Rate for Payer: Wise Provider Network Commercial $1.52
Service Code NDC 0832121601
Hospital Revenue Code 250
Min. Negotiated Rate $1.02
Max. Negotiated Rate $1.63
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.60
Rate for Payer: Altius Auto/Workers Compensation $1.56
Rate for Payer: Altius Commercial $1.56
Rate for Payer: Beech Street Commercial $1.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.34
Rate for Payer: Cash Price $1.14
Rate for Payer: ChoiceCare Network Commercial $1.58
Rate for Payer: Cigna of WY Commercial $1.60
Rate for Payer: Entrust Commercial $1.55
Rate for Payer: First Choice Health Commercial $1.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.08
Rate for Payer: HealthUtah PPO $1.63
Rate for Payer: Idaho Integrated Healthcare Commercial $1.58
Rate for Payer: Multiplan Medicare/VA $1.02
Rate for Payer: One Health Plan of WY PPO $1.60
Rate for Payer: PacificSource Commercial $1.47
Rate for Payer: PHCS PPO $1.60
Rate for Payer: Three Rivers PPO $1.22
Rate for Payer: TriWest Veterans Administration $1.08
Rate for Payer: United Healthcare Commercial $1.42
Rate for Payer: United Healthcare Medicare $1.08
Rate for Payer: WINHealth Partners Commercial $1.55
Rate for Payer: Wise Provider Network Commercial $1.55
Service Code NDC 0832121601
Hospital Revenue Code 250
Min. Negotiated Rate $0.90
Max. Negotiated Rate $1.63
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.60
Rate for Payer: Aetna of WY Medicare $1.08
Rate for Payer: Altius Auto/Workers Compensation $1.56
Rate for Payer: Altius Commercial $1.56
Rate for Payer: Beech Street Commercial $1.60
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.34
Rate for Payer: Cash Price $1.14
Rate for Payer: ChoiceCare Network Commercial $1.58
Rate for Payer: Cigna of WY Commercial $1.60
Rate for Payer: Entrust Commercial $1.55
Rate for Payer: First Choice Health Commercial $1.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.95
Rate for Payer: HealthUtah PPO $1.63
Rate for Payer: Idaho Integrated Healthcare Commercial $1.58
Rate for Payer: Multiplan Medicare/VA $0.90
Rate for Payer: One Health Plan of WY PPO $1.60
Rate for Payer: PacificSource Commercial $1.47
Rate for Payer: PHCS PPO $1.60
Rate for Payer: Three Rivers PPO $1.22
Rate for Payer: TriWest Veterans Administration $0.95
Rate for Payer: United Healthcare Commercial $1.42
Rate for Payer: United Healthcare Medicare $0.95
Rate for Payer: WINHealth Partners Commercial $1.60
Rate for Payer: Wise Provider Network Commercial $1.55
Service Code NDC 0832121689
Hospital Revenue Code 250
Min. Negotiated Rate $1.03
Max. Negotiated Rate $1.64
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.61
Rate for Payer: Altius Auto/Workers Compensation $1.57
Rate for Payer: Altius Commercial $1.57
Rate for Payer: Beech Street Commercial $1.61
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.35
Rate for Payer: Cash Price $1.15
Rate for Payer: ChoiceCare Network Commercial $1.59
Rate for Payer: Cigna of WY Commercial $1.61
Rate for Payer: Entrust Commercial $1.56
Rate for Payer: First Choice Health Commercial $1.56
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.56
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.08
Rate for Payer: HealthUtah PPO $1.64
Rate for Payer: Idaho Integrated Healthcare Commercial $1.59
Rate for Payer: Multiplan Medicare/VA $1.03
Rate for Payer: One Health Plan of WY PPO $1.61
Rate for Payer: PacificSource Commercial $1.48
Rate for Payer: PHCS PPO $1.61
Rate for Payer: Three Rivers PPO $1.23
Rate for Payer: TriWest Veterans Administration $1.08
Rate for Payer: United Healthcare Commercial $1.43
Rate for Payer: United Healthcare Medicare $1.08
Rate for Payer: WINHealth Partners Commercial $1.56
Rate for Payer: Wise Provider Network Commercial $1.56
Service Code NDC 0832121689
Hospital Revenue Code 250
Min. Negotiated Rate $0.90
Max. Negotiated Rate $1.64
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.61
Rate for Payer: Aetna of WY Medicare $1.08
Rate for Payer: Altius Auto/Workers Compensation $1.57
Rate for Payer: Altius Commercial $1.57
Rate for Payer: Beech Street Commercial $1.61
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $1.35
Rate for Payer: Cash Price $1.15
Rate for Payer: ChoiceCare Network Commercial $1.59
Rate for Payer: Cigna of WY Commercial $1.61
Rate for Payer: Entrust Commercial $1.56
Rate for Payer: First Choice Health Commercial $1.56
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.56
Rate for Payer: Government Employees Health Association (GEHA) Medicare $0.95
Rate for Payer: HealthUtah PPO $1.64
Rate for Payer: Idaho Integrated Healthcare Commercial $1.59
Rate for Payer: Multiplan Medicare/VA $0.90
Rate for Payer: One Health Plan of WY PPO $1.61
Rate for Payer: PacificSource Commercial $1.48
Rate for Payer: PHCS PPO $1.61
Rate for Payer: Three Rivers PPO $1.23
Rate for Payer: TriWest Veterans Administration $0.95
Rate for Payer: United Healthcare Commercial $1.43
Rate for Payer: United Healthcare Medicare $0.95
Rate for Payer: WINHealth Partners Commercial $1.61
Rate for Payer: Wise Provider Network Commercial $1.56
Hospital Charge Code 27800000S1
Hospital Revenue Code 278
Min. Negotiated Rate $192.85
Max. Negotiated Rate $350.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $343.00
Rate for Payer: Aetna of WY Medicare $231.00
Rate for Payer: Altius Auto/Workers Compensation $336.00
Rate for Payer: Altius Commercial $336.00
Rate for Payer: Beech Street Commercial $343.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $287.35
Rate for Payer: Cash Price $245.00
Rate for Payer: ChoiceCare Network Commercial $339.50
Rate for Payer: Cigna of WY Commercial $343.00
Rate for Payer: Entrust Commercial $332.50
Rate for Payer: First Choice Health Commercial $332.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $332.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $203.00
Rate for Payer: HealthUtah PPO $350.00
Rate for Payer: Idaho Integrated Healthcare Commercial $339.50
Rate for Payer: Multiplan Medicare/VA $192.85
Rate for Payer: One Health Plan of WY PPO $343.00
Rate for Payer: PacificSource Commercial $315.00
Rate for Payer: PHCS PPO $343.00
Rate for Payer: Three Rivers PPO $262.50
Rate for Payer: TriWest Veterans Administration $203.00
Rate for Payer: United Healthcare Commercial $304.50
Rate for Payer: United Healthcare Medicare $203.00
Rate for Payer: WINHealth Partners Commercial $343.00
Rate for Payer: Wise Provider Network Commercial $332.50
Hospital Charge Code 27800000S1
Hospital Revenue Code 278
Min. Negotiated Rate $219.45
Max. Negotiated Rate $350.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $343.00
Rate for Payer: Altius Auto/Workers Compensation $336.00
Rate for Payer: Altius Commercial $336.00
Rate for Payer: Beech Street Commercial $343.00
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $287.35
Rate for Payer: Cash Price $245.00
Rate for Payer: ChoiceCare Network Commercial $339.50
Rate for Payer: Cigna of WY Commercial $343.00
Rate for Payer: Entrust Commercial $332.50
Rate for Payer: First Choice Health Commercial $332.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $332.50
Rate for Payer: Government Employees Health Association (GEHA) Medicare $231.00
Rate for Payer: HealthUtah PPO $350.00
Rate for Payer: Idaho Integrated Healthcare Commercial $339.50
Rate for Payer: Multiplan Medicare/VA $219.45
Rate for Payer: One Health Plan of WY PPO $343.00
Rate for Payer: PacificSource Commercial $315.00
Rate for Payer: PHCS PPO $343.00
Rate for Payer: Three Rivers PPO $262.50
Rate for Payer: TriWest Veterans Administration $231.00
Rate for Payer: United Healthcare Commercial $304.50
Rate for Payer: United Healthcare Medicare $231.00
Rate for Payer: WINHealth Partners Commercial $332.50
Rate for Payer: Wise Provider Network Commercial $332.50
Service Code NDC 0409488710
Hospital Revenue Code 250
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
Service Code NDC 0409488710
Hospital Revenue Code 250
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 0409488717
Hospital Revenue Code 250
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
Service Code NDC 0409488717
Hospital Revenue Code 250
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 0409488720
Hospital Revenue Code 250
Min. Negotiated Rate $9.61
Max. Negotiated Rate $15.32
Rate for Payer: Aetna of WY Commercial/Medical Rental $15.01
Rate for Payer: Altius Auto/Workers Compensation $14.71
Rate for Payer: Altius Commercial $14.71
Rate for Payer: Beech Street Commercial $15.01
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $12.58
Rate for Payer: Cash Price $10.73
Rate for Payer: ChoiceCare Network Commercial $14.86
Rate for Payer: Cigna of WY Commercial $15.01
Rate for Payer: Entrust Commercial $14.55
Rate for Payer: First Choice Health Commercial $14.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $14.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $10.11
Rate for Payer: HealthUtah PPO $15.32
Rate for Payer: Idaho Integrated Healthcare Commercial $14.86
Rate for Payer: Multiplan Medicare/VA $9.61
Rate for Payer: One Health Plan of WY PPO $15.01
Rate for Payer: PacificSource Commercial $13.79
Rate for Payer: PHCS PPO $15.01
Rate for Payer: Three Rivers PPO $11.49
Rate for Payer: TriWest Veterans Administration $10.11
Rate for Payer: United Healthcare Commercial $13.33
Rate for Payer: United Healthcare Medicare $10.11
Rate for Payer: WINHealth Partners Commercial $14.55
Rate for Payer: Wise Provider Network Commercial $14.55
Service Code NDC 0409488720
Hospital Revenue Code 250
Min. Negotiated Rate $8.44
Max. Negotiated Rate $15.32
Rate for Payer: Aetna of WY Commercial/Medical Rental $15.01
Rate for Payer: Aetna of WY Medicare $10.11
Rate for Payer: Altius Auto/Workers Compensation $14.71
Rate for Payer: Altius Commercial $14.71
Rate for Payer: Beech Street Commercial $15.01
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $12.58
Rate for Payer: Cash Price $10.73
Rate for Payer: ChoiceCare Network Commercial $14.86
Rate for Payer: Cigna of WY Commercial $15.01
Rate for Payer: Entrust Commercial $14.55
Rate for Payer: First Choice Health Commercial $14.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $14.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $8.89
Rate for Payer: HealthUtah PPO $15.32
Rate for Payer: Idaho Integrated Healthcare Commercial $14.86
Rate for Payer: Multiplan Medicare/VA $8.44
Rate for Payer: One Health Plan of WY PPO $15.01
Rate for Payer: PacificSource Commercial $13.79
Rate for Payer: PHCS PPO $15.01
Rate for Payer: Three Rivers PPO $11.49
Rate for Payer: TriWest Veterans Administration $8.89
Rate for Payer: United Healthcare Commercial $13.33
Rate for Payer: United Healthcare Medicare $8.89
Rate for Payer: WINHealth Partners Commercial $15.01
Rate for Payer: Wise Provider Network Commercial $14.55
Service Code NDC 0409488723
Hospital Revenue Code 250
Min. Negotiated Rate $9.61
Max. Negotiated Rate $15.32
Rate for Payer: Aetna of WY Commercial/Medical Rental $15.01
Rate for Payer: Altius Auto/Workers Compensation $14.71
Rate for Payer: Altius Commercial $14.71
Rate for Payer: Beech Street Commercial $15.01
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $12.58
Rate for Payer: Cash Price $10.73
Rate for Payer: ChoiceCare Network Commercial $14.86
Rate for Payer: Cigna of WY Commercial $15.01
Rate for Payer: Entrust Commercial $14.55
Rate for Payer: First Choice Health Commercial $14.55
Rate for Payer: Government Employees Health Association (GEHA) Commercial $14.55
Rate for Payer: Government Employees Health Association (GEHA) Medicare $10.11
Rate for Payer: HealthUtah PPO $15.32
Rate for Payer: Idaho Integrated Healthcare Commercial $14.86
Rate for Payer: Multiplan Medicare/VA $9.61
Rate for Payer: One Health Plan of WY PPO $15.01
Rate for Payer: PacificSource Commercial $13.79
Rate for Payer: PHCS PPO $15.01
Rate for Payer: Three Rivers PPO $11.49
Rate for Payer: TriWest Veterans Administration $10.11
Rate for Payer: United Healthcare Commercial $13.33
Rate for Payer: United Healthcare Medicare $10.11
Rate for Payer: WINHealth Partners Commercial $14.55
Rate for Payer: Wise Provider Network Commercial $14.55