|
CHEST TUBE 10 F WTROC
|
Facility
|
OP
|
$61.75
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.02 |
| Max. Negotiated Rate |
$61.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$60.52
|
| Rate for Payer: Aetna of WY Medicare |
$40.76
|
| Rate for Payer: Altius Auto/Workers Compensation |
$59.28
|
| Rate for Payer: Altius Commercial |
$59.28
|
| Rate for Payer: Beech Street Commercial |
$60.52
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$50.70
|
| Rate for Payer: Cash Price |
$43.22
|
| Rate for Payer: ChoiceCare Network Commercial |
$59.90
|
| Rate for Payer: Cigna of WY Commercial |
$60.52
|
| Rate for Payer: Entrust Commercial |
$58.66
|
| Rate for Payer: First Choice Health Commercial |
$58.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$58.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$35.82
|
| Rate for Payer: HealthUtah PPO |
$61.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$59.90
|
| Rate for Payer: Multiplan Medicare/VA |
$34.02
|
| Rate for Payer: One Health Plan of WY PPO |
$60.52
|
| Rate for Payer: PacificSource Commercial |
$55.58
|
| Rate for Payer: PHCS PPO |
$60.52
|
| Rate for Payer: Three Rivers PPO |
$46.31
|
| Rate for Payer: TriWest Veterans Administration |
$35.82
|
| Rate for Payer: United Healthcare Commercial |
$53.72
|
| Rate for Payer: United Healthcare Medicare |
$35.82
|
| Rate for Payer: WINHealth Partners Commercial |
$60.52
|
| Rate for Payer: Wise Provider Network Commercial |
$58.66
|
|
|
CHEST TUBE 10 F WTROC
|
Facility
|
IP
|
$61.75
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.72 |
| Max. Negotiated Rate |
$61.75 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$60.52
|
| Rate for Payer: Altius Auto/Workers Compensation |
$59.28
|
| Rate for Payer: Altius Commercial |
$59.28
|
| Rate for Payer: Beech Street Commercial |
$60.52
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$50.70
|
| Rate for Payer: Cash Price |
$43.22
|
| Rate for Payer: ChoiceCare Network Commercial |
$59.90
|
| Rate for Payer: Cigna of WY Commercial |
$60.52
|
| Rate for Payer: Entrust Commercial |
$58.66
|
| Rate for Payer: First Choice Health Commercial |
$58.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$58.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$40.76
|
| Rate for Payer: HealthUtah PPO |
$61.75
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$59.90
|
| Rate for Payer: Multiplan Medicare/VA |
$38.72
|
| Rate for Payer: One Health Plan of WY PPO |
$60.52
|
| Rate for Payer: PacificSource Commercial |
$55.58
|
| Rate for Payer: PHCS PPO |
$60.52
|
| Rate for Payer: Three Rivers PPO |
$46.31
|
| Rate for Payer: TriWest Veterans Administration |
$40.76
|
| Rate for Payer: United Healthcare Commercial |
$53.72
|
| Rate for Payer: United Healthcare Medicare |
$40.76
|
| Rate for Payer: WINHealth Partners Commercial |
$58.66
|
| Rate for Payer: Wise Provider Network Commercial |
$58.66
|
|
|
CHEST TUBE THORACIC 20FR
|
Facility
|
IP
|
$27.41
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$27.41 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$26.86
|
| Rate for Payer: Altius Auto/Workers Compensation |
$26.31
|
| Rate for Payer: Altius Commercial |
$26.31
|
| Rate for Payer: Beech Street Commercial |
$26.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22.50
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$26.59
|
| Rate for Payer: Cigna of WY Commercial |
$26.86
|
| Rate for Payer: Entrust Commercial |
$26.04
|
| Rate for Payer: First Choice Health Commercial |
$26.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.09
|
| Rate for Payer: HealthUtah PPO |
$27.41
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$26.59
|
| Rate for Payer: Multiplan Medicare/VA |
$17.19
|
| Rate for Payer: One Health Plan of WY PPO |
$26.86
|
| Rate for Payer: PacificSource Commercial |
$24.67
|
| Rate for Payer: PHCS PPO |
$26.86
|
| Rate for Payer: Three Rivers PPO |
$20.56
|
| Rate for Payer: TriWest Veterans Administration |
$18.09
|
| Rate for Payer: United Healthcare Commercial |
$23.85
|
| Rate for Payer: United Healthcare Medicare |
$18.09
|
| Rate for Payer: WINHealth Partners Commercial |
$26.04
|
| Rate for Payer: Wise Provider Network Commercial |
$26.04
|
|
|
CHEST TUBE THORACIC 20FR
|
Facility
|
OP
|
$27.41
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.10 |
| Max. Negotiated Rate |
$27.41 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$26.86
|
| Rate for Payer: Aetna of WY Medicare |
$18.09
|
| Rate for Payer: Altius Auto/Workers Compensation |
$26.31
|
| Rate for Payer: Altius Commercial |
$26.31
|
| Rate for Payer: Beech Street Commercial |
$26.86
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22.50
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$26.59
|
| Rate for Payer: Cigna of WY Commercial |
$26.86
|
| Rate for Payer: Entrust Commercial |
$26.04
|
| Rate for Payer: First Choice Health Commercial |
$26.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$15.90
|
| Rate for Payer: HealthUtah PPO |
$27.41
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$26.59
|
| Rate for Payer: Multiplan Medicare/VA |
$15.10
|
| Rate for Payer: One Health Plan of WY PPO |
$26.86
|
| Rate for Payer: PacificSource Commercial |
$24.67
|
| Rate for Payer: PHCS PPO |
$26.86
|
| Rate for Payer: Three Rivers PPO |
$20.56
|
| Rate for Payer: TriWest Veterans Administration |
$15.90
|
| Rate for Payer: United Healthcare Commercial |
$23.85
|
| Rate for Payer: United Healthcare Medicare |
$15.90
|
| Rate for Payer: WINHealth Partners Commercial |
$26.86
|
| Rate for Payer: Wise Provider Network Commercial |
$26.04
|
|
|
CHEST TUBE THORACIC 24FR
|
Facility
|
OP
|
$27.68
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.25 |
| Max. Negotiated Rate |
$27.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.13
|
| Rate for Payer: Aetna of WY Medicare |
$18.27
|
| Rate for Payer: Altius Auto/Workers Compensation |
$26.57
|
| Rate for Payer: Altius Commercial |
$26.57
|
| Rate for Payer: Beech Street Commercial |
$27.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22.73
|
| Rate for Payer: Cash Price |
$19.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$26.85
|
| Rate for Payer: Cigna of WY Commercial |
$27.13
|
| Rate for Payer: Entrust Commercial |
$26.30
|
| Rate for Payer: First Choice Health Commercial |
$26.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.05
|
| Rate for Payer: HealthUtah PPO |
$27.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$26.85
|
| Rate for Payer: Multiplan Medicare/VA |
$15.25
|
| Rate for Payer: One Health Plan of WY PPO |
$27.13
|
| Rate for Payer: PacificSource Commercial |
$24.91
|
| Rate for Payer: PHCS PPO |
$27.13
|
| Rate for Payer: Three Rivers PPO |
$20.76
|
| Rate for Payer: TriWest Veterans Administration |
$16.05
|
| Rate for Payer: United Healthcare Commercial |
$24.08
|
| Rate for Payer: United Healthcare Medicare |
$16.05
|
| Rate for Payer: WINHealth Partners Commercial |
$27.13
|
| Rate for Payer: Wise Provider Network Commercial |
$26.30
|
|
|
CHEST TUBE THORACIC 24FR
|
Facility
|
IP
|
$27.68
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.36 |
| Max. Negotiated Rate |
$27.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.13
|
| Rate for Payer: Altius Auto/Workers Compensation |
$26.57
|
| Rate for Payer: Altius Commercial |
$26.57
|
| Rate for Payer: Beech Street Commercial |
$27.13
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$22.73
|
| Rate for Payer: Cash Price |
$19.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$26.85
|
| Rate for Payer: Cigna of WY Commercial |
$27.13
|
| Rate for Payer: Entrust Commercial |
$26.30
|
| Rate for Payer: First Choice Health Commercial |
$26.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.30
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.27
|
| Rate for Payer: HealthUtah PPO |
$27.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$26.85
|
| Rate for Payer: Multiplan Medicare/VA |
$17.36
|
| Rate for Payer: One Health Plan of WY PPO |
$27.13
|
| Rate for Payer: PacificSource Commercial |
$24.91
|
| Rate for Payer: PHCS PPO |
$27.13
|
| Rate for Payer: Three Rivers PPO |
$20.76
|
| Rate for Payer: TriWest Veterans Administration |
$18.27
|
| Rate for Payer: United Healthcare Commercial |
$24.08
|
| Rate for Payer: United Healthcare Medicare |
$18.27
|
| Rate for Payer: WINHealth Partners Commercial |
$26.30
|
| Rate for Payer: Wise Provider Network Commercial |
$26.30
|
|
|
CHEST TUBE THORACIC 32FR
|
Facility
|
OP
|
$28.25
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.57 |
| Max. Negotiated Rate |
$28.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.68
|
| Rate for Payer: Aetna of WY Medicare |
$18.64
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.12
|
| Rate for Payer: Altius Commercial |
$27.12
|
| Rate for Payer: Beech Street Commercial |
$27.68
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.19
|
| Rate for Payer: Cash Price |
$19.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.40
|
| Rate for Payer: Cigna of WY Commercial |
$27.68
|
| Rate for Payer: Entrust Commercial |
$26.84
|
| Rate for Payer: First Choice Health Commercial |
$26.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.38
|
| Rate for Payer: HealthUtah PPO |
$28.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.40
|
| Rate for Payer: Multiplan Medicare/VA |
$15.57
|
| Rate for Payer: One Health Plan of WY PPO |
$27.68
|
| Rate for Payer: PacificSource Commercial |
$25.42
|
| Rate for Payer: PHCS PPO |
$27.68
|
| Rate for Payer: Three Rivers PPO |
$21.19
|
| Rate for Payer: TriWest Veterans Administration |
$16.38
|
| Rate for Payer: United Healthcare Commercial |
$24.58
|
| Rate for Payer: United Healthcare Medicare |
$16.38
|
| Rate for Payer: WINHealth Partners Commercial |
$27.68
|
| Rate for Payer: Wise Provider Network Commercial |
$26.84
|
|
|
CHEST TUBE THORACIC 32FR
|
Facility
|
IP
|
$28.25
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.71 |
| Max. Negotiated Rate |
$28.25 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.68
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.12
|
| Rate for Payer: Altius Commercial |
$27.12
|
| Rate for Payer: Beech Street Commercial |
$27.68
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.19
|
| Rate for Payer: Cash Price |
$19.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.40
|
| Rate for Payer: Cigna of WY Commercial |
$27.68
|
| Rate for Payer: Entrust Commercial |
$26.84
|
| Rate for Payer: First Choice Health Commercial |
$26.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$26.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.64
|
| Rate for Payer: HealthUtah PPO |
$28.25
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.40
|
| Rate for Payer: Multiplan Medicare/VA |
$17.71
|
| Rate for Payer: One Health Plan of WY PPO |
$27.68
|
| Rate for Payer: PacificSource Commercial |
$25.42
|
| Rate for Payer: PHCS PPO |
$27.68
|
| Rate for Payer: Three Rivers PPO |
$21.19
|
| Rate for Payer: TriWest Veterans Administration |
$18.64
|
| Rate for Payer: United Healthcare Commercial |
$24.58
|
| Rate for Payer: United Healthcare Medicare |
$18.64
|
| Rate for Payer: WINHealth Partners Commercial |
$26.84
|
| Rate for Payer: Wise Provider Network Commercial |
$26.84
|
|
|
CHEST TUBE THORACIC 36FR
|
Facility
|
IP
|
$28.52
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.88 |
| Max. Negotiated Rate |
$28.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.95
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.38
|
| Rate for Payer: Altius Commercial |
$27.38
|
| Rate for Payer: Beech Street Commercial |
$27.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.41
|
| Rate for Payer: Cash Price |
$19.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.66
|
| Rate for Payer: Cigna of WY Commercial |
$27.95
|
| Rate for Payer: Entrust Commercial |
$27.09
|
| Rate for Payer: First Choice Health Commercial |
$27.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.82
|
| Rate for Payer: HealthUtah PPO |
$28.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.66
|
| Rate for Payer: Multiplan Medicare/VA |
$17.88
|
| Rate for Payer: One Health Plan of WY PPO |
$27.95
|
| Rate for Payer: PacificSource Commercial |
$25.67
|
| Rate for Payer: PHCS PPO |
$27.95
|
| Rate for Payer: Three Rivers PPO |
$21.39
|
| Rate for Payer: TriWest Veterans Administration |
$18.82
|
| Rate for Payer: United Healthcare Commercial |
$24.81
|
| Rate for Payer: United Healthcare Medicare |
$18.82
|
| Rate for Payer: WINHealth Partners Commercial |
$27.09
|
| Rate for Payer: Wise Provider Network Commercial |
$27.09
|
|
|
CHEST TUBE THORACIC 36FR
|
Facility
|
OP
|
$28.52
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$28.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$27.95
|
| Rate for Payer: Aetna of WY Medicare |
$18.82
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.38
|
| Rate for Payer: Altius Commercial |
$27.38
|
| Rate for Payer: Beech Street Commercial |
$27.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.41
|
| Rate for Payer: Cash Price |
$19.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.66
|
| Rate for Payer: Cigna of WY Commercial |
$27.95
|
| Rate for Payer: Entrust Commercial |
$27.09
|
| Rate for Payer: First Choice Health Commercial |
$27.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.54
|
| Rate for Payer: HealthUtah PPO |
$28.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.66
|
| Rate for Payer: Multiplan Medicare/VA |
$15.71
|
| Rate for Payer: One Health Plan of WY PPO |
$27.95
|
| Rate for Payer: PacificSource Commercial |
$25.67
|
| Rate for Payer: PHCS PPO |
$27.95
|
| Rate for Payer: Three Rivers PPO |
$21.39
|
| Rate for Payer: TriWest Veterans Administration |
$16.54
|
| Rate for Payer: United Healthcare Commercial |
$24.81
|
| Rate for Payer: United Healthcare Medicare |
$16.54
|
| Rate for Payer: WINHealth Partners Commercial |
$27.95
|
| Rate for Payer: Wise Provider Network Commercial |
$27.09
|
|
|
CHEST TUBE THORACIC 40F
|
Facility
|
IP
|
$28.80
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.06 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$28.22
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.65
|
| Rate for Payer: Altius Commercial |
$27.65
|
| Rate for Payer: Beech Street Commercial |
$28.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.64
|
| Rate for Payer: Cash Price |
$20.16
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.94
|
| Rate for Payer: Cigna of WY Commercial |
$28.22
|
| Rate for Payer: Entrust Commercial |
$27.36
|
| Rate for Payer: First Choice Health Commercial |
$27.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$19.01
|
| Rate for Payer: HealthUtah PPO |
$28.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.94
|
| Rate for Payer: Multiplan Medicare/VA |
$18.06
|
| Rate for Payer: One Health Plan of WY PPO |
$28.22
|
| Rate for Payer: PacificSource Commercial |
$25.92
|
| Rate for Payer: PHCS PPO |
$28.22
|
| Rate for Payer: Three Rivers PPO |
$21.60
|
| Rate for Payer: TriWest Veterans Administration |
$19.01
|
| Rate for Payer: United Healthcare Commercial |
$25.06
|
| Rate for Payer: United Healthcare Medicare |
$19.01
|
| Rate for Payer: WINHealth Partners Commercial |
$27.36
|
| Rate for Payer: Wise Provider Network Commercial |
$27.36
|
|
|
CHEST TUBE THORACIC 40F
|
Facility
|
OP
|
$28.80
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.87 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$28.22
|
| Rate for Payer: Aetna of WY Medicare |
$19.01
|
| Rate for Payer: Altius Auto/Workers Compensation |
$27.65
|
| Rate for Payer: Altius Commercial |
$27.65
|
| Rate for Payer: Beech Street Commercial |
$28.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$23.64
|
| Rate for Payer: Cash Price |
$20.16
|
| Rate for Payer: ChoiceCare Network Commercial |
$27.94
|
| Rate for Payer: Cigna of WY Commercial |
$28.22
|
| Rate for Payer: Entrust Commercial |
$27.36
|
| Rate for Payer: First Choice Health Commercial |
$27.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$27.36
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.70
|
| Rate for Payer: HealthUtah PPO |
$28.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$27.94
|
| Rate for Payer: Multiplan Medicare/VA |
$15.87
|
| Rate for Payer: One Health Plan of WY PPO |
$28.22
|
| Rate for Payer: PacificSource Commercial |
$25.92
|
| Rate for Payer: PHCS PPO |
$28.22
|
| Rate for Payer: Three Rivers PPO |
$21.60
|
| Rate for Payer: TriWest Veterans Administration |
$16.70
|
| Rate for Payer: United Healthcare Commercial |
$25.06
|
| Rate for Payer: United Healthcare Medicare |
$16.70
|
| Rate for Payer: WINHealth Partners Commercial |
$28.22
|
| Rate for Payer: Wise Provider Network Commercial |
$27.36
|
|
|
CHEST X-RAY 1 VW
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 71010
|
| Hospital Charge Code |
71010
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$211.68
|
| Rate for Payer: Beech Street Commercial |
$205.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$209.52
|
| Rate for Payer: Cigna of WY Commercial |
$211.68
|
| Rate for Payer: First Choice Health Commercial |
$194.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$205.20
|
| Rate for Payer: HealthUtah PPO |
$216.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$209.52
|
| Rate for Payer: One Health Plan of WY PPO |
$211.68
|
| Rate for Payer: PacificSource Commercial |
$194.40
|
| Rate for Payer: PHCS PPO |
$205.20
|
| Rate for Payer: Three Rivers PPO |
$162.00
|
| Rate for Payer: United Healthcare Commercial |
$187.92
|
| Rate for Payer: WINHealth Partners Commercial |
$205.20
|
|
|
CHEST X-RAY 2 VW
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 71020
|
| Hospital Charge Code |
71020
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$295.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$289.10
|
| Rate for Payer: Beech Street Commercial |
$280.25
|
| Rate for Payer: Cash Price |
$206.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$286.15
|
| Rate for Payer: Cigna of WY Commercial |
$289.10
|
| Rate for Payer: First Choice Health Commercial |
$265.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$280.25
|
| Rate for Payer: HealthUtah PPO |
$295.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$286.15
|
| Rate for Payer: One Health Plan of WY PPO |
$289.10
|
| Rate for Payer: PacificSource Commercial |
$265.50
|
| Rate for Payer: PHCS PPO |
$280.25
|
| Rate for Payer: Three Rivers PPO |
$221.25
|
| Rate for Payer: United Healthcare Commercial |
$256.65
|
| Rate for Payer: WINHealth Partners Commercial |
$280.25
|
|
|
CHLORAPREP 10.5ML TINT 30715
|
Facility
|
IP
|
$11.37
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.14
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.92
|
| Rate for Payer: Altius Commercial |
$10.92
|
| Rate for Payer: Beech Street Commercial |
$11.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.33
|
| Rate for Payer: Cash Price |
$7.96
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.03
|
| Rate for Payer: Cigna of WY Commercial |
$11.14
|
| Rate for Payer: Entrust Commercial |
$10.80
|
| Rate for Payer: First Choice Health Commercial |
$10.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.50
|
| Rate for Payer: HealthUtah PPO |
$11.37
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.03
|
| Rate for Payer: Multiplan Medicare/VA |
$7.13
|
| Rate for Payer: One Health Plan of WY PPO |
$11.14
|
| Rate for Payer: PacificSource Commercial |
$10.23
|
| Rate for Payer: PHCS PPO |
$11.14
|
| Rate for Payer: Three Rivers PPO |
$8.53
|
| Rate for Payer: TriWest Veterans Administration |
$7.50
|
| Rate for Payer: United Healthcare Commercial |
$9.89
|
| Rate for Payer: United Healthcare Medicare |
$7.50
|
| Rate for Payer: WINHealth Partners Commercial |
$10.80
|
| Rate for Payer: Wise Provider Network Commercial |
$10.80
|
|
|
CHLORAPREP 10.5ML TINT 30715
|
Facility
|
OP
|
$11.37
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.26 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.14
|
| Rate for Payer: Aetna of WY Medicare |
$7.50
|
| Rate for Payer: Altius Auto/Workers Compensation |
$10.92
|
| Rate for Payer: Altius Commercial |
$10.92
|
| Rate for Payer: Beech Street Commercial |
$11.14
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.33
|
| Rate for Payer: Cash Price |
$7.96
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.03
|
| Rate for Payer: Cigna of WY Commercial |
$11.14
|
| Rate for Payer: Entrust Commercial |
$10.80
|
| Rate for Payer: First Choice Health Commercial |
$10.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.80
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.59
|
| Rate for Payer: HealthUtah PPO |
$11.37
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.03
|
| Rate for Payer: Multiplan Medicare/VA |
$6.26
|
| Rate for Payer: One Health Plan of WY PPO |
$11.14
|
| Rate for Payer: PacificSource Commercial |
$10.23
|
| Rate for Payer: PHCS PPO |
$11.14
|
| Rate for Payer: Three Rivers PPO |
$8.53
|
| Rate for Payer: TriWest Veterans Administration |
$6.59
|
| Rate for Payer: United Healthcare Commercial |
$9.89
|
| Rate for Payer: United Healthcare Medicare |
$6.59
|
| Rate for Payer: WINHealth Partners Commercial |
$11.14
|
| Rate for Payer: Wise Provider Network Commercial |
$10.80
|
|
|
CHLORAPREP 26ML TINT 930815
|
Facility
|
IP
|
$20.20
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.80
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.39
|
| Rate for Payer: Altius Commercial |
$19.39
|
| Rate for Payer: Beech Street Commercial |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.58
|
| Rate for Payer: Cash Price |
$14.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.59
|
| Rate for Payer: Cigna of WY Commercial |
$19.80
|
| Rate for Payer: Entrust Commercial |
$19.19
|
| Rate for Payer: First Choice Health Commercial |
$19.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$13.33
|
| Rate for Payer: HealthUtah PPO |
$20.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.59
|
| Rate for Payer: Multiplan Medicare/VA |
$12.67
|
| Rate for Payer: One Health Plan of WY PPO |
$19.80
|
| Rate for Payer: PacificSource Commercial |
$18.18
|
| Rate for Payer: PHCS PPO |
$19.80
|
| Rate for Payer: Three Rivers PPO |
$15.15
|
| Rate for Payer: TriWest Veterans Administration |
$13.33
|
| Rate for Payer: United Healthcare Commercial |
$17.57
|
| Rate for Payer: United Healthcare Medicare |
$13.33
|
| Rate for Payer: WINHealth Partners Commercial |
$19.19
|
| Rate for Payer: Wise Provider Network Commercial |
$19.19
|
|
|
CHLORAPREP 26ML TINT 930815
|
Facility
|
OP
|
$20.20
|
|
| Hospital Charge Code |
27200000S1
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$19.80
|
| Rate for Payer: Aetna of WY Medicare |
$13.33
|
| Rate for Payer: Altius Auto/Workers Compensation |
$19.39
|
| Rate for Payer: Altius Commercial |
$19.39
|
| Rate for Payer: Beech Street Commercial |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.58
|
| Rate for Payer: Cash Price |
$14.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$19.59
|
| Rate for Payer: Cigna of WY Commercial |
$19.80
|
| Rate for Payer: Entrust Commercial |
$19.19
|
| Rate for Payer: First Choice Health Commercial |
$19.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.72
|
| Rate for Payer: HealthUtah PPO |
$20.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$19.59
|
| Rate for Payer: Multiplan Medicare/VA |
$11.13
|
| Rate for Payer: One Health Plan of WY PPO |
$19.80
|
| Rate for Payer: PacificSource Commercial |
$18.18
|
| Rate for Payer: PHCS PPO |
$19.80
|
| Rate for Payer: Three Rivers PPO |
$15.15
|
| Rate for Payer: TriWest Veterans Administration |
$11.72
|
| Rate for Payer: United Healthcare Commercial |
$17.57
|
| Rate for Payer: United Healthcare Medicare |
$11.72
|
| Rate for Payer: WINHealth Partners Commercial |
$19.80
|
| Rate for Payer: Wise Provider Network Commercial |
$19.19
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE [10717]
|
Facility
|
OP
|
$0.66
|
|
|
Service Code
|
NDC 0555015902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$0.66 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.65
|
| Rate for Payer: Aetna of WY Medicare |
$0.44
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.63
|
| Rate for Payer: Altius Commercial |
$0.63
|
| Rate for Payer: Beech Street Commercial |
$0.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.54
|
| Rate for Payer: Cash Price |
$0.47
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.64
|
| Rate for Payer: Cigna of WY Commercial |
$0.65
|
| Rate for Payer: Entrust Commercial |
$0.63
|
| Rate for Payer: First Choice Health Commercial |
$0.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.38
|
| Rate for Payer: HealthUtah PPO |
$0.66
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.64
|
| Rate for Payer: Multiplan Medicare/VA |
$0.36
|
| Rate for Payer: One Health Plan of WY PPO |
$0.65
|
| Rate for Payer: PacificSource Commercial |
$0.59
|
| Rate for Payer: PHCS PPO |
$0.65
|
| Rate for Payer: Three Rivers PPO |
$0.50
|
| Rate for Payer: TriWest Veterans Administration |
$0.38
|
| Rate for Payer: United Healthcare Commercial |
$0.57
|
| Rate for Payer: United Healthcare Medicare |
$0.38
|
| Rate for Payer: WINHealth Partners Commercial |
$0.65
|
| Rate for Payer: Wise Provider Network Commercial |
$0.63
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE [10717]
|
Facility
|
OP
|
$2.65
|
|
|
Service Code
|
NDC 6068780711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.46 |
| Max. Negotiated Rate |
$2.65 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.60
|
| Rate for Payer: Aetna of WY Medicare |
$1.75
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.54
|
| Rate for Payer: Altius Commercial |
$2.54
|
| Rate for Payer: Beech Street Commercial |
$2.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$1.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.57
|
| Rate for Payer: Cigna of WY Commercial |
$2.60
|
| Rate for Payer: Entrust Commercial |
$2.52
|
| Rate for Payer: First Choice Health Commercial |
$2.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.54
|
| Rate for Payer: HealthUtah PPO |
$2.65
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.57
|
| Rate for Payer: Multiplan Medicare/VA |
$1.46
|
| Rate for Payer: One Health Plan of WY PPO |
$2.60
|
| Rate for Payer: PacificSource Commercial |
$2.38
|
| Rate for Payer: PHCS PPO |
$2.60
|
| Rate for Payer: Three Rivers PPO |
$1.99
|
| Rate for Payer: TriWest Veterans Administration |
$1.54
|
| Rate for Payer: United Healthcare Commercial |
$2.31
|
| Rate for Payer: United Healthcare Medicare |
$1.54
|
| Rate for Payer: WINHealth Partners Commercial |
$2.60
|
| Rate for Payer: Wise Provider Network Commercial |
$2.52
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE [10717]
|
Facility
|
OP
|
$2.12
|
|
|
Service Code
|
NDC 5107914101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.08
|
| Rate for Payer: Aetna of WY Medicare |
$1.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.04
|
| Rate for Payer: Altius Commercial |
$2.04
|
| Rate for Payer: Beech Street Commercial |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.74
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.06
|
| Rate for Payer: Cigna of WY Commercial |
$2.08
|
| Rate for Payer: Entrust Commercial |
$2.01
|
| Rate for Payer: First Choice Health Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.23
|
| Rate for Payer: HealthUtah PPO |
$2.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.06
|
| Rate for Payer: Multiplan Medicare/VA |
$1.17
|
| Rate for Payer: One Health Plan of WY PPO |
$2.08
|
| Rate for Payer: PacificSource Commercial |
$1.91
|
| Rate for Payer: PHCS PPO |
$2.08
|
| Rate for Payer: Three Rivers PPO |
$1.59
|
| Rate for Payer: TriWest Veterans Administration |
$1.23
|
| Rate for Payer: United Healthcare Commercial |
$1.84
|
| Rate for Payer: United Healthcare Medicare |
$1.23
|
| Rate for Payer: WINHealth Partners Commercial |
$2.08
|
| Rate for Payer: Wise Provider Network Commercial |
$2.01
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE [10717]
|
Facility
|
IP
|
$2.12
|
|
|
Service Code
|
NDC 5107914101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$2.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.08
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.04
|
| Rate for Payer: Altius Commercial |
$2.04
|
| Rate for Payer: Beech Street Commercial |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.74
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.06
|
| Rate for Payer: Cigna of WY Commercial |
$2.08
|
| Rate for Payer: Entrust Commercial |
$2.01
|
| Rate for Payer: First Choice Health Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.40
|
| Rate for Payer: HealthUtah PPO |
$2.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.06
|
| Rate for Payer: Multiplan Medicare/VA |
$1.33
|
| Rate for Payer: One Health Plan of WY PPO |
$2.08
|
| Rate for Payer: PacificSource Commercial |
$1.91
|
| Rate for Payer: PHCS PPO |
$2.08
|
| Rate for Payer: Three Rivers PPO |
$1.59
|
| Rate for Payer: TriWest Veterans Administration |
$1.40
|
| Rate for Payer: United Healthcare Commercial |
$1.84
|
| Rate for Payer: United Healthcare Medicare |
$1.40
|
| Rate for Payer: WINHealth Partners Commercial |
$2.01
|
| Rate for Payer: Wise Provider Network Commercial |
$2.01
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE [10717]
|
Facility
|
OP
|
$2.12
|
|
|
Service Code
|
NDC 5107914120
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.08
|
| Rate for Payer: Aetna of WY Medicare |
$1.40
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.04
|
| Rate for Payer: Altius Commercial |
$2.04
|
| Rate for Payer: Beech Street Commercial |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.74
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.06
|
| Rate for Payer: Cigna of WY Commercial |
$2.08
|
| Rate for Payer: Entrust Commercial |
$2.01
|
| Rate for Payer: First Choice Health Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.23
|
| Rate for Payer: HealthUtah PPO |
$2.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.06
|
| Rate for Payer: Multiplan Medicare/VA |
$1.17
|
| Rate for Payer: One Health Plan of WY PPO |
$2.08
|
| Rate for Payer: PacificSource Commercial |
$1.91
|
| Rate for Payer: PHCS PPO |
$2.08
|
| Rate for Payer: Three Rivers PPO |
$1.59
|
| Rate for Payer: TriWest Veterans Administration |
$1.23
|
| Rate for Payer: United Healthcare Commercial |
$1.84
|
| Rate for Payer: United Healthcare Medicare |
$1.23
|
| Rate for Payer: WINHealth Partners Commercial |
$2.08
|
| Rate for Payer: Wise Provider Network Commercial |
$2.01
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE [10717]
|
Facility
|
IP
|
$0.66
|
|
|
Service Code
|
NDC 0555015902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$0.66 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$0.65
|
| Rate for Payer: Altius Auto/Workers Compensation |
$0.63
|
| Rate for Payer: Altius Commercial |
$0.63
|
| Rate for Payer: Beech Street Commercial |
$0.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$0.54
|
| Rate for Payer: Cash Price |
$0.47
|
| Rate for Payer: ChoiceCare Network Commercial |
$0.64
|
| Rate for Payer: Cigna of WY Commercial |
$0.65
|
| Rate for Payer: Entrust Commercial |
$0.63
|
| Rate for Payer: First Choice Health Commercial |
$0.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$0.63
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.44
|
| Rate for Payer: HealthUtah PPO |
$0.66
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$0.64
|
| Rate for Payer: Multiplan Medicare/VA |
$0.41
|
| Rate for Payer: One Health Plan of WY PPO |
$0.65
|
| Rate for Payer: PacificSource Commercial |
$0.59
|
| Rate for Payer: PHCS PPO |
$0.65
|
| Rate for Payer: Three Rivers PPO |
$0.50
|
| Rate for Payer: TriWest Veterans Administration |
$0.44
|
| Rate for Payer: United Healthcare Commercial |
$0.57
|
| Rate for Payer: United Healthcare Medicare |
$0.44
|
| Rate for Payer: WINHealth Partners Commercial |
$0.63
|
| Rate for Payer: Wise Provider Network Commercial |
$0.63
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE [10717]
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
NDC 6068780711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$2.65 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.60
|
| Rate for Payer: Altius Auto/Workers Compensation |
$2.54
|
| Rate for Payer: Altius Commercial |
$2.54
|
| Rate for Payer: Beech Street Commercial |
$2.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$1.85
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.57
|
| Rate for Payer: Cigna of WY Commercial |
$2.60
|
| Rate for Payer: Entrust Commercial |
$2.52
|
| Rate for Payer: First Choice Health Commercial |
$2.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.75
|
| Rate for Payer: HealthUtah PPO |
$2.65
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.57
|
| Rate for Payer: Multiplan Medicare/VA |
$1.66
|
| Rate for Payer: One Health Plan of WY PPO |
$2.60
|
| Rate for Payer: PacificSource Commercial |
$2.38
|
| Rate for Payer: PHCS PPO |
$2.60
|
| Rate for Payer: Three Rivers PPO |
$1.99
|
| Rate for Payer: TriWest Veterans Administration |
$1.75
|
| Rate for Payer: United Healthcare Commercial |
$2.31
|
| Rate for Payer: United Healthcare Medicare |
$1.75
|
| Rate for Payer: WINHealth Partners Commercial |
$2.52
|
| Rate for Payer: Wise Provider Network Commercial |
$2.52
|
|
