|
CAGE CERVICAL 14.5X12.5X9 MM
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X10 MM
|
Facility
|
IP
|
$10,992.45
|
|
| Hospital Charge Code |
3003075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,370.12 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,035.17
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,705.39
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$6,370.12
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,705.39
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,705.39
|
| Rate for Payer: WINHealth Partners Commercial |
$10,442.83
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X10 MM
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X5 MM
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003070
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X5 MM
|
Facility
|
IP
|
$10,992.45
|
|
| Hospital Charge Code |
3003070
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,370.12 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,035.17
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,705.39
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$6,370.12
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,705.39
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,705.39
|
| Rate for Payer: WINHealth Partners Commercial |
$10,442.83
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X6 MM
|
Facility
|
IP
|
$10,992.45
|
|
| Hospital Charge Code |
3003071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,370.12 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,035.17
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,705.39
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$6,370.12
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,705.39
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,705.39
|
| Rate for Payer: WINHealth Partners Commercial |
$10,442.83
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X6 MM
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X7 MM
|
Facility
|
IP
|
$10,992.45
|
|
| Hospital Charge Code |
3003072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,370.12 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,035.17
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,705.39
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$6,370.12
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,705.39
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,705.39
|
| Rate for Payer: WINHealth Partners Commercial |
$10,442.83
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X7 MM
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X8 MM
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X8 MM
|
Facility
|
IP
|
$10,992.45
|
|
| Hospital Charge Code |
3003073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,370.12 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,035.17
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,705.39
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$6,370.12
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,705.39
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,705.39
|
| Rate for Payer: WINHealth Partners Commercial |
$10,442.83
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X9 MM
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERVICAL 16.5X14.5X9 MM
|
Facility
|
IP
|
$10,992.45
|
|
| Hospital Charge Code |
3003074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,370.12 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,035.17
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,705.39
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$6,370.12
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,705.39
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,705.39
|
| Rate for Payer: WINHealth Partners Commercial |
$10,442.83
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERV LORDOTIC 14.5X12.5X4
|
Facility
|
OP
|
$10,992.45
|
|
| Hospital Charge Code |
3003822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,952.41 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,255.02
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,265.70
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$5,952.41
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,265.70
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,265.70
|
| Rate for Payer: WINHealth Partners Commercial |
$10,772.60
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE CERV LORDOTIC 14.5X12.5X4
|
Facility
|
IP
|
$10,992.45
|
|
| Hospital Charge Code |
3003822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,370.12 |
| Max. Negotiated Rate |
$10,992.45 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10,772.60
|
| Rate for Payer: Aetna of WY Medicare |
$7,035.17
|
| Rate for Payer: Altius Commercial |
$10,552.75
|
| Rate for Payer: Beech Street Commercial |
$10,772.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10,662.68
|
| Rate for Payer: Cash Price |
$7,694.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$10,662.68
|
| Rate for Payer: Cigna of WY Commercial |
$10,772.60
|
| Rate for Payer: Entrust Commercial |
$10,442.83
|
| Rate for Payer: First Choice Health Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10,442.83
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6,705.39
|
| Rate for Payer: HealthUtah PPO |
$10,992.45
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10,662.68
|
| Rate for Payer: Multiplan Medicare/VA |
$6,370.12
|
| Rate for Payer: One Health Plan of WY PPO |
$10,772.60
|
| Rate for Payer: PacificSource Commercial |
$9,893.20
|
| Rate for Payer: PHCS PPO |
$10,772.60
|
| Rate for Payer: Three Rivers PPO |
$8,244.34
|
| Rate for Payer: TriWest Veterans Administration |
$6,705.39
|
| Rate for Payer: United Healthcare Commercial |
$10,497.79
|
| Rate for Payer: United Healthcare Medicare |
$6,705.39
|
| Rate for Payer: WINHealth Partners Commercial |
$10,442.83
|
| Rate for Payer: Wise Provider Network Commercial |
$10,442.83
|
|
|
CAGE EXPAND 10X27X10MM 10-15
|
Facility
|
OP
|
$14,000.00
|
|
| Hospital Charge Code |
2800407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,581.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$9,240.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7,980.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$7,581.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$7,980.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$7,980.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,720.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X10MM 10-15
|
Facility
|
IP
|
$14,000.00
|
|
| Hospital Charge Code |
2800407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,113.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$8,960.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8,540.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$8,113.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$8,540.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$8,540.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,300.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X11MM 10-15
|
Facility
|
IP
|
$14,000.00
|
|
| Hospital Charge Code |
2800408
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,113.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$8,960.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8,540.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$8,113.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$8,540.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$8,540.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,300.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X11MM 10-15
|
Facility
|
OP
|
$14,000.00
|
|
| Hospital Charge Code |
2800408
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,581.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$9,240.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7,980.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$7,581.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$7,980.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$7,980.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,720.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X12MM 10-15
|
Facility
|
IP
|
$14,000.00
|
|
| Hospital Charge Code |
2800409
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,113.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$8,960.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8,540.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$8,113.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$8,540.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$8,540.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,300.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X12MM 10-15
|
Facility
|
OP
|
$14,000.00
|
|
| Hospital Charge Code |
2800409
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,581.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$9,240.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7,980.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$7,581.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$7,980.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$7,980.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,720.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X8MM 10-15
|
Facility
|
IP
|
$14,000.00
|
|
| Hospital Charge Code |
2800405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,113.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$8,960.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8,540.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$8,113.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$8,540.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$8,540.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,300.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X8MM 10-15
|
Facility
|
OP
|
$14,000.00
|
|
| Hospital Charge Code |
2800405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,581.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$9,240.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7,980.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$7,581.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$7,980.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$7,980.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,720.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X9MM 10-15
|
Facility
|
OP
|
$14,000.00
|
|
| Hospital Charge Code |
2800406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,581.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$9,240.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7,980.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$7,581.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$7,980.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$7,980.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,720.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
|
CAGE EXPAND 10X27X9MM 10-15
|
Facility
|
IP
|
$14,000.00
|
|
| Hospital Charge Code |
2800406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,113.00 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$13,720.00
|
| Rate for Payer: Aetna of WY Medicare |
$8,960.00
|
| Rate for Payer: Altius Commercial |
$13,440.00
|
| Rate for Payer: Beech Street Commercial |
$13,720.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$13,580.00
|
| Rate for Payer: Cash Price |
$9,800.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$13,580.00
|
| Rate for Payer: Cigna of WY Commercial |
$13,720.00
|
| Rate for Payer: Entrust Commercial |
$13,300.00
|
| Rate for Payer: First Choice Health Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$13,300.00
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8,540.00
|
| Rate for Payer: HealthUtah PPO |
$14,000.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$13,580.00
|
| Rate for Payer: Multiplan Medicare/VA |
$8,113.00
|
| Rate for Payer: One Health Plan of WY PPO |
$13,720.00
|
| Rate for Payer: PacificSource Commercial |
$12,600.00
|
| Rate for Payer: PHCS PPO |
$13,720.00
|
| Rate for Payer: Three Rivers PPO |
$10,500.00
|
| Rate for Payer: TriWest Veterans Administration |
$8,540.00
|
| Rate for Payer: United Healthcare Commercial |
$13,370.00
|
| Rate for Payer: United Healthcare Medicare |
$8,540.00
|
| Rate for Payer: WINHealth Partners Commercial |
$13,300.00
|
| Rate for Payer: Wise Provider Network Commercial |
$13,300.00
|
|
